Clinical Focus

  • Pain Psychology
  • Psychology

Academic Appointments

  • Clinical Associate Professor, Anesthesiology, Perioperative and Pain Medicine

Honors & Awards

  • 2015 Presidential Commendation, American Academy of Pain Medicine (2015)

Professional Education

  • Fellowship:The Johns Hopkins University (2004) MD
  • Internship:Southern Arizona VA Healthcare System (2002) AZ
  • Medical Education:University of Colorado at Boulder (2002) CO
  • MA, University of Colorado at Boulder, Clinical Psychology (1998)
  • PhD, University of Colorado at Boulder, Clinical Psychology (2002)
  • Post-Doc, The Johns Hopkins University School of Medicine, Rehabilitation Psychology (2004)

Community and International Work

  • Stanford Free Back Pain Education Day 2015, Stanford University


    Community Outreach for people with back pain

    Partnering Organization(s)

    Stanford Hospitals and Clinics

    Populations Served

    Chronic Back Pain



    Ongoing Project


    Opportunities for Student Involvement


  • Stanford 2014 Free Chronic Pain Education Day, Stanford University


    Living Well with Chronic Pain

    Partnering Organization(s)

    Western Pain Society

    Populations Served

    Chronic Pain


    Bay Area

    Ongoing Project


    Opportunities for Student Involvement


  • Mirror therapy certification workshops for physicians, trauma, and healthcare providers in Vietnam, Can Tho, Dong Ha, and Hanoi, Vietnam


    Self-delivered mirror therapy for phantom pain

    Partnering Organization(s)

    International Association for the Study of Pain; End the Pain Project; HealthSaaS

    Populations Served

    Vietnamese amputees



    Ongoing Project


    Opportunities for Student Involvement


Research & Scholarship

Current Research and Scholarly Interests

Current Grants:

NIH / NCCIH 09/01/2015 – 08/31/2020
Title: Single Session Pain Catastrophizing Treatment: Comparative Efficacy & Mechanisms
This project will test the efficacy of a novel treatment for pain catastrophizing I developed and pilot tested at the Stanford Pain Management Center.
Multi-PI: Darnall & Mackey

NIH / NICHD 09/01/2015 – 08/31/2020
Title: Maternal Chronic Pain: Risk for Pain and Poor Outcomes in Children
(PI: Anna Wilson, PhD)
Darnall, Site PI for Stanford University

Stanford Faculty Innovation Program 12/18/14 - 12/17/15
Title: Pain Clinic Optimization of Patient Experience (Pain COPE): Leveraging Open Source Learning Health System for Prescriptive Analytics Approach to Patient Satisfaction
Multi-PI: Kao MC and Darnall

Current projects include:

(1) Pre-surgical delivery of single-session treatment for pain catastrophizing
(2) Mechanisms of pain catastrophizing treatment (pain-CBT and single-session tx)
(3) Quantitative sensory impacts of a pain catastrophizing induction in women with chronic pain
(4) Benzodiazepine and opioid prescribing patterns in US primary care visits
(5) Sex differences in brain structure for patients taking opioids for chronic pain vs. opioid naïve chronic pain patients
(6) Minimizing prescription opioid risks
(7) Mechanisms of complementary and alternative treatments for chronic low back pain
(8) Relationship between opioid prescribing and pain catastrophizing

I have dedicated a large portion of my professional career to studying pain catastrophizing, and quantifying the clinical and behavioral correlates, and to developing an effective, efficient, and specific treatment. I also developed a novel experimental model—a 10-minute pain catastrophizing induction—that allows us to study the immune responses (Darnall et al, Gender Med, 2010) and changes in sensory perception and neural functioning that occur after induced catastrophizing. These studies are designed to inform our understanding of the mechanisms by which pain catastrophizing shapes neural functioning, pain perception, and ultimately CNS structure in women with chronic pain. Current and future studies will use fMRI to examine the neurocorrelates, and CHOIR (Collaborative Health Outcomes Information Registry) to comprehensively phenotype the psychophysical impacts of pain catastrophizing, how we can reverse these negative psychobehavioral patterns (treatment mechanisms), and how early treatment may serve as chronic pain prophylaxis.

