Theses and Dissertations
This collection includes both ASU Theses and Dissertations, submitted by graduate students, and the Barrett, Honors College theses submitted by undergraduate students.
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- All Subjects: Chronic Pain
Description
In rehabilitation settings, activity limitation can be a significant barrier to recovery. This study sought to examine the effects of state and trait level benefit finding, positive affect, and catastrophizing on activity limitation among individuals with a physician-confirmed diagnosis of either Osteoarthritis (OA), Fibromyalgia (FM), or a dual diagnosis of OA/FM. Participants (106 OA, 53 FM, and 101 OA/FM) who had no diagnosed autoimmune disorder, a pain rating above 20 on a 0-100 scale, and no involvement in litigation regarding their condition were recruited in the Phoenix metropolitan area for inclusion in the current study. After initial questionnaires were completed, participants were trained to complete daily diaries on a laptop computer and instructed to do so a half an hour before bed each night for 30 days. In each diary, participants rated their average daily pain, benefit finding, positive affect, catastrophizing, and activity limitation. A single item, "I thought about some of the good things that have come from living with my pain" was used to examine the broader construct of benefit finding. It was hypothesized that state and trait level benefit finding would have a direct relation with activity limitation and a partially mediated relationship, through positive affect. Multilevel modeling with SAS PROC MIXED revealed that benefit finding was not directly related to activity limitation. Increases in benefit finding were associated, however, with decreases in activity limitation through a significant mediated relationship with positive affect. Individuals who benefit find had a higher level of positive affect which was associated with decreased activity limitation. A suppression effect involving pain and benefit finding at the trait level was also found. Pain appeared to increase the predictive validity of the relation of benefit finding to activity limitation. These findings have important implications for rehabilitation psychologists and should embolden clinicians to encourage patients to increase positive affect by employing active approach-oriented coping strategies like benefit finding to reduce activity limitation.
ContributorsKinderdietz, Jeffrey Scott (Author) / Zautra, Alex (Thesis advisor) / Davis, Mary (Committee member) / Barrera, Manuel (Committee member) / Okun, Morris (Committee member) / Arizona State University (Publisher)
Created2012
Description
Pediatric chronic pain is common and costly to children, their families, and society. Importantly, pediatric pain often persists into adulthood. Prior research suggests that parent chronic pain, particularly maternal pain, is a risk factor for the development of chronic pain in children. Existing evidence also suggests that parenting, including parental pain-related pain catastrophizing and general parenting style, are all associated with greater levels of chronic pain in children. The present study examined whether the prospective relations between parent and child pain differed between mothers and fathers, and whether parenting mediated or moderated the parent pain--child pain relations. It was hypothesized that 1a) both maternal and paternal chronic pain prospectively predicts child chronic pain, but that maternal pain would be a stronger predictor; 1b) having 0, 1, or 2 parents will increase the child’s risk of developing chronic pain; 2) maternal pain catastrophizing about their own (a) and their children’ pain (b) would mediate the relations between maternal and child pain; and 3) authoritarian parenting style (a) and negative parenting behaviors (b) would mediate the relationship between parent and child pain. Exploratory analyses tested the whether parental warmth predicted child pain, independent of mom pain. Regression models that account for twin dependency used longitudinal data collected from a sample of 895 twin children showed that maternal pain but not paternal pain predicted child pain. Maternal catastrophizing of her own pain, but not her child’s pain, significantly mediated the relation between maternal and child pain. However, maternal catastrophizing of her child’s pain predicted child pain at age 9, when controlling for child pain at age 8. All proposed relations between general parenting styles as well as warm parenting and child pain were not significant.
ContributorsLagergren, Abigail (Author) / Davis, Mary (Thesis director) / Lemery-Chalfant, Kathryn (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor)
Created2021-12
Description
Pediatric chronic pain is pervasive and associated with myriad adverse consequences, yet due consideration has not been given to the mental health disturbances that often present alongside chronic pain and the etiological mechanisms that potentially underlie both. The current study examined the etiology underlying chronic pain and internalizing symptomology in middle childhood, considering both independent and co-occurring symptom presentations. Phenotypic parent-offspring associations across chronic pain and internalizing symptomology were also examined. Lastly, nuclear twin family models were tested to determine the extent to which genetic and environmental factors underlie parent-offspring transmission. The sample comprised 795 children (399 families; Mage= 9.7 years; SD = 0.92) and their parents drawn from the Arizona Twin Project. Results indicated that chronic pain was highly heritable (78%), whereas internalizing symptomology was modestly heritable (32%) and further subject to moderate shared environmental influence (50%). Moreover, 9% of the variance in chronic pain was explained by additive genetic factors shared with internalizing symptomology. Maternal chronic pain and internalizing symptomology were positively associated with both child chronic pain and internalizing symptomology. The association between maternal chronic pain and child chronic pain was more pronounced for girls than boys, whereas the association between maternal internalizing symptomology and child internalizing symptomology was more pronounced for boys than girls. Paternal chronic pain was not significantly associated with child chronic pain but was unexpectedly associated with lower child internalizing symptomology. The negative association between paternal chronic pain and child internalizing symptomology was more pronounced for boys than girls. Paternal internalizing symptomology was not significantly associated with child chronic pain but was positively associated with child internalizing symptomology. Lastly, the best fitting reduced nuclear twin family models for both chronic pain and internalizing symptomology retained additive genetic, sibling-specific shared environmental, and nonshared environmental parameters, where parent-offspring transmission was solely explained by shared genetics and sibling-specific shared environmental factors further accounted for co-twin resemblance. Results provide novel insight into common liabilities underlying chronic pain and internalizing symptomology in middle childhood, parent-offspring associations across chronic pain and internalizing symptomology, and the etiological mechanisms that explain symptom aggregation across generations.
