Alexithymia among empirically derived subgroups of chronic back pain patients

A seeded cluster analysis procedure was applied to the Minnesota Multiphasic Personality Inventory (MMPI) profiles of 102 male and 63 female back-pain patients. For both men and women, the resulting subgroups were found to correspond closely to similar subgroups obtained in several previous investigations. New data on the psychometric properties of the MMPI Alexithymia scale (Kleiger & Kinsman, 1980) are presented. Significant differences in alexithymia among empirically derived MMPI subgroups were found in the male sample only.     

Differences on the projective hand test among chronic pain patients reporting three different pain experiences

This study examined personality differences among individuals experiencing 3 different types of pain. The projective Hand Test was administered to 90 individuals who were seeking treatment at a pain clinic in an urban area of the southeast United States. These people were seeking treatment for either arthritis (n = 31), fibromyalgia (n = 29), or migraine headaches (n = 30). A 2 (gender) x 3 (pain group) x Age Group multivariate analysis of variance was conducted using the quantitative Hand Test scoring variables as dependent measures. Results indicated that individuals who were seeking treatment for migraine headaches had a higher production rate of responses involving exhibitionistic displays (EXH) than individuals in the other 2 groups. Individuals who were seeking treatment for fibromyalgia had a higher production rate of responses indicating fear and phobic concerns (FEAR) than individuals in the other 2 groups. Individuals who were seeking treatment for arthritis had a higher production rate of Active (ACT) responses than individuals in the other 2 groups. Possible causes and consequences of these effects are discussed.     

Spousal understanding and marital satisfaction in pain patients and their spouses

The current study tested the hypotheses that knee osteoarthritis (OA) patients and spouses who report more spousal understanding of patient's pain would report greater marital satisfaction. A total of 124 couples completed interviews at three time points across 18 months. Results from dyadic analyses showed that patients who felt more understood by their spouse report, and have spouses who report, higher marital satisfaction concurrently. In addition, patients who felt more understood by their spouse reported higher marital satisfaction over time. Spouses' reports of understanding also had a significant influence on the patients' and their own marital satisfaction concurrently. Results highlight the importance of spouses understanding knee OA patients' pain for both dyad members' marital satisfaction.     

Effects of anger suppression on pain severity and pain behaviors among chronic pain patients: evaluation of an ironic process model

OBJECTIVE: Evidence for links between anger inhibition or suppression and chronic pain severity is based mostly on studies with correlation designs. Following from ironic process theory, we proposed that attempts to suppress angry thoughts during provocation would increase subsequent pain intensity among chronic low back pain (CLBP) patients, and do so through paradoxically enhanced accessibility of anger. DESIGN: CLBP patients (N = 58) were assigned to suppression and nonsuppression conditions while performing a computer maze task with a harassing confederate. A structured pain behavior task (SPBT) followed. MAIN OUTCOME MEASURES: Self-reported anger, anxiety, and sadness following maze task. Self-reported pain severity and number of observed pain behaviors during SPBT. RESULTS: Patients told to suppress during provocation: (a) reported greater anger following the maze task, reported greater pain intensity during the SPBT, and exhibited more pain behaviors than patients not suppressing; (b) postmaze anger levels significantly mediated group differences on pain behaviors. CONCLUSION: Attempts by CLBP patients to suppress anger may aggravate pain related to their clinical condition through ironically increased feelings of anger.     

The impact of experiential avoidance on the relations between illness representations,pain catastrophising and pain interference in chronic pain

Objective: The aim of this study was to examine the effects of experiential avoidance (EA) on the indirect relationship of chronic pain patients’ illness representations to pain interference, through pain catastrophising

Design and main outcome measure: The sample consisted of 162 patients diagnosed with an arthritis-related or a musculoskeletal disorder. The effects of EA on the pathway between illness representations, pain catastrophising and pain interference were examined with PROCESS, a computational tool for SPSS

Results: After controlling for patient and illness-related variables and pain severity, the ‘illness representations–pain catastrophising–pain interference’ pathway was interrupted at the higher levels of EA. The reason was that, at the high levels of EA, either the relation of illness representations to pain catastrophising or the relation of pain catastrophising to pain interference was not statistically significant.

