Journal of clinical psychology in medical settings
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J Clin Psychol Med Settings · Mar 2012
Board certification in psychology: insights from medicine and hospital psychology.
For physicians board certification is an accepted tradition that research suggests improves services and outcomes. In contrast, relatively few psychologists pursue board certification suggesting ambivalence or limited contingencies reinforcing it. The authors report on medical school and hospital-based psychologists' attitudes toward board certification and current certification status. ⋯ Half recognized benefits to the profession for psychologists pursuing board certification, yet 70% opposed requiring it for their hospital-based practice. Forces seeking to promote healthcare quality ultimately may increase expectations for board certification. If consumers, employers, hospitals and managed care organizations demand board certification for health professionals, greater numbers of psychologists would likely seek it.
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There is much evidence to suggest that psychological and social issues are predictive of pain severity, emotional distress, work disability, and response to medical treatments among persons with chronic pain. Psychologists can play an important role in the identification of psychological and social dysfunction and in matching personal characteristics to effective interventions as part of a multidisciplinary approach to pain management, leading to a greater likelihood of treatment success. ⋯ In this paper, we briefly describe measures to assess constructs related to pain and intervention strategies for the behavioral treatment of chronic pain and discuss related psychiatric and substance abuse issues. Finally, we offer a future look at the role of integrating pain management in clinical practice in the psychological assessment and treatment for persons with chronic pain.
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J Clin Psychol Med Settings · Dec 2011
The relationship between the fear-avoidance model of pain and personality traits in fibromyalgia patients.
This study examined the relationship between several cognitive-affective factors of the fear-avoidance model of pain, the big five model of personality, and functional impairment in fibromyalgia (FM). Seventy-four FM patients completed the NEO Five-Factor Inventory, the Pain Catastrophizing Scale, the Pain Anxiety Symptoms Scale-20, the Pain Vigilance and Awareness Questionnaire, and the Impairment and Functioning Inventory. Results indicated that the cognitive-affective factors of pain are differentially associated with personality traits. ⋯ The effect of neuroticism upon pain anxiety was mediated by pain catastrophizing, and neuroticism showed a trend to moderate the relationship between impairment and pain anxiety. Results support the fear-avoidance model of pain. Implications of the findings for the understanding and management of FM are discussed.
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J Clin Psychol Med Settings · Sep 2011
ReviewAnesthesia awareness: narrative review of psychological sequelae, treatment, and incidence.
Awareness during general anesthesia occurs when patients recall events or sensations during their surgeries, although the patients should have been unconscious at the time. Anesthesiologists are cognizant of this phenomenon, but few discussions occur outside the discipline. This narrative review summarizes the patient recollections, psychological sequelae, treatment and follow-up of psychological consequences, as well as incidence and etiology of awareness during general anesthesia. ⋯ Limited discussion for therapeutic treatment after an anesthesia awareness experience exists. The incidence of anesthesia awareness ranges from 0.1 to 0.2% (e.g., 1-2/1000 patients). Increased recognition of awareness during general anesthesia within the psychological/counseling community, with additional research focusing on optimal therapeutic treatment, will improve the care of these patients.
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J Clin Psychol Med Settings · Sep 2011
Pain intensity, psychological inflexibility, and acceptance of pain as predictors of functioning in adolescents with juvenile idiopathic arthritis: a preliminary investigation.
Juvenile Idiopathic Arthritis (JIA) is a chronic rheumatic disease associated with pain and maladjustment. This study investigated whether pain, acceptance of pain, and psychological inflexibility uniquely predicted functional disability, anxiety, general quality of life (QOL), and health-related quality of life (HQOL) among adolescents with JIA. Twenty-three adolescents with JIA and pain were recruited from a pediatric rheumatology clinic. ⋯ Greater psychological inflexibility uniquely predicted higher anxiety, lower general QOL, and lower HQOL. Increases in acceptance of pain were found to be uniquely related to increases in general QOL. These data confirm prior findings that pain impacts functioning, and provide preliminary findings that psychological inflexibility and acceptance may be important targets of psychological intervention for youth with JIA and pain to improve functioning and QOL.