Browsing by Author "Keefe, Francis J"

Based on a biopsychosocial model of mammography pain, the current study assessed if specific biological and psychosocial factors were associated with higher reported mammography pain in early stage breast cancer survivors. One hundred and twenty-seven women completed questionnaires assessing demographic information, cancer treatment history, ongoing breast pain, mammography-related anxiety, and social support immediately prior to receiving a mammogram. They then completed questionnaires assessing mammography pain and mammography-related pain catastrophizing immediately following the mammogram. Using path modeling and mediation analyses, relations among these variables were examined. Results revealed that mammography-related pain catastrophizing was related to higher mammography pain directly, while ongoing breast pain, lower social support quantity, and lower perceived quality of social support related to higher mammography pain indirectly through mammography-related pain catastrophizing. Moderated mediation analyses found that the mediation effects of mammography-related pain catastrophizing were significantly different at varying levels of perceived quality of social support, with more pronounced negative effects for those with higher quality support than those with lower quality support. The theoretical, clinical, and research implications of these findings are discussed.

Controlled breathing techniques are widely used to help people manage pain, and there is growing interest in using these approaches during painful outpatient medical procedures. The outpatient MRI-guided breast biopsy is one setting where patients may particularly benefit from breathing interventions for pain. To date, however, no studies have examined interventions for pain reduction in this setting. This randomized controlled pilot study assessed the feasibility, acceptability, and efficacy of a novel audio-recorded controlled breathing intervention for reducing breast and body pain in women undergoing MRI-guided breast biopsy. Fifty-eight women undergoing MRI-guided breast biopsy were randomized to a 1) controlled breathing intervention or 2) usual care condition. Assessments of pain, anxiety, distraction from pain, relaxation, blood pressure, heart rate, pain catastrophizing, and self-efficacy for managing pain and anxiety were administered. Participants were assessed at baseline, during biopsy, immediately post-biopsy, and 24 hours post-biopsy. Results demonstrated that the intervention was feasible and acceptable. However, when compared to usual care, controlled breathing did not significantly reduce pain, increase distraction from pain or relaxation during biopsy, decrease physiological reactivity, reduce pain catastrophizing, or increase self-efficacy for pain and anxiety from pre- to post-biopsy. These findings could be used to revise the controlled breathing intervention.

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Breast cancer is the most common type of cancer among women in the United States. Despite more women undergoing treatment and increased survival rates, many women continue to suffer from emotional distress and physical symptoms associated with treatments for breast cancer (e.g., surgery). To date, there has been limited research investigating the efficacy of psychosocial interventions for breast cancer patients during the surgical time frame. This randomized controlled pilot study examined the effect of a lovingkindness meditation intervention on key psychological and physical outcomes surrounding breast surgery. Sixty women undergoing surgery were randomly assigned to one of three treatment conditions at breast biopsy: 1) lovingkindness meditation, 2) music, 3) standard care. Assessments of emotional distress, physical symptoms, and positive psychosocial resources occurred prior to patients' biopsy, following their biopsy, one week after receipt of their biopsy results, and one week following breast surgery. Multilevel model analyses demonstrated that lovingkindness meditation significantly improved anxiety, pain, self-compassion, emotional suppression, mindfulness, social isolation, and heart rate levels over time compared to control conditions. These results support the efficacy of a brief lovingkindness meditation intervention for breast cancer patients during the surgical time frame. The implications of these findings on future research, theory, and policy are discussed.

There are an unlimited number of ways a person may respond to someone sharing pain-related thoughts or feelings. Understanding what types of responses may result in positive outcomes for individuals with pain is important, yet limited research has been conducted in this area. The purpose of this dissertation was to understand how validation as a response to verbal disclosures about pain influences positive and negative affect, pain intensity, and pain tolerance as compared to other responses. To examine this question, an experimental design with best friend dyads was used. Participants engaged in a pain induction task and were asked to verbally share about their pain, and either their friend or a research assistant delivered validating, neutral, or invalidating responses. Results found that receiving validating was related to greater positive affect and reduced negative affect as compared to receiving in validating responses, and some group differences emerged between participants who received responses from friends as compared to research assistants.