The Clinical journal of pain
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The purposes of the present study of chronic pain patients were to (a) assess whether cognitive and behavioral coping style is related to personality factors, (b) assess how coping styles differ across personality types, and (c) assess how outpatient interdisciplinary intervention affects the coping styles of various personality types. Four MMPI clusters (Depression/Pathological, V-type, Marginal Depression, and Marginal V-type) were derived using a hierarchical clustering procedure. Seventy subjects also completed the Coping Strategies Questionnaire before and after a 3-week outpatient pain management program. ⋯ These results suggest that different personality types use different pain coping strategies prior to multidisciplinary treatment. Groups showing more severe psychological distress, perhaps related to an underlying personality disorder, displayed greater changes in coping strategies with treatment, but remained more dysfunctional after treatment. These findings suggest that the alteration of coping strategies may be an important treatment effect needing more individualization to maximize treatment response.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comment Letter Randomized Controlled Trial Clinical Trial
The needle and the brain: psychophysiological factors involved in nerve blocking for chronic pain. In response to article by Drs. Brena, Chapman, and Sanders.
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Pain management is a serious problem for individuals with spinal cord injury (SCI). Recent developments in pain assessment indicate that multiaxial approaches, assessing medical, psychosocial, and behavioral/functional dimensions, are necessary to measure adequately the impact of chronic pain. The application of this multiaxial system to persons with SCI and chronic pain is presented. ⋯ The assessment task is further confounded by the functional limitations and psychosocial impairments that may accompany SCI. Recommendations are made for adapting established pain measures for use with SCI individuals. The choice of assessment tools for these patients is guided by the multidimensional nature of the pain experience, functional limitations, and the goals of treatment.
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One hundred fifty randomly selected hospitalized children between the ages of 4-14 were interviewed to assess their pain experience in the hospital. Follow-up information was obtained through parent interviews 3 weeks, 3 months, and 6 months later. On enrollment, more than 87% of children reported having had pain within 24 h and, of those, 19% reported their usual pain intensity as in the severe range. ⋯ In spite of these reports of significant pain by a substantial number of children during hospitalization, at the 3-week follow-up check, by parent report, 68% were pain free. The parents of those with pain were contacted at 3 and 6 months postenrollment, and 96% of children were no longer experiencing pain. Five children reported pain at all contact points; three of these were suffering chronic diseases and the other two had suffered major trauma from motor-vehicle accidents.