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Beverly E Thorn

Publications and source records attributed to Beverly E Thorn.

17 recordsLinked to original sources
PubMed2007

Meta-analyses and systematic reviews of psychological treatments for chronic pain: relevance to an evidence-based practice.

As evidence-based practitioners become more reliant on systematic reviews to inform treatment, it becomes important to systematize reporting details as well as improve the quality of the primary studies that will later be incorporated into this secondary literature. In this article, the authors consider several specific factors that can serve this function in the area of chronic pain: (a) adhering to a standardized set of reporting standards; (b) measuring a standardized set of short- and long-term outcome variables; (c) providing information about individual differences; and (d) providing detailed, easily accessible documentation of the treatment program (or progams). The article also highlights ways that practitioners and researchers can collaborate on treatment outcome research, thereby improving the ability to discover and disseminate effective treatments for patients who suffer from chronic pain.

Chronic Disease↗
PubMed2006

Psychological treatments for persistent pain: an introduction.

Psychological treatments for persistent pain have been demonstrated to be effective alternatives or adjuncts to more traditional methods for promoting optimal pain management. The primary goal of this issue is to provide the clinician with updated information on the state of the art of a variety of psychological treatments for persistent pain. Specifically emphasized are important issues that add to the complexity of effective pain management and practical recommendations for clinicians to use in enhancing the outcomes of these various treatment approaches. This introductory article provides a brief review of the empirical literature supporting the utility of psychological treatments for persistent pain, describes the content of this issue, and highlights several of the common themes highlighted by our panel of expert contributors.

Chronic Disease↗
PubMed2006

Group cognitive therapy for chronic pain.

Group therapy for chronic pain management, particularly that using cognitive-behavioral treatment (CBT), has become a common treatment format. This article provides a rationale and framework for group CBT, including the research evidence and clinical considerations related to the practitioner and patient. We then present an example of group therapy focusing on the cognitive components of CBT for chronic pain. Examples from group therapy are used in order to illustrate the principles of optimizing the group approach in the context of cognitive therapy.

Arthritis↗
PubMed2006

Obtaining self-report data from cognitively impaired elders: methodological issues and clinical implications for nursing home pain assessment.

PURPOSE: We developed and evaluated an explicit procedure for obtaining self-report pain data from nursing home residents across a broad range of cognitive status, and we evaluated the consistency, stability, and concurrent validity of resident responses. DESIGN AND METHODS: Using a modification of the Geriatric Pain Measure (GPM-M2), we interviewed 61 residents from two nursing homes (Mini-Mental State Examination score, M = 15 +/- 7) once a week for 4 consecutive weeks. We collected additional data by means of chart review, cognitive status assessments, and surveys of certified nursing assistants. We used descriptive and correlational analyses to address our primary aims. RESULTS: Eighty-nine percent of residents completed all four scheduled interviews. Cognitive status was not significantly correlated with number of nonresponses and prompts for yes-no questions, but it was significantly correlated with nonresponses and prompts for Likert-scale questions (r = -.48, p <.001 and r = -.59, p <.001, respectively). Completion time for the 17-item pain measure (M = 13 min) was not predicted by cognitive status. Residents' scores on the GPM-M2 were significantly correlated with number of chronic pain-associated diagnoses, r =.37, p <.01, and internal consistency was excellent, alpha = 0.87 - 0.91. Residents' GPM-M2 scores were stable over time, r =.74-.80, p <.0001, for all comparisons. IMPLICATIONS: Using explicit protocols and reporting procedural data allows researchers and clinicians to better understand and apply results of self-report studies with cognitively impaired elders. Results suggest that many nursing home residents can provide consistent and reliable self-report pain data, given appropriate time and assistance.

Aged↗
PubMed2006

Measurement of agency, communion, and emotional vulnerability with the Personal Attributes Questionnaire.

Factor analytic studies of the 24-item Personal Attributes Questionnaire (Spence & Helmreich, 1978) have reported inconsistent results, and a previous confirmatory factor analysis (CFA) indicated inadequate fit for factors corresponding to Masculinity, Femininity, and Masculinity-Femininity scales. In this research, we used CFA in a college sample (N = 382) to evaluate the 3-factor model, and we revised scales by eliminating 6 misspecified items. The revised model fit well in another college sample (N = 230). We renamed the revised scales Agency, Communion, and Emotional Vulnerability. In relation to Five-factor theory, Emotional Vulnerability and Communion correlated well with Neuroticism and Agreeableness, respectively, and Agency had moderate correlations with Neuroticism, Extraversion, and Conscientiousness. Psychometric results in the context of current theory suggest that Agency (Masculinity) may not be a fully adequate measure of the agency construct.

Adolescent↗
PubMed2005

In search of pain.

Explore the source record for details and available documents.

Anxiety Disorders↗
PubMed2004

Catastrophizing and perceived partner responses to pain.

