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Pain and illness behavior
100 (966) Influence of group identification and conformity to gender group norms on pain tolerance G. Pool, A. Schwegler, S. LaGraize, P. Fuchs; University of Texas at Arlington, Arlington, TX Previous research indicates that men typically tolerate more pain in experimental settings than women. One likely explanation for these group differences in pain tolerance is conformity to traditional, gender group social norms (i.e., the ideal man is masculine and tolerates more pain, whereas the ideal woman is feminine and tolerates less pain). According to social identity and self-categorization theories, norms guide and/or constrain social behavior to the degree that group members adopt the group identity. Therefore, we expect high identifying men to conform to gender norms and tolerate more pain than high identifying women who conform to different gender norms as a guide for their behavior. Because low identifying men and women should be less motivated to conform to their gender norms for pain tolerance, we expect no differences between them. To test these predictions, we conducted a study to investigate whether gender group identification moderates individuals’ conformity to pain tolerance and reporting norms. In the present research, participants indicated their gender identification and expected tolerance of a hypothetical painful stimulus. As anticipated, high identifying men reported significantly greater pain tolerance than high identifying women. No differences existed between low identifying men and women. These results highlight the influence of norms on social behavior and suggest the need to explore the role of social norms in clinical pain management.
(967) Gender differences in cold pressor pain are demonstrated by the Multidimensional Affect and Pain Survey (MAPS) factor scores J. Kuhl, W. Clark; New York State Psychiatric Institute, New York, NY The Multidimensional Affect and Pain Survey (MAPS) is a questionnaire organized into 30 clusters of items subsumed under 3 superclusters: I.Somatosensory Pain, II.Emotional Pain, and III.Well-Being. The instrument is based on a dendrogram derived from a cluster analysis of similarity judgments of 189 descriptors of pain and well-being by 104 healthy volunteers in a pain-free state. To assess the validity of the conceptual structure of pain produced under those conditions, the same participants later used MAPS descriptors to rate cold pressor pain. Principal components analysis of their responses produced a 6-factor solution. A factor loading of .6 was adopted as the criterion. Factor 1 was loaded on by 5 of the 8 Emotional Pain clusters and 3 of the 17 Somatosensory Pain clusters. Factor 2 was loaded on by 7 other Somatosensory Pain clusters. Factor 3 was loaded on by 3 of the 5 Well-Being clusters, and the one Emotional Pain apathy cluster (associated with stoicism). Factor 4 was loaded on by the clusters cold and numb, Factor 5 by the cluster physically active, and Factor 6 by the cluster temporal qualities.. The factor structure, which reflects independent domains of pain and suffering with reasonable face validity, demonstrates the validity of the conceptual organization of the MAPS. The mean(SD) regresssion scores for Factor 1 were higher for women, 0.20(0.14) than for men, -0.23(0.10), F⫽4.80,p⬍.04,df ⫽1,102, while scores for Factor 3 were higher for men, .26(.16) than for women -.22(.12), F⫽6.17,p⬍.02,df⫽1,102. Thus, women experienced both greater negative emotions and diminished positive emotions relative to men. Sex differences were not significant for the other factors, most notably Factor 2, which was loaded on exclusively by sensory clusters. Together, these results suggest that the difference in pain experience between men and women is more affective than sensory in nature.
Abstracts (968) Sex differences are detected by the Coping Strategies Questionnaire (CSQ), but not by other psychological and sensory tests W. Clark, C. Wei, B. Cesario; Columbia University, New York, NY The aim was to investigate possible sex differences in response to various pain questionnaires and noxious calibrated stimulation. Healthy, pain-free volunteers responded to the CSQ, psychological and sensory tests, and to an inquiry regarding the frequency and intensity of painful events previously experienced. Sex differences were found on 3 of the 7 subscales of the CSQ: Women scored higher than men on (M, SD) Total Score, 117.8 (38.8), men 88.3 (41.8), df ⫽ 37, p ⫽ 0.36; Praying/Hoping, women 17.5 (9.6), men 10.1 (8.4) df ⫽ 40, p ⫽ 0.025; and, Increased Behavioral Activities, women 16.8 (6.9), men 12.2 (6.5), df ⫽ 39, p ⫽ 0.040. In contrast, no sex differences were found on the Beck Depression Inventory, the Profile of Mood States (POMS), Spielberger Present Anger and State Anxiety Scales, although women were marginally less anxious -0.67 (0.49) than men, -0.94 (0.38), df ⫽ 40, p ⫽ 0.06. Also, the sexes did not differ in the total intensity rating of 21 painful conditions, and in the number of types of pain experienced, or in the method of limit thresholds for noxious heat and noxious cold stimuli. These results for healthy volunteers differ from reports in the literature in two ways: women who visit physicians are much more likely to complain of pain than male patients, and women are generally found to have lower thresholds to calibrated noxious stimuli. Women have higher scores than men on CSQ measures of Praying/Hoping, Increased Behavioral Activities, and Total Score. Thus, the CSQ is more sensitive to sex differences than are measures of many of the standard psychological tests, as well as previous pain experiences and laboratory calibrated pain thresholds.
