Sequential analysis of chronic pain behaviors and spouse responses.

Social reinforcers such as spouse behaviors have been hypothesized to be important in maintaining chronic pain behavior. This study used direct observation to test whether solicitous and aggressive spouse behaviors systematically precede and follow patient pain behaviors. 50 chronic pain patients and spouses and 33 control couples were videotaped performing specified tasks. Spouse solicitous behaviors were significantly more likely to precede and follow nonverbal pain behaviors, and nonverbal pain behaviors were significantly less likely to follow spouse aggressive behaviors in pain than in control couples. Within couples, spouse solicitous behaviors preceded and followed verbal and nonverbal pain behaviors beyond chance levels more often in pain than in control couples. Results support an operant conceptualization of factors maintaining chronic pain behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of spouse involvement in the behavioral treatment of overweight women.

Assigned 68 overweight women (mean age 39 yrs) to 1 of 5 groups: (a) cooperative spouse, in which spouses were trained in modeling, monitoring, and reinforcement techniques; (b) wives alone, in which Ss underwent the basic behavioral program by themselves; (c) nonparticipating spouse, in which spouses were told not to participate in their wives' behavioral program; (d) alternative treatment; and (e) delayed treatment control. The cooperative spouse group lost significantly more weight than the alternative treatment at the 3-, 6-, and 12-mo follow-ups and significantly more weight than the wives-alone group at the final follow-up. Both the cooperative spouse and the nonparticipating spouse conditions maintained their weight losses at the final follow-up, whereas the wives-alone group regained some weight. The absence of significant differences between the cooperative spouse and the nonparticipating spouse conditions suggests that instructing spouses not to sabotage their wives' efforts may be as effective for long-term maintenance as actively training them to aid their wives. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapeutic alliance: Predicting continuance and success in group treatment for spouse abuse.

This study examined the role of the therapeutic alliance between client and therapist on group treatment outcome in 70 husband-to-wife violent couples. Strength of husbands' alliance assessed at Session 1 was positively associated with treatment outcome, as measured by decreased husband-to-wife mild and severe psychological and physical aggression. Strength of wives' alliance was unrelated to treatment outcome. Finally, although alliance was related to treatment, outcome, it was unrelated to treatment completion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of operant behavioral and cognitive-behavioral group treatment for chronic low back pain.

To evaluate and compare the efficacy of two widely used behavioral approaches for the treatment of chronic pain, 81 mildly dysfunctional chronic low back pain patients were randomly assigned to operant behavioral (OB) treatment, cognitive-behavioral (CB) treatment, or a waiting-list (WL) control condition. Both treatments, which were conducted in eight-session outpatient groups, resulted in decreased physical and psychosocial disability. The OB patients showed greater pre- to posttreatment improvement as rated by patients and their spouses than did the CB patients. Generally, the OB patients showed a leveling off in improvement at 6- and 12-month follow-ups, whereas the CB patients generally continued to improve over the 12 months following treatment. At 12-month follow-up, patients in both treatments remained significantly improved, with no significant differences between conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital therapy and spouse involvement in the treatment of depression, agoraphobia, and alcoholism.

Examines the literature on marital therapy and spouse involvement as treatments for major psychopathology. The focus is on three disorders that have attracted a sufficient number of empirical findings: depression, agoraphobia, and alcoholism. For each of these disorders, we first examine the relation between marital dynamics and the disorder and next discuss empirical efforts to evaluate the impact of marital therapy or spouse involvement on the disorder. In addition, we summarize trends and suggest methodological refinements for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

有氧运动对治疗慢性下背痛的疗效

目的:探索有氧运动对治疗慢性下背痛疗效的影响.方法:选择社区医疗服务中心40例病史3个月以上的下背痛患者,采用电脑随机方法将受试者分为两组:一组为实验组,进行有氧训练;另一组为对照组,不接受任何训练计划.对照组和实验组分别在干预介入前与介入后进行下背痛失能程度量表和疼痛评分(Visual Analogue Scale,VAS).结果:治疗12周后,发现实验组在治疗后欧式下背痛失能程度显著小于对照组,且VAS评分结果显著优于对照组.结论:有氧运动可以改善慢性下腰痛患者的疼痛程度及改善其失能状况.     

Age analysis of cognitive-behavioral group therapy for chronic pain outpatients.

