Journal of behavioral medicine
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Six hundred thirty-five chronic pain patients completed the Minnesota Multiphasic Personality Inventory (MMPI) prior to participation in a multidisciplinary inpatient pain treatment program. Three male and four female MMPI subgroups were identified by means of cluster analyses for each of two samples. ⋯ However, at long-term follow-up only a few outcome differences were identified among male subgroups, while no differences were found among female subgroups. Possible explanations for no differential treatment outcomes among the MMPI subgroups are discussed.
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Four hundred fifty-three chronic pain patients completed a Symptom Checklist 90 (SCL-90) and a comprehensive pain evaluation questionnaire. All patients were evaluated by a physician and rated on degree of pain pathology and pain behavior. The SCL-90 data were analyzed using two clustering procedures and replicated over two similar samples. ⋯ Patients in the high-profile subgroup showed the most emotional distress, reported that their pain interfered the most with all activities, and were most often judged to have high pain behavior. Little evidence was found to support a "denial" profile, as previously predicted. Further support was found for using the SCL-90 in assessing chronic pain patients.
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Chronic back pain patients were compared to two nonpain comparison groups on Minnesota Multiphasic Personality Inventory (MMPI) Hysteria (Hy) scores and scores on two Hy subscales: Bodily Concern and Psychological Denial. Pain subjects had significantly higher scores on the Bodily Concern Subscale and lower scores on the Psychological Denial Subscale than nonpain subjects with similar elevated Hy scores. ⋯ Finally, within pain patients, scores on the Bodily Concern subscale were significantly related to more indices of pain duration and severity than were scores on the Psychological Denial subscale. The potential clinical utility of scoring these subscales is discussed.
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The psychophysiological correlates of induced headaches were examined. Subjects with frequent muscle-contraction headaches, frequent migraine headaches, or infrequent headaches were exposed to a 1-h cognitive stressor while multiple electromyographic and cardiovascular measures were monitored. The stressor was associated with significant changes in all psychophysiological measures. ⋯ Significant associations between several psychophysiological variables and headache occurrence were found and individual differences in the association between psychophysiological variables and headaches intensity were examined. The results were consistent with the hypothesized role of cardiovascular factors in the pathophysiology of muscle-contraction headache. This was the first controlled demonstration of headaches occurring as a function of environmental stressors.
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Subjective stress sensitivity and physiological parameters were compared between 24 migraine subjects and 24 matched headache-free controls during a multifrequency 85-dB (A) aversive auditory stressor and during a recovery period. Measures consisted of frontalis EMG, temporal artery blood volume pulse, heart rate, a stress sensitivity questionnaire, stress reaction during the stress-expectation period, and ratings of noise aversiveness. Migraine subjects showed a higher level of general stress sensitivity, increased situational stress sensitivity, and higher ratings of noise aversiveness; this supports the general notion that migraine sufferers are psychologically more sensitive toward stress stimulation than nonheadache controls. Physiologically, the migraine subjects differed from the control group only with regard to the temporal blood volume pulse during stress stimulation; this finding is consistent with Wolff's weak-link theory.