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(329) Preference of social support types and differential effects of pain controllability, perceived social support, and disparity in social support on depression and adjustment
P58 (328) Pain catastrophizing assessed before and after experimental pain testing: Temporal stability and relations with pain and nociception J Russell, E Bartley, K McCabe, A Williams, J Rhudy; University of Tulsa, Tulsa, OK Recent evidence suggests the relationship between pain catastrophizing and experimental pain may depend on when catastrophizing is assessed. Specifically, catastrophizing measured during or after pain testing better predicts pain outcomes than catastrophizing measured before pain testing. This study assessed pain catastrophizing from subscales (rumination, magnification, helplessness) of the Pain Catastrophizing Scale (PCS) in 30 participants before and after pain testing. Electrodermal stimuli were delivered over the sural nerve to assess nociceptive flexion reflex (NFR) threshold, pain threshold, and pain tolerance. Three ascending-descending series of stimuli were first delivered to assess NFR threshold, followed by a short break, and then the stimuli were increased until pain tolerance was reached (or 40 mA maximum). Following every stimulus, participants rated their subjective reaction on a 0 (no sensation) to 100 (maximum tolerable) scale in which pain was anchored at 50. In the last ascending series, pain threshold was defined as the stimulus intensity that was rated 50, and pain tolerance was the stimulus intensity rated 100. Immediately following pain testing, participants also rated their overall subjective pain using the McGill Pain Questionnaire-short form (MPQ-SF). All procedures were IRB approved. Results suggested PCS subscale means were similar pre- and post-test (ps⬎.65); however, test-retest correlations were non-significant (rs⫽ -.02 to .07, ps⬎.71). Moreover, most relationships between PCS subscales and pain outcomes were only significant for catastrophizing assessed post-pain-testing. Post-test rumination, magnification, and helplessness were associated with MPQ-SF ratings, and post-test magnification was associated with pain threshold and tolerance (ps⬍.05). Surprisingly, pre-test helplessness was positively correlated with NFR threshold and negatively correlated with MPQ-SF affective ratings (ps⬍.05). These results contribute to the growing literature suggesting the relationships between pain catastrophizing and experimental pain depend on the timing of assessment. This research was supported by an Oklahoma Center for the Advancement of Science and Technology grant.
(329) Preference of social support types and differential effects of pain controllability, perceived social support, and disparity in social support on depression and adjustment S Cho, P Chao, I Zunin, J Mckoy, E Heiby; University of Hawaii at Manoa, Honolulu, HI At least three types of social support have been identified: informational, instrumental, and emotional. Considerable evidence suggests that social support helps individuals reduce and cope with psychological distress. However, preference of specific types of social support varies across recipients, and inadequate social support could elicit lower satisfaction and negative outcomes (e.g., depression). In particular, Optimal Matching Theory suggests while informational or instrumental support is beneficial to an individual with a controllable major stressor, emotional support is beneficial to an individual with an uncontrollable major stressor. Pain patients identify their pain as a major life stressor and its relief as a primary concern. This study investigated: 1) preference of specific types of social support, depending on the level of pain controllability (PC); and 2) along with the effects of PC, differential effects of perceived social support, and disparity in preferred vs. obtained social support on depression and adjustment. 173 chronic pain patients attending three outpatient clinics in Honolulu were recruited for this study. A repeated-measures one-way ANOVA and subsequent post-hoc tests indicated that participants significantly preferred informational and emotional support to instrumental support regardless of the level of PC. Subsequently, four hierarchical multiple regressions indicated that 1) PC and perceived emotional support significantly predicted depression, 2) PC and disparity in emotional support significantly predicted depression, 3) the slope of disparity in emotional support was significantly steeper than that of perceived emotional support in predicting depression, and 4) only PC significantly predicted adjustment. Therefore, this study would suggest that behavioral health specialists focus on both increasing PC and reducing disparity in emotional support for alleviation of depression, and increasing PC for adjustment enhancement. Specifically, this study would suggest how to target cognitive restructuring and involve emotionally-supportive friends and family in the care of chronic pain patients.
