Assessing negative thoughts in response to pain among people with HIV

A growing body of literature suggests that negative thoughts and interpretations in response to pain can significantly increase the suffering associated with the pain experience. As part of an outcome study on a cognitive-behavioral treatment for HIV-related peripheral neuropathic pain, 85 seropositive men and women were administered the inventory of negative thoughts in response to pain (INTRP), a self-report assessment that includes three subscales: negative self-statements, negative social cognitions and self-blame. Pearson product moment correlations coefficients were calculated between INTRP scores and pain and distress ratings. A series of regression analyses were performed to determine predictors of pain and distress. Results demonstrated highly significant associations between the negative self-statements and negative social cognitions and pain intensity. Highly significant associations were also found between negative self-statements, negative social cognitions, self-blame and measures of pain interference, affective symptoms and distress. Additionally, negative cognitions significantly predicted interference in daily functional activities, overall distress and affective symptoms. Future directions for developing and testing cognitive-behavioral treatments for restructuring dysfunctional cognitions are indicated. Finally, internal scale reliability of the INTRP was shown to be moderately high and this study offers construct validity of the INTRP as a useful tool for assessing thoughts in response to pain in people with HIV.