Matching Items (5)
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- All Subjects: Chronic Pain
- Creators: Karoly, Paul
- Resource Type: Text
Description
The present study examined the association of pain intensity and goal progress in a community sample of 132 adults with chronic pain who participated in a 21 day diary study. Multilevel modeling was employed to investigate the effect of morning pain intensity on evening goal progress as mediated by pain's interference with afternoon goal pursuit. Moderation effects of pain acceptance and pain catastrophizing on the associations between pain and interference with both work and lifestyle goal pursuit were also tested. The results showed that the relationship between morning pain and pain's interference with work goal pursuit in the afternoon was significantly moderated by a pain acceptance. In addition, it was found that the mediated effect differed across levels of pain acceptance; that is: (1) there was a significant mediation effect when pain acceptance was at its mean and one standard deviation below the mean; but (2) there was no mediation effect when pain acceptance was one standard deviation above the mean. It appears that high pain acceptance significantly attenuates the power of nociception in disrupting one's work goal pursuit. However, in the lifestyle goal model, none of the moderators were significant nor was there a significant association between pain interference with goal pursuit and goal progress. Only morning pain intensity significantly predicted afternoon interference with lifestyle goal pursuit. Further interpretation of the present findings and potential explanations of those inconsistencies are elaborated on discussion. Limitations and the clinical implication of the current study were considered, along with suggestions for future studies.
ContributorsMun, Chung Jung (Author) / Karoly, Paul (Thesis advisor) / Okun, Morris A. (Committee member) / Enders, Craig K. (Committee member) / Arizona State University (Publisher)
Created2014
Description
Despite the strong link between pain and depressive symptoms, the mechanisms by which they are connected in the everyday lives of individuals with chronic pain are not well understood. In addition, previous investigations have tended to ignore biopsychosocial individual difference factors, assuming that all individuals respond to pain-related experiences and affect in the same manner. The present study tried to address these gaps in the existing literature. Two hundred twenty individuals with Fibromyalgia completed daily diaries during the morning, afternoon, and evening for 21 days. Findings were generally consistent with the hypotheses. Multilevel structural equation modeling revealed that morning pain and positive and negative affect are uniquely associated with morning negative pain appraisal, which in turn, is positively related to pain’s activity interference in the afternoon. Pain’s activity interference was the strongest predictor of evening depressive symptoms. Latent profile analysis using biopsychosocial measures identified three theoretically and clinically important subgroups (i.e., Low Functioning, Normative, and High Functioning groups). Although the daily pain-depressive symptoms link was not significantly moderated by these subgroups, individuals in the High Functioning group reported the lowest levels of average morning pain, negative affect, negative pain appraisal, afternoon pain’s activity interference, and evening depressive symptoms, and the highest levels of average morning positive affect across 21 days relative to the other two groups. The Normative group fared better on all measures than did the Low Functioning group. The findings of the present study suggest the importance of promoting morning positive affect and decreasing negative affect in disconnecting the within-day pain-depressive symptoms link, as well as the potential value of tailoring chronic pain interventions to those individuals who are in the greatest need.
ContributorsMun, Chung Jung (Author) / Karoly, Paul (Thesis advisor) / Davis, Mary C. (Thesis advisor) / Suk, Hye Won (Committee member) / Dishion, Thomas J (Committee member) / Arizona State University (Publisher)
Created2017
Description
Current models of pain coping typically focus on how pain contributes to poor physical and psychological functioning. Researchers have argued that this focus on the negative consequences is too narrow and does not account for times when individuals are able to maintain meaningful functioning despite their pain. Thus, the current study sought to investigate the day-to-day processes that both help and hinder recovery from pain and persistence towards daily goals. Specifically, the present study tested: a) a two-factor model of risk and resilience “factors” that capture key processes across affective, cognitive and social dimensions of functioning, and b) whether the relation between morning pain and end-of-day physical disability is mediated by increases in these afternoon risk and resilience factors. Within-day study measures were collected for 21 days via an automated phone system from 220 participants with Fibromyalgia. The results of multi-level confirmatory factor analysis indicated that, consistent with prediction, risk and resilience do constitute two factors. Findings from multilevel structural equation models also showed resilience factor mediated the link between late morning increases in pain and end-of-day disability, in line with hypotheses. Although the vulnerability factor as a whole did not mediate the within-day link between pain and disability, pain-catastrophizing individually did serve as a significant mediator of this relation. This study was the first to empirically test a within-day latent factor model of resilience and vulnerability and the first to capture the multidimensional nature of the pain experience by examining mechanisms across affective, cognitive and social domains of functioning. The findings of the current study suggest that in addition to studying the processes by which pain has a negative influence on the lives of pain sufferers, our understanding of the pain adaptation process can be further improved by concurrently examining mechanisms that motivate individuals to overcome the urge to avoid pain and to function meaningfully despite it.