This study examined the relationship between catastrophizing and patient-perceived partner responses to pain behaviors. The Catastrophizing subscale of the Cognitive Coping Strategy Inventory and the West Haven-Yale Multidimensional Pain Inventory were completed by 62 adult chronic pain patients. Consistent with past research, catastrophizing and patient-perceived solicitous partner behaviors were positively correlated with negative pain outcomes. The communal coping theory of catastrophizing suggests that catastrophizing might be undertaken to solicit support and empathy from others. However, catastrophizing was not related to perceived solicitous partner behavior in this study. Rather, catastrophizing was associated with perceived punishing partner responses. Implications are that catastrophizing and perceived solicitous partner behaviors are independently associated with pain and that catastrophizing may not be reinforced by empathy from significant others.

Adaptation, Psychological↗
PubMed2004

An evaluation of sex differences in psychological and physiological responses to experimentally-induced pain: a path analytic description.

A cold pressor task (CPT) was used with 203 college students (112 women and 91 men) in a study of sex differences in pain response. Physiological measures were taken before and after pain induction, and sex-differentiating personality traits were assessed with the Personal Attributes Questionnaire (PAQ). The Pain Catastrophizing Scale (PCS) was given with standard instructions prior to the CPT, and it was re-administered after the CPT with modified instructions to assess catastrophic thinking during the CPT. Hypotheses were formulated into an explanatory model that was evaluated by path analysis. Pain induction elevated blood pressures and cortisol levels for both sexes, but systolic blood pressure reactivity and cortisol response were greater in men, even with sex differences in CPT tolerance times controlled statistically. Post-CPT PCS scores were positively related to pain ratings and negatively related to tolerance, but baseline PCS scores did not predict tolerance or pain ratings. Pre-PCS scores were not well correlated with post-PCS scores (r=0.46) and underestimated post-PCS scores, particularly for women. The Sex difference on the post-CPT PCS was largely attributable to the PAQ personality trait of Emotional Vulnerability. The differential results obtained from assessing catastrophizing before and after the CPT emphasized the importance of specifying the context in which catastrophizing is assessed (both timing and instructions). Theoretical considerations in the construct of catastrophizing are also highlighted, including, but not limited to, the confounding of variables such as pain intensity and unpleasantness.

Adolescent↗
PubMed2003

Prescription and dosage of analgesic medication in relation to resident behaviors in the nursing home.

OBJECTIVES: To examine correlates of analgesic medication prescription and administration in communicative, cognitively impaired nursing home residents. Residents' behaviors were assessed using computer-assisted real-time observations as potential adjunctive indicators of pain. DESIGN: Cross-sectional study over a 4-week period. SETTING: Five nursing homes in the greater Birmingham, Alabama, area. PARTICIPANTS: Ninety-two residents (mean age +/- standard deviation = 83.86 +/- 8.55) with a mean Mini-Mental State Examination (MMSE) score of 13.81 +/- 6.34. MEASUREMENTS: Data were obtained via chart review, resident assessments, questionnaire completion by certified nursing assistants familiar with residents' care, and direct observation of residents' daily behaviors. RESULTS: Receipt of analgesic medication was related to self-report of pain (F2,89 = 9.89, P =.0001), MMSE (F2,88 = 3.98, P =.022), and time spent inactive (F2,89 = 3.04, P =.053). Residents who received analgesic medication reported greater intensity of pain than other residents. Residents who received analgesics had higher MMSE scores than those who did not receive analgesics. Residents who received analgesics spent less time being inactive than those not prescribed analgesics. Receipt of higher dosage of opioid analgesic medication was associated with more time spent with others in verbal interaction (r =.22, P =.03). CONCLUSION: This study refines the methodology of measuring analgesic medication dosage and its effect on resident behavior. Analgesic prescription and administration patterns are related to time residents spend being inactive. Results suggest that opioid analgesics may hold particular promise in alleviating pain, as indicated by resident behaviors.

Aged↗
PubMed2002

The effect of headache pain on attention (encoding) and memory (recognition).

Memory is a key cognitive variable in pain management. This study examined the effect of headaches on participants' encoding of words (attention) and later memory for words. The dependent measures were response time during encoding and recognition memory; headache pain was the independent measure. Eighty participants were randomized to one of four groups: two groups had the same condition (headache pain or no headache pain) for both the encoding and memory tasks and two groups had mixed conditions (i.e. pain during encoding/no pain during recognition; no pain during encoding/pain during recognition). Participants with pain during encoding judged words significantly slower (177.53ms) than participants without pain during encoding. Participants with pain during the memory task recognized significantly fewer words (5.4%) than participants without pain during the memory task, regardless of pain condition during encoding. Results from this and other pain and memory studies conducted in this laboratory suggest that pain, as it adversely affects memory, may operate at a threshold level rather than on a dose-response continuum.

Acute Disease↗
PubMed2002

Pain assessment and management in cognitively impaired nursing home residents: association of certified nursing assistant pain report, Minimum Data Set pain report, and analgesic medication use.

