Lecture 5 Flashcards
Objectives when assessing patients presenting for help with pain:
- Identify what is unique to patient
- Co-create a strategy for intervention
- Consider prognostic indicators
Objectives:
- Identify how you will know if treatment is progressing
- Provide pre-post treatment comparisons
A few considerations:
- Is it covered?
- Will the assessment speak to treatment planning issues?
- Who is the audience for the report?
- Standard measures of psychopathology may not be useful
What do we want in an assessment?
- Short, valid, user-friendly battery
- Good coverage of relevant domains
- Help in treatment planning
- Help in evaluating treatment
- Efficiency
- Something the referring physician will value and use
Main points to remember from B Thorn:
- Measures of psychopathology have limited utility
- Pain-specific instruments are more useful
- Practitioner needs pre-treatment measures, within-treatment measures, and process measures
- Cognitive dimensions are the most important predictors of and targets for treatment
Must move away from traditional measure of psychopathology (e.g., MMPI) toward assessment of pain-specific psychosocial issue such as…
-Beliefs/ attitudes, cognitions, coping
Are we measuring psychopathology or
underlying psychological vulnerability exacerbated by stress(diathesis/ stress model)
Here is what we think…
- Personality influences individual’s cognitive processing of the meaning of pain
- Personality is the moderator
- Cognitive processing is the mediator
Pain-specific psychosocial assessments: lots of options, but often…
-Too lengthy to be practical; too restricted in focus; not readily interpretable; have probable construct overlap
Catastrophizing is a robust predictor of:
-pain, analgesic use, distress, psychosocial dysfunction, and disability
Patient global impression of change:
-Pain is a subjective experience; improvement also involves subjective evaluation - getting the patient’s perspective on what has changed