Conclusion: The findings indicate that EA is not a generalised negative response to highly aversive conditions, at least as far as the factors examined in this study are concerned. EA may rather reflect a coping reaction, the impact of which depends on its specific interactions with the other aspects of the self-regulation mechanism. At least in chronic pain, EA should become the focus of potential intervention only when its interaction with the illness-related self-regulation mechanism results in negative outcomes.     

Distress in spouses of chronic pain patients

This paper critiques the research on distress in spouses of chronic pain patients and includes a review of two studies of spouses conducted at the Miriam Hospital Chronic Pain Research Unit. The clinical implications of this research are discussed and case material is presented to illustrate the role of spouse distress in the treatment of patients with chronic pain. Future directions for research in this area are recommended.The research conducted at the Miriam Hospital Chronic Pain Research Unit was supported by the Alcohol, Drug and Mental Health Administration of the National Institute of Mental Health, Small Grants Program, Grant No. 1 R03 MH39257001A1.     

Choices among marital observation coding systems

It is argued that researchers and therapists could benefit from a detailed comparison of marital observation coding systems. The five chosen for comparison are Weiss' Marital Interaction Coding System, Gottman's Couples Interaction Scoring System, Filsinger's Dyadic Interaction Scoring Code, Olson and Ryder's Marital and Family Interaction Coding System, and Raush's Coding Scheme for Interpersonal Conflict. The strengths and weaknesses of each are noted, along with recommendations for their use in clinical situations.     

Daily marital interactions and positive affect during marital conflict among newlywed couples

The mundane and often fleeting moments that a couple experiences in their everyday lives may contribute to the health or deterioration of a relationship by serving as a foundation to major couple events such as conflict discussions and caring days. This study examines the role of playfulness and enthusiasm in everyday life to the use of humor and affection during conflict. Using observational methods, we studied 49 newlywed couples in a 10-minute dinnertime interaction and in a 15-minute conflict discussion. The conflict discussion was coded using the Specific Affect Coding System (SPAFF; Gottman, Coan, & McCoy, 1996), and a new observational system was developed to capture dinnertime interactions in a seminatural setting. We analyzed the data using path analysis and found a stronger path model when the direction of correlation moved from daily moments to the conflict discussion. These findings provide preliminary support for the importance of daily moments in couple relationships, but this research was strictly observational and therefore correlational, so further research is necessary to determine direction of causation.     

Spousal conflict resolution strategies and marital relations in late adulthood

In this study, we examined differences in the spousal conflict resolution strategies of husbands and wives in late adulthood among a sample of 76 married Israeli couples (N = 152). Using dyadic analysis (the actor–partner interdependence model), we examined the impacts of the strategies adopted by each spouse as well as their partner on evaluations of marital life as reflected in their assessments of positive and negative dimensions of marital life. The findings revealed that integration was the most prevalent strategy used by both spouses, whereas dominance and avoidance were the least prevalent strategies. Moreover, integration contributed most significantly to explaining assessments of marital life.     

Aggression in toddlers: associations with parenting and marital relations.

This study examined the relation among parenting factors, marital relations, and toddler aggression. A structured questionnaire was administered to both parents of 254 2-year-olds. The authors used correlation and hierarchical multiple regression analyses to assess the extent to which certain personality traits, drug use, parenting style, and marital conflicts were related to the toddlers' aggressive behavior. Results showed that the maternal child-rearing and parental aggression domains had a direct effect on toddler aggression. The domain of maternal child rearing also served as a mediator for the domains of marital relations, paternal child rearing, parental aggression, and parental drug use. The findings indicated that maternal child-rearing practices, personality attributes, and drug use were more important than paternal attributes in relation to toddler aggression. Implications for prevention among families at risk are discussed.     

Anxiety,as experienced by chronic pain patients

This article developed out of the author's work with patients at the Pain Control Center at Emory University Hospital in Atlanta, Georgia. The purpose of the article is to show how anxiety, an experience common to all persons, is particularly experienced by chronic pain patients.Linda P. Jones, United Methodist minister with the North Georgia Conference, served from June 1983 to June 1984 as chaplain at Emory University Hospital in Atlanta, Georgia.     

