Browsing by Author "Trost, Zina"

Now showing 1 - 7 of 7
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    Differential Effect of Patient Weight on Pain-Related Judgements About Male and Female Chronic Low Back Pain Patients
    (Elsevier, 2017) Miller, Megan M.; Allison, Ashley; Trost, Zina; De Ruddere, Lies; Wheelis, Tori; Goubert, Liesbet; Hirsh, Adam T.; Psychology, School of Science
    Compared with men, women report more pain and are at increased risk for having pain discounted or misattributed to psychological causes. Overweight individuals experience high rates of pain and may receive suboptimal care because of provider bias. Research suggests the social consequences of being overweight are worse for women than men, and that gender and weight uniquely and interactively affect pain experience and care. Healthy participants (n = 616) viewed 6 videos of back pain patients (1 female and 1 male of normal weight, overweight, and obese categories) performing a functional task. Participants provided judgements/ratings regarding patient pain (intensity, interference, exaggeration), potential sources of patient pain (medical, psychological), and treatment recommendations (opioids, psychological therapy, seek workplace accommodations). Results suggest that the pain of normal and overweight women and obese men was discounted (judged as less intense, less interfering, more exaggerated, and less attributable to medical factors) and judged as less in need of treatment (treated with less opioids and workplace accommodations). Across all weight categories, women's pain was attributed more to psychological factors and was more likely to receive recommendations for psychological therapy than men's pain. These findings highlight the differential effect of patient weight on pain-related judgements about women and men. Perspective This article examines the relationships among patient weight, patient gender, and observers' pain appraisals and treatment recommendations. These findings highlight the differential effect of patient weight on pain-related judgements about women and men and indicate the need for research to determine how these judgements affect treatment decisions in clinical settings.
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    (Dis)Agreement in Parent-Child Perceptions of Injustice and Their Relationship to Pain Outcomes
    (Office of the Vice Chancellor for Research, 2016-04-08) Wuest, David G.; Miller, Megan M.; Scott, Eric. L.; Trost, Zina; Hirsh, Adam T.
    Perceiving one’s pain as unjust and thinking about pain in a catastrophic manner are linked to worse outcomes in children with chronic pain. Dyads where the child catastrophized more than the parent experienced particularly poor outcomes in previous research. We investigated the concordance between parent and child injustice perceptions and its relationship to pain outcomes. 139 patients (age=15.4±2.1; 71.9% female) attending the pain clinic at Riley Children’s Hospital completed measures of perceived injustice, pain, and QOL. Parents completed a measure of perceived injustice about their child’s pain. Parent-child dyads were categorized into one of four groups based on concordance of injustice perceptions: (1) concordant high, (2) concordant low, (3) discordant high parent (P) – low child (C), and (4) discordant low P – high C. Parent injustice perceptions were significantly higher than child perceptions (t(138)=5.80, p<.001, d=.50). ANOVAs identified significant group differences for pain intensity (F(3,138)=2.80, p<.05, η2=.06) and QOL (F(3,138)=15.11, p<.01, η2=.25). For pain intensity, discordant low P – high C dyads reported the highest pain, and significantly higher pain than discordant high P – low C dyads (mean difference [MD]=1.94, p<.05). Concordant high dyads reported the second highest pain. A similar pattern emerged for QOL. Discordant low P – high C dyads reported the worst QOL, and significantly worse QOL than concordant high dyads (MD=-10.22, p<.01), concordant low dyads (MD=-23.70, p<.01), and discordant high P – low C dyads (MD=-28.97, p<.01). Concordant high dyads reported the second worse QOL. Overall, dyads where the child endorsed high injustice perceptions, regardless of parental perceptions, experienced worse pain and QOL, with the worst outcomes observed for discordant dyads (low P – high C). Children in low P – high C dyads may feel invalidated and, thus, use maladaptive strategies in an attempt to communicate the severity of their pain. Research is needed to identify the mechanisms underlying these relationships.
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    Examining Gender Differences in Pain Treatment Recommendations
    (Office of the Vice Chancellor for Research, 2015-04-17) Free, Charnelle A.; Miller, Megan M.; Trost, Zina; Wheelis, Tori; Hirsh, Adam T.
