Dissertation
The West Haven-Yale multidimensional pain inventory as a predictor of outcome in chronic pain patients who undergo spinal cord stimulator or infusion pump implantations
Doctor of Philosophy (Ph.D.), Drexel University
1999
DOI:
https://doi.org/10.17918/00008430
Abstract
Spinal cord stimulator (SCS) and infusion pump (IP) implantations have become increasingly popular for treating patients suffering from intractable, chronic pain. However, SCS and IP are still viewed as invasive procedures and their efficacy may vary widely. Adhering to a cognitive-behavioral framework of evaluating pain, four subscales from the West Haven-Yale Multidimensional Pain Inventory (MPI) were chosen to determine their contribution to the variability of SCS and IP outcome. Several unanticipated, but clinically- and empirically-meaningful findings emerged. First, both response style on the Minnesota Multiphasic Personality Inventory - 2 (MMPI-2) and the 4 MPI scales significantly discriminated between patients whose trial implants were failures and those whose trial implants were successful, with response style and the Negative Mood scale from the MPI being the most significant contributors to accurate classification. An underreporting response bias was more prevalent in the trial failure group, and increased negative mood symptoms predominated the trial success group. Second, for the trial success group, the 4 MPI scales together did not significantly predict any of the 4 aspects of outcome examined (pain intensity, depressive and anxiety symptoms, and participation in common daily activities) above and beyond that accounted for by demographic/clinical variables. Considered individually, the Negative Mood scale significantly predicted pain severity post-implant, and was the only one of the 4 MPI scales to significantly predict any of the 4 outcome dimensions after the effects of demographic/clinical variables were controlled. Of the demographic/clinical variables assessed, education level, pain duration, employment status, and primary pain site significantly predicted at least one of the four components of outcome. Finally, of the 4 outcome dimensions, only pain severity showed a significant change pre- to post-implant, was significantly influenced by any of the 4 MPI scales (i.e., Negative Mood), and was best predicted by the independent variables. Factors that may have contributed to variance in the findings are discussed, and clinical and research implications are proposed.
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Details
- Title
- The West Haven-Yale multidimensional pain inventory as a predictor of outcome in chronic pain patients who undergo spinal cord stimulator or infusion pump implantations
- Creators
- Raquelle I. Mesholam
- Contributors
- Lamia Barakat (Advisor) - Drexel University, Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- viii, 166 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- College of Arts and Sciences; Drexel University
- Other Identifier
- 991021889105304721