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Title page for ETD etd-09012011-213917

Type of Document Dissertation
Author Shirkey, Kezia Coleman
URN etd-09012011-213917
Title Changes in pain self-efficacy and functional self-efficacy from childhood to young adulthood
Degree PhD
Department Psychology
Advisory Committee
Advisor Name Title
Lynn S. Walker Committee Chair
Bruce Compas Committee Member
Craig Smith Committee Member
James Pace Committee Member
  • development
  • chronic pain
  • longitudinal
  • self-efficacy
Date of Defense 2011-08-25
Availability unrestricted
Self-efficacy has been conceptualized in two ways in the context of chronic pain—both as people’s beliefs that they can function and cope emotionally despite the pain (functional self-efficacy) and as people’s beliefs that they can alleviate pain (pain self-efficacy). Successful management of chronic pain does not necessarily mean getting rid of the pain. Rather, interventions are often aimed at increasing levels of psychological and physical functioning in spite of pain. There is strong evidence, across a variety of pain populations, that pain-related self-efficacy is associated with better physical and psychological functioning. However, little is known about the development of pain-related self-efficacy or how it is related to pain outcomes.

The current study examined pain-related self-efficacy in patients with a history of chronic abdominal pain in childhood with regard to its change over time and its relation to health outcomes. Participants (N=863) comprised three separate cohorts of consecutive new patients to the Pediatric Gastroenterology clinic. The same criteria and procedure was used across cohorts. Subsets of these initial participants then participated at 2 week (N=300), 6 month (N=121) and long-term (5-15 years, N=258) follow-ups. Measures at each assessment included self-reported pain-related self-efficacy, pain, age, and time since baseline. HLM and linear regression were used to assess change over time.

Several patterns emerged regarding changes in pain-related self-efficacy from the current study. First, the largest increases in pain-related self-efficacy occurred early after a clinic visit. Second, differences in the rate of change in self-efficacy, rather than initial values, predicted several important long-term outcomes. Third, child age at the time of assessment of pain-related self-efficacy did not influence the utility of self-report in predicting children’s later physical and psychological functioning. Finally, baseline pain coping strategies, particularly passive coping, influenced patterns of change in pain-related self-efficacy.

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