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Title: Self-as-context in chronic pain : examination of a component process of psychological flexibility
Author: Yu, Lin
ISNI:       0000 0004 6348 1649
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2017
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Sense of self appears to be fundamental to human wellbeing. Previous research suggests that people with chronic pain perceive threats to their sense of self and struggle with self-related experiences. This struggling may have detrimental effect on their functioning and wellbeing. This thesis investigates the self, in particular a component process called self-as-context within the framework of psychological flexibility (PF) and Acceptance and Commitment Therapy (ACT). Study 1: A systematic review examined the conceptualization, methods, and evidence from empirical investigations of the self in chronic pain. These investigations of the self appear to lack theoretical clarity. A model of the self, based in the PF model and ACT, was suggested for future research on the self. Study 2: Evidence from the model of self was lacking partly due to lack of adequate measurement. In study 2 a measure of the self based on this model of the self, called the Self Experiences Questionnaire (SEQ) was developed in a chronic pain sample. The results of this study suggest that the SEQ appears to be a reliable and valid measure of self-as-context. Study 3: In study 3 self-as-context was investigated using the SEQ with a longitudinal, single-group design, in the setting of an ACT-oriented multidisciplinary programme for chronic pain. Process variables and outcomes variables were measured at pre-treatment, upon completion of treatment, and at nine-month follow-up. Increase in self-as-context from pre- to post-treatment was associated with improvement in functioning from pre-treatment to follow-up. Study 4: In study 4 the feasibility of an online experiment protocol for the examination of the impact of self-as-context on avoidance behaviour was tested. The recruitment and technical delivery were successful, and retention and data completion were only marginally successful. This online experiment protocol appears to be partially feasible. This set of projects produced a synthesis of evidence related to self in chronic pain, a tool for the investigation of self-as-context, and provided preliminary evidence for change in self-as-context in relation to treatment outcomes in people with chronic pain. This effort may facilitate empirical and clinical investigation of the self in people with chronic pain, improve our understanding of the self, and inform treatment development.
Supervisor: McCracken, Lance ; Norton, Sam Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available