Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-05T10:48:47.601Z Has data issue: false hasContentIssue false
  • English
  • Français

Pain Related-Visual Imagery is Associated with Distress in Chronic Pain Sufferers

Published online by Cambridge University Press:  23 March 2012

David Gillanders ,
Louise Potter  and
Paul Graham Morris
David Gillanders*
Affiliation:
University of Edinburgh and Lothian Chronic Pain Service, UK
Louise Potter
Affiliation:
NHS Grampian, Elgin, UK
Paul Graham Morris
Affiliation:
University of Edinburgh, UK
*
Reprint requests to David Gillanders, University of Edinburgh, Clinical and Health Psychology, School of Health in Social Science, Teviot Place, Edinburgh EH8 9AQ, Scotland, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Chronic pain patients often describe their pain in ways that suggest vivid mental images, with some reporting images relating to their pain. Despite these clinical observations, there are few studies describing the nature and consequences of these images. This study examined whether mental imagery of pain is associated with levels of reported distress, cognitions, disability or pain severity. Method: In a postal survey, 83 adult chronic pain patients indicated whether or not they experienced mental images of their pain. They also completed standardized measures of depression, anxiety, cognitions, disability and pain severity. Those reporting images were compared to those not reporting images on their responses to the other variables. Results: People with pain imagery reported significantly higher levels of anxiety, depression and catastrophizing than patients who did not report such images. No differences were found on measures of physical disability. Discussion: Mental images of pain appear to be associated with higher levels of anxiety, depression and catastrophizing. It is possible that these images play a role in maintaining such difficulties. For these patients, imagery may provide a route via which clinicians can work with patients to help them reinterpret or respond more flexibly to their pain.

