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Objectives when assessing patients presenting for help with pain:

-Identify what is unique to patient
-Co-create a strategy for intervention
-Consider prognostic indicators



-Identify how you will know if treatment is progressing
-Provide pre-post treatment comparisons


A few considerations:

-Is it covered?
-Will the assessment speak to treatment planning issues?
-Who is the audience for the report?
-Standard measures of psychopathology may not be useful


What do we want in an assessment?

-Short, valid, user-friendly battery
-Good coverage of relevant domains
-Help in treatment planning
-Help in evaluating treatment
-Something the referring physician will value and use


Main points to remember from B Thorn:

-Measures of psychopathology have limited utility
-Pain-specific instruments are more useful
-Practitioner needs pre-treatment measures, within-treatment measures, and process measures
-Cognitive dimensions are the most important predictors of and targets for treatment


Must move away from traditional measure of psychopathology (e.g., MMPI) toward assessment of pain-specific psychosocial issue such as...

-Beliefs/ attitudes, cognitions, coping


Are we measuring psychopathology or

underlying psychological vulnerability exacerbated by stress(diathesis/ stress model)


Here is what we think...

-Personality influences individual's cognitive processing of the meaning of pain
-Personality is the moderator
- Cognitive processing is the mediator


Pain-specific psychosocial assessments: lots of options, but often...

-Too lengthy to be practical; too restricted in focus; not readily interpretable; have probable construct overlap


Catastrophizing is a robust predictor of:

-pain, analgesic use, distress, psychosocial dysfunction, and disability


Patient global impression of change:

-Pain is a subjective experience; improvement also involves subjective evaluation - getting the patient's perspective on what has changed