REACTIVE EFFECTS OF DIARY SELF-ASSESSMENT IN CHRONIC PAIN PATIENTS

Several studies of experimental and acute clinical pain have indicated reactive effects of self-assessment on pain intensity and tolerance. A recent study of chronic pain patients (vonBaeyer 1994), however, fai led to show these effects. The present investigation sought to determi ne whether reactive effects can be produced in chronic pain patients b y an intensive self-assessment protocol. Using the methodology of ecol ogical momentary assessment (EMA; Stone and Shiffman 1994), thirty-fiv e chronic rheumatoid arthritis patients completed diaries of pain and mood seven times a day for 1 wk. Eighteen patients were included in th e final sample because they responded to at least half of the number o f hourly prompts for each of the 7 days. Using repeated measures analy sis of the daily means, no significant effects of time were found for any measures. Reactive effects that result in an average change in pai n levels over time, therefore, do not appear to be produced by intensi ve self-assessment in a naturalistic context. Results are discussed in terms of cognitive and behavioral theories of pain reactivity.