Medical help-seeking by different types of chronic pain patients

Abstract

This paper reports on a study of the use of health services by different types of patients with chronic benign pain. The purpose of the study was to identify differences in medical consumption between different types of pain patients. In the course of one year 586 patients were selected by 45 general practitioners: they included patients who had had almost daily chronic pain symptoms for at least six months, without a medical diagnosis (such as cancer or arthritis) to explain the pain. Patients were categorized according to the Multidimensional Pain Inventory which distinguishes four categories: the dysfunctional, who perceive severe pain and gain social support; the interpersonally distressed, who combine pain with affective and relational distress; adaptive copers, who cope with their pain in a number of ways; the average type, with characteristics of all three other types. It was hypothesised that adaptive copers would make less use of health services and would be more involved in self-help activities than dysfunctional or interpersonally distressed patients. Frequent use of psychological services by the interpersonally distressed group was expected. It was predicted that difference in health services use would continue during the subsequent year.

No differences were found between the four groups in location, temporal characteristics, or possible medical causes of the pain symptoms. Dysfunctional patients used more services than the others. Adaptive copers used the least. The four groups did not differ in self-care activities. Group-membership as well as pain severity are related to the use of health services. None of the groups showed a significant decline in the use of health services during the year. It is concluded that chronic pain is invalidating, but that not all patients are equally excessive in their use of medical services.     

Sex role identity,marital power,and marital satisfaction among middle-class couples in India

The study attempted to ascertain the circumstances or conditions under which power structure in families may vary from husband domination to egalitarianism and to wife domination. Power was inferred on the basis of decision-making outcome. Among the antecedents were included two variables of wives' employment and androgyny. Consequences of power were explored with reference to marital satisfaction. Data were collected through in-home interviews conducted with husbands and wives in 101 families. The results indicated wives' employment and androgyny to be significantly and positively related to their decision-making authority in the family. Also, as compared to those in autonomic or wife-dominated families, respondents in syncratic and husband-dominated families reported higher levels of marital satisfaction. Results are explained in the light of theoretical formulations relating to resources and norms. The need for taking an unconventional approach to the conceptualization of resources is stressed.     

Alexithymia and Early Maladaptive Schemas in chronic pain patients

Psychological factors have an impact on subjective pain experience. The aim of this study was to explore the occurrence of alexithymia and Early Maladaptive Schemas in a sample of 271 first visit chronic pain patients of six pain clinics. The patients completed the study questionnaire consisting of the Toronto Alexithymia Scale‐20, the Finnish version of the Young Schema Questionnaire short form‐extended, the Beck Depression Inventory‐II, and pain variables. Alexithymic patients scored higher on Early Maladaptive Schemas and had more pain intensity, pain disability and depression than nonalexithymic patients. Both alexithymia and depression correlated significantly with most Early Maladaptive Schemas. The co‐occurrence of alexithymia, Early Maladaptive Schemas and depression seems to worsen the pain experience. Screening of alexithymia, depression and Early Maladaptive Schemas may help to plan psychological treatment interventions for chronic pain patients.     

Topics of marital disagreement among African-American and Euro-American newlyweds

To see what issues couples most and least often reported as topics of marital disagreement, survey data were analyzed for 113 African-American and 131 Euro-American couples reporting in the first and third years of marriage. Friedman tests showed that in both the first and third years of marriage, money was most often reported as a topic of marital disagreement; tensions about leisure, each spouse's family of origin. and children were reported significantly less often; and tensions about religion were reported least often. Findings were very similar for African Americans and Euro-Americans, and for husbands and wives. Overall, findings show considerable stability in the relative frequency with which specific topics reportedly evoke tension early in marriage.     

MMPI-2 subgroups in a sample of chronic pain patients

MMPI-2 scores of 307 female and 161 male chronic pain patients were analyzed by gender using a multivariate clustering method. Two subgroups were found for both sexes replicating previous results. The major subgroup corresponded to the classical "Conversion V" and the minor corresponded to the "Generally elevated" profile. The results also indicated a satisfactory internal consistency and a high discriminant validity of the Swedish version of the MMPI-2.