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- All Subjects: Chronic pain--Psychological aspects.
- Genre: Academic theses
- Creators: Davis, Mary C.
- Creators: Mistretta, Erin
- Member of: ASU Electronic Theses and Dissertations
- Member of: Theses and Dissertations
- Resource Type: Text
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
Prevailing models describing coping with chronic pain posit that it is a complex day-to-day process that can involve psychosocial factors, including cognitive appraisals about pain, interpersonal challenges such as distressed social relationships, and reduced engagement in enjoyable experiences. Few studies, however, have applied a process-oriented approach to elaborate the relations between key pain-related appraisals, social environmental factors, and self-efficacy, a key self-appraisal for successful adaptation to chronic pain. This study used within-day daily diary methodology to test the following hypotheses: (a) increases in morning pain catastrophizing predict decreases in end of day pain self-efficacy; (b) increases in perceived stressfulness of interpersonal relations occurring during the day exacerbate the negative effects of morning catastrophizing on end-of-day pain self-efficacy; and (c) increases in perceived enjoyment of interpersonal relations occurring during the day mitigate the negative effects of morning pain catastrophizing on end of day pain self-efficacy. Within-day measures, including morning pain catastrophizing, afternoon interpersonal stress and enjoyment ratings, and end-of-day pain self-efficacy, were collected for 21 days via an automated phone system from 223 participants with widespread chronic pain. The use of diary data allowed for examination of time-varying processes related to pain adaptation. Results of multilevel regression models indicated that, consistent with prediction, increases in morning pain catastrophizing and predicted decreases in end-of-day pain self-efficacy. Contrary to prediction, changes in midday interpersonal enjoyment and stress did not moderate the within-day catastrophizing-efficacy relation. Rather increases in midday enjoyment and stable individual differences in enjoyment predicted end-of-day efficacy. Overall, findings suggest a within-day relation between pain cognition and social context and subsequent self-efficacy, and highlight potential targets for intervention in chronic pain.
ContributorsThummala, Kirti (Author) / Davis, Mary C. (Thesis advisor) / Zautra, Alex (Committee member) / Okun, Morris (Committee member) / Arizona State University (Publisher)
Created2018
Description
An abundance of data has established the links between both pain-related cognitions and relationship attachment qualities in the experience of pain, including long-term functional health in chronic pain patients. However, relatively few studies have explored the dynamic relation between pain and pain-related cognitions within a day, and no studies have tested the moderating role of relationship attachment on the within-day cognition—pain association in chronic pain patients. The objectives of this study were to: 1) assess whether late morning pain flares predicted changes in afternoon positive and negative pain-related cognitive appraisals, and whether these changes in turn predicted end-of-day pain, and 2) explore whether adult attachment anxiety moderated the pain-cognition relation in individuals with chronic pain due to fibromyalgia. One hundred and seventy four partnered individuals with fibromyalgia completed initial assessments of demographics and attachment anxiety, and subsequently completed electronic assessments of pain intensity and positive and negative cognitive pain-related appraisals three times a day for three weeks. Multilevel structural equation modeling established that a latent negative cognitive appraisal factor (encompassing shared variance from catastrophizing, pain irritation, and self-criticism related to pain) mediated the link between late morning and end-of-day pain intensity, in line with the hypothesis. Analyses also provided some support for a mediating role for a positive cognitive appraisal factor (a composite of pain control, pain self-efficacy, and feeling pain without reacting) in the daily course of pain; the mediated effect for positive appraisals was weaker than the mediated effect of negative appraisals, but was sustained in a model that included negative appraisals. Inconsistent with prediction, attachment anxiety did not moderate the within-day links between pain and cognitions. These findings establish the dynamic links within day between pain and pain-related cognitions, and highlight the potential impact of both negative and positive cognitions on daily pain regulation. They point to the value of broadening cognitive-behavioral treatment strategies for chronic pain patients to target not only negative but also positive cognitions.
ContributorsTaylor, Shannon Stark (Author) / Davis, Mary C. (Thesis advisor) / Zautra, Alex (Committee member) / Okun, Morris (Committee member) / Doane, Leah (Committee member) / Arizona State University (Publisher)
Created2015
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