F07 - Pain and Illness Behavior (969) Developing a Pain Medication Attitude Questionnaire: Preliminary analyses of the relationships between pain medication concerns, medication behaviours, psychological distress, and disability J. Hoskins, L. McCracken, C. Eccleston; University of Bath, Bath, UK There has been little study of chronic pain patient‘s psychological experiences of taking analgesic medications. The Pain Medication Attitude Questionnaire (PMAQ) has been developed to assess chronic pain patients concerns about their analgesic medications, it consists of 49 self report items divided in to the following 7 scales: perceived need for medication, concern about adverse scrutiny, addiction, side effects, tolerance, withdrawal, and relationship with the prescribing doctor. Participants for this study were attending one of two pain management services in Southwest England (N⫽160). This study investigates the relationships between chronic pain patients concerns about analgesic medication, their self reported medication behaviours, and measures of disability and psychological distress. All of the PMAQ scales were found to have significant positive relationships with pain related anxiety, depression, disability, reported frequency of adverse side effect, and heath care use (frequency of GP visits in last 6 months). An analysis of the relationships between medication concerns and self reported medication behaviours found a significant negative relationship between perceived need and taking less medication (r⫽ -.24, p⬍ .01) and a positive relationship with taking more medication than prescribed (r⫽ .49, p⬍ 001). Taking more medication was also positively related to concern about adverse scrutiny (r⫽ .34, p⬍ .001) and concern about tolerance (r⫽ .31, p⬍ .001). These results suggest that concerns about analgesic medications contribute to the psychological distress experienced by chronic pain patients. A high perceived need for analgesic medications is associated with taking more medication. This behaviour is also associated with increased concerns about medication, greater reported incidence of adverse side effects and higher levels of psychological distress, which in turn is associated with increased scores of reported pain. Regression analyses of the unique contributions of patients concerns to distress and disability, separate from pain and reported pain relief, are discussed.
(967) Gender differences in cold pressor pain are demonstrated by the Multidimensional Affect and Pain Survey (MAPS) factor scores J. Kuhl, W. Clark; New York State Psychiatric Institute, New York, NY The Multidimensional Affect and Pain Survey (MAPS) is a questionnaire organized into 30 clusters of items subsumed under 3 superclusters: I.Somatosensory Pain, II.Emotional Pain, and III.Well-Being. The instrument is based on a dendrogram derived from a cluster analysis of similarity judgments of 189 descriptors of pain and well-being by 104 healthy volunteers in a pain-free state. To assess the validity of the conceptual structure of pain produced under those conditions, the same participants later used MAPS descriptors to rate cold pressor pain. Principal components analysis of their responses produced a 6-factor solution. A factor loading of .6 was adopted as the criterion. Factor 1 was loaded on by 5 of the 8 Emotional Pain clusters and 3 of the 17 Somatosensory Pain clusters. Factor 2 was loaded on by 7 other Somatosensory Pain clusters. Factor 3 was loaded on by 3 of the 5 Well-Being clusters, and the one Emotional Pain apathy cluster (associated with stoicism). Factor 4 was loaded on by the clusters cold and numb, Factor 5 by the cluster physically active, and Factor 6 by the cluster temporal qualities.. The factor structure, which reflects independent domains of pain and suffering with reasonable face validity, demonstrates the validity of the conceptual organization of the MAPS. The mean(SD) regresssion scores for Factor 1 were higher for women, 0.20(0.14) than for men, -0.23(0.10), F⫽4.80,p⬍.04,df ⫽1,102, while scores for Factor 3 were higher for men, .26(.16) than for women -.22(.12), F⫽6.17,p⬍.02,df⫽1,102. Thus, women experienced both greater negative emotions and diminished positive emotions relative to men. Sex differences were not significant for the other factors, most notably Factor 2, which was loaded on exclusively by sensory clusters. Together, these results suggest that the difference in pain experience between men and women is more affective than sensory in nature.