This study explored the effectiveness, in terms of age of the client, of a 10-week cognitive–behavioral group therapy (stress inoculation training) for chronic pain. A total of 69 outpatients between the ages of 27 and 80 (M?=?52.74 years, SD?=?14.40) with diverse types of chronic pain were assigned randomly to immediate or wait-list-delayed therapy. Self-report measures of pain, activities, coping, and the use of medications and other physical pain control techniques were obtained at baseline, during therapy, and at 1- and 6-month follow-up. Treatment decreased the degree to which pain interfered with activity, increased ability to cope with pain, and decreased use of some medications and other physical treatments. It had little effect on perceived pain intensity. Gains were maintained through 6-month follow-up. Age was unrelated to outcome. Stress inoculation training appears to be an effective method of ameliorating the interference of chronic pain with the daily activities of life for adults of all ages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychophysiologic treatment of chronic lower back pain.

Research concerning the mechanisms and efficacy of psychophysiological treatments for chronic low back pain is reviewed. Despite methodological shortcomings, the literature supports the efficacy of a number of psychophysiological treatments. The mechanism of successful treatment is poorly understood. New models of pathophysiology of muscle pain are presented, and it is hoped that they will clarify treatment issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multidisciplinary treatment of chronic low back pain: A review.

Presents an overview of the general theoretical viewpoint of a multidisciplinary treatment of chronic low-back pain. Results from a number of multidisciplinary pain clinics are summarized, and major treatment modalities utilized by this approach are critically reviewed. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of group progressive-relaxation training and cognitive-behavioral group therapy for chronic low back pain.

36 20–63 yr old chronic low-back-pain outpatients were randomly assigned to group progressive-relaxation training, cognitive-behavioral group therapy, or waiting list/attention conditions. Both relaxation-training and cognitive-behavioral-therapy Ss improved significantly on self-report measures of pain, depression, and disability (e.g., Sickness Impact Profile, Beck Depression Inventory) and on a significant-other-rated measure of physical and psychosocial dysfunction pre- to posttreatment, whereas waiting-list Ss did not. Posttreatment, cognitive-behavioral-therapy Ss did not differ from relaxation-training Ss on most variables, but they did rate themselves as having improved more in ability to tolerate pain and participate in normal activities. At 1-mo follow-up, relaxation-training Ss showed no significant further improvement and had a significant increase in pain. Cognitive-behavioral-therapy Ss demonstrated further improvement at 1-mo follow-up on several measures of pain, depression, and disability. A 1?–2 yr mail follow-up indicated a marked reduction in health-care use for Ss in both treatments, and the cognitive-behavioral-therapy Ss had improved markedly in time spent working. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dropout from treatment for chronic low-back pain.

Chronic low-back pain is a common clinical complaint, and patient dropout can be a major complication to treatment. The authors examined the variables predicting dropout from a 12-week outpatient clinical trial on the treatment of chronic low-back pain. Findings underscore the importance of carefully evaluating the patient's pain severity, attitudes about pain symptoms, and expectations and goals for treatment. Attempts should be made to correct misconceptions and unrealistic expectations regarding the nature of the pain condition, treatment options, likely outcomes, the role of self-regulation training, and family support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of on-demand versus fixed-interval schedules in the treatment of chronic pain with analgesic compounds.

The effects of fixed-interval and on-demand administration of analgesic medication in chronic pain patients were compared in a cross-over design. It was hypothesized that each analgesic schedule would have a different effect on subjective pain experience, mood experience, and physical activity. A fixed-interval analgesic schedule was found more effective than an on-demand analgesic schedule in reducing subjective pain and elevating mood. No differences were found between the two conditions on measures of physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of improvement in multidisciplinary treatment of chronic pain.