Keywords

Chronic painmental imagerycognitive behavioural therapycatastrophizinganxietydepression
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 40 , Issue 5 , October 2012 , pp. 577 - 589
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. New York: American Library.Google Scholar
Bergner, M., Bobbitt, R. A., Carter, W. B. and Gilson, B. S. (1981) The Sickness Impact Profile: development and final revision of a health status measure, Medical Care, 19, 787–805.Google Scholar
Berna, C., Vincent, K., Moore, J., Tracey, I., Goodwin, G. M. and Holmes, E. A. (2011). Presence of mental imagery associated with chronic pelvic pain: a pilot study. Pain Medicine, 12, 1086–1093. doi: 10.1111/j.1526-4637.2011.01152.xGoogle Scholar
Bjelland, I., Dahl, A., Haug, T. T. and Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic Research, 52, 69–77.Google Scholar
Carruthers, H. R., Miller, V., Morris, J., Evans, R., Tarrier, N. and Whorwell, P. J. (2009). Using art to help understand the imagery of irritable bowel syndrome and its response to hypnotherapy. The International Journal of Clinical and Experimental Hypnosis, 57, 162–173. doi: 10.1080/00207140802665401Google Scholar
Day, S. J., Holmes, E. A. and Hackmann, A. (2004). Occurrence of imagery and its link with early memories in agoraphobia. Memory, 12, 416–427.Google Scholar
de Silva, P. (1986). Obsessional-compulsive imagery. Behaviour Research and Therapy, 24, 333–350.Google Scholar
Deyo, R. A. (1986). Comparative validity of Sickness Impact Profile and shorter scales for functional assessment in low back pain. Spine, 11, 951–954.CrossRefGoogle ScholarPubMed
Deyo, R. A. and Centor, R. M. (1986). Assessing the responsiveness of functional scales to clinical change: analogy to diagnostic test performance. Journal of Chronic Diseases, 39, 897–906.Google Scholar
Dunst, C. J., Hamby, D. W. and Trivette, C. M. (2004). Guidelines for calculating effect sizes for practice based research syntheses, Centerscope, 3, 1–10.Google Scholar
Eccleston, C., Williams, A.C.D.C. and Morley, S. (2009). Psychological therapies for the management of chronic pain (excluding headache) in adults (Review). Cochrane Database of Systematic Reviews, (2), 2–4. doi: 10.1002/14651858.CD007407.pub2Google Scholar
Fernandez, E. and Turk, D.C. (1989). The utility of cognitive coping strategies for altering pain perception: a meta-analysis. Pain, 38, 123–135.Google Scholar
Field, A. (2005). Discovering Statistics using SPSS (2nd edn.). London: Sage.Google Scholar
Flor, H., Behle, D.J. and Birbaumer, N. (1993). Assessment of pain-related cognitions in chronic pain patients, Behaviour Research and Therapy, 31, 63–73.CrossRefGoogle ScholarPubMed
Flor, H. and Turk, D. C. (1988). Chronic back pain and rheumatoid arthritis: predicting pain and disability from cognitive variables. Journal of Behavioural Medicine, 11, 251–265.Google Scholar
Gosden, T. (2008). Mental Imagery in Chronic Pain: prevalence and characteristics. Unpublished Doctoral Thesis, University of Edinburgh.Google Scholar
Hackmann, A., Surawy, C. and Clark, D. M. (1998). Seeing yourself through others’ eyes: a study of spontaneously occurring images in social phobia. Behavioural and Cognitive Psychotherapy, 26, 3–12.Google Scholar
Harrison, R. and Cock, D. (2004). Increasing response to a postal survey of sedentary patients: a randomised controlled trial. BMC Health Services Research, 4, 31.Google Scholar
Holmes, E. A., Arntz, A. and Smucker, M. R. (2007). Imagery rescripting in cognitive behaviour therapy: images, treatment techniques and outcomes. Journal of Behavior Therapy and Experimental Psychiatry, 38, 297–305.Google Scholar
Jamani, N. and Clyde, Z. (2008). Treatment of pain related fear in chronic (persistent) pain: the role of safety seeking behaviour and imagery. The Cognitive Behaviour Therapist, 1, 3–15.CrossRefGoogle Scholar
Jensen, M. P., Strom, S. E., Turner, J. A. and Romano, J. M. (1992). Validity of the Sickness Impact Profile Roland Scale as a measure of dysfunction in chronic pain patients. Pain, 50, 157–162.Google Scholar
Jensen, M. P., Turner, J. A., Romano, J. M. and Karoly, P. (1991). Coping with chronic pain: a critical review of the literature. Pain, 47, 249–283.Google Scholar
Just, N. and Alloy, L. B. (1997). The response styles theory of depression: tests and an extension of the theory. Journal of Abnormal Psychology, 106, 221–229.Google Scholar
Lonsdale, J. (2010). Imagery and Emotion in Chronic Pain. Unpublished Doctoral Thesis, University of Edinburgh.Google Scholar
Main, C. and Spanswick, C. (2000). Pain Management: an interdisciplinary approach. New York: Hardcourt Publishers, Ltd.Google Scholar
Marks, D. F. (1973). Visual imagery differences in the recall of pictures, British Journal of Psychology, 64, 17–24.Google Scholar
Melzack, R. (1987). The short form McGill Pain questionnaire. Pain, 30, 191–197.Google Scholar
Morley, S., Eccleston, C. and Williams, A. (1999). Systematic review and meta-analysis of randomised controlled trials of cognitive behaviour therapy for chronic pain in adults, excluding headache. Pain, 80, 1–13.Google Scholar
Osman, S., Cooper, M., Hackmann, A. and Veale, D. (2004). Spontaneously occurring images and early memories in people with body dysmorphic disorder. Memory, 12, 428–436.CrossRefGoogle ScholarPubMed
Patel, T., Brewin, C., Wheatley, J., Wells, A., Fisher, P. and Myers, S. (2007). Intrusive images and memories in major depression. Behaviour Research and Therapy, 45, 2573–2580.Google Scholar
Philips, H. C. (2011). Imagery and pain: the prevalence, characteristics, and potency of imagery associated with pain. Behavioural and Cognitive Psychotherapy, 39, 1–18. doi: 10.1017/S1352465811000282Google Scholar
Rachman, S. (2007). Unwanted intrusive images in obsessive compulsive disorders. Journal of Behavior Therapy and Experimental Psychiatry, 38, 402–410.Google Scholar
Reisberg, D., Pearson, D. G. and Kosslyn, S. M. (2003). Intuitions and introspections about imagery: the role of imagery experience in shaping an investigator's theoretical views. Applied Cognitive Psychology, 17, 147–160.Google Scholar
Roelofs, J., McCracken, L., Peters, M. L., Crombez, G., Breukelen, G. van and Vlaeyen, J. W. (2004). Psychometric evaluation of the Pain Anxiety Symptoms Scale (PASS) in chronic pain patients. Journal of Behavioral Medicine, 27, 167–183.Google Scholar
Roland, M. and Morris, R. (1983). Study of natural history of low back pain. Part II: development of guidelines for trials of treatment in primary care. Spine, 8, 145–150.Google Scholar
Sheehan, P. W. (1967). A shortened form of Betts’ questionnaire upon mental imagery. Journal of Clinical Psychology, 23, 386–389.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Sloman, R. (1995). Relaxation and the relief of cancer pain. Nursing Clinics of North America, 30, 697–709.Google Scholar
Somerville, K., Cooper, M. and Hackmann, A. (2007). Spontaneous imagery in women with bulimia nervosa: an investigation into content, characteristics and links to childhood memories. Journal of Behavior Therapy and Experimental Psychiatry, 38, 435–446.Google Scholar
Troesch, L. M., Rodehaver, C. B., Delaney, E. A. and Yanes, B. (1993). The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncology Nursing Forum, 20, 1179–1185.Google ScholarPubMed
Turk, D. C., Meichenbaum, D. and Genest, M. (1983). Pain and Behavioral Medicine: a cognitive-behavioral perspective. New York: Guilford Press.Google Scholar
Turk, D. C. and Rudy, T.E. (1992). Neglected topics in the treatment of chronic pain patients: relapse, non-compliance and adherence enhancement. Pain, 44, 5–28.CrossRefGoogle Scholar
Tusek, D. L., Church, J. M., Strong, S. A, Grass, J. A. and Fazio, V. W. (1997). Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Diseases of the Colon and Rectum, 40, 172–178.Google Scholar
White, C. (2001). Cognitive Behaviour Therapy for Chronic Medical Problems: a guide to assessment and treatment in practice. Chichester: John Wiley and Sons.Google Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.