Chronic pain is a highly prevalent and costly health care problem. Yet, little is known about the optimal ways for health care providers and family members to respond to the distress expressed by people with chronic pain. The aim of the current study is to compare two models of responsiveness to identify responses that result in better functioning and adjustment. An experimental design will be used to test the extent to which emotional validation (e.g., an empathic response to distress) increases or decreases pain behaviors during physical activity. Romantic partners of individuals with chronic pain will be randomly assigned to receive validation or control training. Following training, people with chronic pain and their partners will engage in a discussion about pain and complete household tasks to examine the effects of partner training on communication, pain intensity, and pain behavior. Additionally, each individual in the couple will complete self-report measures after the discussion, after the household tasks, and one-month following the laboratory visit.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
80
In this intervention, romantic partners of individuals with chronic pain are trained individually by a research assistant. The romantic partner is trained on how to validate the individual with chronic pain's pain-related distress and given education about validation. This involves an approximately 45-minute brief, interactive training.
In this intervention, romantic partners of individuals with chronic pain are trained individually by a research assistant. The romantic partner is trained on how to ask health professionals questions about treatment options and given health education about chronic pain. This involves an approximately 45-minute brief, interactive training.
Wayne State University's Relationships and Health Lab
Detroit, Michigan, United States
Pain Behavior (Behavioral coding)
Pain behaviors (e.g., grimacing, guarding) measured with behavioral coding conducted by research assistants.
Time frame: During lab visit, during household tasks conducted in the laboratory, approx. 15 - 35 mins. after partner training (intervention)
Pain Intensity (0 - 10 self-report rating scale)
The individual with chronic pain will be asked to report on the pain they experienced during the discussion with their partner, controlling for their baseline pain rating at the beginning of their laboratory visit.
Time frame: During lab visit, during discussion task, approx. 5 minutes after partner training (intervention)
Pain Intensity (0 - 10 self-report rating scale)
The individual with chronic pain will be asked to report on the pain they experienced during each household task (e.g., making a bed), controlling for baseline pain rating at the beginning of their laboratory visit.
Time frame: During lab visit, during household tasks, approx. 15 - 35 mins. after partner training (intervention)
Number of Partner Validating Responses (Behavioral coding)
Validating responses will be coded by research assistants.
Time frame: During lab visit, during discussion task, approx. 5 minutes after partner training (intervention)
Number of Partner Invalidating Responses (Behavioral coding)
Invalidating responses will be coded by research assistants.
Time frame: During lab visit, during discussion task, approx. 5 minutes after partner training (intervention)
Pain-Related Emotional Disclosures (Behavioral coding)
Behavioral coding by research assistants, accounting for activity level during household tasks.
Time frame: During lab visit, during household tasks, approx. 15 - 35 mins. after partner training (intervention)
Number of Partner Validating Responses (Behavioral coding)
Validating responses will be coded by research assistants
Time frame: During lab visit, during household tasks, approx. 15 - 35 mins. after partner training (intervention)
Number of Partner Invalidating Responses (Behavioral coding)
Invalidating responses will be coded by research assistants
Time frame: During lab visit, during household tasks, approx. 15 - 35 mins. after partner training (intervention)
Partner Instrumental support (Behavioral coding)
Partner instrumental support includes number of offers of assistance, acts of assistance, and behaviors that discourage physical activity, which will be measured by behavioral coding by research assistants
Time frame: During lab visit, during household tasks, approx. 15 - 35 mins. after partner training (intervention)
Individual with Chronic Pain Assistance Behavior (Behavioral coding)
Includes requests for assistance and accepting assistance, as measured by behavioral coding conducted by a research assistant
Time frame: During lab visit, during household tasks, approx. 15 - 35 mins. after partner training (intervention)
Relationship Satisfaction (Questionnaire)
Couples Satisfaction Index, Funk \& Rogge, 2007. Both partners' self-reports of relationship satisfaction.
Time frame: 1-month after the intervention
Interpersonal Closeness (Questionnaire)
Inclusion of Other in Self Scale, Aron, Aron, \& Smollan, 1992. Both partners' self-reports of interpersonal closeness.
