To allow for a comparison between chronic and acute groups, the mean, standard deviation and range of the four PBAPI subscales for the acute pain sample {N = 28) were computed in the same way as for the chronic pain group and are shown in Table 8.
Table 8. Mean, standard deviation and range of the four PBAPI subscales for the acute pain sample {N = 28)
PBAPI subscale Mean SD Range
Pain constancy -0.95 0.79 -2-+1
Pain permanence -1.59 0.40 -2 - -0.60
Mystery -1.30 0.68 -2 - +0.5
Self-blam e -1.64 0.60 -2 - +0.8
Note. A positive score indicates endorsement o f the belief, a negative score indicates that the b elief
As can be seen from the table, none o f the beliefs, which were endorsed by the chronic group, about their pain being constant, permanent and mysterious, were also endorsed by this acute pain sample. Nor did they believe themselves to be to blame for their pain. Given the variance in responses, the percentage o f the sample that, to some extent, endorsed each belief was also examined. None o f the sample (0%) believed their pain would be permanent, 21.6% believed that it was constant, 7.2% felt it to be mysterious and 3.6% felt that they were to blame for their pain.
Independent t-tests which compared the chronic and acute pain samples with regards their specific pain beliefs confirmed that the two groups differed significantly on each PBAPI subscale o f ‘permanency’, ‘constancy’, ‘mystery’ and ‘self-blame’ (/ (60) = 14.02,;? = .000; t (60) = 11.03,;? = .000; t (60) = 9.58,p = .000; t (54.71) = 5.87, ;? = .000 respectively). Unlike the results shown for the chronic pain group, only one significant correlation was found between EMSs and PBAPI for the acute pain group. This was between the ‘overvigilance and inhibition’ higher-order domain and ‘constancy’ (r = .375, p = .049).
Research Question 3
Do people with chronic pain have significantly different early maladaptive schemas than people with acute pain?
In order to investigate possible differences between the chronic pain {N = 34) and acute pain {N = 28) samples on each schema and higher-order schema domain, a multivariate analysis of variance (MANOVA) was carried out. Results revealed that, overall, there was a significant multivariate effect (Wilks’ Lambda = .470, F (21,40) = 2.15, /? = .018). Table 9 shows the results from follow-up one-way analyses of variance (ANOVAs).
Table 9. Group differences in early maladaptive schema mean scores Early maladaptive schema Chronic pain (A^=34)
Mean (SD )
Acute pain (A^=28) Mean (SD )
F d.f. P
S elf-sacrifice 3.52 (0.84) 3.13(0.80) 3.43 1,60 .069
U n relen tin g stan d ard s 3.07(1.11) 3.11 (1.17) 0.00 1,60 .954
Em otional d eprivation 2.80(1.45) 2.07 (0.82) 4.18 1,60 .045
E m otional inhibition 2.61 (1.22) 2.26(1.06) 1.44 1,60 .234
Insufficient self-control 2.54 (0.98) 2.66 (0.78) 1.50 1,60 .226
Social isolation / alienation 2.47(1.22) 2.05 (0.95) 2.15 1,60 .147
F ailure 2.47(1.23) 1.73 (0.67) 6.97 1,60 .011
V u ln erab ility to harm o r illness 2.45 (0.99) 1.92 (0.72) 5.72 1,60 .020
S u bjugation 2.40(1.11) 1.88 (0.59) 4.60 1,60 .036
Social undesirab ility 2.38(1.02) 1.77 (0.72) 5.97 1,60 .018
A b an d o n m en t / in stability 2.28(1.11) 1.99 (0.70) 0.74 1,60 .394
E n titlem en t / g ran d io sity 2.20(1.06) 2.79(1.28) 4.06 1,60 .048
M istrust / abuse 2.19(0.87) 2.28 (0.80) 0.29 1,60 .594
D ep en d en ce / incom petence 2.07 (0.76) 1.68 (0.68) 5.21 1,60 .026
D efectiv en ess / sham e 1.97 (0.84) 1.81 (0.84) 0.63 1,60 .429
It was revealed that the chronic pain group scored significantly higher than the acute pain group on each of the following schemas:
• Emotional deprivation: e.g. 'For the most part I have not had someone who really listens to me, understands me, or is tuned into my true needs and feelings ’ • Social undesirability: e.g. *'People do n ’t want to include me in their groups; 7
never know what to say socially ’
• Failure: e.g. 'I'm a fa ilu re’; 'Most other people are more capable than I am in areas o f work and achievement '
• Vulnerability to harm or illness: e.g. 7 take great precautions to avoid getting sick or hurt ’; 7 can 7 seem to escape the feeling that something bad is about to happen’
• Subjugation: e.g. 7 worry a lot about pleasing other people so they won 7 reject me ’; ‘I get back at people in little ways instead o f showing my anger '
• Dependence/incompetence: e.g. 7 do not feel I can cope well by m yself; 7 fin d the responsibilities o f everyday life overwhelming’
The chronic pain group scored significantly lower than the acute pain group on one schema, that o f ‘entitlement/grandiosity (example items: 7 ca n ’t tolerate other people telling me what to do ’; 7 usually put my needs ahead o f the needs o f others ’).
With regards higher-order domains, significant differences were found between the two groups on the ‘impaired autonomy and performance’ domain (F (1,60) = 6.87,
p = .011) and the ‘other directedness’ domain (F (1,60) = 6.95, = .011). The mean scores of the chronic pain group were significantly higher than those o f the acute pain group on these domains.
Section 4: Longitudinal study
Section 4 reports the results of a short-term longitudinal study which used a repeated measures design to follow a group of individuals, from the chronic pain sample already described, through a treatment programme. Responses made by this group were examined before and after treatment and at a three-month follow-up with the use of repeated measures ANOVAs. As follow-up data were not available for all those who had provided post-treatment data, it was necessary to conduct separate analyses for treatment outcome and for maintenance o f treatment benefits.