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Posttraumatic Stress Symptoms and General Activity Level in the Prediction of Neurocognitive Performance in Chronic Pain Patients

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International Journal of Rehabilitation and Health

Abstract

The relative contribution of posttraumatic stress symptoms and general activity level to the prediction of neurocognitive performance among individuals with chronic pain was investigated. Posttraumatic stress symptoms accounted for significant proportions of the variance in attention and concentration and memory after controlling for years of education and pain severity. Level of engagement in common daily activities was also a significant predictor of attention and concentration. Level of general activity moderated the relation between posttraumatic stress symptoms and reasoning ability, the expected negative relation between posttraumatic stress symptoms and reasoning ability was significant only among those chronic pain patients who reported low levels of engagement in tasks of daily living. Discussion focuses on the findings in terms of their many implications for assessment and treatment of emotional and neurocognitive difficulties experienced by persons with chronic pain.

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REFERENCES

  • Aiken, L. S., and West, S. G. (1991). Multiple Regression: Testing and Interpreting Interactions, Sage, Newbury Park, CA.

    Google Scholar 

  • Asmundson, G. J., Norton, G. R., Allerdings, M. D., Norton, P. J., and Larsen, D. K. (1998). Posttraumatic stress disorder and work-related injury. J. Anx. Disord. 12: 57-69.

    Google Scholar 

  • Asmundson, G. J., Norton, P. J., and Norton, G. R. (1999). Beyond pain: The role of fear and avoidance in chronicity. Clin. Psychol. Rev. 19: 97-119.

    Google Scholar 

  • Benedikt, R. A., and Kolb, L. C. (1986). Preliminary findings on chronic pain and posttraumatic stress disorder. Am. J. Psychiat. 143: 908-910.

    Google Scholar 

  • Benton, A. L., and Hamsher,K. (1978). Multilingual Aphasia Examination: Manual of Instruction, AJAAssociates, Iowa City.

    Google Scholar 

  • Bremner, J. D., Scott, T. M., Delaney, R. C., Southwick, S. M., Mason, J. W., Johnson, D. R., Innis, R. B., McCarthy, G., and Charney, D. S. (1993). Deficits in short-term memory in posttraumatic stress disorder. Am. J. Psychiat. 150: 1015-1019.

    Google Scholar 

  • Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Tellegen, A. M., and Kaemmer, B. (1989). MMPI-2: Minnesota Multiphasic Inventory-2: Manual for Administration and Scoring, University of Minnesota Press, Minneapolis, MN.

    Google Scholar 

  • Dinklage, D., and Grodzinsky, G. M. (1993, February). Neuropsychological deficits in severely sexually abused children. Paper presented at the meeting of the International Neuropsychological Society, Galveston, TX.

  • Geisser, M. E., Roth, R. S., Bachman, J. E., and Eckert, T. A. (1996). The relationship between symptoms of posttraumatic stress disorder, affective disturbance and disability among patients with accident and non-accident related pain. Pain 66: 207-214.

    Google Scholar 

  • Golden, D. J. (1978). Stroop Colour Word Test, Stoelting, Chicago.

    Google Scholar 

  • Gronwall, D. M. A., and Sampson, H. (1974). The Psychological Effects of Concussion, Auckland University Press/Oxford University Press, Auckland.

    Google Scholar 

  • Heaton, R. K. (1981). Wisconsin Card Sorting Test Manual, Psychological Assessment Resources, Odessa.

    Google Scholar 

  • Hickling, E. J., and Blanchard, E. B. (1992). Post-traumatic stress disorder and motor vehicle accidents. J. Anx. Disord. 6: 285-291.

    Google Scholar 

  • Hovens, J., and van der Ploeg, M. (1993). Posttraumatic stress disorder in Dutch psychiatric in-patients. J. Traum. Stress 6: 91-102.

    Google Scholar 

  • Iezzi, A., Archibald, Y., Barnett, P., Klinck, A., and Duckworth, M. (1999a). Neurocognitive performance and emotional status in chronic pain patients. J. Behav. Med. 22(3): 205-216.

    Google Scholar 

  • Iezzi, T., Archibald, Y., Duckworth, M. P., and Klinck, A. (1999b, November). Predictors of neurocognitive performance in chronic pain patients. Poster presented at the meeting of the Association for the Advancement of Behavior Therapy, Toronto, Ontario.

  • Jones-Gottman, M., and Milner, B. (1977). Design fluency: The invention of nonsense drawings after focal cortical lesions. Neuropsychology 15: 653-674.

