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Imagery and Pain: The Prevalence, Characteristics, and Potency of Imagery Associated with Pain

Published online by Cambridge University Press:  31 May 2011

H. Clare Philips
H. Clare Philips*
Affiliation:
Back In Motion Rehabilitation Center, Richmond, Canada
*
Reprint requests to H. Clare Philips, Research Affiliate, Back In Motion Rehabilitation Center, #110-6651 Elmbridge Way, Richmond V7C 5C2, BC, Canada. E-mail: clarephilips@yahoo.com
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Abstract

Background: There is a dearth of information about imagery in pain sufferers. Aim: The aim of this study was to collect data on the characteristics, prevalence, and potency of imagery associated with pain. Method: The images of 59 pain sufferers were assessed by means of a semi-structured interview. The emotional, cognitive, behavioural, and pain-inducing properties (potency) of their index images were assessed by an image induction procedure and self-report scales of anxiety, depression and trauma symptoms. Results: The results showed a remarkably high incidence of images in pain sufferers, with 78% of participants reporting one or more repetitive images when in pain. Exposure to their most powerful/distressing image (Index image) resulted in significant increases in negative emotions, negative cognitive appraisals, and in pain levels. In a sub-group of sufferers with significant levels of trauma symptoms, the index images elicited significantly higher levels of emotion and pain increment than did those respondents in a low/no trauma group. Conclusion: It was concluded that imagery is a prevalent, often “unobserved” but potent cognition in pain sufferers. The implications for CBT approaches to chronic pain, including image rescripting, are considered.

Keywords

Paincognitionpain imagesIndex imagechronicacutetrauma
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 39 , Issue 5 , October 2011 , pp. 523 - 540
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

