Off-campus WSU users: To download campus access dissertations, please use the following link to log into our proxy server with your WSU access ID and password, then click the "Off-campus Download" button below.
Non-WSU users: Please talk to your librarian about requesting this thesis through interlibrary loan.
Access Type
WSU Access
Date of Award
January 2025
Degree Type
Thesis
Degree Name
M.A.
Department
Psychology
First Advisor
Mark Lumley
Abstract
Adverse childhood experiences (ACE) are defined as traumatic events such as poverty or abuse that occur before the age of 18 (Chung et al., 2016). There are several consequences of experiencing ACEs, including psychopathology, physical health problems, and conflictual adult relationships (Basu et al., 2017; Dube et al., 2003). Individuals who experience ACEs are also more likely to experience and seek treatment for chronic pain, which is pain that endures for greater than 3 months (Davis et al., 2005). Psychological factors influence chronic pain, and pain is often more severe if one has a history of childhood adversity (Briere et al., 2008). The relationships among trauma, psychological functioning, and chronic pain suggest that chronic pain results from biopsychosocial factors, and its treatment should include psychosocial, not just biomedical, interventions. Standard psychological treatments for chronic pain include the widely studied and used cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT); however, these therapies have limited efficacy in treating chronic pain (Williams et al., (2020), and the majority of patients fail to find relief from their pain following these treatments (Williams et al., 2020) The limitations of these and similar approaches may be due to a failure to address childhood adversity and trauma. Emotional awareness and expression therapy (EAET) and intensive short-term dynamic therapy (ISTDP) can address these limitations. EAET and ISTDP assume that suppressing emotions related to unresolved ACEs and current interpersonal conflicts trigger or exacerbate pain, and several studies suggest that these interventions may be more effective at pain reduction (Abbass et al., 2020; Lumley et al., 2017; Yarns, 2020). EAET and ISTDP are effective as both multi-session and single-session therapies (Carty et al., 2019; Ziadni et al., 2018). A recent randomized controlled trial, the Pain and Stress Study (PASS), was conducted as a dissertation by Shoshana Krohner, who found that a single-session EAET/ISTDP interview for chronic pain patients with childhood adversity reduced pain interference and pain-related anxiety (Krohner, 2022) compared to a waitlist control condition. However, the main effects of the interview mask the fact that participants varied greatly in response to it. Such individual differences in engagement and responses to the interview had yet to be examined. For example, the degree of insight demonstrated, emotional expression, therapeutic alliance, and alexithymia might influence participants’ pain responses and satisfaction with the interview. In addition, variables that predicted interview engagement had not been examined, such as baseline levels of assertiveness, pain-related anxiety, and beliefs about one’s pain. An in-depth analysis of the interviews was important to guide treatment and clarify the outcomes of psychodynamic therapies for chronic pain. Thus, the present study analyzed the content of the interviews from the PASS dataset and measures of patient interview engagement to both predictors of and responses to the interview.
Recommended Citation
Blank, Sabrina, "Individual Differences In Engagement In A Single Session Psychodynamic Interview Among People With Chronic Pain: Predictors And Outcomes" (2025). Wayne State University Theses. 988.
https://digitalcommons.wayne.edu/oa_theses/988