Self-report Measures Of Pain Research Articles

Discordance between self-report and behavioral pain measures in children aged 3–7 years after surgery

This study examined concurrent self-reports of pain intensity and behavioral responses in 25 children aged 3–7 yr. Behavioral (Children's Hospital of Eastern Ontario Pain Scale, cheops) and self-report (the Oucher and Analogue Chromatic Continuous Scale) measures of pain were obtained following major surgery. The two self-report measures were strongly and significantly correlated, and the pattern of scores over the 36-hr observation period was as expected. There was little relationship between the scores for the self-report and the behavioral measures. Many children who reported severe pain manifested few of the bihavioral indicators of distress used in the cheops. This behavioral response pattern may occur commonly in children experiencing pain after surgery and may limit the applicability of current behavioral scales as sole measures of pain intensity in younger children.

A causal analysis of chronic pain and depression.

There is considerable controversy in the literature regarding the extent to which chronic pain and depression are associated and the possible causal relationship of such an association. The present study examines these issues with a sample of 243 patients diagnosed with rheumatoid arthritis (RA) who were mailed questionnaires for six waves of data collection. The results indicated that RA patients experience higher levels of depressive symptomatology than community samples. Using a two-latent-variable, cross-lagged design, covariance structural modeling was conducted on self-report measures of pain and depression over 6-month intervals. Results most strongly supported a causal model in which pain predicts depression during the last 12 months of the study.

An experimental investigation of the construct validity of the McGill Pain Questionnaire

In order to circumvent problems with self-report measures of pain we conducted an experimental analysis of MPQ pain descriptors using a Stroop task. In this task subjects are asked to name the colours in which stimulus words are written. Previous research has demonstrated that words with emotional significance interfere (indexed by increased latencies to respond) with a person's ability to name the colour. We predicted that: (1) chronic pain patients, compared with normal controls, would show more interference to words drawn from the MPQ, and (2) affective/evaluative descriptors would produce greater interference than sensory descriptors. There was support for the first hypothesis but not the second. Possible reasons for these findings are discussed.

Facial expressions of pain and emotions in chronic TMD patients

This research was designed to identify and validate facial expressions of pain occurring in a clinical chronic pain condition. Facial expressions of 28 patients with chronic temporomandibular disorder pain were videotaped during a painful clinical examination procedure and coded using an anatomically based system. Characteristics of the expressions occurring most frequently were compared with self-report measures of pain, anxiety, depression and somatic symptoms. The frequency, duration and intensity of the identified expressions were dependably correlated with pain report, but unrelated to self report of other somatic symptoms, depression or anxiety. A small number of facial expressions of specific negative emotions were also observed; pain report and pain facial expressions were higher for persons showing a greater number of negative affects. These findings support the promise of facial expressions as measures of clinical pain.

Overt pain behaviors: Relationship to patient functioning and treatment outcome

Two related studies examined the relationship of overt pain behaviors to measures of patient functioning and treatment outcome. In Study 1, overt pain behaviors of 45 chronic low back pain patients beginning inpatient pain treatment were assessed, and self-report measures of pain, pain behaviors, and physical and psychosocial disability were also obtained. Frequency of observed pain behaviors was significantly associated with patient ratings of pain, pain behaviors, and physical disability, but not psychosocial functioning. In Study 2, changes in observed pain behaviors and self-report measures of pain, pain behaviors, and depression following inpatient treatment were examined. Observed pain behaviors and self-reported pain, pain behaviors, and depression decreased significantly pre- to posttreatment. Decreases in observed pain behaviors were significantly associated with decreases in depression, but not with changes in self-reported pain or pain behaviors. Results support the use of both observational and self-report measures in the comprehensive evaluation of chronic pain problems.

Relationship between observer and self-report pain measures during venipuncture in pediatric oncology patients

Relationship between observer and self-report pain measures during venipuncture in pediatric oncology patients

Relationships of stress, appraisal and coping, to chronic low back pain

There is evidence that coping strategies play an important role in chronic pain problems. The purpose of this study was to examine the relationships between Stressors, appraisals, coping responses, and chronic low back pain. Eighty-five community volunteers with chronic low back pain completed self-report measures of pain and the reversed Ways of Coping Checklist, a questionnaire assessing primary Stressor and related appraisals and coping responses. Only 43% identified pain or physical limitations as their primary Stressor. Significant differences in average pain during the past week, coping strategies, and appraisals of the Stressor were found between patients who identified pain or physical limitations as their primary Stressor and those who did not. Examination of the relationships between appraisal and coping revealed that certain appraisals of the pain problem were associated with certain coping responses. Appraisals were not directly associated with pain ratings, but blaming oneself was negatively related to ratings of average pain during the previous week, and seeking social support was negatively related to present pain ratings on the McGill Pain Questionnaire. The findings indicate the importance of studying appraisal and coping processes in chronic pain patients, and directions for future research are suggested.

Development of an observation method for assessing pain behavior in rheumatoid arthritis patients

Four studies examined the reliability and validity of a behavioral observation method for the assessment of pain associated with rheumatoid arthritis (RA). The major purpose of experiment 1 was to evaluate the interobserver reliability of the observation method. Two observers recorded the frequencies of pain behaviors displayed by 20 RA patients. Each of 3 types of reliability estimates indicated that the pain behavior could be reliably observed. The purpose of experiment 2 was to examine the concurrent validity of the observation system by correlating 53 patients' self-reports of pain with the frequencies of their pain behaviors. Significant and positive correlations were found between patients' total pain behavior and 3 self-report measures of pain and functional disability. Furthermore, unlike the self-reports of pain, total pain behavior was only minimally related to self-report of depression. Experiment 3 was performed in order to assess the observation method's construct validity. Naive observers viewed video recordings of 25 RA patients and made global estimates of patients' pain severity and unpleasantness. Highly significant and positive correlations were found between these global estimates and total pain behavior. In experiment 4, the pain behaviors of 11 RA patients were recorded prior to and immediately following cognitive-behavioral treatment for the reduction of RA pain. There was a significant decrease in total pain behavior from pretreatment to posttreatment. The data indicate that the observation method provides a reliable, valid, and relatively objective measure of RA patient pain behavior. Future validation studies of the observation method are discussed.

Examining the interaction effects of coping style and brief interventions in the treatment of postsurgical pain

The present study sought to ameliorate two major deficiencies in the literature on treating response to surgery, viz., (1) the failure to compare clearly delineated treatments, alone and in combination; and (2) the failure to examine treatment × coping style interactions. Information imparting and brief relaxation were examined in this study as they interacted with an avoidance-sensitization coping style. No differences were found between treatments or coping styles. Sensitizers, on the other hand, were found to profit most from the relaxation training. Avoiders appeared to do well when they were left alone. The interaction effect was demonstrated for both self-report measures of pain and a behavioral measure of potency of medications ingested. The effects on self-report of pain were more evident on the second postsurgical day than on the fourth postsurgical day. The results indicate that brief relaxation training, often the only kind available to the medical psychologist dealing with surgical patients, is best confined to patients with a sensitizing coping style. Further, the results of this study, in conjunction with a reanalysis of previous studies, cast considerable doubt on information imparting when presented alone as a viable technique for reducing the distress consequent on surgery.