Time frame: During lab visit, during discussion task (approx. 5 mins. after intervention), and during household tasks (approx. 15 - 35 mins. after intervention), and 1-month after intervention
Perceived Partner Responsiveness (Questionnaire)
Reis et al., 2003.Both partners' self-reports on Perceived Partner Responsiveness.
Time frame: During lab visit, during discussion task (approx. 5 mins. after intervention), and during household tasks (approx. 15 - 35 mins. after intervention), and 1-month after intervention
Pain Intensity (Questionnaire)
Brief Pain Inventory, Cleeland, 1992. The individual with chronic pain reports on their pain intensity using a 0 - 10 self-report scale, and indicates their average pain intensity over the last 24 hours.
Time frame: 1-month after the intervention
Accuracy of Estimate of Individual with Chronic Pain's Pain Intensity
Romantic partner will be asked to estimate the individual with chronic pain's average pain intensity, which will be compared to the individual with chronic pain's report to assess accuracy.
Time frame: During lab visit, during discussion task (approx. 5 mins. after intervention), and during household tasks (approx. 15 - 35 mins. after intervention), and 1-month after intervention
Close other responses to pain and partner support (Questionnaire)
West Haven-Yale Multidimensional Pain Inventory, Kerns, Turk, \& Rudy, 1985. Both partners' reports of partner responses to pain and partner support, i.e., self-report for the partner, and other-report for the individual with chronic pain.
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Time frame: 1-month after the intervention
Perceived Partner Validation (Questionnaire)
Both partners' reports of partner's validation behavior, i.e., self-report for the partner, and other-report for the individual with chronic pain.
Time frame: During lab visit, during discussion task (approx. 5 mins. after intervention), and during household tasks (approx. 15 - 35 mins. after intervention), and 1-month after intervention
Perceived Partner Invalidation (Questionnaire)
Both partners report on partner's invalidation behavior, i.e., self-report for the partner, and other-report for the individual with chronic pain.
Time frame: During lab visit, during discussion task (approx. 5 mins. after intervention), and during household tasks (approx. 15 - 35 mins. after intervention), and 1-month after intervention
Ambivalence about emotional expression measured by Holding Back Scale (Questionnaire)
* (Holding Back Scale; Pistrang \& Barker, 1995) * (Holding Back Scale; Pistrang \& Barker, 1995) * (Holding Back Scale; Pistrang \& Barker, 1995) * (Holding Back Scale; Pistrang \& Barker, 1995) * (Holding Back Scale; Pistrang \& Barker, 1995) Holding Back Scale, Pistrang \& Barker, 1995; Both partners report on individual with chronic pain's behavior.
Time frame: 1-month after the intervention
Self- and Other-Oriented Distress (Questionnaire)
Batson, Fultz, \& Schoendrade, 1987. Both partners' self-report of self- and other-oriented distress.
Time frame: During lab visit, during discussion task (approx. 5 mins. after intervention) and during household tasks (approx. 15 - 35 mins. after intervention)
Individual with Chronic Pain's Emotional Expression (Questionnaire)
Both partners' report on individual with chronic pain's emotional expression.
Time frame: During lab visit, during discussion task (approx. 5 mins. after intervention), and during household tasks (approx. 15 - 35 mins. after intervention), and 1-month after intervention
Individual with Chronic Pain's Pain Expression (Questionnaire)
Both partners' report on individual with chronic pain's pain expression.
Time frame: During lab visit, during discussion task (approx. 5 mins. after intervention)and during household tasks (approx. 15 - 35 mins. after intervention)
Perceived Division of Workload and Collaboration (Questionnaire)
Both partners' report on their perceptions of division of workload and collaboration during household tasks.
Time frame: After household tasks (approx. 35 - 45 mins. after intervention)
Satisfaction with the discussion (Questionnaire)
Both partners' report on their satisfaction with the discussion.
Time frame: After discussion (approx. 15 mins. after intervention)
Satisfaction with household tasks
Both partners' report
Time frame: After household tasks (approx. 35 - 45 mins. after intervention)