Pain Management Commons^™

Coping With Medically Unexplained Physical Symptoms: The Role Of Illness Beliefs And Behaviors, Lisa M. Mcandrew, Nicole Sullivan, L. Alison Phillips, Wilfred R. Pigeon, Karen S. Quigley, Fiona Graff, David R. Litke, Drew A. Helmer, Joseph F. Rath

Educational & Counseling Psychology Faculty Scholarship

Background: Medically unexplained syndromes (MUS) are both prevalent and disabling. While illness beliefs and behaviors are thought to maintain MUS-related disability, little is known about which specific behavioral responses to MUS are related to disability or the way in which beliefs and behaviors interact to impact functioning. The purpose of the present study was to examine the relationship between illness beliefs and disability among patients with MUS, and assess the extent to which behaviors mediate this relationship. Methods: The study examined data from the baseline assessment of a multi-site randomized controlled trial (RCT). Participants were 248 veterans with MUS. Illness …

Predictors And Health Outcomes Of Treatment-Resistant Depression Among Adults With Chronic Non-Cancer Pain Conditions And Major Depressive Disorder, Drishti Shah

Graduate Theses, Dissertations, and Problem Reports (ETD)

Understanding major depressive disorder (MDD) as a comorbidity in patients with chronic non-cancer pain conditions (CNPC) is of importance because of the high prevalence and well documented bi-directional relationship between MDD and pain. Furthermore, presence of CNPC among adults with MDD often reduces benefits of antidepressant therapy, thereby increasing the possibility of treatment resistance. Treatment-resistant depression (TRD) commonly defined as insufficient response to multiple antidepressant trials, often worsens depression and pain symptoms and can amplify the clinical and economic burden among adults with CNPC and MDD. Additionally, long-term opioid therapy (LTOT) may be prescribed at a higher rate to adults …

A Military Chronic Pain Interdisciplinary Outpatient Program’S (Iop) Approach To Reducing Pain And Disability And Increasing Functional Ability, Paris N. Mcdonald

USC Aiken Psychology Theses

The present study employed self-report measures to assess pain intensity, self-report perception of disability, and patient activation, and objective functional measures to explore the outcomes of a military interdisciplinary chronic pain intensive outpatient program. Seventy-three Active Duty Service Members (SM) with chronic pain completed baseline measures (pre-IOP) and graduation day measures, 60 SMs completed one-month follow-up measures, and 28 completed three-month follow-up measures. Results indicated that self-report pain levels decreased from pre-IOP to graduation day. The decrease was maintained; however, no additional significant decrease in pain occurred following program completion. Further, participant’s self-reported perception of disability due to back pain …

A Program Evaluation On The Effectiveness Of Chronic Pain Management In A Rural Community, Sylvia D. Ramirez

Doctor of Psychology (PsyD)

Chronic pain is a well-known, significant problem in the United States, affecting approximately 55% of adults in Western countries. Opioid use to manage chronic pain impacts individual’s social, psychological, and physiological health. The shortcomings of monotherapy, such as opioid use, have been led to extensive research to develop and assess the outcome of multi-disciplinary evidence-based programs. Rather than eliminating pain, interventions focus on pain management and improving quality of life, independence, and mobility. This quasiexperimental study examined the effectiveness of the Persistent Pain Program (PPP), an 8-week Cognitive Behavioral Treatment program and movement therapy intervention for patients living in a …

Chronic Pain Profiles And Past Bullying Experiences, Stephen Ratliff

Electronic Theses and Dissertations

The biopsychosocial model of chronic pain posits that chronic pain is influenced by factors such as depression, somatization, and psychological trauma (Gatchel, Peng, Peters, Fuchs, & Turk, 2007). Being bullied in childhood is one such factor that has been shown to be associated with chronic pain (Sigurdson, Wallander, & Sund, 2014; Voerman et al. 2015). Furthermore, those with chronic pain fit into one of three distinct psychological profiles (Williams, Urban, Keefe, Shutty, & France, 1995). The purpose of the current study was to examine the relationship between chronic pain profiles and reports of past bullying experiences. It was hypothesized that …