    Google Scholar 

  • Keane, T. M., Malloy, P. F., and Fairbank, J. A. (1984). Empirical development of an MMPI subscale for the assessment of combat-related posttraumatic stress disorder. J. Consult. Clin. Psychol. 52: 888-891.

    Google Scholar 

  • Kerns, R. D., Turk, D. C., and Rudy, T. E. (1985). The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain 23: 345-356.

    Google Scholar 

  • Knight, J. A. (1997). Neuropsychological assessment in posttraumatic stress disorder. (1997). In Wilson, J. P., and Keane, T. M. (eds.), Assessing Psychological Trauma and PTSD Guilford, New York, NY, pp. 448-492.

    Google Scholar 

  • Koretsky, M., and Peck, A. (1990). Validation and crossvalidation of the PTSD subscale of the MMPI with civilian trauma victims. J. Clin. Psychol. 46: 296-300.

    Google Scholar 

  • Kuch, K., Evans, R. E., Watson, P. C., Bubela, C., and Cox, B. J. (1991). Road vehicle accidents and phobias in 60 patients with fibromyalgia. J. Anx. Disord. 5: 273-280.

    Google Scholar 

  • Matthews, C. G., and Klove, H. (1964). Instruction Manual for the Adult Neuropsychology Test Battery, Madison University of Wisconsin Medical School, Madison.

    Google Scholar 

  • Mayer, T. G., Gatchel, R. J., Kishino, N., Keeley, J., Mayer, H., Capra, P., and Mooney, V. (1986). A prospective short-term study of chronic low back pain patients utilizing novel objective functional measurement. Pain 25: 53-68.

    Google Scholar 

  • Melzack, R. (1999). From the gate to the neuromatrix. Pain (Suppl. 6): S121-S126.

    Google Scholar 

  • Norris, F. H., and Riad, J. K. (1997). Standardized self-report measures of civilian trauma and posttraumatic stress disorder. In Wilson, J. P., and Keane, T. M. (eds.), Assessing Psychological Trauma and PTSD, Guilford, New York, NY, pp. 7-42.

    Google Scholar 

  • Norusis, M. J. (1996). SPSS for Windows: Release 7.5, SPSS, Chicago, IL.

    Google Scholar 

  • Osterreith, P. (1944). Le test de copie d'une figure complexe. Archives de Psychologie 30: 206-356.

    Google Scholar 

  • Rey, A. (1941). L'examen psychogique dans les cas d'encephalopathie traumatique. Archives de Psychologie 28: 286-340.

    Google Scholar 

  • Spreen, O., and Benton, A. L. (1965). Comparative studies of some psychological tests for cerebral damage. J. Nerv. Ment. Dis. 140: 323-333.

    Google Scholar 

  • Tabachnick, B. G., and Fidell, L. S. (1996). Using Multivariate Statistics, 3rd Ed., Harper Collins College Publishers, New York.

    Google Scholar 

  • Tartar, R. E., Hegedus, A. M., Winsten, N. E., and Alterman, A. I. (1984). Neuropsychological, personality and familial characteristics of physically abused delinquents. J. Acad. Child Psychiat. 23: 668-674.

    Google Scholar 

  • Uddo, M., Vasterling, J. J., Brailey, K., and Sutker, P. (1993). Memory and attention in combat-related PTSD. J. Psychopathol. Behav. Assess. 15: 43-52.

    Google Scholar 

  • van der Kolk, B. A. (1996). The body keeps the score: Approaches to the psychobiology of posttraumatic stress disorder. In van der Kolk, B. A., McFarlane, A. C., and Weisaeth, L. (eds.), Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society, Guilford, New York, NY, pp. 214-241.

    Google Scholar 

  • Waddell, G. (1987). A new clinical model for the treatment of low-back pain. Spine 12: 632-644.

    Google Scholar 

  • Wechsler, C. (1981). Wechsler Adult Intelligence Scale-Revised Manual, Psychological Corporation, New York.

    Google Scholar 

  • Wechsler, C. (1987). Wechsler Memory Scale-Revised-Manual, Psychological Corporation, New York.

    Google Scholar 

  • West, S. G., Aiken, L. S., and Krull, J. L. (1996). Experimental personality designs: Analyzing categorical by continuous variable interactions. J. Person. 64: 1-48.

    Google Scholar 

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Thomas, S., Iezzi, T., Duckworth, M.P. et al. Posttraumatic Stress Symptoms and General Activity Level in the Prediction of Neurocognitive Performance in Chronic Pain Patients. International Journal of Rehabilitation and Health 5, 31–42 (2000). https://doi.org/10.1023/A:1012907102560

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