title: An investigation of personality, coping and emotion in patients with persistent pain
Creators: name: Rafsanjani, Gholamreza Ebrahimi Nejad
Publisher: name: University of Glasgow
Year: 1997

description: This thesis reports a study of the role of personality, emotion and coping in patients suffering persistent pain. The matter of personality is of particular interest because although the factor has been shown important in determining the response to acute pain, its role in chronic pain states is less well established. Review of the literature leads to the hypothesis that the personality factor of neuroticism may predict pain and emotional responses in the chronic pain state. The thesis is also concerned with the extent to which chronic pain patients benefit from attending a Pain Relief Clinic, and the factors that predict benefit. The literature review begins in Chapter 1 by briefly setting the scene of the problem that persistent pain creates for sufferers. In Chapter 2, attention turns to theories that have attempted to explain the experience of pain in physiological and psychological terms. Chapter 3 describes psychological factors in the patient's response to pain, including coping strategies and the importance of support from family and other significant individuals. In Chapter 4, there is discussion of the role of personality in the experience of pain, and this leads to the rationale for the present experimental work and the research hypotheses to be developed in Chapter 5. The Methods section of Chapter 5 states the research hypotheses and describes the method to be used to test them. Three studies assess the role of personality, coping and social support in the chronic pain state, the response to the pain clinic and the clinician's rating of the outcome. The principal research hypotheses are stated in Chapter 5; (1) that neuroticism will predict higher pain scores and increased distress, (2) that active coping strategies may exert beneficial effects upon pain and distress, and (3) that social support may also exert a beneficial effect reflected in lower pain and distress scores. The Results are described in Chapters 6 to 8 inclusive. In Chapter 9, the General Discussion considers the results in light of studies discussed in the literature review and concludes that the present results are both consistent with those earlier findings and provide new insight concerning the effects of personality. There is also discussion of the implications of the results for theory and practice in the pain relief clinic. It is concluded that it would be helpful for the clinician to have knowledge of the way in which certain personality factors, social support and coping styles may predict those who benefit from treatment in the pain relief clinic. The chapter also describes the psychological interventions available to help patients in persistent pain, and considers some avenues for future research. A substantial section of the chapter is devoted to discussion of methodological issues in the present work that would be revised if such a research programme were to be repeated. The final section of the chapter considers briefly the role of unconscious processes as a neglected facet of the psychological approach to understanding persistent pain.