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883 BODY PERCEPTION AND THE PAIN SENSITIVITY IN EATING DISORDERS
Topic F: TREATMENT APPROACHES (PSYCHOSOCIAL & COGNITIVE) 883 BODY PERCEPTION AND THE PAIN SENSITIVITY IN EATING DISORDERS H. Papezova1 ° , A. Yamamotova2 , I. Vurmova1 , V. Kmoch1 . 1 Department of Psychiatry, Charles University, 1st Faculty of Medicine, Prague, 2 Department of Normal, Pathological and Clinical Physiology, Charles University, 3rd Faculty of Medicine, Prague, Czech Republic Background and Aims: In anorexia nervosa (AN), changed body image perception and pain perception have been repeatedly described, but the mechanism remains unclear. However, several factors were demonstrated to modulate pain and one’s own body perception in a similar way. We examined the influence of hormonal replacement therapy (HRT). Methods: The hormonal levels (estradiol, 17-OH progesterone, DHEA, DHEA-S and cortisol), psychological factors – body image perception Body Attitude Test (BAT) and Somatoform Dissociation Questionnaire (SDQ) and thermal pain perception were measured in 20 anorexic patients with HRT and 21 age-matched controls. Results: We found a significant association between estrogen levels and body perception pathology (BAT) but no association with somatoform dissociation (SDQ). Medicated patients showed the lower estradiol and higher cortisol levels than non-medicated ones. In AN, estrogens increased the thermal pain perception and the score of BAT-1 (appreciation of one’s own body size) similarly to the controls. Conclusions: HRT seems to increase, e.g. normalizes the pain perception in AN patients and scores of body dissatisfaction. Association between two diagnose-related perception modalities and HRT should be implemented into complex therapy oriented to improve the perception (one’s own body) and adaptation to the reality (stress and pain). This underlines the importance and benefits of interdisciplinary collaboration between physiological research and psychoeducation in clinical practice. Supported by grant VZ 0021620816.
884 MULTIDISCIPLINARY CHRONIC PAIN TREATMENT: EFFECTS AND COGNITIVE-BEHAVIORAL PREDICTORS OF OUTCOME H.J. Samwel1,2 ° , F.J. Kraaimaat2 , B.J. Crul1 , A.W. Evers2 . 1 Interdisciplinary Pain Center, Department of Anesthesiology, 2 Department of Medical Psychology, Nijmegen, The Netherlands Background: In spite of large individuel differences in treatment outcome, multidisciplinary treatment is effective for patients with chronic pain. The overall effect of treatment may be improved by identifying those patients who benefit the most from multidisciplinary pain treatment. The object of the present study was to study the effects of multidisciplinary pain treatment in patients with chronic pain and to identify predictors of treatment outcome. Methods: The effects and cognitive-behavioral predictors of a multidisciplinary pain treatment on pain intensity, functional disability, depression, and medication use were studied in 110 patients with chronic pain, compared to a waiting list control group (n = 110). Results: In the treatment group, primary outcomes of pain intensity, functional disability, depression, and medication use decreased significantly after treatment. Moreover, the decrease in pain intensity and functional disability was significant compared with that in the control group. In terms of cognitive-behavioral predictors of treatment success, higher levels of acceptance predicted a greater decrease in pain intensity in the treatment group compared with the control group. Conclusion: Patients with chronic pain benefit from multidisciplinary treatment with respect to pain intensity and functional disability. Patients who are able to accept the pain problem seem to benefit the most from such treatment.
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F08 PAIN IN CHILDREN – PSYCHOSOCIAL 885 Accepted for oral presentation DO KISS DECREASES INFANT’S PAIN? A. Agha Yousefi ° . Payam-E-Noor University, Qom, Iran To assessing the role of maternal kissing and caress in decreasing infant’s pain during incubation, we selected 60 infants (2−18 month) include 32 female and 28 male, randomly. Infants divided to two equal groups randomly too. There was an independent variable (maternal caress) and a dependent variable (total score of injection pain). Vaccine incubator recorded 16 other mediator variables – such as job of their fathers, education of their mother, infant age, sex, height and weight, vaccine type, injection type, mother’s age, birth order, wanted child, nationality, relationship of along and so on. In experimental group, mothers were educated to do particular caress behaviors during 5 minutes just before vaccine injection. An educated observer was recording pain signs just after injection. Data analyzed by linear multivariate regression – stepwise method. Findings: maternal caress did not predict pain scores variation. Among all variables, injection type and wanted child variables predicted total scores of injection pain significantly (17/5% and 9/2% of dependent variable, ordinarily). Discussion: I.M injection may produce lower pain and wanted children experience pain at lower degrees. There are some limitations in our research that must be attended in further studies such as doing caress behavior after injection and recording total time of showing pain by infants.
