The major purpose of this study was to determine chronic pain patient's differential use and perceived effectiveness of various cognitive, affective and psychomotor treatment strategies used in the management of pain. Utilizing the TFA System (tm) to determine patient's behavior patterns, a second goal was to determine if treatments were more effective when they matched the behavior pattern. The TFA System is a systematic and integrated approach using thinking (T), feeling (F) and acting (A) components which provides a chance for individual and situation specificity in a treatment situation. The major research questions were addressed through empirical results obtained from a volunteer sample of 39 chronic back pain patients. Five thinking, five feeling, and eight acting treatment methods were examined. T methods were used by slightly more than 50% of the patients, and had the highest frequency of monthly use. F methods were the least used, and had the lowest frequency of use even among those who did use then. Only half of the A methods were used by most of the chronic pain patients, but these were used rather often in a month. Effectiveness for all methods was viewed as being relatively moderate, irrespective of use, with spirituality being perceived as being most effective. Overall, the majority of subjects were not successful in their pain management. Furthermore, there was no relationship between success and personal outlook when a published scale was used to categorize subjects as optimistic or pessimistic. However, based on a self-categorization, almost all the pessimists were not successful, while self-proclaimed optimists were equally likely to be successful as not. There was no apparent relationship between chronic pain patient's behavior profiles and type of treatment methods used. Individual's TFA patterns did not "match" the methods being used to deal with their pain. Overall, no significant differences were revealed in type of treatment method used depending on the demographic characteristics of gender, age, income, education and marital status. Recommendations for both future research and clinical practice were presented. / Ed. D.

Chronic pain sufferers are frequently misunderstood and stigmatised. The aim of this investigation was to provide a description of the lifewor1d of people with chronic low back pain, using the phenomenological method. Themes which emerged were that the persistent nature of chronic pain makes it particularly difficult to endure, arousing a profound fear of the future. It causes a disruption in the relationship between the person and the body, in which the person is forced to function within the constraints of pain. Sufferers are unable to fulfil social roles as expected and are forced to revise their goals and activities. The distress of their experience is mediated by the ability to make sense of their condition, finding meaning in the pain itself. The study highlights the value of the phenomenological method in health psychology. Recommendations are made which may be of benefit to people with chronic pain and their families. / Psychology / M. Sc. (Psychology)

The primary purpose of the present study was to examine the potential relationships that exist between anger expression, as measured by several MMPI-2 scales, and chronic pain.

The Behavioral Medicine Questionnare (BMQ) is a 44- item instrument administered via a computer CRT display or pencil and paper. The BMQ was designed to help primary care physicians treating spinal disorders to screen for emotional factors which warrant further psychological evaluation. The test is composed of three scales: Anxiety, Depression, and Somatization. Concurrent validity for each scale was determined through comparisons with subject (n = 133) scores on clinician judgement ratings, pain drawings, and the MMPI. The psychometric properties of the test were supported through statistical analysis. Significant correlations were found between the BMQ, MMPI, and clinician ratings, with the latter showing relationships of lesser strength. The only significant correlation to subject generated pain drawings was to the BMQ depression scale. Analysis indicated the need for seperate norms for males and females. Further research is needed to facilitate measurement and interpretation of the BMQ.

The purpose of the present study was to determine the extent of emotional alienation consistent with ecological and chronic pain patients and to assess differences on this dimension between these two patient populations. Ecological group included 100 ecological inpatients, chronic pain group, 30 spinal pain clinic patients. Tests administered were the Sixteen Personality Factor (16 PF) and the Minnesota Multiphasic Personality Inventory (MMPI) including Harris and Lingoes subscales. The ecological group was significantly higher on measures of alienation than the pain group or the standardization population. Results also indicated that the ecological group demonstrated more psychopathology. Emotional alienation appeared to be a consistent stressor in ecological and chronic pain patients. Treatment of these patients should include the reduction of this emotional correlate.

The disabling conditions of chronic low-back pain continue to cost patient, family, and society. The intricate mechanisms which perpetuate this medical condition often consist of both organic and functional factors. This study evaluated personality and psychosocial variables which may control individual responses to facet denervation, a treatment for chronic lumbar distress. The subjects were 47 chronic pain patients whose symptoms conformed to the facet syndrome. Patient responses to the Minnesota Multiphasic Personality Inventory (MMPI) and the Sixteen Personality Factor Questionnaire were reviewed in an effort to predict statistically symptomatic relief. Also, the patients' involvement in litigation and their accuracy in determining their pain level were studied as possible influencing variables. Results show the litigation factor and two scalesof the MMPI to be most useful in predicting patient response from facet denervation treatment.

