Top

Gepubliceerd in:

08-06-2016

The “self” in pain: the role of psychological inflexibility in chronic pain adjustment

Auteurs: Silvia Sze Wai Kwok, Esther Chin Chi Chan, Phoon Ping Chen, Barbara Chuen Yee Lo

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 5/2016

Abstract

Self-discrepancy occurs when a person feels the failure to fulfill one’s hopes or responsibilities. Although self-discrepancy has been widely examined to elucidate patients’ chronic pain adjustment, the underlying mechanism is unclear. The present study proposes that the effect of self-discrepancy on pain outcomes is accounted for by psychological inflexibility, which involves the psychological processes that guide behaviors in the pursuit of goals and values. One-hundred patients with chronic pain were recruited from a public hospital. They were invited to participate in a semi-structured interview regarding their self-discrepancy and complete self-reported questionnaires regarding their psychological inflexibility and pain outcomes. The results confirmed that psychological inflexibility partly accounts for the variance observed between self-discrepancy and pain outcomes. The current study provides additional insight into the mechanism underpinning the impact of self-discrepancy on patients’ pain adjustment and offers clinical implications regarding the use of acceptance commitment therapy for chronic pain management.

vorige artikel Acculturation and bicultural efficacy effects on Chinese American immigrants’ diabetes and health management

volgende artikel Low-grade inflammation may moderate the effect of behavioral treatment for chronic pain in adults

Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1182, 1173.

Bearden, D. J., Feinstein, A., & Cohen, L. L. (2012). The influence of parent preprocedural anxiety on child procedural pain: Mediation by child procedural anxiety. Journal of Pediatric Psychology, 37, 680–686.CrossRefPubMedPubMedCentral

Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42, 676–688.CrossRefPubMed

Cao, J., Yang, J., & Zhu, Z.-H. (2013). Reliability and validity of the Chinese version of the Acceptance and Action Questionnaire-Second Edition (AAQ-II) in college students. Chinese Mental Health Journal, 27, 873–877.

Cheung, M. N., Wong, T. C. M., Yap, J. C. M., & Chen, P. P. (2008). Validation of the chronic pain acceptance questionnaire (CPAQ) in Cantonese-speaking Chinese patients. The Journal of Pain, 9, 823–832.CrossRefPubMed

Cleeland, C., & Ryan, K. (1994). Pain assessment: Global use of the brief pain inventory. Annals of the Academy of Medicine, Singapore, 23, 129–138.PubMed

Dahl, J., & Lundgren, T. (2006). Acceptance and commitment therapy (ACT) in the treatment of chronic pain. In R. A. Baer (Ed.), Mindfulness-based treatment approaches: Clinician’s guide to evidence base and applications (pp. 285–306). Oxford: Academic Press.CrossRef

Dezutter, J., Luyckx, K., & Wachholtz, A. (2015). Meaning in life in chronic pain patients over time: Associations with pain experience and psychological well-being. Journal of Behavioral Medicine, 38, 384–396.CrossRefPubMed

Eccleston, C., Williams, A. C. D. C., & Rogers, W. S. (1997). Patients’ and professionals’ understandings of the causes of chronic pain: Blame, responsibility and identity protection. Social Science and Medicine, 45, 699–709.CrossRefPubMed

Edwards, W. (1954). The theory of decision making. Psychological Bulletin, 51, 380–417.CrossRefPubMed

Esteve, R., Ramírez-Maestre, C., & López-Martínez, A. E. (2007). Adjustment to chronic pain: the role of pain acceptance, coping strategies, and pain-related cognitions. Annals of Behavioral Medicine, 33, 179–188.CrossRefPubMed

Gollwitzer, P. M., & Sheeran, P. (2006). Implementation intentions and goal achievement: A meta-analysis of effects and processes. Advances in Experimental Social Psychology, 38, 69–119.CrossRef

Goossens, M. E., Kindermans, H. P., Morley, S. J., Roelofs, J., Verbunt, J., & Vlaeyen, J. W. (2010). Self-discrepancies in work-related upper extremity pain: Relation to emotions and flexible-goal adjustment. European Journal of Pain, 14, 764–770.CrossRefPubMed

Hann, K. E., & McCracken, L. M. (2014). A systematic review of randomized controlled trials of acceptance and commitment therapy for adults with chronic pain: Outcome domains, design quality, and efficacy. Journal of Contextual Behavioral Science, 3, 217–227.CrossRef

Hardin, E. E., & Leong, F. T. L. (2005). Optimism and pessimism as mediators of the relations between self-discrepancies and distress among Asian and European Americans. Journal of Counseling Psychology, 52, 25–35.CrossRef

Harris, S., Morley, S., & Barton, S. B. (2003). Role loss and emotional adjustment in chronic pain. Pain, 105, 363–370.CrossRefPubMed

Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press.

Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44, 1–25.CrossRefPubMed

Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press.

Higgins, E. T., Klein, R., & Strauman, T. (1985). Self-concept discrepancy theory: A psychological model for distinguishing among different aspects of depression and anxiety. Social Cognition, 3, 51–76.CrossRef

Huijnen, I. P., Kindermans, H. P., Seelen, H. A., Peters, M. L., Smeets, R. J., Serroyen, J., & Verbunt, J. A. (2011). Effects of self-discrepancies on activity-related behaviour: Explaining disability and quality of life in patients with chronic low back pain. Pain, 152, 2165–2172.CrossRefPubMed

International Association for the Study of Pain. (1986). Classification of chronic pain: Descriptions of chronic pain syndromes and definitions of pain terms. Pain Supplement, 3, S1–S226.

Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30, 865–878.CrossRefPubMedPubMedCentral

Kindermans, H. P., Huijnen, I. P., Goossens, M. E., Roelofs, J., Verbunt, J. A., & Vlaeyen, J. W. (2011). “Being” in pain: The role of self-discrepancies in the emotional experience and activity patterns of patients with chronic low back pain. Pain, 152, 403–409.CrossRefPubMed

Leung, C. M., Wing, Y. K., Kwong, P. K., Shum, A., & Lo, K. (1999). Validation of the Chinese-Cantonese version of the hospital anxiety and depression scale and comparison with the Hamilton rating scale of depression. Acta Psychiatrica Scandinavica, 100, 456–461.CrossRefPubMed

Lundgren, T., Dahl, J., & Hayes, S. C. (2008). Evaluation of mediators of change in the treatment of epilepsy with acceptance and commitment therapy. Journal of Behavioral Medicine, 31, 225–235.CrossRefPubMed

McCracken, L. M. (1998). Learning to live with the pain: Acceptance of pain predicts adjustment in persons with chronic pain. Pain, 74, 21–27.CrossRefPubMed

McCracken, L. M., & Velleman, S. C. (2010). Psychological flexibility in adults with chronic pain: A study of acceptance, mindfulness, and values-based action in primary care. Pain, 148, 141–147.CrossRefPubMed

McCracken, L. M., & Vowles, K. E. (2007). Psychological flexibility and traditional pain management strategies in relation to patient functioning with chronic pain: An examination of a revised instrument. The Journal of Pain, 8, 700–707.CrossRefPubMed

McCracken, L. M., & Vowles, K. E. (2014). Acceptance and commitment therapy and mindfulness for chronic pain: Model, process, and progress. American Psychologist, 69, 178–189.CrossRefPubMed

McCracken, L. M., Vowles, K. E., & Eccleston, C. (2004). Acceptance of chronic pain: Component analysis and a revised assessment method. Pain, 107, 159–166.CrossRefPubMed

McCracken, L. M., Vowles, K. E., & Eccleston, C. (2005). Acceptance-based treatment for persons with complex, long standing chronic pain: A preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour Research and Therapy, 43, 1335–1346.CrossRefPubMed

McCracken, L. M., & Yang, S.-Y. (2006). The role of values in a contextual cognitive-behavioral approach to chronic pain. Pain, 123, 137–145.CrossRefPubMed

McCracken, L. M., & Zhao-O’Brien, J. (2010). General psychological acceptance and chronic pain: There is more to accept than the pain itself. European Journal of Pain, 14, 170–175.CrossRefPubMed

Pincus, T., Fraser, L., & Pearce, S. (1998). Do chronic pain patients ‘Stroop’ on pain stimuli? British Journal of Clinical Psychology, 37, 49–58.CrossRefPubMed

Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891.CrossRefPubMed

Raes, F. (2010). Rumination and worry as mediators of the relationship between self-compassion and depression and anxiety. Personality and Individual Differences, 48, 757–761.CrossRef

