Browsing by Author "Edwards, Deidre Marie"
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Item The Comorbidity of Emotional Distress with Two Common Acute Pain Populations: Jaw and Low Back(2005-08-11) Edwards, Deidre Marie; Stowell, Anna W.The present study was undertaken to evaluate emotional distress in two common acute pain populations: jaw pain (JAW; n = 135) and low back pain (LB; n=71). Prevalence of psychopathology in each group was evaluated, using the Structured Clinical Interview of Diagnostic and Statistical Manual IV - I and II, and compared to general population estimates. Analyses also examined discrepancies between low risk (LR) JAW and LR LB and high risk (HR) JAW and HR LB. Additionally, medication usage was evaluated to see if differences existed in types of medications used in these groups. Subjects were evaluated on a variety of psychosocial and functional measures, including the Beck Depression Inventory, Multidimensional Pain Inventory, Characteristic Pain Intensity, and Ways of Coping measures. Analyses revealed that there were significant differences between the JAW and LB groups, as well as differences between both risk status groups and the general population and specifically for DSM-IV Diagnoses. JAW subjects were found to have lower BDI and CPI scores, as well as a higher level of functioning on the Global Assessment of Functioning (GAF) from the DSM-IV. JAW patients had significantly more current Axis I and II diagnoses, while the LB group had significantly more lifetime Axis I and II disorders. Both acute pain groups had significantly more Axis I and II disorders than the general population. Additionally, it was discovered that the JAW group used more benzodiazepines, while the LB group used more Schedule II Narcotics. A logistic regression created from significant variables found a six-factor solution, created by the Characteristic Pain Intensity, MPI Coping Style Anomalous, Ways of Coping Problem-Solving, Global Assessment of Functioning, Anxiety Disorders, and Cluster C personality disorder diagnoses, that differentiates the JAW from the LB group. Overall, differences identified between these two groups indicate that the JAW group has increased current psychopathology, while the LB group has more enduring psychopathology. Future treatment should more uniquely correspond to the specific acute pain group.Item Psychosocial Variables in Outpatients Receiving Intrathecal Baclofen or Pain-Pump Therapy(2013-01-17) Edwards, Deidre Marie; Gatchel, Robert J.Numerous studies have demonstrated that patients suffering from chronic health conditions are at an increased risk for experiencing psychosocial distress and developing psychological difficulties. Spasticity, a chronic condition generally defined as an increase in muscle tone while at rest, is frequently observed in a variety of medical populations. Spasticity is not only painful, it can also significantly impair mobility, daily functioning, and quality of life. Intrathecal baclofen and pain pump therapy have been viable treatment options for those patients with severe spasticity who have not responded to less invasive treatments. Several small studies have examined quality of life and patient-reported efficacy for spasticity patients receiving implantable intrathecal baclofen (ITB) therapy. However, no research has examined what variables may play a role in quality of life outcomes for spasticity patients across and between the varied diagnostic populations treated with ITB or baclofen pain-pump therapy in a large sample. The proposed study examined several psychosocial variables (e.g. health-related quality of life [HRQOL], level of social functioning, self-reported levels of optimism/pessimism) and psychological variables (e.g. depressive and other psychiatric symptoms, as well as self-reported pain ratings) within a heterogeneous population of patients that receive ongoing care with intrathecal baclofen or baclofen pain-pump therapy. A sample of 125 adults, aged 19 - 82 years (M=49.06) who had been treated with ITB and other intrathecal pain medications, were assessed. Participants individually completed a packet of questionnaires measuring the primary study constructs. Analyses (One-way ANOVAs and t-tests) showed that the sample differed greatly from the normative population across measures of depression, quality of life, pain, and social functioning. Additionally, group differences were discovered between subgroups of spasticity patients. Multiple regression analyses showed that higher satisfaction with one's social roles, lower levels of feeling limited in one's roles by his/her emotional health, and higher rates of vitality were predictive of quality of life.