Dissertation/Thesis Abstract

The utility of brief cognitive skills training in reducing pain catastrophizing during experimental pain
by Stonerock, Gregory L., Jr., Ph.D., The University of North Carolina at Chapel Hill, 2011, 132; 3477510
Abstract (Summary)

Individuals who experience pain often engage in catastrophizing (CAT), a cognitive style involving rumination about pain, magnification of perceived threat, and a feeling of helplessness to cope with the pain. Moreover, high levels of catastrophizing have been shown to lead to poorer pain outcomes, such as lower pain tolerance and greater pain-related disability. Training in cognitive coping skills can help individuals to manage pain more effectively. In the current study, 111 pain-free undergraduate participants completed two modalities of experimental pain tasks (pressure, cold pressor) before and after an intervention targeted at reducing CAT through three cognitive-behavioral coping strategies: distraction, mindfulness/acceptance of pain, and cognitive restructuring. Pain responses from this group were compared to two other groups, one that underwent a positive mood induction procedure and one that underwent a similar procedure aimed at having no effect on mood (neutral mood group), which served as a control group. Participants also completed a new measure, the Catastrophizing Visual Analog Scale (CAT-VAS), designed to assess in-the-moment CAT during pain tasks. This new measure improves upon previous retrospective self-report measures of CAT given that CAT measured during or immediately after the pain experience accounts for more variance in pain responses (e.g., Edwards, Campbell, & Fillingim, 2005). Overall, the cognitive skills group showed lower CAT, higher pain tolerance, and greater reductions in subjective pain report post-intervention than either the positive or neutral mood groups. In addition, the CAT-VAS was more powerful in predicting pain response than existing retrospective questionnaire measurements. The results provide support for cognitive appraisal and fear-avoidance models of pain and pain coping, in which rumination and negative appraisal of pain escalate over time and promote a continued state of pain and distress whereas active coping attempts lead to greater pain relief.

Indexing (document details)
Advisor: Gil, Karen M.
Commitee: Abramowitz, Jonathan S., Bauer, Daniel J., Gil, Karen M., Hollins, Mark, Neblett, Enrique W.
School: The University of North Carolina at Chapel Hill
Department: Psychology
School Location: United States -- North Carolina
Source: DAI-B 73/01, Dissertation Abstracts International
Subjects: Clinical psychology, Experimental psychology
Keywords: Assessment, Cold pressor, Coping, Experimental pain, Pain catastrophizing
Publication Number: 3477510
ISBN: 978-1-124-94169-1
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