Development of a theoretical model and preliminary evaluation of a self-management programme for different

  • Anthony Mark Harrison

Student thesis: Doctoral ThesisDoctor of Philosophy


Previous research indicates that many people with MS (pwMS) experience pain. Studies show that pain is associated with several potentially unhelpful psychosocial factors or processes, which may impact on pwMS’ functioning and quality of life.
This thesis presents a series of studies outlining the development of a theoretical model of Multiple Sclerosis (MS) pain and a preliminary intervention to support pain management for pwMS.
Study 1: A systematic review of the literature proposed a cognitive behavioural model of MS pain showing that several psychosocial factors are associated with pain and related disability. A literature review of predominant theoretical models in chronic pain, their key constructs, empirical evidence, and treatment approaches, were shown to have comparable efficacy, and may potentially be relevant to pwMS.
Study 2: Following the literature reviews, a qualitative interview study exploring pwMS experiences of pain (n = 25) provided insights into pain-related beliefs, emotional reactions, disparate pain management attitudes and behaviours.
Study 3: A large quantitative cross-sectional questionnaire study of pwMS (n = 608) explored additional psychological factors, focusing on theory and gaps identified within the literature reviews. Cognitive and contextual behavioural variables explained substantial variance in pain and related functioning.
Study 4: The literature reviews, interviews and survey refined the MS pain model. This informed the development of a telephone supported hybrid cognitive and contextual behavioural self-management intervention aiming to alleviate the negative impact of pain in MS.
Study 5: A case series (n = 7) explored the potential efficacy of the self-management intervention for pwMS with different types of MS pain, showing mixed findings in pain outcomes and psychological process variables from the MS pain model.
This project has improved our understanding of MS pain, providing a potential tool that requires further evaluation, which may help pwMS better manage pain more effectively in the future.
Date of Award2016
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorLance McCracken (Supervisor) & Rona Moss-Morris (Supervisor)

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