Pain research & management : the journal of the Canadian Pain Society = journal de la société canadienne pour le traitement de la douleur
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The Multidimensional Pain Inventory (MPI) is a reliable and valid self-report instrument that measures the impact of pain on an individual's life, quality of social support and general activity. Criticism of the MPI has focused on this instrument's internal structure and the stability of its classification taxonomy. ⋯ Based on principal components analysis, three summary scales were developed that reflected level of impairment, social support and activity. Summary scales possessed good psychometric qualities and, when cluster analyzed, replicated the MPI taxonomy. Exploratory analyses of the MPI taxonomy revealed that goodness-of-fit values generally became less reliable as respondent profiles approached the overall sample mean. When the relative distance between respondents fit to taxonomy profiles and the distance from the sample mean was considered, profile stability using summary scales was predicted with good precision. These results suggest that summary scales may enhance the usefulness of the MPI, and that the traditional method of determining profile fit within the MPI is not stable and needs to be reconsidered.
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The present article addresses two related developments in the psychology of pain, and integrates them into a coherent framework to better understand the relationship between pain and trauma. The first is an emerging conceptualization regarding the nature of the hierarchical organization of major pain-related anxiety constructs. The second is the theoretical rationale and empirical evidence linking pain and symptoms of post-traumatic stress disorder. ⋯ Twenty items from the ASI, the PASS-20 and the PCS loaded exclusively on one higher-order factor. The authors suggest the term 'sensitivity to pain traumatization' (SPT) for the underlying construct based in part on the strong, significant positive correlation between SPT scores and scores on the Post-traumatic Stress Disorder Checklist - Civilian Version. Finally, the total SPT score was significantly higher for patients with a history of pain than for those without a history of pain, both before surgery and one year after surgery. SPT describes the propensity to develop anxiety-related somatic, cognitive, emotional and behavioural responses to pain that resemble features of a traumatic stress reaction. Together, the results of the present study provide preliminary evidence for the construct validity of SPT.
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The fear-avoidance model of chronic pain posits that fear of pain is associated with fear and avoidance of activity, which can lead to deconditioning and persistence of pain and disability. Despite being well supported in adults, little is known about the role of fear-avoidance beliefs regarding physical activity in children. Research has shown that parental protectiveness contributes to activity limitations in children; however, no studies have examined relationships between protectiveness, and fear and avoidance. ⋯ Fear-avoidance beliefs may be an important target for interventions focused on decreasing activity limitations in youth with chronic pain. Future research should investigate these associations longitudinally.
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To explore how adolescents' pain coping profiles relate to their expectations regarding psychological treatment recommendations, and to examine patients' functioning and engagement in psychological treatment three months following a multidisciplinary pain clinic evaluation. ⋯ The results of the present study identify preliminary clinical implications for the way in which practitioners in multidisciplinary pain clinics present recommendations for psychological treatment to patients and their families.