The Elkins Distress Inventory : development of a brief biopsychosocial battery for the assessment of pain and psychological distress in a chronic pain population.
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Gartner, Ashley M.
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Pain is among the most commonly experienced symptoms for which individuals seek health care and is the cause of significant medical expenditures. For many patients, pain may also lead to psychological distress, sleep disturbances, reduced quality of life, and impaired social relationships. Thus, thorough assessment of pain should encompass physical, as well as emotional, cognitive, and social components of a patient’s experience of pain. Such a comprehensive, biopsychosocial approach to the assessment of pain is not typically feasible in medical settings due to the length and format of existing measures of pain and distress. This dissertation examines the convergent and discriminant validity, reliability, factor structure, and clinical utility of the Elkins Distress Inventory as a brief, multidimensional measure of psychological distress in a chronic pain population. A retrospective chart review of 113 chronic pain patients who underwent the standard pre-pain-pump or pre-dorsal-column-stimulator surgery neuropsychological evaluation at the Scott and White Memorial Hospital Division of Neuropsychology was conducted. Correlations between the Elkins Distress Inventory, Battery for Health Improvement-II, Beck Depression Inventory-II, Beck Anxiety Inventory, Beck Hopelessness Scale, and State-Trait Anger Expression Inventory-II were calculated in order to examine the convergent and discriminant validity of the Elkins Distress Inventory and its subscales. Additionally, the internal consistency of the Elkins Distress Inventory and its subscales was calculated. Exploratory and confirmatory factor analysis procedures were also conducted. The results of these analyses support the convergent and discriminatory of the Elkins Distress Inventory. The internal consistency and four-factor structure of the Elkins Distress Inventory were also supported by these analyses. Based on these results, the Elkins Distress Inventory appears to be a valid, reliable, and clinically useful tool to measure of psychological distress in a chronic pain population. Further, the Elkins Distress Inventory may be useful for the assessment of psychological distress associated with other medical conditions and appears to meet a clinical need for a brief, multidimensional measure of psychological distress in medical settings, thereby enhancing the assessment and treatment of psychological and physical symptoms of patients with medical conditions.