The Role Of Diaphragmatic Breathing In Self-Regulation Skills Training, Matthew E. B. Russell

Theses and Dissertations--Psychology

A central component of many psychological interventions is breathing training. Breathing training protocols based on a mindfulness or a cognitive behavioral therapy (CBT) have demonstrated value in the management of psychological and medical ailments. Yet, despite the wealth of literature examining each approach, little direct comparison exists. An additional concern is the proliferation of smart phone health (mHealth) applications (apps) providing breathing training with little empirical evidence to support their clinical use. A possible explanation for the interest in breathing and mHealth apps is the growing body of literature indicating breathing training provides wide ranging health benefits through improved stasis …

Is The Relationship Between Trait Mindfulness And Psychological Distress Indirect?, Sailesh Maharjan

Electronic Theses, Projects, and Dissertations

Mindfulness, purposeful attention without judgment or acceptance, and related practices are increasingly popular with a large number of people and have been incorporated into many western psychotherapies (e.g., Mindfulness-Based Stress Reduction, Dialectical Behavior Therapy, Acceptance and Commitment Therapy and Mindfulness Based Cognitive Therapy). There is considerable debate over whether mindfulness is best studied as a state, trait or procedure. Although many studies have found that trait mindfulness is related to physical and mental health outcomes, less is known about the mechanism(s) through which mindfulness enhances clinical outcomes. The current study explored the role of potential mediators of the relationship between …

Reconnecting The Mind And Body: A Pilot Study Of Developing Compassion For Persistent Pain, Sarah L. Parry Dr, Zoey Malpus Dr

Patient Experience Journal

As an alternative to the more typical cognitive behavioural approach to pain management, a novel pain management group based on the principles of compassionate mind training was developed for a particular sub-group of patients. Participants were patients of a community pain clinic, who were invited to participate in this alternative approach to pain management. The eight-week Compassion in Pain Groups included psychoeducation around persistent pain, the underlying principles of compassionate mind training, practical exercises such as diaphragmatic breathing, followed by a series of compassionate imagery exercises and group discussions. Both quantitative and qualitative analyses were undertaken to gain further insights …

Optimism And Pain Interference In Aging Women, Stephanie T. Judge

Theses and Dissertations--Psychology

Pain interferes with people's daily lives and often limits the extent to which they can pursue goals and engages in activities that promote well-being. The present study test how optimism affects and is affected by pain interference and activity among older women. Every three months for two years, middle- and older-age women (N = 199) complete daily diaries at home for a seven-day period, reporting their daily pain, pain interference, and activity. Optimism was measured at baseline and end-of-study. Multilevel models test the between- and within-person relationships among pain, optimism, pain interference and activity. Pain best predicted pain interference …

Chronic Pain Causal Attributions In An Interdisciplinary Primary Care Clinic: Patient-Provider And Provider-Provider Discrepancies, Bryan Jensen

Theses and Dissertations

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed …

The Role Of N-Acetyl-L-Cysteine (Nac) As An Adjuvant To Opioid Treatment In Patients With Inadequately Controlled Chronic Neuropathic Pain, Thomas B. Moore

Theses and Dissertations

Introduction. While opioid medications are commonly prescribed for management of neuropathic pain (NP), long-term use has been associated with increased risk for overdose, drug interactions and addiction. New strategies are necessary to better manage chronic pain, thereby reducing need for opioid medications and their associated adverse consequences. N-acetyl-L-cysteine (NAC), an over-the-counter supplement, has shown promise in the treatment of psychiatric and addictive disorders. In addition, NAC has shown promise for reducing physiological signs of NP in laboratory rat models, prompting this study.

