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The impact of a lack of medical explanation for pain, 'medically unexplained' comorbid conditions, and ethnicity on CBT therapists' judgments of pain and treatment decisions

Jones, BF; (2016) The impact of a lack of medical explanation for pain, 'medically unexplained' comorbid conditions, and ethnicity on CBT therapists' judgments of pain and treatment decisions. Doctoral thesis , UCL (University College London). Green open access

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Abstract

This three-part thesis reviews the effectiveness of cognitive behavioural therapies for medically unexplained symptoms on healthcare use, investigates the impact of a lack of a medical explanation for pain, ‘medically unexplained’ comorbid conditions, and ethnicity on CBT therapists’ judgments of pain and treatment decisions, and discusses the challenges that were faced in the conducting and reporting of this research. Part one of this volume is a review and meta-analysis of 16 randomised controlled trials of cognitive behavioural interventions for people with medically unexplained symptoms. Borderline significant effects were found for one analysis each of reduced healthcare contacts/resource use, as well as for medication use. There was no significant effect found for reduced medical investigations. Part two of this volume is an empirical study that investigates the impact of a lack of a medical explanation for pain, ‘medically unexplained’ comorbid conditions, and ethnicity on CBT therapists’ judgments of pain and treatment decisions. Small, but significant effects were found for the impact of a lack of a medical explanation for pain and comorbid conditions on CBT therapists’ estimations of pain severity and exaggeration. A large effect was found for the impact of comorbid conditions on estimations of pain being caused by a mental health problem. These factors were also found to have an impact on treatment decisions. No effect on pain judgments was found for the variable of ethnicity, but ethnicity was found to have an impact on treatment decisions. Part three is a critical appraisal of the literature review and research process as a whole. It contains some personal reflections on the different stages of research and the challenges that were faced.

Type: Thesis (Doctoral)
Title: The impact of a lack of medical explanation for pain, 'medically unexplained' comorbid conditions, and ethnicity on CBT therapists' judgments of pain and treatment decisions
Event: UCL
Open access status: An open access version is available from UCL Discovery
Language: English
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/1521056
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