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The purpose of this study is to replicate and extend earlier work involving cluster analysis of MMPI profiles among persons with chronic low back pain. There are two specific goals. The first goal is to demonstrate the existence in a new sample of four distinct and homogenous profile clusters that have been found in previous research. The second goal is to investigate the relationship of the four profiles to the subjects, self-reported pain history and response to treatment. This study concludes that four distinct MMPI profiles can be identified among chronic low back pain patients. Further, these profiles are the same for males and females, and are the same profiles found in previous research. These profiles are significantly related to subjects' history of behaviors in dealing with pain. However, no relationship to treatment response was found. It was inferred that the MMPI is of value in understanding the nature of patients' pain coping behaviors, but that further research is needed before any statements can be made regarding the utility of the MMPI in understanding their response to treatment.

M.A. (Clinical Psychology) / The increasing interest in cognitive factors both in the literature on pain and in developments in research on depression has led to the present study, where cognitive factors associated with depression were investigated in clinical groups of chroni c pa in patients. The cognitive factors studied were learned helplessness (Seligman, 1975), cognitive errors and distortions (Beck, 1976), perfectionism (Bums, 19800 1980b), as well as hopelessness (Beck, 1974). It was hypothesised that these factors would occur in definite patterns in relation to each other, in groups of pain patients categorised into four groups on the basis of raised or lowered levels of both depression and a subjective pain rating. It was hypothesised that learned helplessness would vary in direct relationship to depression but that simultaneously increased levels of pain would elevate helplessness further. It was also hypothesised that perfectionism and cognitive errors and distortions would vary inversely with helplessness and that amongst pain patients with high levels of pain and low levels of depression, raised scores on measures of perfectionism and cognitive errors may indicate the presence of a 'masked' depression. Some evidence was found to suggest that cognitive factors do play an important role in pain, although no significant results were found to support the specific hypotheses of this study. The need for finer discrimination in the type' of pain patient selected, particularly in regard to ·the diagnosis of the pain syndrome, as well as the inclusion of cognitive factors other than those presently considered, is indicated for future research.

Research examining social influences on pain has largely neglected the impact of friends, while studies on the social context of emotional display have demonstrated differences in expressivity in the presence of friends versus strangers. Given that pain is a universal phenomenon with both affective and sensory components, it appeared important to merge and extend research in both pain and emotions domains by examining the role of friends as determinants of pain experience and expression. An experimental investigation was undertaken to examine the impact of friendship, as a feature of audience effects and social modeling, on pain expression, as well as to examine the impact of menstrual factors that have been hypothesized to contribute to young women's current pain experience. Participants were female undergraduate students from the University of British Columbia. They were randomly assigned to undergo the cold pressor task with either a friend or a stranger, resulting in 52 pairs of friends and 52 pairs of strangers. Half of the participants had been exposed to the friend or stranger undertaking the task in advance of their own exposure to the cold pressor, so as to examine social modeling phenomenon. Measures of pain expression included self-rated pain intensity and unpleasantness, behavioural tolerance time, and facial pain activity. Robust social modeling effects were observed in all measures of pain, with the bulk of the modeling effect being expression modality-specific. A differential social modeling effect of friends vs. strangers was observed only in pain facial activity. Women's dysmenorrhea status and its severity, when evident, were unrelated to current pain expression. The presence of friends significantly facilitated expression of disgust but no significant group differences were observed for other emotions. Results are discussed from social communication model of pain and evolutionary perspectives and highlight individuals' apparent innate propensity to evaluate the costs and benefits associated with social communication. Future research is needed to elucidate factors that influence the transmission and reception of social information. / Arts, Faculty of / Psychology, Department of / Graduate

This correlational study investigated the relationship between changes in the psychosocial scales of the MPI Screener Patient Report Card (Clark, 1996) with changes in depression and anxiety with a sample of chronic pain patients who completed a 4-week outpatient interdisciplinary treatment program located in a large regional medical center. Race, gender, and primary pain diagnosis were additional predictors. Data analyzed came from an existing patient outcome database (N = 203). Five research assumptions were examined using ten separate (five pre and five post-treatment) hierarchical multiple regression analyses. Statistical significance was found in pre and post-treatment analyses with predictors BDI-II (Beck, Steer, & Brown, 1996) and BAI (Beck & Steer, 1993) on criterions Pain Interference, Emotional Distress, and Life Control, and Total Function.

Measures of pain tolerance and threshold were obtained for 100 male and female subjects in a pretest treatment posttest experiment using the cold pressor test. Subjects were divided into five treatment groups with an equal representation of males and females in each group. In addition each group was divided into high and low locus of control, resulting in a 2 X 5, locus of control-by—treatment, experimental design. Treatment groups received one of the following five sets of instructions: prescribed pleasant imagery, prescribed angry imagery, self-generated pleasant imagery, self-generated angry imagery, and expectancy control. Credibility checks were obtained on all groups, and an ANOVA revealed no significant differences in credibility ratings among the groups.

This investigation evaluated the efficacy of relaxation training and cognitive therapy separately and in combination in enhancing the coping skills of patients during epidural steroid injections. Subjects consisted of 80 back pain patients. They were randomly assigned to four groups to receive either relaxation training, cognitive therapy, relaxation and cognitive therapy, or attention control treatment. All subjects were provided preparatory information describing the procedure for the epidural injection and typical physical sensations experienced by patients undergoing the procedure. Relaxation training consisted of Jacobsonian progressive relaxation instructions which were modelled by the trainer. Cognitive therapy consisted of instructions and a work sheet designed to assist subjects in designing positive (rational) self statements concerning the injection procedure. Attention control procedures involved instructions and written exercises of equal duration to the relaxation and cognitive treatments but containing no instructions for the control of anxiety and pain. The three experimental groups exhibited significantly fewer "ae1f-distress" verbalizations during the injection. On other dependent measures, namely, the remaining catagories of pain verbalizations, gross body movements, heart rate, and independent ratings of anxiety there were no significant differences among experimental and control groups. Results are discussed in terms of spontaneous use of coping skills, habituation, individual differences in predisposition to specific coping strategies, and possible cultural/class/educational correlates of specific coping strategies. Improvements in methodology and directions for future research are recommended.

The purposes of the study were to examine the psychosocial variables of hostility and social support, and their independent relationships with resting physiological levels and chronic pain symptoms, and to examine the independent relationships of chronic pain chronicity and social support with hostility.

Sixty subjects divided equally among Anglo-Americans, Black Americans, and Hispanic Americans participated in the study. They were classified as chronic pain patients by medical diagnosis and duration of pain. They were drawing Workers' Compensation and were all blue-collar workers from the Dallas-Fort Worth area. Cognitive complexity is a measure of individuals' ability to construe their feelings, events of their lives, and their world in a meaningful manner. Cognitive complexity appeared to differ among the cultural groups as indicated by significantly different functionally independent construct scores. Anglo-Americans appeared to have a greater internal complexity than did Black Americans and Hispanic Americans.

The purpose of this study is to ascertain whether or not the Good Samaritan Pain Evaluation Clinic can be considered a success.