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Biomedical subjects

R A Sternbach

Publications and source records attributed to R A Sternbach.

At least 19 recordsLinked to original sources
PubMed1993

Behavioral management of chronic pain and excess disability: long-term follow-up of an outpatient program.

OBJECTIVE: To assess the overall efficiency of an outpatient behavioral rehabilitation program for excess disability and chronic pain and to describe the program staff, treatment components and outcomes in sufficient detail to facilitate comparison with similar programs. DESIGN: Eight-year follow-up study of patients referred and treated. SETTING: Outpatient primary care and multispecialty group medical practice. PATIENTS: 354 of 421 unselected patients referred for the behavioral management of excess disability, who completed the treatment program and participated in follow-up. INTERVENTIONS: 15-20 sessions of physical and occupational therapy, 5-10 sessions of biofeedback, and one or two family sessions all based upon behavioral techniques described by Fordyce and by Roberts. MAIN OUTCOME MEASURES: Questionnaires, including analog scales, administered before treatment and at 1, 6, 12, and 24 months posttreatment. RESULTS: Patients (n = 67) who dropped out did not differ systematically from those who participated (n = 354). The treatment program resulted in a marked and enduring reduction of pain, and a statistically and clinically significant improvement in patients' ability to function at work and in the home. Patients overwhelmingly endorsed the program. CONCLUSIONS: A brief, inexpensive, outpatient behavioral rehabilitation program for chronic pain and excess disability can achieve a clinically significant and lasting reduction of pain and improvement in function at work and at home.

Adolescent↗
PubMed1978

Treatment of the chronic pain patient.

A small percentage of patients with persistent pain are sufficiently angry, demanding, and manipulative to require the negotiation of an explicit treatment and/or management contract. The very few studies in this field suggest that pain is both a function of and a stimulus to abnormal illness behavior, thus requiring special attention to therapeutic "ground rules." Treatment requires an unequivocal assertion by the patient that he wishes to get better and is willing to work at doing so; the specification of clearcut goals and the means of working towards them ("pacing behavior"); and the possible use of electrical neurostimulation and/or weak analgesics for pain control. Explicit understanding of mutual expectations and the patient's and doctor's "rights" is also helpful in fostering goodwill and desirable results.

Adult↗
PubMed1976

Genetic correlates and sex differences in Holtzman Inkblot Technique responses of twins.

Holtzman Inkblot Technique (HIT) responses of 36 monozygotic (MZ), 18 dizygotic same-sex (DZ-S) and 29 dizygotic opposite-sex (DZ-O) college student twin pairs were analyzed. MZ group twins were significantly more alike across a variety of HIT response dimensions than DZ-S or DZ-O group twins. The following variables indicated a possible significant genetic contribution to response determination: Movement, Abstract Content, Hostility, Pathognomic Verbalization and Popular Responses. DZ-O groups data (representing a high degree of control for environmental influences) indicated significant sex differences on the following variables: M less than F -- Rejection, Form Appropriateness, Anatomical Content, and Balance; F less than M -- Human Content and Popular. The results are discussed in terms of (a) comparable genetic determination studies with Rorschach responses and (b) the necessity for separate male and female norms on several HIT scored response scales.

Adult↗
PubMed1975

Psychophysiology of pain.

The recent literature on pain states shows: pain thresholds are relatively constant for an individual, but pain tolerance is influenced by psychological state; the expression of pain is a function partly of ethnic membership and degree of extroversion; pain complaints are determined as well by cultural and extroversive factors, and also degree of neuroticism. Studies of pain patients reveals that those with acute pain tend to show normal personality profiles, but the degree of pain experienced is related to the degree of anxiety present. Most chronic pain patients, like those with psychogenic pain, show somatic preoccupations and reactive depression. The treatment and/or rehabilitation of pain patients has developed in three areas. In cases of peripheral neuropathy and some spinal cord lesions, electrical stimulation with "neural pacemakers" can often "close the gate" to pain signals and provide significant reduction or abolition of pain. Psychotropic medications, particularly the tricyclic antidepressants, sometimes in combination with phenothiazines and antihistamines, are effective in many instances of central pain, and help increase the pain tolerance and decrease the need for narcotics in other pain states. Operant conditioning, including the use of biofeedback, extinguishes pain behavior and increases pain-incompatible behaviors, with good long-term results.

Antidepressive Agents, Tricyclic↗
PubMed1975

Evaluation of pain relief.

Obtaining objective data on pain-relieving procedures is a simple matter. Measures of pain, activity levels and analgesic intake can be collected not only in a hospital but also in an outpatient setting. The data obtained make possible assessment of the effectiveness of a technique in any particular patient, and when combined for groups of patients, such data facilitate comparison of the effectiveness of different techniques in different pain states.

Activities of Daily Living↗
PubMed1974

Factors of human chronic pain: an analysis of personality and pain reaction variables.

Factor analysis of pain and personality test data obtained from 119 patients with chronic pain syndromes yields seven factors: four composed of personality measures, two involving different psychophysical pain measures, and one sex-related factor. The chief factors, comprising more than 50 percent of the total variance, are "interpersonal alienation and manipulativeness," "clinical pain intensity", and "pain endurance."

Age Factors↗