DOI
https://doi.org/10.25772/225P-VB72
Defense Date
2016
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Clinical Psychology
First Advisor
Stephen Auerbach
Second Advisor
Bruce Rybarczyk
Third Advisor
Sandra Gramling
Fourth Advisor
Bennett Lee
Fifth Advisor
Rachel Waller
Abstract
The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed that patients’ chronic pain attributions did influence pain-related functioning, however the impact was relatively small. There was insufficient evidence to conclude that chronic pain attributions influence a patient’s readiness to adopt self-management coping strategies and their subsequent treatment engagement. Additionally, results confirmed that different health care disciplines attribute the cause of patients’ chronic pain in distinct ways and these unique perspectives can lead to discrepant pain-related functioning assessments between providers. Discordant ratings between providers were shown to influence referring patterns for interdisciplinary services and the patient’s overall opioid dose. Similarly, discrepancies between patients and their providers influenced subsequent referral for behavioral health services, the patient’s attendance at those visits, and their overall morphine equivalent doses. Together the results indicate the important role pain attributions can play in chronic pain management and highlight the central role of the patient-provider and provider-provider relationship.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
4-1-2016
Included in
Clinical Psychology Commons, Cognition and Perception Commons, Diagnosis Commons, Health Psychology Commons, Health Services Research Commons, Other Mental and Social Health Commons, Other Psychiatry and Psychology Commons, Pain Management Commons, Psychiatric and Mental Health Commons