Dissertations and Theses @ UNI


Open Access Thesis


Pain--Treatment--Psychological aspects; Distress (Psychology);


Pain often signals a problem that needs our attention, but after healing has occurred and pain persists, protective behaviors may become maladaptive to day-to-day functioning. Through education, therapy, and self-management, individuals can learn to function well on a daily basis even with some pain present, but not all pain patients are ready for this type of self-management. The transtheoretical model has been adapted to assess individuals with chronic pain. If individuals are not ready for behavior change, relapse chances increase; therefore it becomes beneficial to understand an individual's level of readiness to change when judging potential treatment success. The ability of current pain stages of change instruments to categorize individuals into distinct groups has been limited.

The first purpose of the current study was to analyze the relationship between chronic pain acceptance and cognitive and emotional distress related to pain. Results showed chronic pain acceptance did significantly correlate with both catastrophizing and emotional distress in a negative direction.

The second purpose was to explore the relationship between acceptance, cognitive distress, and emotional distress related to pain, and stages of behavior change. Groups formed by the Freiburg Questionnaire-Stages of Chronic Pain Management (FQ-STAPM) were expected to vary significantly on acceptance of pain. Results indicated that individuals in the maintenance stage had significantly higher acceptance scores compared to individuals in each of the other three stages, and individuals in the action stage scored significantly higher than those in the preparation stage. It was also hypothesized that FQ-STAPM groups would vary significantly on measures of cognitive and emotional distress. The maintenance group did in fact have significantly lower levels of cognitive and emotional distress compared to the precontemplation and preparation groups. The action group also scored significantly lower on these measures compared to individuals in the preparation group.

Participants from this study seemed to endorse different emotional and cognitive qualities across the stages of behavior change readiness. Those who endorsed items within the precontemplation and preparation subscales report moderate to high levels of emotional and cognitive distress according to their responses on the PDI and PCS. They also reported a moderate level of unwillingness to experience pain.

These results offer significant theoretical and clinical implications. Individuals with chronic pain experience distinctly different types of emotional and cognitive distress as they deal with pain. Clinicians may also need to realize that even though lowering distress is important, a certain amount of distress may propel patients to take action toward self-management of pain symptoms. Acceptance of chronic pain also appears to be an important variable in successful self-maintenance of pain symptoms.

Year of Submission


Degree Name

Master of Arts


Department of Psychology

First Advisor

John Somervill, Chair, Thesis Committee

Date Original


Object Description

1 PDF file (vi, 56 pages)



File Format