Abstracts (330) Do food fantasies facilitate coping with acute pain? H Hekmat, P Staats, A Staats; University of Wisconsin, Stevens Point, WI This study explores the effect of food fantasies on the experience of acute pain. Sixty participants, who experienced acute cold water pain, were randomly assigned to one of the following interventions: (a) Food fantasies, (b) neutral fantasy control (NFC), and (c) non-treatment control (NC). Prior to and after treatment, participants were given measures of pain threshold, pain tolerance, pain intensity, and other scales measuring depression, anxiety, and mood states. Self-report measures included: Pain Anxiety Symptoms Scale (PASS), the revised Multiple Affect Adjective Checklist (MAACL-R), the Depression Anxiety Stress Scale (DASS) and Semantic Differential Scales for evaluating personal meaning of food fantasies. A cold pressor task was used to induce acute pain. Participants submerged their hand in ice water before and after interventions and pain measures were gathered. The food fantasy participants rehearsed scenarios involving deriving pleasure from eating their favorite meal. Participants next applied food fantasies to cope with ice water pain. The neutral fantasy participants rehearsed imagining neutral fantasies and applied them later during the cold pressor task. Univariate and Multivariate statistics were used to analyze data. Results indicated that food fantasies significantly reduced pain threshold, pain tolerance, pain intensity, and self-reports of pain and anxiety. Food fantasies significantly enhanced positive mood and reduced the negative mood states of the participants (p⬍ .01). Results suggest that food fantasies have beneficial effects on pain.
(331) Maintenance of pain self-management behaviors after treatment in interdisciplinary pain treatment J Wallach, R Schleser, G Wallach, R Harden; Rehabilitation Institute of Chicago, Chicago, IL Multidisciplinary pain treatment (PMP) has demonstrated efficacy in chronic pain management with significant effects at long-term followup. Many aspects of these programs have demonstrated effectiveness, with greater response from the combined approaches. Limited evidence has been presented demonstrating the continued use of the pain selfmanagement techniques developed during PMP in relation to the maintenance of treatment effects. The goals of this study were: (1) survey the long-term use of different pain management behaviors after PMP treatment, (2) test for a relationship between reported use of pain management behaviors and pain experience, (3) assess whether increased time since treatment is associated with decreased pain self-management behaviors, (4) explore the utility of the Total Design Method (TDM) for maximizing response rate. The TDM included (a) survey design, (b) standardized protocol for initial telephone contact of potential participants for verbal consent, (c) mailing of the recruitment package within one week of verbal consent, (d) reminder postcards two weeks later to participants who had not returned the mailing, (e) phone call reminder one week later, and (f) finally a second recruitment package three weeks after the telephone reminder. An optional second data collection for test-retest reliability was completed. Sixty-four participants completed Time 1 and thirty completed Time 2. The Survey of Current Pain Management (SCPM) was developed for this study and was used to collect self-report data on pain management behaviors. Participants endorsed a wide range of pain management behaviors on the SCPM (0% - 85.9%). Pain self-management accounted for 8% of the variance in pain change since evaluation. Pain self-management does not appear to decline over time in the majority of subjects. The TDM methodology was not conclusively supported for use in the chronic pain population. Supported by the Center for Pain Studies at the Rehabilitation Institute of Chicago.
(329) Preference of social support types and differential effects of pain controllability, perceived social support, and disparity in social support on depression and adjustment S Cho, P Chao, I Zunin, J Mckoy, E Heiby; University of Hawaii at Manoa, Honolulu, HI At least three types of social support have been identified: informational, instrumental, and emotional. Considerable evidence suggests that social support helps individuals reduce and cope with psychological distress. However, preference of specific types of social support varies across recipients, and inadequate social support could elicit lower satisfaction and negative outcomes (e.g., depression). In particular, Optimal Matching Theory suggests while informational or instrumental support is beneficial to an individual with a controllable major stressor, emotional support is beneficial to an individual with an uncontrollable major stressor. Pain patients identify their pain as a major life stressor and its relief as a primary concern. This study investigated: 1) preference of specific types of social support, depending on the level of pain controllability (PC); and 2) along with the effects of PC, differential effects of perceived social support, and disparity in preferred vs. obtained social support on depression and adjustment. 173 chronic pain patients attending three outpatient clinics in Honolulu were recruited for this study. A repeated-measures one-way ANOVA and subsequent post-hoc tests indicated that participants significantly preferred informational and emotional support to instrumental support regardless of the level of PC. Subsequently, four hierarchical multiple regressions indicated that 1) PC and perceived emotional support significantly predicted depression, 2) PC and disparity in emotional support significantly predicted depression, 3) the slope of disparity in emotional support was significantly steeper than that of perceived emotional support in predicting depression, and 4) only PC significantly predicted adjustment. Therefore, this study would suggest that behavioral health specialists focus on both increasing PC and reducing disparity in emotional support for alleviation of depression, and increasing PC for adjustment enhancement. Specifically, this study would suggest how to target cognitive restructuring and involve emotionally-supportive friends and family in the care of chronic pain patients.