ContributorsOro, Veronica (Author) / Lemery-Chalfant, Kathryn (Thesis advisor) / Chassin, Laurie (Committee member) / Davis, Mary (Committee member) / Su, Jinni (Committee member) / Arizona State University (Publisher)
Created2021
Description
Chronic pain is common during childhood and has negative immediate and long-term implications for physical and mental health. Prior research points to physical activity and sleep as protective health-promoting behaviors predicting lower chronic pain intensity and disability during adulthood. No study has yet examined the interaction of physical activity and sleep parameters in prediction of chronic pain in a community sample of children. Guided by the biopsychosocial model of pediatric chronic pain, this study explored objectively assessed physical activity and sleep patterns at age 8 as predictors of childhood chronic pain at age 9 in a racially/ethnically and socioeconomically diverse sample of 896 twins participating in the longitudinal Arizona Twin Project. It was hypothesized that parameters of physical activity levels and sleep health would independently predict chronic pain one year later, and that sleep parameters would moderate the association between physical activity and chronic pain. Monthly chronic pain was common, with 57.1% of participants reporting at least one pain location. Headaches, stomachaches, and backaches were the most frequent chronic pain presentations. Participants exceeded physical activity guidelines but did not meet sleep recommendations for their age group. Multilevel modeling analyses revealed that physical activity and sleep parameters at age 8 did not predict chronic pain one year later, and that sleep parameters did not moderate the associations between physical activity and chronic pain. The present study provides evidence that the associations between objectively assessed physical activity and sleep and chronic pain are not yet evident during middle childhood in this community sample compared to patient samples who have existing pain, suggesting that these health behaviors may play distinct roles in pain development versus pain management. They also point to the need to pinpoint the time frame during which these health behaviors become relevant and potentially interact to predict chronic pain development and maintenance. Longitudinal research tracking these health behaviors and pain using both subjective and objective methods as children transition into and through adolescence can help to identify optimal developmental stages at which to target prevention and intervention efforts to promote long term health.
ContributorsBartsch, Eva Marie (Author) / Davis, Mary C (Thesis advisor) / Doane, Leah D (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / Arizona State University (Publisher)
Created2023
Description
Chronic pain is among the most prevalent health issues experienced by older adults and negatively impacts daily functioning and psychosocial well-being through mechanisms that include energy depletion, pain interference, and pain-related changes in negative affect. The capacities to be aware of and regulate negative emotions play a critical role in the successful management of chronic pain. One dimension of negative emotion awareness, termed negative emotion differentiation (NED), is the ability to discriminate between negative affective experiences and recognize them as discrete categories. The ability to identify and distinguish between the various emotions that accompany pain flares and other stressors may enhance the precision of the individual’s regulatory efforts. In doing so, NED may be one possible resilience resource that can facilitate adaptive functioning in the context of chronic pain by buffering the effects of chronic pain flares on daily interpersonal stress. However, this has not yet been investigated. The current study aimed to examine the moderating effect of trait NED on the relationship between daily pain and same-day stress in 259 patients diagnosed with osteoarthritis (OA) or fibromyalgia syndrome (FMS). Individuals completed daily diaries each evening for 30 days reporting on average daily pain, negative emotions, interpersonal stress, and depressive symptoms. It was hypothesized that higher levels of NED would buffer the effects of daily pain on same-day stress. In exploratory analyses, it was evaluated whether the buffering effects were larger for individuals with FMS versus OA. Results of multilevel models revealed that, as expected, higher levels of trait NED predicted lower levels of same-day negative interpersonal events and perceived interpersonal stress. Trait NED also moderated the relationship between pain-related increases in same-day perceived interpersonal stress. Additionally, findings indicated that NED was similarly important for those with FMS and OA. Taken together, the current findings suggest that NED is an important resilience trait that can attenuate chronic pain-related increases in daily experiences of interpersonal stress.
ContributorsOlah, Meryl (Author) / Davis, Mary C (Thesis advisor) / Lemery-Chalfant, Kathryn (Committee member) / Infurna, Frank (Committee member) / Arizona State University (Publisher)
Created2022