Miles, Anne Elizabeth; (2001) An investigation into psychological aspects of chronic pain. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

This thesis studied the role of schema and meaning in chronic pain. Four studies, using a range of different methods, were used to assess pain schema and pain meanings, and two aspects of pain schema were considered; schema function and schema content. Study 1 adopted an information processing approach and explored the role of retrieval inhibition in the pain-related recall bias, previously demonstrated in chronic pain sufferers. Whilst no evidence was found to support the role of retrieval inhibition in the pain-related recall bias, both this study and Study 2, on group differences in perceived word meaning, provided evidence consistent with the view that categorization processes may play an important role in the pain-related recall bias and that interpretative biases may be a key function of pain schema. Study 3 investigated the role of specific types of schema content / pain meanings (understandings of pain and perceptions of loss accompanying pain experience) in pain adjustment, exploring evidence for both 1) Lacroix et al.'s assertion that symptom understanding is an important predictor of pain-adjustment, and 2) Schmitz et al.'s claim that chronic pain adjustment is moderated by the flexible adjustment coping style. Little evidence was found to support either of these models, although this could have been due to insufficient power in the analysis. However there was evidence that factors such as levels of involvement in a pre-pain hobby may be important predictors of depression. Study 4 used an unconstrained method to explore broader aspects of pain meanings and their relation to pain adjustment, developing a grounded theory based on interviews with chronic pain sufferers. The concept of constraint emerged as an important aspect of schema content in understanding pain-adjustment. Furthermore, the analogy between having pain and the ageing process emerged and the parallels between the two were found to be worthy of further exploration.

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