I have a specific passion for developing low-cost, low-burden, easily accessible treatments that reduce suffering in patients. My work in this area includes the development of 4 patient products: a book (Less Pain, Fewer Pills, 2014), an enhanced pain management CD (2013), an evidence-based DVD (2010) (Darnall & Li, J Rehabil Med, 2010), and a standard pain management CD (2010). In 2013, I developed a single-session 2-hour class to treat pain catastrophizing (Darnall et al, J Pain Res, 2014; also see ‘treatment’ at The class is novel because pain catastrophizing is typically treated across 6-12 individual or group psychology sessions, and thus treatment imposes substantial burdens to patients in terms of time and costs. We are now testing the single-session pain catastrophizing class in the perioperative setting to determine its efficacy in improving time to pain resolution and opioid cessation, as well as in improving other post-surgical outcomes.

Clinical Trials

  • Stanford Center for Back Pain Recruiting

    The purpose of the Stanford Center for Back Pain is to investigate and characterize the mechanisms of four treatments for chronic low back pain. These interventions (research treatment) include real-time fMRI neurofeedback, mindfulness based stress reduction, cognitive behavioral therapy, and acupuncture treatment. The investigators plan to characterize both mechanisms of treatment effects and efficacy.

    View full details


2015-16 Courses


All Publications

  • Pain Psychology and Pain Catastrophizing in the Perioperative Setting: A Review of Impacts, Interventions, and Unmet Needs. Hand clinics Darnall, B. D. 2016; 32 (1): 33-39


    This article provides a brief overview of the literature on perioperative pain psychology in terms of relevant factors and treatments. Where possible, the content emphasizes hand surgery or hand trauma populations, although this literature is notably limited, as well as the relevant musculoskeletal surgery literature. In addition, gaps in understanding and patient care are identified and discussed.

    View details for DOI 10.1016/j.hcl.2015.08.005

    View details for PubMedID 26611387

  • Pain Psychology: A Global Needs Assessment and National Call to Action. Pain medicine Darnall, B. D., Scheman, J., Davin, S., Burns, J. W., Murphy, J. L., Wilson, A. C., Kerns, R. D., Mackey, S. C. 2016; 17 (2): 250-263


    The Institute of Medicine and the draft National Pain Strategy recently called for better training for health care clinicians. This was the first high-level needs assessment for pain psychology services and resources in the United States.Prospective, observational, cross-sectional.Brief surveys were administered online to six stakeholder groups (psychologists/therapists, individuals with chronic pain, pain physicians, primary care physicians/physician assistants, nurse practitioners, and the directors of graduate and postgraduate psychology training programs).1,991 responses were received. Results revealed low confidence and low perceived competency to address physical pain among psychologists/therapists, and high levels of interest and need for pain education. We found broad support for pain psychology across stakeholder groups, and global support for a national initiative to increase pain training and competency in U.S. therapists. Among directors of graduate and postgraduate psychology training programs, we found unanimous interest for a no-cost pain psychology curriculum that could be integrated into existing programs. Primary barriers to pain psychology include lack of a system to identify qualified therapists, paucity of therapists with pain training, limited awareness of the psychological treatment modality, and poor insurance coverage.This report calls for transformation within psychology predoctoral and postdoctoral education and training and psychology continuing education to include and emphasize pain and pain management. A system for certification is needed to facilitate quality control and appropriate reimbursement. There is a need for systems to facilitate identification and access to practicing psychologists and therapists skilled in the treatment of pain.

