Fifty-seven chronic pain patients rated their pain intensity, mood and activity level, at a random time schedule, eight times a day during 6 consecutive days, according to the Experience Sampling Method (ESM). Within-person correlations among pain intensity, mood and activity level were calculated. We found pain intensity to be significantly associated with mood. However, the associations between pain intensity and activity level, and activity level and mood could not be supported. Further, we examined whether the relationship between pain intensity and mood was the result of a pattern across the day. Results showed that pain intensity and mood were worst in the morning and improved during the afternoon among participants whose pain intensity and mood were correlated significantly. We suggest that attentional as well as behavioural processes might explain the established day pattern of pain intensity and mood.
These early results indicate that a multimodal treatment program has the potential to be an effective treatment for patients with chronic symptoms after a whiplash injury of the neck--a group of patients who have in the past been considered intractable or, at the very least, puzzling.
This study investigated the utility of the MMPI-2-based Personality Psychopathology Five (PSY-5) scales (Harkness, McNulty, & Ben-Porath, 1995) in the outcome prediction of behaviorally oriented chronic-pain treatment. The PSY-5 is a dimensional descriptive system for personality and its disorders. The sample consisted of 120 consecutive chronic-back-pain patients who followed a 4-week multimodal treatment program aimed at achieving a normal pattern of functioning, including return to regular work. The psychometric properties of the PSY-5 scales (Aggressiveness, Psychoticism, Constraint, Negative Emotionality/Neuroticism, and Positive Emotionality/Extraversion) were highly similar to the data reported by Harkness et al. (1995) and also corresponded to the characteristics of chronic-pain patients. The results of the hierarchical regression analyses provided support for the utility of the PSY-5 Positive Emotionality/Extraversion scale for the prediction of emotionally oriented outcome. We conclude that the PSY-5 model of personality psychopathology provides a solid basis for the more systematic study of the complex relation between personality characteristics and multidimensional treatment.
was examined in relation to a number of physical and psychosocial measures of treatment outcome in patients reporting chronic back pain. MMPI-2 scales assessing manifestations of emotional distress were considered: anxiety (Scale 7 [Pi]: Anxiety [ANX\ and Obsessiveness [OBS]), depression (Scale 2 [D]: Depression [DEP]), and somatic discomfort (Scale 1 [Hs]: Lassitude-Malaise [Hy3], Somatic Complaints [Hy4], and Health Concerns [HEA]). The outcome results at 6-month follow-up for 120 patients who participated in a 4-week outpatient multimodal treatment program were examined. Results showed several of the selected scales to be predictive of less improvement, depending on the outcome measures used.
Purpose The purpose of this study is to measure the psychometric properties of the Work and Wellbeing Inventory (WBI) (in Dutch: VAR-2), a screening tool that is used within occupational health care and rehabilitation. Our research question focused on the reliability and validity of this inventory. Methods Over the years seven different samples of workers, patients and sick listed workers varying in size between 89 and 912 participants (total: 2514), were used to measure the test-retest reliability, the internal consistency, the construct and concurrent validity, and the criterion and predictive validity. Results The 13 scales displayed good internal consistency and test-retest reliability. The constructive validity of the WBI could clearly be demonstrated in both patients and healthy workers. Confirmative factor analyses revealed a CFI >.90 for all scales. The depression scale predicted future work absenteeism (>6 weeks) because of a common mental disorder in healthy workers. The job strain scale and the illness behavior scale predicted long term absenteeism (>3 months) in workers with short-term absenteeism. The illness behavior scale moderately predicted return to work in rehab patients attending an intensive multidisciplinary program. Conclusions The WBI is a valid and reliable tool for occupational health practitioners to screen for risk factors for prolonged or future sickness absence. With this tool they will have reliable indications for further advice and interventions to restore the work ability.
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