Journal of health psychology
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Daily diary methodology was used to examine within- and between-person associations among pain appraisals, coping strategies, personal characteristics, perceived spousal responses and daily (30 days) changes in negative mood and pain for 88 women with chronic back pain. Multilevel models revealed that control appraisals and distraction and ignoring pain coping strategies were associated with same-day reductions in negative mood and pain; whereas catastrophizing appraisals and praying and hoping coping strategies were associated with an increase in negative mood or pain. With appraisals and coping controlled for, average within-day decreases in depression were associated with perceived control in one's life; increases in anxiety were associated with spousal distracting responses; and increases in pain intensity were associated with spousal punishing responses and pain interference.
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A description of factors influencing perceptions of nonpharmacological treatment was derived inductively from interviews with people receiving chiropractic treatment for back pain, using grounded theory analysis. A theoretical model linking these factors was constructed, and was tested using interview data from a longitudinal study of people undertaking exercise therapy for dizziness. The model highlights the potential for reciprocal interactions between abstract beliefs relevant to illness and treatment and concrete experiences of therapy, and for interactions between perceptions of symptom change and of therapist competence. Therapist communication may modify abstract illness/treatment models and symptom perceptions, thus mediating effects of concordance on adherence and placebo effects.
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The role of stress and mood in the onset and course of sickle cell disease (SCD) pain was examined using a daily diary design. Fifteen adults with SCD completed daily diaries about their pain, stress, mood, and health care and medication use for an average of 94 days. Multilevel random effects models indicated that stress was significantly and positively related to same-day pain ratings. ⋯ Mood also showed significant associations with same-day pain in the expected directions. In addition, stress and mood were associated with health care and medication use during painful episodes. Finally, painful episodes were preceded by increases in stress 2 days previously, suggesting that stress may play a role in the onset of SCD pain.