Abstract
The spontaneous cognitive strategies employed by 75 patients undergoing dental extractions or mandibular block injections were elicited using a structured interview. Interest focused on the relationship between these strategies and several personality variables, including state and trait anxiety, locus of control, and absorption. In addition, the effect of strategy utilization on perceived pain and stress was assessed. Fourty-four percent of the patients employed cognitive strategies designed to minimize pain and stress, while 37% catastrophized, engaging in cognitive activity which exaggerated the fearful aspects of their experience. Only 19% of the patients denied any cognitive activity during the clinical procedure, and many of these used noncognitive coping strategies. Discriminant analysis revealed that situational anxiety was associated with the use of cognitive coping strategies. Catastrophizing was associated with increasing age, past dental stress, and higher levels of stress vulnerability (high trait anxiety and external locus of control). Copers reported less stress than catastrophizers but not less pain.
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References
Andrew, J. (1970). Recovery from surgery, with and without preparatory instructions, for three coping styles.J. Personal. Soc. Psychol. 15: 223–226.
Bandura, A. (1977) Self-efficacy: Toward a united theory of behavioral change.Psychol. Rev. 84: 191–215.
Barber, T. X., Spanos, N. P., and Chaves, J. F. (1974).Hypnotism, Imagination, and Human Potentialities, Pergamon, New York.
Beers, T. M., Jr., and Karoly, P. (1979). Cognitive strategies, expectancy and coping style in the control of pain.J. Consult. Clin. Psychol. 47: 179–180.
Borgen, F. N., and Seling, M. J. (1978). Uses of discriminant analysis following MANOVA: Multivariate statistics for multivariate purposes.J. Appl. Psychol. 63: 689–697.
Boucher, C. (ed.) (1963).Current Clinical Dental Terminology, C. V. Mosby, St. Louis.
Brown, J. M. (1984). Imagery coping strategies in the treatment of migraine.Pain 18: 157–167.
Burstein, S., and Meichenbaum, D. (1974). The work of worrying in children undergoing surgery, Unpublished manuscript, Department of Psychology, University of Waterloo.
Chaves, J. F., and Barber, T. X. (1974). Cognitive strategies, experimenter modeling and expectation in the attenuation of pain.J. Abnorm. Psychol. 83: 356–363.
Chaves, J. F., and Doney, T. (1976). Cognitive attenuation of pain: The roles of strategy relevance, absorption and expectation, Paper presented at the Meeting of the American Association for Behavioral Therapy, New York.
Chaves, J. F., and Scott, D. (1979). Effects of cognitive strategies and suggested criterion alteration of pain threshold, Paper presented at the Annual Meeting of the Eastern Psychological Association, Philadelphia.
Corah, N. L. (1969). Development of a dental anxiety scale.J. Dent. Res. 48: 596.
Egbert, L., Battit, G., Welch, C., and Bartlett, M. (1964). Reduction of post-operative pain by encouragement and instruction.N. Engl. J. Med. 270: 825–827.
Fox, J. E., Houston, B. K., and Pittner, M. S. (1983). Trait anxiety and childrens' cognitive behaviors in an evaluative situation.Cog. Ther. Res. 7: 149–154.
Grimm, L., and Kanfer, F. W. (1976). Tolerance of aversive stimulation.Behav. Ther. 7: 593–601.
Haug, M. R. (1973). Social class measurement and women's occupational roles.Soc. Forces 52: 86–98.
Hollingshead, A. B. (1957).Two-Factor Index of Social Position, Yale Station, New Haven, Conn.
Houston, B. K. (1977). Dispositional anxiety and the effectiveness of cognitive coping strategies in stressful laboratory and classroom situations. In Spielberger, C. (ed.),Stress and Anxiety, Vol. 4, Hemisphere, New York, pp. 205–228.
Janis, I. (1965). Psychodynomic aspects of stress tolerance. In Klausner, S. (ed.).The Quest for Self-Control, Free Press, New York, pp. 215–249.
Johnson, J., Leventhal, H., and Dabbs, J., Jr. (1971). Contribution of emotional and instrumental response processes in adaption of surgery.J. Personal. Soc. Psychol. 20: 55–64.
Kanfer, F. W., and Goldfoot, D. (1966). Self-control and the tolerance of anxious stimulation.Psychol. Rep. 18: 79–85.
Meichenbaum, D., and Turk, D. (1976). The cognitive behavioral management of anxiety, anger, and pain. In Davidson, P. O. (ed.),The Behavioral Management of Anxiety, Depression and Pain, Bruner/Mazel, New York, pp. 1–34.
Rotter, J. B. (1966). Generalized expectancies for internal versus external control of reinforcement.Psychol. Monogr. Gen. Appl. 80: Whole No. 609.
Rybstein-Blinchek, E. (1979). Effects of different cognitive strategies on chronic pain experience.J. Behav. Med. 2: 93–101.
Sanathanan, L. (1975). Discriminant analysis. In Amick, D., and Walberg, H. (eds.),Introductory Multivariate Analysis for Education, Psychological and Social Research, McCutchan, Calif, pp. 236–256.
Siegel, S. (1956).Nonparametric Statistics for the Behavioral Sciences, McGraw-Hill, New York.
Spanos, N. P., Brown, J. M., Jones, B., and Horner, D. (1981). Cognitive activity and suggestion for analgesia in reduction of reported pain.J. Abnorm. Psychol. 90: 554–561.
Spielberger, C. D., Gorsuch, R. L., and Lushene, R. N. (1970).Manual for the State-Trait Anxiety Inventory, Consulting Psychologists Press, Palo Alto, Calif.
Tan, S. Y. (1982). Cognitive and cogntive-behavioral methods for pain control: A selective review.Pain 12: 201–228.
Tellegen, A., and Atkinson, G. (1974). Openness to absorbing and self-altering experiences (“absorption”), a trait related to hypnotic susceptibility.J. Abnorm. Psychol. 83: 268–277.
Turk, D. C., Meichenbaum, D., and Genest, M. (1983).Pain and Behavioral Medicine: A Cognitive-Behavioral Perspective, Guilford Press, New York.
Turner, J. A., and Chapman, C. R. (1982). Psychological interventions for chronic pain: A critical review. II. Operant conditioning, hypnosis, and cognitive behavior therapy.Pain 12: 23–46.
Worthington, E. L. (1978). The effects of imagery content, choice of imagery content and self-verbalization on the self-control of pain.Cog. Ther. Res. 2: 225–240.
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This study was conducted at the Southern Illinois University School of Dental Medicine. We wish to acknowledge the assistance of M. B. Kenkel and S. Kontas, the dental students, and the dental faculty participating in this study, especially Bruno Kwapis and James Schmidt.
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Chaves, J.F., Brown, J.M. Spontaneous cognitive strategies for the control of clinical pain and stress. J Behav Med 10, 263–276 (1987). https://doi.org/10.1007/BF00846540
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DOI: https://doi.org/10.1007/BF00846540