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References

Aldrich, S., Eccleston, C. and Crombez, G. (2000). Worrying about chronic pain: vigilance to threat and misdirected problem solving. Behaviour Research and Therapy, 38, 457–470.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th edn). Washington, DC: APA.Google Scholar
Andrykowski, M. A., Cordova, M. J., Studts, J. L. and Miller, T. W. (1998). Post-traumatic stress disorder after treatment for breast cancer: prevalence of diagnosis and use of the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C) as a screening instrument. Journal of Consulting and Clinical Psychology, 66, 586–590.Google Scholar
Blanchard, E. B., Jones-Alexander, J., Buckley, T. C. and Forneris, C. (1996). Psychometric properties of the Post-Traumatic Stress Disorder Checklist (PCL). Behaviour Research and Therapy, 34, 669–673.CrossRefGoogle ScholarPubMed
Brewin, C. R., Wheatley, J., Patel, T., Fearon, P., Hackmann, A., Wells, A., et al. (2009). Imagery rescripting as a brief stand-alone treatment for depressed patients with intrusive memories. Behaviour Research and Therapy, 47, 569–576.CrossRefGoogle ScholarPubMed
Carroll, J. S. (1978). The effects of imagining events on the expectations for that event: an interpretation in terms of the availability heuristic. Journal of Experimental and Social Psychiatry, 14, 88–96.Google Scholar
Day, S. J., Holmes, E. A. and Hackmann, A. (2004) Occurrence of imagery and its link with early memories in agoraphobia. Memory, 12, 416–427.CrossRefGoogle ScholarPubMed
Eccleston, C. (2001). Role of psychology in pain management. British Journal of Anaesthesia, 87, 144–152.Google Scholar
Eccleston, C., Crombez, G., Aldrich, S. and Stannard, C. (1997). Attention and somatic awareness in chronic pain. Pain, 72, 209–215.Google Scholar
Ehlers, A., Hackmann, A. and Michael, T. (2004). Intrusive re-experiencing in posttraumatic stress disorder: phenomenology, theory and therapy. Memory, 12, 403–415.CrossRefGoogle ScholarPubMed
Hackmann, A., Ehlers, A., Speckens, A. E. M. and Clark, D. M. (2004). Characteristics and content of intrusive memories in PTSD and their changes with treatment. Journal of Traumatic Stress, 17, 231–240.CrossRefGoogle ScholarPubMed
Hackmann, A. and Holmes, E. A. (2004). Reflecting on imagery: a clinical perspective and overview of the Special Issue of Memory on Mental Imagery in Psychopathology. Memory, 12, 289–402.Google Scholar
Helmes, E. and Goburdhun, A. (2007). Cognitions related to chronic pain: revision and extension of the Cognitive Evaluative Questionnaire. Clinical Journal of Pain, 23, 53–61.CrossRefGoogle ScholarPubMed
Holmes, E. A., Arntz, A. and Smucker, M. R. (2007) Imagery rescripting in cognitive behaviour therapy: images, treatment techniques and outcomes. Journal of Behavior Therapy and Experimental Psychiatry, 38, 297–305.CrossRefGoogle Scholar
Holmes, E. A. and Mathews, A. (2005). Mental imagery and emotion: a special relationship? Emotion, 5, 489–497.Google Scholar
Holmes, E. A. and Mathews, A. (2010). Mental imagery in emotion and emotional disorders. Clinical Psychological Review, 30, 349–362.CrossRefGoogle ScholarPubMed
Hunt, M. and Fenton, M. (2007). Image rescripting versus in vivo exposure in the treatment of snake fear. Journal of Behaviour Therapy and Experimental Psychiatry, 38, 329–344.Google Scholar
Jamani, N. and Clyde, Z. (2008). Treatment of pain-related fear in chronic (persistent) pain: the role of safety-seeking behaviour and imagery. The Cognitive Behaviour Therapist, 1, 3–15.Google Scholar
Lang, A. J. and Stein, M. B. (2005). An abbreviated Post-Traumatic Stress Disorder checklist for use as a screening instrument in primary care. Behaviour Research and Therapy, 43, 585–594.CrossRefGoogle ScholarPubMed
Morley, S., Eccleston, C. and Williams, A. (1999). Systematic review and meta-analysis of randomized controlled trials of cognitive-behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain, 80, 1–13.Google Scholar
Philips, H. C. (1989). Thoughts provoked by pain. Behaviour Research and Therapy, 27, 469–473.Google Scholar
Philips, H. C. and Rachman, S. (1996). The Psychological Management of Chronic Pain: a treatment manual. New York: Springer.Google Scholar
Pincus, T., Rusu, A. and Santos, R. (2008). Responsiveness and construct validity of the Depression, Anxiety and Positive Outlook Scale (DAPOS). Clinical Journal of Pain, 24, 431–437.CrossRefGoogle ScholarPubMed
Potter, L. (2007). Pain Related Mental Imagery. Doctoral Thesis, University of Edinburgh.Google Scholar
Pratt, D., Cooper, M. J. and Hackmann, A. (2004). Imagery and its characteristics in people who are anxious about spiders. Behavioural and Cognitive Psychotherapy, 32, 165–176.Google Scholar
Rachman, S. J. (2007). Unwanted intrusive images in obsessive compulsive disorders. Journal of Behaviour Therapy and Experimental Psychiatry, 38, 402–410.Google Scholar
Ruggiero, K. J., Del, B. K., Scotti, J. R. and Rabalais, A. E. (2003). Psychometric properties of the Post-Traumatic Stress Disorder Check List-Civilian Version. Journal of Traumatic Stress, 16, 495–502.CrossRefGoogle Scholar
Shafran, R. and Rachman, S. (2004). Thought-action fusion: a review. Journal of Behaviour Therapy and Experimental Psychiatry, 35, 87–107.Google Scholar
Sherman, S. J., Cialdini, R. B., Schwartzman, D. F. and Reynolds, K. D. (1985). Imagining can heighten or lower the perceived likelihood of contracting a disease: the mediating effects of ease of imagining. Personality and Social Psychology Bulletin, 11, 118–127.CrossRefGoogle Scholar
Speckens, A. E. M., Hackmann, A., Ehlers, A. and Cuthbert, B. (2007). Imagery special issue: intrusive images and memory of earlier adverse events in patients with obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 38, 411–422.Google Scholar
Sullivan, M. J. T., Bishop, S. R. and Pivik, J. (1995). The Pain Catastrophizing Scale: development and validation. Psychological Assessment, 7, 524–532.Google Scholar
Tang, N. K. Y., Salkovskis, P. M. and Hanna, M. (2007). Mental defeat in chronic pain: initial exploration of the concept. Clinical Journal of Pain, 23, 222–232.CrossRefGoogle ScholarPubMed
Tang, N. K. Y., Salkovskis, P. M., Poplavekaya, E., Wright, K. L., Hana, M. and Hester, J. (2007). Increased use of safety-seeking behaviors in chronic back pain patients with high health anxiety. Behaviour Research and Therapy, 45, 2821–2835.Google Scholar
Taylor, R., Lovibond, P. F., Nicholas, M. K., Cayley, C. and Wilson, P. H. (2005). The utility of somatic items in the assessment of depression in patients with chronic pain: a comparison of the Zung Self-Rating Depression Scale (SPS) and the Depression Anxiety Stress Scale (DASS) in chronic pain and clinical and community samples. Clinical Journal of Pain, 21, 91–100.Google Scholar
Turk, D. and Rudy, T. (1992). Cognitive factors and persistent pain: a glimpse into Pandora's Box. Cognitive Therapy and Research, 16, 99–122.Google Scholar
Vlaeyen, J. W. S. and Linton, S. J. (2000). Fear avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85, 317–332.Google Scholar
Wild, J., Hackmann, A. and Clark, D. M. (2007). When the present visits the past: updating traumatic memories in social phobia. Journal of Behaviour Therapy and Experimental Psychiatry, 38, 386–401.Google Scholar
Winterowd, C., Beck, A. T. and Gruener, D. (2003). Eliciting and modifying imagery. In Cognitive Therapy in Chronic Pain Patients (pp. 183–207). New York: Springer Publishing Co.Google Scholar
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