UBC Theses and Dissertations
Induced pain : cognitive and behavioural correlates Aquan-Assee, Jasmin Soylin Elizabeth
Cognitive processes have recently received considerable attention in studies of pain. Belief systems, coping mechanisms, perceptions of control and self-efficacy, and other cognitive systems appear to play a central role in determining individual differences to painful events (Rollman, 1983; Turk, Meichenbaum & Genest, 1983; Weisenberg, 1984). The present investigation sought to examine the cognitive and behavioural relationships that are associated with individual differences in responses to painful stimuli. Sixty female undergraduate psychology students participated in the experimental pain induction procedure which used the cold pressor test as the noxious stimulation. To gain a broad assessment of the different factors that may be characteristic of differences in response to pain, tolerant subjects were contrasted with less tolerant subjects on a variety of self-report, cognitive and behavioural - facial expression - measures. As part of the assessment procedure, subjects completed measures of state anxiety, self-efficacy to withstand pain, and a questionnaire involving a retrospective analysis of cognitive techniques. Half of the subjects were interviewed regarding their cognitions concerning the cold pressor task both pre and post their immersion, and the other half were interviewed post only. Transcriptions were coded independently of pain tolerance status. Subjects' facial expressions were videotaped during the cold pressor task and coded using the Facial Action Coding System (FACS) developed by Ekman and Friesen (1978). It was hypothesized that dysfunctional cognitions, lack of effective coping activity, amplification of sensory intensity and affective discomfort and high levels of facial activity would characterize subjects who were less tolerant of the induced pain. The distribution of the endurance times to the cold pressor task confirmed past observations that subjects cluster into two major groups of high and low tolerance (Turk et al. 1983). The results confirmed the major hypotheses that there are cognitive and self-report differences between pain tolerance groups. In comparison to tolerant subjects, less tolerant subjects had lower scores of perceived self-efficacy to withstand pain, higher scores for both sensation and discomfort ratings, retrospectively reported having experienced more pain, and made more accurate estimates of their duration in the cold water. Less tolerant subjects also reported more dysfunctional cognitions during the cold pressor task and reported using effective coping techniques to a lesser extent than tolerant subjects. Major differences between the tolerance groups also appeared in the length of post-test interviews. Tolerant subjects had much lengthier interviews at the post-test than less tolerant subjects. A discriminant analysis revealed that self-efficacy beliefs during the experimental task and the length of the post-test interviews were the most important discriminators between the groups. These results highlight the role of cognition in individual differences in pain tolerance. These results also suggest that low pain tolerance subjects may be better conceptualized as being ineffective and overwhelmed in their attempts to cope with pain which supports the current notion that cognitive based therapies may be the key in managing and alleviating pain states. No support was found for the hypothesis that subjects of differing pain tolerance thresholds would be characterized by differences in facial activity. Facial actions associated with pain in the present study were similar with facial expressions in previous studies (cf. Craig & Patrick, 1985; Hyde, 1986; Swalm, 1987). Contrary to previous results (Craig & Patrick, 1985), measures of facial expression increased over exposure time similarly to self-report. High levels of facial expression were associated with low levels of self-report of coping cognitions assessed at the post-test and with shorter post-test interviews.
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