    View details for DOI 10.1093/pm/pnv095

    View details for PubMedID 26803844

  • Pain Psychology: A Global Needs Assessment and National Call to Action Pain Medicine Darnall, B. D., Scheman, J., Davin, S., Burns, J. W., Murphy, J. L., Wilson, A. C., Kerns, R., Mackey, S. C. 2016; 17: 250-263

    View details for DOI 10.1093/pm/pnv095

  • From Catastrophizing to Recovery: a pilot study of a single-session treatment for pain catastrophizing JOURNAL OF PAIN RESEARCH Darnall, B. D., Sturgeon, J. A., Kao, M., Hah, J. M., Mackey, S. C. 2014; 7: 219-226


    Pain catastrophizing (PC) - a pattern of negative cognitive-emotional responses to real or anticipated pain - maintains chronic pain and undermines medical treatments. Standard PC treatment involves multiple sessions of cognitive behavioral therapy. To provide efficient treatment, we developed a single-session, 2-hour class that solely treats PC entitled "From Catastrophizing to Recovery" [FCR].To determine 1) feasibility of FCR; 2) participant ratings for acceptability, understandability, satisfaction, and likelihood to use the information learned; and 3) preliminary efficacy of FCR for reducing PC.Uncontrolled prospective pilot trial with a retrospective chart and database review component. Seventy-six patients receiving care at an outpatient pain clinic (the Stanford Pain Management Center) attended the class as free treatment and 70 attendees completed and returned an anonymous survey immediately post-class. The Pain Catastrophizing Scale (PCS) was administered at class check-in (baseline) and at 2, and 4 weeks post-treatment. Within subjects repeated measures analysis of variance (ANOVA) with Student's t-test contrasts were used to compare scores across time points.All attendees who completed a baseline PCS were included as study participants (N=57; F=82%; mean age =50.2 years); PCS was completed by 46 participants at week 2 and 35 participants at week 4. Participants had significantly reduced PC at both time points (P<0001) and large effect sizes were found (Cohen's d=0.85 and d=1.15).Preliminary data suggest that FCR is an acceptable and effective treatment for PC. Larger, controlled studies of longer duration are needed to determine durability of response, factors contributing to response, and the impact on pain, function and quality of life.

    View details for DOI 10.2147/JPR.S62329

    View details for Web of Science ID 000364587600005

    View details for PubMedID 24851056

  • Medical and Psychological Risks and Consequences of Long-Term Opioid Therapy in Women PAIN MEDICINE Darnall, B. D., Stacey, B. R., Chou, R. 2012; 13 (9): 1181-1211


    Long-term opioid use has increased substantially over the past decade for U.S. women. Women are more likely than men to have a chronic pain condition, to be treated with opioids, and may receive higher doses. Prescribing trends persist despite limited evidence to support the long-term benefit of this pain treatment approach.To review the medical and psychological risks and consequences of long-term opioid therapy in women.Scientific literature containing relevant keywords and content were reviewed.Long-term opioid use exposes women to unique risks, including endocrinopathy, reduced fertility, neonatal risks, as well as greater risk for polypharmacy, cardiac risks, poisoning and unintentional overdose, among other risks. Risks for women appear to vary by age and psychosocial factors may be bidirectionally related to opioid use. Gaps in understanding and priorities for future research are highlighted.

    View details for DOI 10.1111/j.1526-4637.2012.01467.x

    View details for Web of Science ID 000308713600011

    View details for PubMedID 22905834

  • Sex Differences in Long-term Opioid Use Cautionary Notes for Prescribing in Women ARCHIVES OF INTERNAL MEDICINE Darnall, B. D., Stacey, B. R. 2012; 172 (5): 431-432

    View details for Web of Science ID 000301381300012

    View details for PubMedID 22412108

  • Hysterectomy and Predictors for Opioid Prescription in a Chronic Pain Clinic Sample PAIN MEDICINE Darnall, B., Li, H. 2011; 12 (2): 196-203


    To describe the prevalence of hysterectomy for women aged 18-45 seeking treatment at a chronic pain clinic, to describe patient characteristics (pain intensity, age, smoking status, hormone replacement status, and psychosocial factors) based on opioid and hysterectomy status, and to determine whether hysterectomy status predicted receipt of opioid prescription.Retrospective cross-sectional chart review.Total 323 new female patients aged 18-45 who completed the Brief Pain Inventory-Short Form at initial evaluation at a chronic pain clinic during a 12-month period (July 2008-June 2009).Data were collected from the Brief Pain Inventory and medical charts. Variables included opioid prescription, average pain intensity, pain type, age, hysterectomy status, smoking status, and pain-related dysfunction across domains measured by the Brief Pain Inventory. The association of opioid prescription with hysterectomy and other factors were determined by logistic regression.Prevalence of hysterectomy was 28.8%. Average pain intensity was not associated with either hysterectomy or opioid prescription status. However, hysterectomy and high levels of pain-related dysfunction were significantly and independently associated with opioid prescription after adjusting for age and pain intensity. More than 85% of women with hysterectomy and high pain-related dysfunction had opioid prescription.Hysterectomy may confer risk for pain-related dysfunction and opioid prescription in women 45 and younger. More research is needed to understand 1) how patient characteristics influence prescribing patterns and 2) the specific medical risks and consequences of chronic opioid therapy in this population.