Abstracts (968) Sex differences are detected by the Coping Strategies Questionnaire (CSQ), but not by other psychological and sensory tests W. Clark, C. Wei, B. Cesario; Columbia University, New York, NY The aim was to investigate possible sex differences in response to various pain questionnaires and noxious calibrated stimulation. Healthy, pain-free volunteers responded to the CSQ, psychological and sensory tests, and to an inquiry regarding the frequency and intensity of painful events previously experienced. Sex differences were found on 3 of the 7 subscales of the CSQ: Women scored higher than men on (M, SD) Total Score, 117.8 (38.8), men 88.3 (41.8), df ⫽ 37, p ⫽ 0.36; Praying/Hoping, women 17.5 (9.6), men 10.1 (8.4) df ⫽ 40, p ⫽ 0.025; and, Increased Behavioral Activities, women 16.8 (6.9), men 12.2 (6.5), df ⫽ 39, p ⫽ 0.040. In contrast, no sex differences were found on the Beck Depression Inventory, the Profile of Mood States (POMS), Spielberger Present Anger and State Anxiety Scales, although women were marginally less anxious -0.67 (0.49) than men, -0.94 (0.38), df ⫽ 40, p ⫽ 0.06. Also, the sexes did not differ in the total intensity rating of 21 painful conditions, and in the number of types of pain experienced, or in the method of limit thresholds for noxious heat and noxious cold stimuli. These results for healthy volunteers differ from reports in the literature in two ways: women who visit physicians are much more likely to complain of pain than male patients, and women are generally found to have lower thresholds to calibrated noxious stimuli. Women have higher scores than men on CSQ measures of Praying/Hoping, Increased Behavioral Activities, and Total Score. Thus, the CSQ is more sensitive to sex differences than are measures of many of the standard psychological tests, as well as previous pain experiences and laboratory calibrated pain thresholds.
F07 - Pain and Illness Behavior (969) Developing a Pain Medication Attitude Questionnaire: Preliminary analyses of the relationships between pain medication concerns, medication behaviours, psychological distress, and disability J. Hoskins, L. McCracken, C. Eccleston; University of Bath, Bath, UK There has been little study of chronic pain patient‘s psychological experiences of taking analgesic medications. The Pain Medication Attitude Questionnaire (PMAQ) has been developed to assess chronic pain patients concerns about their analgesic medications, it consists of 49 self report items divided in to the following 7 scales: perceived need for medication, concern about adverse scrutiny, addiction, side effects, tolerance, withdrawal, and relationship with the prescribing doctor. Participants for this study were attending one of two pain management services in Southwest England (N⫽160). This study investigates the relationships between chronic pain patients concerns about analgesic medication, their self reported medication behaviours, and measures of disability and psychological distress. All of the PMAQ scales were found to have significant positive relationships with pain related anxiety, depression, disability, reported frequency of adverse side effect, and heath care use (frequency of GP visits in last 6 months). An analysis of the relationships between medication concerns and self reported medication behaviours found a significant negative relationship between perceived need and taking less medication (r⫽ -.24, p⬍ .01) and a positive relationship with taking more medication than prescribed (r⫽ .49, p⬍ 001). Taking more medication was also positively related to concern about adverse scrutiny (r⫽ .34, p⬍ .001) and concern about tolerance (r⫽ .31, p⬍ .001). These results suggest that concerns about analgesic medications contribute to the psychological distress experienced by chronic pain patients. A high perceived need for analgesic medications is associated with taking more medication. This behaviour is also associated with increased concerns about medication, greater reported incidence of adverse side effects and higher levels of psychological distress, which in turn is associated with increased scores of reported pain. Regression analyses of the unique contributions of patients concerns to distress and disability, separate from pain and reported pain relief, are discussed.