Psychology ETDs

Publication Date

Summer 7-1-2018

Abstract

Over the previous half-century, the framework for chronic pain management has expanded beyond the biomedical perspective to include psychosocial treatments that fall under the cognitive-behavioral tradition. Chronic pain patients, however, tend to endorse the biomedical model, perceiving pain as a problem that requires medical interventions. Enhancing motivation to engage in cognitive-behavioral treatment has therefore been a major theoretical focus in the research literature, much of which has been informed by Motivational Interviewing (MI) and the Transtheoretical Model. At present, however, there is a paucity of empirical evidence supporting motivational enhancement in this context. Furthermore, the research literature has largely overlooked the importance of ambivalence, a core aspect of MI, which would indicate at least some interest in engaging in cognitive-behavioral treatment for pain. Therefore, the primary objective of the present study was to develop and test a new instrument, the Pain Response Style Inventory (PRSI), which can assess attitudes about treatment and is capable of measuring ambivalence. The PRSI consisted of two parts, the PRSI-A and PRSI-B, and employed two different methods for evaluating ambivalence. Using Amazon Mechanical Turk, the vi PRSI-A, PRSI-B, and other measures of pain-related functioning were administered to 398 community-dwelling participants with chronic pain. The factor structure for both parts was tested with Exploratory Factor Analyses. The final version of the PRSI-A consisted of 7 items and showed the presence of one factor that demonstrated good internal consistency. The final 19-item PRSI-B consisted of three factors, which also showed good internal consistency. In order to evaluate aspects of predictive validity, separate sets of simultaneous regression analyses for the PRSI-A and PRSI-B were performed to evaluate the variance accounted for across measures of pain acceptance, pain-related anxiety, depression, and physical and psychosocial disability. Results indicated that both the PRSI-A and PRSI-B had significant direct effects on the measures of health-related functioning, after controlling for age, sex, average pain, and pain duration as well the Pain Stages of Change Questionnaire, a theoretically similar measure. The overall results indicated that two novel measures, which are capable of assessing ambivalent attitudes about chronic pain treatment, demonstrated good psychometric properties. These measures show promise for use in future studies that assess the relationship between attitudes and treatment response.

Degree Name

Psychology

Level of Degree

Doctoral

Department Name

Psychology

First Committee Member (Chair)

Kevin Vowles

Second Committee Member

Theresa Moyers

Third Committee Member

Patrick Coulombe

Fourth Committee Member

Brian Kersh

Keywords

chronic pain, cognitive behavioral therapy, motivational interviewing

Document Type

Dissertation

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