Hoffman, KE;
(2007)
Reported pain in multiple sclerosis (MS) and its relationship with affect and attention.
Doctoral thesis , UCL (University College London).
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Abstract
Pain is an important part of MS symptomatology. Studies, with other pain populations, suggest distress is associated with pain. However, models of the influence of psychological factors on pain have not been carefully applied and tested with the MS population. The hypothesis was: many patients do not classify much of their sensory disturbance as pain due to their conceptual framework and this may affect the relationship between pain and distress. A model of these factors was developed for MS patients. A clinic sample of MS patients, expected to have varying degrees of subjective pain, was recruited. Standard, adapted and new measures were used to characterise the population along the following dimensions: pain, level of cognitive ability (general intelligence and working memory) and cognitive bias, mood, and coping styles. Amount of distress was assessed using a semantic differential measure of wellbeing/distress, Survey of Pain Attitudes and Coping with MS Scale. A Pain Discomfort Scale was adapted to discern differences between people reporting "pain" versus those reporting "discomfort." Pain cognitive-processing bias was explored using assessments including a stem completion task, an experimental recall task using pain and illness words and a restructured Hayling sentence completion task. Power calculations showed that with 100 patients a detectable correlation would be 0.28 (p=0.05, power = 80%). Measures were compared using paired t-tests for repeated measures, independent t-tests for measures across patients, and regression modelling. McGill adjectives chosen were similar across both high and low pain responders. Participants reporting "pain" experienced significantly greater physical impact of MS whereas participants reporting "discomfort" experienced greater emotional distress. Cognitive bias towards pain, illness and MS related material was not linked with overall pain or disease state but with coping styles. A model of how emotional stressors affect reported pain in MS was created.
| Type: | Thesis (Doctoral) |
|---|---|
| Title: | Reported pain in multiple sclerosis (MS) and its relationship with affect and attention |
| Identifier: | PQ ETD:593661 |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Thesis digitised by ProQuest. Third party copyright material has been removed from the ethesis. Images identifying individuals have been redacted or partially redacted to protect their identity. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1446315 |
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