Abstracts (330) Do food fantasies facilitate coping with acute pain? H Hekmat, P Staats, A Staats; University of Wisconsin, Stevens Point, WI This study explores the effect of food fantasies on the experience of acute pain. Sixty participants, who experienced acute cold water pain, were randomly assigned to one of the following interventions: (a) Food fantasies, (b) neutral fantasy control (NFC), and (c) non-treatment control (NC). Prior to and after treatment, participants were given measures of pain threshold, pain tolerance, pain intensity, and other scales measuring depression, anxiety, and mood states. Self-report measures included: Pain Anxiety Symptoms Scale (PASS), the revised Multiple Affect Adjective Checklist (MAACL-R), the Depression Anxiety Stress Scale (DASS) and Semantic Differential Scales for evaluating personal meaning of food fantasies. A cold pressor task was used to induce acute pain. Participants submerged their hand in ice water before and after interventions and pain measures were gathered. The food fantasy participants rehearsed scenarios involving deriving pleasure from eating their favorite meal. Participants next applied food fantasies to cope with ice water pain. The neutral fantasy participants rehearsed imagining neutral fantasies and applied them later during the cold pressor task. Univariate and Multivariate statistics were used to analyze data. Results indicated that food fantasies significantly reduced pain threshold, pain tolerance, pain intensity, and self-reports of pain and anxiety. Food fantasies significantly enhanced positive mood and reduced the negative mood states of the participants (p⬍ .01). Results suggest that food fantasies have beneficial effects on pain.
(331) Maintenance of pain self-management behaviors after treatment in interdisciplinary pain treatment J Wallach, R Schleser, G Wallach, R Harden; Rehabilitation Institute of Chicago, Chicago, IL Multidisciplinary pain treatment (PMP) has demonstrated efficacy in chronic pain management with significant effects at long-term followup. Many aspects of these programs have demonstrated effectiveness, with greater response from the combined approaches. Limited evidence has been presented demonstrating the continued use of the pain selfmanagement techniques developed during PMP in relation to the maintenance of treatment effects. The goals of this study were: (1) survey the long-term use of different pain management behaviors after PMP treatment, (2) test for a relationship between reported use of pain management behaviors and pain experience, (3) assess whether increased time since treatment is associated with decreased pain self-management behaviors, (4) explore the utility of the Total Design Method (TDM) for maximizing response rate. The TDM included (a) survey design, (b) standardized protocol for initial telephone contact of potential participants for verbal consent, (c) mailing of the recruitment package within one week of verbal consent, (d) reminder postcards two weeks later to participants who had not returned the mailing, (e) phone call reminder one week later, and (f) finally a second recruitment package three weeks after the telephone reminder. An optional second data collection for test-retest reliability was completed. Sixty-four participants completed Time 1 and thirty completed Time 2. The Survey of Current Pain Management (SCPM) was developed for this study and was used to collect self-report data on pain management behaviors. Participants endorsed a wide range of pain management behaviors on the SCPM (0% - 85.9%). Pain self-management accounted for 8% of the variance in pain change since evaluation. Pain self-management does not appear to decline over time in the majority of subjects. The TDM methodology was not conclusively supported for use in the chronic pain population. Supported by the Center for Pain Studies at the Rehabilitation Institute of Chicago.