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Access Type

WSU Access

Date of Award

January 2019

Degree Type


Degree Name




First Advisor

Mark A. Lumley


Chronic urogenital pain is a common chronic pain condition. Women with these symptoms tend to have mood disturbances, relatively high rates of lifetime trauma and abuse, and relational conflicts. A prior study by Carty et al. (in press) indicated that the life stress interview, an emotion-focused and disclosure-based intervention, reduced some yet not all symptoms among women with chronic urogenital pain. Variation in individual characteristics before the intervention and in behaviors during the intervention could explain the limited effectiveness of the life stress interview. It was hypothesized that more pathological individual characteristics would predict more narrative disorganization and disintegration, higher alexithymic characteristics, and more disclosure of more severe and pervasive stressors during the intervention. It was hypothesized that more adaptive interview process and content, more disclosure, lower alexithymia, and more integrated narrative-emotional processes would predict improvement in health outcomes. The present study examined whether narrative-emotion processes would predict symptom improvement above and beyond the therapeutic alliance. Participants had completed measures of individual characteristics and health at baseline and 6-week follow-up. Audio recordings of the life stress interview were coded for interview process and content. Findings from this study suggest that there is little relationship between baseline individual characteristics with subsequent interview process and content. Adaptive narrative-emotion processes and the disclosure of severe stressors during the interview were found to significantly predict improvement in pain severity and pain interference, and predicted change in pain severity above and beyond the therapeutic alliance. Expressing more maladaptive narrative-emotion processes predicted less improvement in pain interference.

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