ContributorsThummala, Kirti (Author) / Davis, Mary C. (Thesis advisor) / Doane, Leah (Committee member) / Karoly, Paul (Committee member) / Barrera, Manuel (Committee member) / Arizona State University (Publisher)
Created2018
Description
Experiencing poor, unrefreshing sleep is a common occurrence for individuals with chronic pain. Sleep disturbance predicts not only greater pain and disability, but also heightened negative affect and reduced positive affect in individuals with chronic pain. Such fluctuations in affect have been linked with more negative and fewer positive social events. For those with chronic pain, negative social relations can exacerbate pain, whereas positive social interactions can help decrease disability. Thus, exploring the sleep‒social functioning process in chronic pain may be one way to improve daily functioning and quality of life. The current study examined positive and negative affect as two parallel mediators of the within-day relations between sleep quality and positive and negative social events in individuals with chronic pain. For 21 days, electronic daily diary reports were collected from 220 individuals with fibromyalgia, a condition characterized by widespread chronic pain. Within-person relations among reports of last night’s sleep quality, afternoon affects and pain, and evening social events were estimated via multilevel structural equation modeling. Findings showed that positive affect mediated both the sleep quality‒positive social events and sleep quality‒negative social events relations. That is, greater than usual sleep disturbance last night predicted afternoon reports of lower than usual positive affect. Low positive affect, in turn, predicted evening reports of fewer than usual positive social events and more than usual negative social events that day, controlling for the effects of afternoon pain. In addition, negative affect mediated the sleep quality‒negative social events link. That is, greater than usual sleep disturbance last night predicted afternoon reports of higher than usual negative affect, which, in turn, predicted evening reports of more than usual negative social events that day, controlling for the effects of afternoon pain. Of the three significant mediated paths, the sleep quality‒positive affect‒positive social events path was the strongest in magnitude. Thus, a night of poor sleep can have an impact on social events the next day in those with chronic pain by dysregulating affect. Further, findings highlight the key role of positive affect in the sleep‒social functioning process and potential socio-affective benefits of sleep interventions in chronic pain.
ContributorsKothari, Dhwani J. (Author) / Davis, Mary (Thesis advisor) / Luecken, Linda (Committee member) / Karoly, Paul (Committee member) / Infurna, Frank (Committee member) / Arizona State University (Publisher)
Created2019
Description
Interpersonal strain is linked with depressive symptoms in middle-aged adults. Self-compassion is an emerging resilience construct that may be advantageous in navigating relationship strain by helping individuals respond to emotions in a kind and nonjudgmental way. Although theory and empirical evidence suggests that self-compassion is protective against the impact of stress on mental health outcomes, many studies have not investigated how self-compassion operates in the context of relationship strain. In addition, few studies have examined psychological or physiological mechanisms by which self-compassion protects against mental health outcomes, depression in particular. Thus, this study examined 1) the extent to which trait self-compassion buffers the relation between family strain and depressive symptoms, and 2) whether these buffering effects are mediated by hope and inflammatory processes (IL-6) in a sample of 762 middle-aged, community-dwelling adults. Results from structural equation models indicated that family strain was unrelated to depressive symptoms and the relation was not moderated by self-compassion. Hope, but not IL-6, mediated the relation between family strain and depressive symptoms and the indirect effect was not conditional on levels of self-compassion. Taken together, the findings suggest that family strain may lead individuals to experience less hope and subsequent increases in depressive symptoms, and further, that a self-compassionate attitude does not affect this relation. Implications for future self-compassion interventions are discussed.
ContributorsMistretta, Erin (Author) / Davis, Mary C. (Thesis advisor) / Karoly, Paul (Committee member) / Infurna, Frank (Committee member) / Arizona State University (Publisher)
Created2019