Journal of behavioral medicine
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Fifty-seven male chronic pain patients admitted to an inpatient multimodal pain treatment program at a Midwestern Veterans Administration hospital completed the MMPI, Profile of Mood States (POMS), Tennessee Self-Concept Scale (TSCS), Rathus Assertiveness Schedule (RAS), activity diaries, and an extensive pain questionnaire. All patients were assessed both before and after treatment, and most also were assessed 2-5 months prior to treatment. ⋯ MMPI subgroup membership, based on a hierarchical cluster analysis in a larger sample, was not predictive of differential treatment outcome. Possible reasons for comparable treatment gains among these subgroups, which previously have been shown to differ on many psychological and behavioral factors, are discussed.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparing physical and behavior therapy for chronic low back pain on physical abilities, psychological distress, and patients' perceptions.
A treatment-outcome study was conducted to study the impact of behavior and physical therapy on components of the chronic low back pain syndrome. Eighteen patients received behavior therapy and 15 patients received physical therapy. All patients had at least a 6-month history of seeking treatment for chronic low back pain. ⋯ Physical therapy was based upon traditional rehabilitation theory and was designed to improve low back function. Patients were reevaluated at posttreatment, 6 months, and 1 year. The results showed a general improvement for patients in both groups and a few treatment-specific differences in outcome measures.
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Previous research involving cluster analysis of Minnesota Multiphasic Personality Inventory (MMPI) profiles among persons with chronic low back pain has suggested the existence of four distinct profile clusters. The present study had two goals: (1) to replicate the previous finding independently and (2) to investigate the relationship of the profiles to the subjects' self-reported pain history and response to treatment. Subjects were 92 patients in a multimodal inpatient low back-pain treatment program. ⋯ The four clusters were successfully replicated for the total sample and for males and females separately. The profiles were significantly related to subjects' pain histories, but only one outcome difference was found. It was inferred that the MMPI is of value in understanding patients' pain coping behaviors but that further research is needed to explore the utility of the MMPI in understanding their response to treatment.
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The current study evaluated a behavioral program for the management of chronic pain. One hundred twenty-one patients were treated. ⋯ Several measures of verbal/nonverbal pain behavior and physical functioning were obtained over the baseline, treatment, and follow-up periods. Results showed significant reductions in analgesic medication use and verbal/nonverbal pain behavior and improvements in physical functioning, employment status, and pro-health behaviors which were maintained at 12-month follow-up.
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Spectral analysis was used to investigate the modification of the excessive crying (48% of waking time observed during baseline) of a terminal cancer patient. Initial assessment revealed a cyclic pattern of crying and dozing throughout the day and night. Intervention involved timeout from social stimulation contingent upon crying and differential social reinforcement for behaviors incompatible with crying. ⋯ During the initial phase of intervention crying ceased to be emitted in the presence of hospital staff but was evoked by the presence of family members. As this pattern of crying diminished, the frequency and duration of family visits, as well as the frequency of positive patient utterances and conversation, increased. Clinical, ethical, and methodological issues surrounding the use of timeout are discussed.