Although multidisciplinary pain programs have been demonstrated to be effective, the processes of improvement have yet to be clarified. Cognitive-behavioral models posit that improvement is due, in part, to changes in patient pain beliefs and coping strategies. To test the relationships between treatment outcome and changes in beliefs and coping strategies, 94 chronic pain patients (aged 21–64 yrs) completed measures of physical and psychological functioning, health care utilization, pain beliefs, and use of pain coping strategies at admission and 3 to 6 mo after inpatient pain treatment. Improved functioning and decreased health care use were associated with changes in both beliefs and cognitive coping strategies. However, changes in some coping strategies, such as exercise and use of rest, were not associated with improvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of relaxation therapy as group and individual treatment of chronic tinnitus

42 patients, suffering from chronic tinnitus, participated in our psychological orientated treatment consisting of relaxation therapy with autogenic training according to J. H. Schultz. The results of individual therapy are compared with group therapy. Using visual analogy scales the therapeutical efficiency can be tested. The individual estimated loudness and annoyance of tinnitus are registered as well as a general emotional status. The results show a positive short-time effect in most cases. A reduction of tinnitus loudness and annoyance after individual and group therapy is seen directly. A positive effect throughout the whole treatment is only found in individual therapy. Concerning the group therapy, many of our patients reported an increase of the pretherapeutical estimation of tinnitus loudness and -annoyance. We believe that the permanent confrontation with the tinnitus problem may advance the psychological conflict in many cases. Therefore psychological management of tinnitus should be concentrated on a temporary limited support aiming to the neglect of tinnitus sensation.     

Narcosynthesis in the treatment of posttraumatic chronic pain: A case study.

Presents the case history of a 49-yr-old White male with chronic traumatically induced pain complaints who was treated with narcosynthesis. Narcosynthesis was indicated because of the lack of initial success with behavioral treatment strategies, such as psychodrama-assisted implosion techniques and hypnosis-assisted desensitization. The use of sodium-amytal-assisted psychotherapy in the treatment of the condition proved singularly efficacious in the short term. In this therapy, the S was administered iv sodium amytal to induce narcosis and then regressed back by the therapist to the day of the industrial accident that had injured him. Repetition of emotionally laden material allowed the anxiety to subside. Upon awakening, all symptoms were absent. However, the symptoms began to worsen 3 mo later when the S found out that he would be returning to the same work. The role of narcosynthesis in the treatment of traumatically induced chronic pain is discussed, with special reference to a behavioral interpretation of the results obtained. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repression predicts outcome following multidisciplinary treatment of chronic pain.

This study examined whether repression predicts outcome following multidisciplinary treatment for chronic pain and whether links between anxiety and outcome are obscured by repressors. Ninety-three chronic pain patients completed a 4-week pain program. Lifting capacity, walking endurance, depression, pain severity, and activity were measured at pre- and posttreatment. Low-anxious, repressor, high-anxious, and defensive/high-anxious groups were formed from median splits of Anxiety Content (ACS) and Lie scales of the Minnesota Multiphasic Personality Inventory–2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Significant ACS?×?Lie interactions were found for lifting capacity, depression, and pain severity changes. Planned comparisons showed that both repressors and high-anxious patients performed poorly on lifting capacity; repressors alone recovered poorly on depression and pain severity. Results imply that repression may interfere with the process and outcome of pain programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in pain perception after treatment for chronic pain

Pain threshold, sensitivity, response bias and ability to discriminate were measured before and after treatment for 15 improved and 15 unimproved chronic pain patients diagnosed as having myofascial pain dysfunction (MPD) syndrome, There were no differences between the groups before treatment. After treatment, the improved group showed an increase in pain threshold, sensitivity and ability to discriminate between different levels of painful stimulation and a decrease in response bias to report pain. The unimproved group showed no changes.     

Behavioral assessment and treatment of chronic pain: Current status and future directions.

A literature review indicates that behavioral assessment methods assess 3 categories of behavior: overt motor, cognitive-verbal, and physiologic. Evidence for the efficacy of operant conditioning and self-management techniques is presented. Data from both multimodal pain-treatment programs and controlled studies are reviewed. Advances in behavioral assessment research allow for a more precise and objective analysis of the behavior of chronic-pain patients. Controlled treatment–outcome studies suggest that behavioral methods may help modify pain behavior and pain report in chronic-pain patients. (93 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Our general chronic pain (centers for treatment chronic pain: therapeutic and organizational work principles)]

Management of chronic pain is now not only medical but a very important social and economic problem. The approaches to its management in specialized pain control centers are discussed basing on the 20-year experience of the first such center in Russia: pain control clinic with therapeutic and diagnostic center "Integrative Medicine" at Research Center of Surgery. The problems of personnel for such pain control centers, cost-effect issues, diagnostic and therapeutic methods including an advanced technique, resonance electropuncture analgesia and therapy, are reviewed.