886 PARENTAL CATASTROPHIZING ABOUT THEIR CHILD’S PAIN. THE PARENT VERSION OF THE PAIN CATASTROPHIZING SCALE (PCS-P): A PRELIMINARY VALIDATION L. Goubert1 ° , C. Eccleston2 , T. Vervoort1 , A. Jordan2 , G. Crombez1 . 1 Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium, 2 Pain Management Unit, University of Bath, Bath, UK Background and Aims: Catastrophizing about pain has been found to be an important variable in how we understand adjustment to pain in both adults and children. As preliminary research has shown that parents of children with chronic pain are highly distressed, we hypothesized that also parental catastrophizing about their child’s pain may be a critical variable in explaining parental distress and a child’s disability. The study aimed at investigating the factor structure of a recently developed questionnaire to measure parental catastrophic thoughts about their child’s pain, the Pain Catastrophizing Scale for Parents (PCS-P). Methods: The factor structure of the PCS-P was investigated in both a non-clinical sample of parents of school children and a clinical sample of parents with a child suffering from chronic pain. Confirmatory factor analyses were performed to assess 3 models of parental catastrophizing about pain. Results: The results indicated that a 3-factor model provided the best fit to the data in both the non-clinical and clinical sample. Further, in the clinical sample, parents’ catastrophic thinking about their child’s pain had a significant contribution in explaining (a) childhood illnessrelated parenting stress, parental depression and anxiety, and (b) the child’s disability and school attendance, beyond the child’s pain intensity. Conclusions: Our findings indicate that our adjusted questionnaire measuring parental catastrophizing about their child’s pain has good construct validity. Furthermore, it was found that children of parents who catastrophize about their child’s pain experience more functional disability, and that catastrophizing parents were more distressed.
884 MULTIDISCIPLINARY CHRONIC PAIN TREATMENT: EFFECTS AND COGNITIVE-BEHAVIORAL PREDICTORS OF OUTCOME H.J. Samwel1,2 ° , F.J. Kraaimaat2 , B.J. Crul1 , A.W. Evers2 . 1 Interdisciplinary Pain Center, Department of Anesthesiology, 2 Department of Medical Psychology, Nijmegen, The Netherlands Background: In spite of large individuel differences in treatment outcome, multidisciplinary treatment is effective for patients with chronic pain. The overall effect of treatment may be improved by identifying those patients who benefit the most from multidisciplinary pain treatment. The object of the present study was to study the effects of multidisciplinary pain treatment in patients with chronic pain and to identify predictors of treatment outcome. Methods: The effects and cognitive-behavioral predictors of a multidisciplinary pain treatment on pain intensity, functional disability, depression, and medication use were studied in 110 patients with chronic pain, compared to a waiting list control group (n = 110). Results: In the treatment group, primary outcomes of pain intensity, functional disability, depression, and medication use decreased significantly after treatment. Moreover, the decrease in pain intensity and functional disability was significant compared with that in the control group. In terms of cognitive-behavioral predictors of treatment success, higher levels of acceptance predicted a greater decrease in pain intensity in the treatment group compared with the control group. Conclusion: Patients with chronic pain benefit from multidisciplinary treatment with respect to pain intensity and functional disability. Patients who are able to accept the pain problem seem to benefit the most from such treatment.
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F08 PAIN IN CHILDREN – PSYCHOSOCIAL 885 Accepted for oral presentation DO KISS DECREASES INFANT’S PAIN? A. Agha Yousefi ° . Payam-E-Noor University, Qom, Iran To assessing the role of maternal kissing and caress in decreasing infant’s pain during incubation, we selected 60 infants (2−18 month) include 32 female and 28 male, randomly. Infants divided to two equal groups randomly too. There was an independent variable (maternal caress) and a dependent variable (total score of injection pain). Vaccine incubator recorded 16 other mediator variables – such as job of their fathers, education of their mother, infant age, sex, height and weight, vaccine type, injection type, mother’s age, birth order, wanted child, nationality, relationship of along and so on. In experimental group, mothers were educated to do particular caress behaviors during 5 minutes just before vaccine injection. An educated observer was recording pain signs just after injection. Data analyzed by linear multivariate regression – stepwise method. Findings: maternal caress did not predict pain scores variation. Among all variables, injection type and wanted child variables predicted total scores of injection pain significantly (17/5% and 9/2% of dependent variable, ordinarily). Discussion: I.M injection may produce lower pain and wanted children experience pain at lower degrees. There are some limitations in our research that must be attended in further studies such as doing caress behavior after injection and recording total time of showing pain by infants.
886 PARENTAL CATASTROPHIZING ABOUT THEIR CHILD’S PAIN. THE PARENT VERSION OF THE PAIN CATASTROPHIZING SCALE (PCS-P): A PRELIMINARY VALIDATION L. Goubert1 ° , C. Eccleston2 , T. Vervoort1 , A. Jordan2 , G. Crombez1 . 1 Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium, 2 Pain Management Unit, University of Bath, Bath, UK Background and Aims: Catastrophizing about pain has been found to be an important variable in how we understand adjustment to pain in both adults and children. As preliminary research has shown that parents of children with chronic pain are highly distressed, we hypothesized that also parental catastrophizing about their child’s pain may be a critical variable in explaining parental distress and a child’s disability. The study aimed at investigating the factor structure of a recently developed questionnaire to measure parental catastrophic thoughts about their child’s pain, the Pain Catastrophizing Scale for Parents (PCS-P). Methods: The factor structure of the PCS-P was investigated in both a non-clinical sample of parents of school children and a clinical sample of parents with a child suffering from chronic pain. Confirmatory factor analyses were performed to assess 3 models of parental catastrophizing about pain. Results: The results indicated that a 3-factor model provided the best fit to the data in both the non-clinical and clinical sample. Further, in the clinical sample, parents’ catastrophic thinking about their child’s pain had a significant contribution in explaining (a) childhood illnessrelated parenting stress, parental depression and anxiety, and (b) the child’s disability and school attendance, beyond the child’s pain intensity. Conclusions: Our findings indicate that our adjusted questionnaire measuring parental catastrophizing about their child’s pain has good construct validity. Furthermore, it was found that children of parents who catastrophize about their child’s pain experience more functional disability, and that catastrophizing parents were more distressed.