Risdon, A., Eccleston, C., Crombez, G., & McCracken, L. (2003). How can we learn to live with pain? A Q-methodological analysis of the diverse understandings of acceptance of chronic pain. Social Science and Medicine, 56, 375–386.CrossRefPubMed

Schmitz, U., Saile, H., & Nilges, P. (1996). Coping with chronic pain: Flexible goal adjustment as an interactive buffer against pain-related distress. Pain, 67, 41–51.CrossRefPubMed

Schrooten, M. G., Vlaeyen, J. W., & Morley, S. (2012). Psychological interventions for chronic pain: reviewed within the context of goal pursuit. Pain Management, 2, 141–150.CrossRefPubMed

Smith, J. A., & Osborn, M. (2007). Pain as an assault on the self: An interpretative phenomenological analysis of the psychological impact of chronic benign low back pain. Psychology and Health, 22, 517–534.CrossRef

Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology, 13, 290–312.CrossRef

Sutherland, R., & Morley, S. (2008). Self-pain enmeshment: Future possible selves, sociotropy, autonomy and adjustment to chronic pain. Pain, 137, 366–377.CrossRefPubMed

Thompson, M., & McCracken, L. M. (2011). Acceptance and related processes in adjustment to chronic pain. Current Pain and Headache Reports, 15, 144–151.CrossRefPubMed

Van Damme, S., & Kindermans, H. (2015). A self-regulation perspective on avoidance and persistence behavior in chronic pain: New theories, new challenges? The Clinical Journal of Pain, 31, 115–122.CrossRefPubMed

Vowles, K. E., & McCracken, L. M. (2010). Comparing the role of psychological flexibility and traditional pain management coping strategies in chronic pain treatment outcomes. Behaviour Research and Therapy, 48, 141–146.CrossRefPubMed

Wang, X. S., Mendoza, T. R., Gao, S.-Z., & Cleeland, C. S. (1996). The Chinese version of the Brief Pain Inventory (BPI-C): Its development and use in a study of cancer pain. Pain, 67, 407–416.CrossRefPubMed

Waters, S. J., Keefe, F. J., & Strauman, T. J. (2004). Self-discrepancy in chronic low back pain: Relation to pain, depression, and psychological distress. Journal of Pain and Symptom Management, 27, 251–259.CrossRefPubMed

Werner, A., Isaksen, L. W., & Malterud, K. (2004). ‘I am not the kind of woman who complains of everything’: Illness stories on self and shame in women with chronic pain. Social Science and Medicine, 59, 1035–1045.CrossRefPubMed

Whiting, D. L., Deane, F. P., Ciarrochi, J., McLeod, H. J., & Simpson, G. K. (2015). Validating measures of psychological flexibility in a population with acquired brain injury. Psychological Assessment, 27, 415–423.CrossRefPubMed

Wrosch, C., Scheier, M. F., & Miller, G. E. (2013). Goal adjustment capacities, subjective well-being, and physical health. Social and Personality Psychology Compass, 7, 847–860.CrossRefPubMedPubMedCentral

Yu, L., Norton, S., Harrison, A., & McCraken, L. M. (2015). In search of the person in pain: A systematic review of conceptualization, assessment methods, and evidence for self and identity in chronic pain. Journal of Contextual Behavioral Science, 4(4), 246–262.CrossRef

Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefPubMed

Titel: The “self” in pain: the role of psychological inflexibility in chronic pain adjustment
Auteurs: Silvia Sze Wai Kwok
Esther Chin Chi Chan
Phoon Ping Chen
Barbara Chuen Yee Lo
Publicatiedatum: 08-06-2016
Uitgeverij: Springer US
Gepubliceerd in: Journal of Behavioral Medicine / Uitgave 5/2016
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-016-9750-x

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen

Andere artikelen Uitgave 5/2016

Young women’s alcohol expectancies for sexual risk-taking mediate the link between sexual enhancement motives and condomless sex when drinking

Association of social support during emergency department evaluation for acute coronary syndrome with subsequent posttraumatic stress symptoms

Between-person and within-person approaches to the prediction of ambulatory blood pressure: the role of affective valence and intensity

Explaining fatigue in multiple sclerosis: cross-validation of a biopsychosocial model

Multiplex crack smoking and sexual networks: associations between network members’ incarceration and HIV risks among high-risk MSM

Pain beliefs and problems in functioning among people with arthritis: a meta-analytic review