Behaviour research and therapy
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The current study examined validity and reliability of the Pain Vigilance and Awareness Questionnaire (PVAQ) in two samples of healthy college students. Exploratory and confirmatory factor analysis showed that a two-factor model of the PVAQ was most suitable in the present study. The first factor could be referred to as attention to pain whereas the second factor could be specified as attention to changes in pain. ⋯ Altogether, these findings suggest that the PVAQ is a valid and reliable measure of pain vigilance in healthy individuals. The results of this study can be regarded as a starting point for further validation of the PVAQ in clinical pain populations. Implications for future research and treatment interventions are discussed.
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This study sought to investigate cognitive-behavioural predictors of children's tolerance for laboratory-induced cold-pressor pain. It was hypothesised that pain tolerance, as measured by immersion time, would be greater in children who were high in self-efficacy for pain, high in self-reported use of cognitive-coping strategies, and low in emotion-focused coping strategies such as catastrophising. Age and sex differences were also examined in post hoc analyses. ⋯ Self-efficacy for pain, in general, was found to be positively correlated with age. The results support efforts to identify children who, because they have lower confidence or lower skills in coping with distress, may need extra support and preparation for painful procedures. Further research is needed to investigate these findings within a clinical pain context.
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Comparative Study
Multimethod assessment of treatment process in chronic low back pain: comparison of reported pain-related anxiety with directly measured physical capacity.
Although cognitive behavioural treatments (CBT) have proven efficacy in improving symptom management, pain-related distress, physical performance and return to work. few studies have examined the relationship between changes in behavioural process variables during treatment and improvement in outcome variables following treatment. We designed a multimethod assessment strategy to test the relative contribution of changes in physical capacity and pain-related anxiety to treatment outcome variables. Low back pain patients (n = 59) were treated with an intensive programme of physical exercise and CBT. ⋯ Further analyses demonstrated that the relationship between changes in pain-related anxiety and treatment outcome were independent of changes in physical capacity performance. Changes during treatment in pain-related anxiety may be more important than changes during treatment in physical capacity when predicting the effect of treatment on behavioural outcome measures. These results are discussed in the context of how to improve assessment of the chronic pain patient and improve the effectiveness of multidisciplinary CBT.
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Using data from a nationwide project on young people in Australia aimed at assessing suicidality in general health settings, we present a brief screening tool for suicidality (the depressive symptom index suicidality subscale). Two thousand eight hundred and fifty-one (15-24 year old) patients presenting to 247 Australian general practitioners between 1996 and 1998 were assessed. In addition to the suicide screen, patients completed the general health questionnaire-12 and the Center for Epidemiological Studies depression scale. ⋯ Using inter-item correlational and factor-analytic techniques, as well as a general approach to construct validity, we show that the measure has favorable reliability and validity characteristics. We also provide results on cut-points that may facilitate its use in clinical and research settings. Because the screen is brief, easy to use, reliable, and valid, we encourage its use to combat the vexing international health problem of suicide.
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Randomized Controlled Trial Comparative Study Clinical Trial
Expected and reported pain in children undergoing ear piercing: a randomized trial of preparation by parents.
This study examined experimentally the effectiveness of preparatory information provided by parents in creating accurate expectations and reducing children's procedural pain. Ear piercing was used as an analogue to minor painful medical procedures. Sixty children, aged 5-12 years, requesting ear piercing and accompanied by their parents, were randomly assigned to a parental information or contact-control condition. ⋯ Prepared children had more accurate expectations and reported significantly less pain (M=27.3) than non-prepared children (M=49.8). The validity of the measures was supported by strong correlations (r=0.87 to 0.96) between the VAS and FPS-R. The findings suggest that parental provision of preparatory information creates accurate expectations and reduces pain for children.