Of Pain and Suffering: exploring the role of psychological processes in chronic pain, and development of a compassionate acceptance program for pain management (COMP.ACT)

Bibliographic Details
Main Author: Carvalho, Sérgio Andrade
Publication Date: 2021
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: https://hdl.handle.net/10316/93850
Summary: Tese de doutoramento em Psicologia, especialidade em Psicologia Clínica, apresentada à Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra
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spelling Of Pain and Suffering: exploring the role of psychological processes in chronic pain, and development of a compassionate acceptance program for pain management (COMP.ACT)chronic painfunctioningdepressionpsychosocialmindfulness(self)compassionacceptance and commitment therapyDomínio/Área Científica::Ciências Sociais::PsicologiaTese de doutoramento em Psicologia, especialidade em Psicologia Clínica, apresentada à Faculdade de Psicologia e de Ciências da Educação da Universidade de CoimbraIntroduction: Chronic pain is a debilitating medical condition with a detrimental impact on patients quality of life, functioning and mental health. In addition to pain itself, psychopathological symptoms usually co-occur and contribute to the nefariousness and pervasiveness of chronic pain. The study of psychological factors contributing to chronic pain has been fueled by scientific advances in clinical psychology, particularly in cognitive and behavioral approaches. Mindfulness, acceptance and compassion-based approaches have recently helped shift the focus of therapy from the elimination of symptoms and maladaptive cognitions, to the overall cultivation of an open, aware and self-compassionate stance to personal suffering, while fostering commitment to valued action. However, although these approaches seem to be valuable tools to chronic pain management, their core processes present conceptual overlap (e.g., by sharing core elements, such as mindful awareness and acceptance), thus raising concerns regarding their unique contribution to chronic pain. The current thesis aimed to study the uniqueness and interconnection between mindfulness-, acceptance- and compassion-related processes in chronic pain, through four main routes: 1) to develop and/or validate adequate assessment tools; 2) to explore patterns of associations between psychological processes, pain outputs and depressive symptoms; 3) to examine risk and protective psychological factors associated with the development of depressive symptoms; 4) to develop and pilot test the efficacy of a Compassionate Acceptance and Committment Therapy (COMP.ACT), and examine the added value of (self)compassion in ACT for chronic pain. Methods: The present thesis comprises 10 empirical studies, including 2 psychometric studies, 5 cross-sectional studies, 2 time-lagged studies, and 1 clinical study. These were performed in convenience samples of adult women with musculoskeletal chronic pain, as well as of adult men and women from the general population. Recruitment was conducted online and in a chronic pain healthcare unit. Data was collected through self-report measures. Results: The psychometric studies showed that i) the Valuing Questionnaire (VQ) presents good psychometric properties and its original factor structure was confirmed; ii) the Perceived Validation and Criticism in Pain Questionnaire (PVCPQ) is a psychometrically valid two-factor measure of perceived validation and criticism by signficant others when experiencing pain, and PVCPQ contributes to functional impairment beyond pain, background variables and other related psychological processes. Cross-sectional studies showed that iii) self-compassion is more strongly (negatively) associated with depressive symptoms than mindful awareness, and activity engagement mediates this relationship; iv) self-compassion buffers the mediator effect of cognitive fusion between pain intensity and depression; v) rumination and obstructions to valued living mediate the negative association between mindful awareness and depression; vi) self-compassion relates to social safeness through less fears of receiving compassion from others; vii) uncompassionate self-responding is a strong contributor to depression. Time-lagged studies showed that viii) cognitive fusion is a predictor of the trajectory of depression beyond pain intensity and impairment, and ix) self-compassion prospectively predicts depression. The clinical study showed that x) COMP.ACT did not significantly differ from ACT-only, both were acceptable, and COMP.ACT seemed to result in more valued living. Conclusions: Overall, these studies suggest that, more than pain intensity and functional impairment, psychological processes contribute significantly to depression in chronic pain, which suggests the importance of targeting psychological processes, and not only focus on reducing pain in pain management programs. Self-compassion seems to be an especially protective factor against depression in chronic pain, which suggests the usefulness of integrating compassion-inducing practices in chronic pain management programs.2021-01-04doctoral thesisinfo:eu-repo/semantics/publishedVersionhttps://hdl.handle.net/10316/93850https://hdl.handle.net/10316/93850TID:101645520engCarvalho, Sérgio Andradeinfo:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2022-05-25T10:20:16Zoai:estudogeral.uc.pt:10316/93850Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-29T05:41:51.751208Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Of Pain and Suffering: exploring the role of psychological processes in chronic pain, and development of a compassionate acceptance program for pain management (COMP.ACT)
title Of Pain and Suffering: exploring the role of psychological processes in chronic pain, and development of a compassionate acceptance program for pain management (COMP.ACT)
spellingShingle Of Pain and Suffering: exploring the role of psychological processes in chronic pain, and development of a compassionate acceptance program for pain management (COMP.ACT)
Carvalho, Sérgio Andrade
chronic pain
functioning
depression
psychosocial
mindfulness
(self)compassion
acceptance and commitment therapy
Domínio/Área Científica::Ciências Sociais::Psicologia
title_short Of Pain and Suffering: exploring the role of psychological processes in chronic pain, and development of a compassionate acceptance program for pain management (COMP.ACT)
title_full Of Pain and Suffering: exploring the role of psychological processes in chronic pain, and development of a compassionate acceptance program for pain management (COMP.ACT)
title_fullStr Of Pain and Suffering: exploring the role of psychological processes in chronic pain, and development of a compassionate acceptance program for pain management (COMP.ACT)
title_full_unstemmed Of Pain and Suffering: exploring the role of psychological processes in chronic pain, and development of a compassionate acceptance program for pain management (COMP.ACT)
title_sort Of Pain and Suffering: exploring the role of psychological processes in chronic pain, and development of a compassionate acceptance program for pain management (COMP.ACT)
author Carvalho, Sérgio Andrade
author_facet Carvalho, Sérgio Andrade
author_role author
dc.contributor.author.fl_str_mv Carvalho, Sérgio Andrade
dc.subject.por.fl_str_mv chronic pain
functioning
depression
psychosocial
mindfulness
(self)compassion
acceptance and commitment therapy
Domínio/Área Científica::Ciências Sociais::Psicologia
topic chronic pain
functioning
depression
psychosocial
mindfulness
(self)compassion
acceptance and commitment therapy
Domínio/Área Científica::Ciências Sociais::Psicologia
description Tese de doutoramento em Psicologia, especialidade em Psicologia Clínica, apresentada à Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra
publishDate 2021
dc.date.none.fl_str_mv 2021-01-04
dc.type.driver.fl_str_mv doctoral thesis
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://hdl.handle.net/10316/93850
https://hdl.handle.net/10316/93850
TID:101645520
url https://hdl.handle.net/10316/93850
identifier_str_mv TID:101645520
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
_version_ 1833602440661827584

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