OBJECTIVES: The primary purpose of this preliminary study was to investigate the associations between certified nursing assistant (CNA) report of pain, Minimum Data Set (MDS) report of pain, and analgesic medication use in cognitively impaired nursing home residents. DESIGN: Correlational study. SETTING: Three nursing homes in the greater Birmingham, Alabama area. PARTICIPANTS: Fifty-seven cognitively impaired nursing home residents with a mean Mini-Mental State Examination (MMSE) score of 11.1. MEASUREMENTS: Pain was assessed using a three-item proxy pain questionnaire (PPQ), developed by the researchers and administered to the residents' primary CNA. MDS and analgesic medication data corresponding with the time of PPQ data collection were gathered from medical records. Cognitive status was measured with the MMSE. RESULTS: The PPQ elicited substantially higher estimates of pain prevalence than the MDS (48% versus 20%), and the PPQ and the MDS were not well correlated (pain frequency: r=.19, P=.18; pain intensity: r=.22, P=.11). The PPQ was also more strongly associated with analgesic medication use than the MDS. Cognitive status was significantly associated with pain report on the PPQ but not on the MDS. Test-retest reliability coefficients for the three items of the PPQ were excellent, ranging from.84 to.87 (P </=.01). CONCLUSIONS: The CNA-generated PPQ was a more sensitive measure of pain than the MDS for this sample. Although the MDS represents an important step toward systematic and standardized assessment of pain, more emphasis should be placed on multimodal assessment, including CNAs' perceptions and observations about pain experienced by cognitively impaired nursing home residents.

Aged↗
PubMed2002

Psychosocial mediators of sex differences in pain responsivity.

The objective of this study was to examine gender role and primary pain appraisal as mediators of the relation between sex and pain responsivity in experimental pain. A sample of 145 introductory psychology students participated in a cold pressor task and completed inventories that assessed pain appraisal and gender role. Results showed that threat appraisals of pain and positive feminine gender role, in combination, mediate the relation between sex and experimental pain responsivity, suggesting that psychosocial variables play an important role in this relation. However, the influences of gender role and threat appraisal were relatively independent, suggesting that psychosocial mediators of the sex/pain relation are complex.

Journal Article↗
PubMed1996

Client-therapist intimacy: responses of psychotherapy clients to a consumer-oriented brochure.

Psychotherapy clients read two consumer-oriented brochures: a general brochure on psychology and a brochure on the topic of client-therapist intimacy. Half of the participants read the general brochure first and the brochure on client-therapist intimacy second, and half the participants did the reverse. Participants reported favorable reactions to the brochures, indicating they thought both should be made available to psychotherapy clients; that neither were too long, too sensitive, or too difficult to read; and that the brochures should be made available early during the therapeutic process. After reading the client-therapist intimacy brochure, participants also showed some changes in Likert-type scores measuring attitudes regarding intimate contact between clients and therapists. Although participants were more negative about issues of sexual misconduct after reading the client-therapist intimacy brochure, they did not indicate a decrease in trust of therapists, nor did they indicate a greater likelihood of filing a false complaint. We concluded that therapists' reservations about presenting clients with factual information regarding therapist sexual exploitation of clients are not empirically founded.

Alabama↗
PubMed1989

An empirical assessment of pain beliefs.

Pain beliefs represent patients' own conceptualizations of what pain is and what pain means for them. Such beliefs may be discordant with current scientific understanding and may serve to adversely affect compliance with modern methods of chronic pain treatment. This study attempts to assess several of the core dimensions around which pain beliefs develop and examines the relationship between pain beliefs and behavioral manifestations of the pain experience. An empirically and factorially derived product of this study, the Pain Beliefs and Perceptions Inventory (PBAPI) assess 3 dimensions of pain beliefs: (1) self-blame, (2) perception of pain as mysterious, and (3) beliefs about the duration of pain. These core pain beliefs were found to be predictive of subjective pain intensity, multidisciplinary chronic pain treatment compliance, poor self-esteem, somatization and psychological distress, and associated with attributions about health locus of control.

Adult↗
PubMedDate not supplied

Personality factors in the explanation of sex differences in pain catastrophizing and response to experimental pain.

OBJECTIVE: To examine the effects of personality and pain catastrophizing upon pain tolerance and pain ratings and to examine the impact of an experimental pain induction on subsequent ratings of catastrophizing. METHOD: Two hundred nineteen college students participated in a cold pressor task. Sex-differentiating personality constructs were measured by the Extended Personal Attributes Questionnaire. The Pain Catastrophizing Scale was given before and after the cold pressor task. RESULTS: A path-analytic model fit the data well and permitted tests of explanatory relationships. Mediational analyses demonstrated that sex differences in catastrophizing were explained by the Personal Attributes Questionnaire Masculinity-Femininity and Verbal Passive-Aggressiveness scales. Pain tolerance and pain ratings differed significantly between men and women, but Masculinity-Femininity partially mediated those sex-pain relationships. Additionally, higher pain ratings and lower pain tolerance were independently associated with increased catastrophizing after the cold pressor task. CONCLUSIONS: The results suggest that sex differences in catastrophizing and pain responsivity are partially accounted for by the dispositional tendency to describe oneself as emotionally vulnerable. The findings also suggest that pain catastrophizing may be situational as well as dispositional.

Adolescent↗