    Understanding how pain treatment decisions are made has important clinical implications for healthcare. Research suggests that men and women receive disparate pain care, however, little is known about the specific treatment recommendations that are differentially made for men and women. The purpose of this study was to examine differences between the types of pain treatments recommended for men and women. Undergraduate psychology students from Indiana University-Purdue University Indianapolis (IUPUI) and the University of North Texas (UNT) (n=621) made treatment recommendations for 8 chronic pain patients after reading a vignette describing the patient’s pain and watching a video of each patient completing a pain-inducing task (i.e., transition between sitting and standing). Participants made pain treatment recommendations for each patient using separate 0-100 visual analogue scales (VASs). Dependent samples t-tests indicated that participants were more likely to recommend workplace accommodations (t(620)= -3.05, p= .002, d= 0.17), disability compensation (t(620)= -7.77, p< .001, d= 0.44), and opioid medications (t(620)= -5.16, p< .001, d= 0.29) for men compared to women. Moreover, participants were more likely to recommend psychological therapy (t(620)= 4.59, p< .001, d= 0.26), rest (t(620)= 7.80, p< .001, d= 0.44), and diet/exercise (t(620)= 2.97, p= .003, d= 0.17) for women compared to men. These results are consistent with social psychological theories of gender-based stereotyping and suggest that men’s pain was perceived to be more legitimate, severe, and disabling than was women’s pain. Future studies are needed to examine how these differences affect pain outcomes and whether knowledge of these factors can improve training for future health care providers.
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    Injustice perceptions about pain: parent–child discordance is associated with worse functional outcomes
    (Wolters Kluwer, 2018-06) Miller, Megan M.; Wuest, David; Williams, Amy E.; Scott, Eric L.; Trost, Zina; Hirsh, Adam T.; Psychology, School of Science
    Pain is experienced within and influenced by social environments. For children with chronic pain, the child–parent relationship and parental beliefs about pain are particularly important and may influence pain outcomes. Pain-related injustice perceptions have recently been identified as an important cognitive–emotional factor for children with pain. The current study aimed to better understand the pain-related injustice perceptions of children with chronic pain and their parents. The sample consisted of 253 pediatric chronic pain patients (mean age = 14.1 years, 74% female) presenting to a tertiary pain clinic. Patients completed measures of pain intensity, pain-related injustice perceptions, stress, functional disability, and quality of life. Parents completed a measure of pain-related injustice perceptions about their child's pain. Child–parent dyads were categorized into 1 of 4 categories based on the degree of concordance or discordance between their scores on the injustice measures. One-way analysis of variances examined differences in pain intensity, stress, functional disability, and quality of life across the 4 dyad categories. Our findings indicated that both the degree (concordant vs discordant) and direction (discordant low child–high parent vs discordant high child–low parent) of similarity between child and parent injustice perceptions were associated with child-reported pain intensity, stress, functional disability, and quality of life. The poorest outcomes were reported when children considered their pain as highly unjust, but their parents did not. These findings highlight the important role of parents in the context of pain-related injustice perceptions in pediatric chronic pain.
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    Pain Intensity And Attribution Mediate The Impact Of Patient Weight And Gender On Activity Recommendations For Chronic Pain
    (Dovepress, 2019-09-19) Mehok, Lauren E.; Miller, Megan M.; Trost, Zina; Goubert, Liesbet; De Ruddere, Lies; Hirsh, Adam T.; Psychology, School of Science
    Background and purpose: Despite the notable benefits of physical activity for chronic pain, a large proportion of patients with chronic pain report that they do not receive activity-related recommendations from their providers. Research suggests that patient factors such as weight and gender influence activity-related recommendations for chronic pain. Research also suggests that appraisals of the intensity and cause of pain may explain these weight and gender effects. We investigated the influence of patient weight and gender on observers' likelihood of recommending activity-related treatments for pain. We also explored the mediating effects of observers' ratings of pain severity and the extent to which pain was due to medical and lifestyle factors (pain attribution). Patients and methods: Healthy young adults (N=616; 76% female) viewed videos (Ghent Pain Videos of Daily Activities) and vignettes of 4 patients with chronic back pain performing a standardized functional task. Patients varied by gender (female, male) and weight (normal, obese), but were otherwise equivalent on demographic characteristics and pain behaviors. Participants rated how much pain they perceived the patients to be experiencing, the extent to which they attributed the pain to medical and lifestyle factors, and their likelihood of recommending exercise, physical therapy (PT), and rest. Results: Patient weight and gender significantly interacted to influence exercise, PT, and rest recommendations. Both pain intensity and pain attribution mediated the relationships between patient weight and activity recommendations; however, these mediation effects differed across gender and recommendation type. Conclusion: Patient weight and gender influenced laypeople's activity recommendations for chronic pain. Moreover, the results suggest that observers' perceptions of pain intensity and pain attributions are mechanisms underlying these effects. If these findings are replicated in providers, interventions may need to be developed to reduce provider biases and increase their recognition of the benefits of physical activity for chronic pain.