Objective: Chronic pain is a common condition worldwide that poses significant impact to society in terms of its health and economic costs. It has been found to be related to a number of emotional and cognitive factors that are amenable to psychological treatments. Traditional cognitive-behavioral therapy (CBT) for chronic pain has become the gold standard of psychological treatment with reported efficacy. However, recent meta-analyses have found its effect size to be only modest at most. Moreover, its specific mechanisms of action are not well elucidated. With recent advances in neuroscience on possible neurocognitive processes underlying chronic pain, alternative treatment models targeting these specific neurocognitive processes are worth exploring. The present study tested the effectiveness of the Four-step Mindfulness-based Therapy (FSMT) for chronic pain in a randomized-controlled trial. The FSMT was chosen because of its explicit emphasis on altering neurocognitive processes that appear to be highly relevant in treating chronic pain. Method: Ninety-nine chronic pain patients in a hospital cluster-based outpatient pain clinic were randomly allocated to either the FSMT treatment or wait-list control group. The FSMT was modified for use with chronic pain and incorporated mindfulness exercises, such as mindful breathing and mindful meditation. Treatment consisted of eight weekly two-hour group sessions conducted by a clinical psychologist experienced in the implementation of the FSMT protocol. Assessment took place at baseline and post-treatment for both the FSMT and wait-list control. For the FSMT, assessment also took place at mid-group and 3-month follow-up. Results: Findings showed that the FSMT produced superior outcomes in terms of activity interference (primary endpoint), pain unpleasantness, and depression when compared to the wait-list control group or over time. Improvements were also found in the process measures of pain catastrophizing and pain acceptance. All treatment effects were maintained at follow-up. Further, the effects have been shown to be clinically significant and reliable above and beyond measurement errors. Mediational analyses revealed that pain catastrophizing and pain acceptance mediated the effects of FSMT on the outcomes of activity interference and depression; pain catastrophizing also mediated the effect of FSMT on the outcome of pain unpleasantness. Conclusions: The present study was the first to establish statistical and clinical evidence of the FSMT for chronic pain. It also revealed possible processes and mechanisms that might have brought about the changes in outcome, namely reduction in pain catastrophizing and improvement in pain acceptance. How the FSMT led to the outcome changes via these two processes was discussed and enriched by neurocognitive perspectives. Future studies should seek to further compare the FSMT with other active psychological treatments for chronic pain and collect neuroimaging data to further illustrate the neurocognitive processes involved. / Wong, Chi Ming. / "October 2009." / Adviser: Freedom Leung. / Source: Dissertation Abstracts International, Volume: 72-01, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 139-175). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

This investigation utilized a novel, self-help, multi-element psychological program to manage chronic low back pain. A literature review indicated that this disorder was costly and prevalent, yet a large percentage of chronic low back pain patients did not respond to traditional treatment. Recent research has demonstrated that numerous psychological difficulties have been associated with this disorder, including depression and anxiety. It was hypothesized that these psychological concomitants of chronic low back pain maintain and promote further pain, as part of a vicious cycle. Self-help treatment attempted to break this tension-pain-anxiety cycle using various stress reduction, and cognitive and behavioral management strategies.

The present investigation sought to explore the efficacy of stress inoculation in the management of pain with severely burned adults. Subjects were 16 adult burn patients randomly assigned to either the stress-inoculation or no-treatment comparison group. The focus of the analysis was the amount of change or improvement from pretreatment to posttreatment periods. The stress-inoculation group showed significant improvement on all nine dependent measures, while the no-treatment group improved significantly on only two (physical and emotional self-ratings). The overall comparison of the amount of change between groups revealed that the stress-inoculation group showed significantly greater improvement in pain management than the no-treatment group during this time. It was concluded that stress inoculation, as a flexible treatment package, was efficacious in the management of pain experience of burn patients.

Chronic pain sufferers are frequently misunderstood and stigmatised. The aim of this investigation was to provide a description of the lifewor1d of people with chronic low back pain, using the phenomenological method. Themes which emerged were that the persistent nature of chronic pain makes it particularly difficult to endure, arousing a profound fear of the future. It causes a disruption in the relationship between the person and the body, in which the person is forced to function within the constraints of pain. Sufferers are unable to fulfil social roles as expected and are forced to revise their goals and activities. The distress of their experience is mediated by the ability to make sense of their condition, finding meaning in the pain itself. The study highlights the value of the phenomenological method in health psychology. Recommendations are made which may be of benefit to people with chronic pain and their families. / Psychology / M. Sc. (Psychology)