Psy. D., Antioch University, 2016, Antioch Seattle: Clinical Psychology

Negative stereotypes about people with chronic pain pose a barrier in the delivery of care; contribute to worsening symptoms of physical and psychological distress; and play a role in policy decisions that adversely affect patients and providers. Pain-care seekers may be accused of malingering, laziness, mental aberration, attention seeking, and drug seeking. The propagation of stigmatizing attitudes was explored in this Critical Discourse Analysis of online-reader-comments responding to a series of pain-care policy articles published by a large metropolitan newspaper. Results suggest that framing pain patients as legitimate and deserving can inadvertently reproduce the inequities advocates seek to redress. Ascriptions of deservingness were associated with the locus of choice and agency. Assignments of blameworthiness were used to distinguish the legitimate pain patient from the illegitimate care seeker. Motivation for seeking pain care, as much as the effects of opioids, provided crucial determinants in evaluating legitimacy claims and blame ascriptions. Evaluations of deservingness were predicated on the valence of social regard. Compassion, empathy, respect and believability were rewards of positive social regard. The subjects of addiction and drug abuse were maligned to the detriment of people with pain and people with opioid addiction alike. The disease-entity model of chronic pain was associated with psychiatric discourses of mental illness through a narratives inaccurate reality perception. Loss of independence, rationality, and respectability were semantically linked to negative stereotypes of pain patients, drug addicts, and mentally ill groups. Medical discourses drawing on empirical materialist traditions assert taken-for-granted population categories (e.g. chronic noncancer pain patient) with little acknowledgment of confounding variables, lack of evidence, or their social impact. For the benefit of people seeking care, there is a critical need for moral (open full item for complete abstract)

Committee: Mary Wieneke Ph.D. (Committee Chair); Philip Cushman Ph.D. (Committee Member); Elin Björling Ph.D. (Committee Member) Subjects: Health Care; Public Health; Social Research; Sociolinguistics

MA, University of Cincinnati, 2024, Arts and Sciences: Psychology

Chronic pain can disrupt adolescents' attention. Such interruptions, in turn, may negatively impact one's overall functioning, causing frustration and distress when trying to engage in important tasks (e.g., schoolwork). This experience has been referred to as cognitive intrusion of pain (Attridge et al., 2015). To date, only one adult self-report measure of cognitive intrusion of pain exists: the Experience of Cognitive Intrusion of Pain Scale (ECIP). This is a critical gap in the literature, as there is currently no known measure of experienced cognitive intrusion of pain for pediatric chronic pain patients. The current study examined the psychometric properties of an adapted version of the ECIP (ECIP-A) among children and adolescents (ages 11-18) with pediatric chronic pain. Data were collected from pediatric chronic pain patients (N = 194) presenting for treatment at a tertiary pain clinic at a large Midwestern children's hospital. Exploratory analyses were conducted for deeper understanding of the current sample, as this is the first study to assess the ECIP-A in pediatric patients with chronic pain. The current sample consisted of 81.9% self-identified as Non-Hispanic White and 77.5% female chronic pain patients. There were no significant differences in ECIP-A scores between males and females, across patient age, or across primary pain condition. ECIP-A scores and Pain Frequency-Severity-Duration composite scores were significantly correlated, indicating that as pain symptoms increase, so does cognitive intrusion of pain (r = 0.23, p = 0.002). Confirmatory factor analysis (CFA) results supported a one-factor model for the ECIP-A, with excellent model fit (?2 = 30.24, df = 23, p = 0.14; CFI = 0.99, TLI = 0.99, RMSEA = .042 (90% CI 0.00 - 0.078), and SRMR = 0.021). Results suggest excellent internal consistency of ECIP-A scores (Cronbach's alpha = 0.94). Pearson correlations indicated good convergent and discriminant validity, as the ECIP-A was moderately and p (open full item for complete abstract)

Committee: Kristen Jastrowski Mano Ph.D. (Committee Chair); Quintino Mano Ph.D. (Committee Member); Cathleen Stough Ph.D. (Committee Member) Subjects: Psychology

Doctor of Philosophy, Case Western Reserve University, 1994, Psychology

Chronic pain differs from acute pain in a number of ways. A prominent difference between the two lies in the most beneficial method of treatment. The most effective means of coping with acute pain are passive approaches, based on traditional medical models. The most effective means of coping with chronic pain, when examined in isolation from acute pain, are active approaches in which the individual in pain plays a more aggressive role in the management. Previous research has not addressed the issue of the most effective use of coping style for chronic pain populations, who are faced with managing episodes of both acute and chronic pain. The present study was designed to investigate the coping styles (active vs. passive) which a chronic pain population uses to manage both acute and chronic pain episodes, and to examine the relationship of these coping styles to depression and anxiety. Subjects with chronic pain completed two versions of the Pain Management Inventory (Brown & Nicassio, 1987), one in regard to their chronic pain and the other in regard to acute pain which they experience, indicating the frequency with which they used various active and passive coping strategies. Depression and anxiety were assessed using the Center for Epidemiological Studies Depression Scale (Radloff, 1977) and the trait anxiety scale of the State Trait Personal ity Inventory (Spielberger et al., 1979). Results indicate that chronic pain patients use a mixture of both passive and active strategies, and that they use similar strategies for both acute and chronic pain experiences. The most important predictor of depression and trait anxiety, however, is the use of passive coping in response to chronic pain. Using the current methodology, it was impossible to identify adequately sized groups of subjects who selectively used different coping styles for the two types of pain in order to determine if this selective use of coping styles is beneficial in this population. These results are dis (open full item for complete abstract)

Committee: Dianne Tice (Advisor) Subjects: Psychology, Clinical

Doctor of Philosophy, University of Akron, 2009, Counseling Psychology

Chronic pain is a pervasive and often intractable health problem that affects approximately one fifth of the population in the United Sates. Despite the moderate effectiveness of some biomedical and multimodal psychotherapeutic treatments for pain, chronic pain remains highly distressing and disabling for many. A modern behavioral model of chronic pain expands upon earlier operant – behavioral and cognitive – behavioral models of pain (W. E. Fordyce, 1976; D. Turk, D. Meichenbuam, & M. Genest, 1983) by viewing much of the accompanying distress and disability as arising from experiential avoidance (S. C. Hayes, K. D. Strosahl, & K. G. Wilson, 1999) and by asserting the importance of acceptance of pain as a key behavioral process in undermining suffering and promoting adjustment to chronic pain (L. M. McCracken, 2005). Acceptance of chronic pain is conceptualized as the adoption of flexible behavioral response patterns aimed at increasing one's engagement in meaningful activities and the willingness to experience pain sensations in some circumstances when doing so serves to enhance adaptation and life functioning. Acceptance of chronic pain is emerging as a robust predictor of enhanced psychosocial and physical functioning in patients with chronic pain. Given the prevalence and severity of distress and disability experienced by some treatment-seeking chronic pain patients and the apparent contribution of acceptance to enhanced patient functioning, the current study sought to provide an independent test of the validity of a modern behavioral theory of acceptance of chronic pain by examining whether greater acceptance of pain predicts enhanced patient adjustment to chronic pain. A total of 117 patients seeking treatment at a chronic pain rehabilitation program responded to questionnaires assessing acceptance of pain and other indices of emotional distress, pain intensity, and pain-related disability. Results indicated that greater chronic pain acceptance is related to l (open full item for complete abstract)

Committee: John Queener E. (Advisor) Subjects: Psychology