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    Parental Injustice Appraisals in the Context of Child Pain: Examining the Construct and Criterion Validity of the IEQ-Pc and IEQ-Ps
    (Elsevier, 2019) Baert, Fleur; Miller, Megan Marie; Trost, Zina; Hirsh, Aaron Todd; McParland, Joanna; De Schryver, Maarten; Vervoort, Tine; Psychology, School of Science
    A growing pediatric and adult literature highlights the role of injustice appraisals in adjustment to pain. However, interpersonal injustice dynamics have remained largely unexplored. The present study investigated the factor structure and criterion validity of parentally adjusted versions of the Injustice Experience Questionnaire, assessing child-oriented (IEQ-Pc) and self-oriented appraisals (IEQ-Ps) in the context of child pain. Participants were triads of healthy children (N = 407, Mage = 12) and both their parents and dyads of children with chronic pain (N = 319, Mage = 14) and 1 parent. In both samples, children completed measures of functional disability and quality of life (physical, emotional, social, and academic); parents completed the IEQ-Pc, IEQ-Ps, and a measure of parental catastrophizing about child pain. Across samples, a confirmatory oblique two-factor model (Severity/Irreparability-Blame/Unfairness) provided a better fit to the data compared to a one-factor model; nevertheless, the two-factor solution was considered suboptimal. A post hoc exploratory factor analysis consistently revealed 1 factor. In terms of criterion validity, the IEQ-Pc and IEQ-Ps demonstrated differential associations depending on the child's pain versus healthy status, independent of parental catastrophizing. Further, findings in the healthy sample indicated that fathers’ self-oriented injustice appraisals related to lower child social function. In the clinical sample, parental child-oriented injustice appraisals related to greater child functional disability and lower physical, emotional, social, and academic function. Current findings support the unique role of parental injustice appraisals, assessed by the IEQ-Pc and IEQ-Ps, in understanding child pain, but also suggest these may only partially capture the phenomenology of parental injustice appraisals in the context of child pain.
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    Perceived Injustice Is Associated With Pain and Functional Outcomes in Children and Adolescents With Chronic Pain: A Preliminary Examination
    (Elsevier, 2016-11) Miller, Megan M.; Scott, Eric L.; Trost, Zina; Hirsh, Adam T.; Department of Psychology, School of Science
    Chronic pain is prevalent in children/adolescents and contributes to high rates of healthcare utilization. Research suggests injustice perceptions about pain are important in adult patients and a possible treatment focus. We conducted a preliminary evaluation of the psychometric properties of the Injustice Experiences Questionnaire (IEQ) and the relationship between injustice perceptions, pain, and functioning in chronic pain patients (N = 139, mean age = 15 years, 72% female) presenting to a pediatric pain clinic. Patients completed measures assessing pain intensity, injustice perceptions about pain, catastrophizing, overall functional disability, emotional functioning, social functioning, and school functioning. The IEQ showed good reliability and validity. Higher levels of perceived injustice were associated with higher levels of pain intensity, catastrophizing, and functional disability, and with poorer emotional, social, and school functioning. Additionally, perceived injustice remained significantly associated with pain intensity, functional disability, emotional functioning, social functioning, and school functioning after accounting for relevant demographic and clinical factors. This is the first study to suggest that injustice perceptions are important in the experience of pediatric chronic pain patients. Future studies should more thoroughly examine the psychometric properties of the IEQ in children/adolescents and elucidate the causal nature of these relationships, which will inform treatment efforts to improve pediatric pain care. Perspective This initial investigation suggests that injustice perceptions about pain can be reliably and validly measured and are tied to important clinical outcomes in children/adolescents. Future studies that replicate and extend these preliminary results are necessary to determine the extent to which injustice perceptions are an important target for intervention.