Purpose. The present study was an open-label clinical trial of NAC as an adjuvant to opioid treatment for …

Trauma In Patients With Serious Mental Illness: The Acceptability And Impact Of A Brief Psychoeducational Intervention For Trauma In The General Acute Inpatient Psychiatric Setting, Kevin E. A. Giangrasso

PCOM Psychology Dissertations

Prevalence rates of posttraumatic stress disorder (PTSD) for individuals with serious mental illnesses (SMIs) are high, with an estimated 49% to 100% being exposed to potentially traumatic events. The consequences of these disorders are serious and lasting, with PTSD being the costliest of mental health disorders. At the same time, established evidence-based treatments for PTSD are often not feasible in treatment settings utilized by individuals with SMIs, namely the general acute inpatient psychiatric hospital. Psychoeducational approaches have been incorporated as a component of evidence-based interventions for trauma and have been feasibly implemented in the general acute inpatient psychiatric hospital. The …

The Cessation Of Nssi: Differences In Acquired Capability And Distress Tolerance, Rondel T. Kittleman

Masters Theses & Specialist Projects

The purpose of this investigation was to examine the role of cessation of NSSI in acquired capability and distress tolerance. It was hypothesized that individuals with longer time in-between assessment and NSSI would show lower levels of acquired capability and higher levels distress tolerance regardless of lifetime frequency. These hypotheses were tested by surveying 375 undergraduate university students (64% female; mean age = 20.3) Participants completed packets with self-report measures that included: Inventory of Statements about Self- Injury, Acquired Capability of Suicide Scale, Distress Tolerance Scale, and Demographics. Results suggested that individuals with longer amount of time since last NSSI …

A Psychoeducational Group Intervention For Fibromyalgia Patients, Derek O. Bacchus

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the effect of a multidisciplinary psychoeducational treatment group on Fibromyalgia Syndrome (FMS) pain, depression, catastrophizing, and quality of life. The Short-Form McGill Pain Questionnaire (SF-MPQ), Center for Epidemiologic Studies Depression Scale (CES-D), Coping Strategies Questionnaire (CSQ), and the World Health Organization Quality of Life Assessment—Abbreviated Version were used to assess these constructs in 15 participants. The sample was composed entirely of female participants and was predominantly middle aged, which is typical of the FMS population. Two separate groups of FMS patients—seven in Group 1, eight in Group 2—completed a 10-week psychoeducational intervention where they were presented with …

Mindfulness In Childbirth: An Investigation Of The Effects Of Mindfulness Training On Maternal Satisfaction With Childbirth And Obstetric Outcomes, Brenda L. Bratton

Dissertations

This study investigated the effects of mindfulness training on obstetric outcomes and maternal satisfaction with childbirth. We were interested in whether mindfulness training was more effective than a control group receiving psychoeducation on stress reduction. The goal of the intervention group was to increase participants' moment-to-moment awareness of thoughts, feelings, and body sensations during childbirth so that they would respond to these experiences rather than react to them in an automatic manner. These strategies were hypothesized to help a laboring woman minimize fear or anxiety associated with pain and complications and be more adaptive to whatever circumstances arose. Repeated measures …

The Nature Of The Traumatic Event As A Predictor Of Posttraumatic Stress Disorder In Chronic Low Back Pain Patients, Lorie Tulia Decarvalho

Loma Linda University Electronic Theses, Dissertations & Projects

The present study investigated the specific nature of the traumatic event in patients with chronic low back pain (CLBP). Specifically, the following questions were asked: (1) Do individuals with CLBP evidence posttraumatic stress disorder?, (2) In patients with CLBP, what is the trauma which predicts the development of PTSD- the specific event which led to the lower back pain, any other traumatic event, or is it the chronic low back pain itself which is traumatic? (3) In CLBP patients who evidence PTSD, do the intensity and duration of the trauma predict the development of PTSD? Participants were 112 patients receiving …

Introducing The Living With Illness Group: A Specialized Treatment For Patients With Chronic Schizophrenic Conditions, Thomas G. Plante, Stephanie L. Pinder, David Howe

Psychology

This paper introduces a specialized psychotherapy/psychoeducational group treatment for patients with chronic psychotic symptoms who receive only partial benefit from psychotropic medications, psychotherapy, and milieu/activities therapy. The goal of the group is to assist patients to accurately identify the feelings, thoughts, and behaviors that are dysfunctional symptoms of their disability and then use the functional aspects of their brain as well as learned coping strategies to compensate for their disability. The group format, philosophy, procedures, and typical topics of discussion are detailed.