    View details for DOI 10.1111/j.1526-4637.2010.01038.x

    View details for Web of Science ID 000287200000003

    View details for PubMedID 21223499

  • Pilot Study of Inflammatory Responses Following a Negative Imaginal Focus in Persons With Chronic Pain: Analysis by Sex/Gender GENDER MEDICINE Darnall, B. D., Aickin, M., Zwickey, H. 2010; 7 (3): 247-260


    Recent evidence suggests that differential stress and immune responses may play a role in the sex/gender disparity for pain. Pain pathology and psychological stress are both associated with elevated levels of proinflammatory cytokines.This pilot study tested a negative imaginal focus to assess whether it would elicit a proinflammatory cytokine response and whether responses would vary by sex/gender.Adults with chronic musculoskeletal pain were recruited from an outpatient, multidisciplinary pain clinic in Portland, Oregon, between 2007 and 2008. All participants underwent a psychologist-guided 10-minute focus on the negative aspects of their pain condition and the imagined worsening of their pain; no control group was used. Serum collected at baseline and postfocus (1, 2, and 2.5 hours) was assayed for interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha). Cortisol was assayed at each time point and at 15 minutes postfocus.Thirty-six outpatients (aged 26-62 years; 23 women, 13 men) participated in the study. Compared with men, women displayed greater negative emotional expression during the experiment, and this in turn mediated their IL-6 inflammatory responses. Relative to men, the IL-6 response trajectory was delayed for women. The IL-6 and TNF-a findings suggest women's maximal cytokine responses were not captured by the final time point.This pilot study provides preliminary evidence that women with chronic pain may experience increased and delayed inflammatory responses following negative emotional expression induced by thinking negatively about their pain condition. The findings have implications for pain catastrophizing research. This early-phase research suggests that the timing and duration of the cytokine response are critical factors to consider in future pain research.

    View details for DOI 10.1016/j.genm.2010.06.003

    View details for Web of Science ID 000279749600007

    View details for PubMedID 20638630

  • Sex and gender in psychoneuroimmunology research: Past, present and future BRAIN BEHAVIOR AND IMMUNITY Darnall, B. D., Suarez, E. C. 2009; 23 (5): 595-604


    To date, research suggests that sex and gender impact pathways central to the foci of psychoneuroimmunology (PNI). This review provides a historical perspective on the evolution of sex and gender in psychoneuroimmunology research. Gender and sexually dimorphic pathways may have synergistic effects on health differences in men and women. We provide an overview of the literature of sex and gender differences in brain structure and function, sex steroids, gender role identification, hypothalamic-pituitary-adrenal axis function, genetics, immunology and cytokine response. Specific examples shed light on the importance of attending to sex and gender methodology in PNI research and recommendations are provided.

    View details for DOI 10.1016/j.bbi.2009.02.019

    View details for Web of Science ID 000267274000005

    View details for PubMedID 19272440

  • Conflict of Interest, Part II: Pain Society Leadership and Industry Pain Medicine Schatman, M. E., Darnall, B. D. 2016; 17

    View details for DOI 10.1093/pm/pnv041

  • Contributions of physical function and satisfaction with social roles to emotional distress in chronic pain: a Collaborative Health Outcomes Information Registry (CHOIR) study PAIN Sturgeon, J. A., Dixon, E. A., Darnall, B. D., Mackey, S. C. 2015; 156 (12): 2627-2633


    Individuals with chronic pain show a greater vulnerability to depression or anger than those without chronic pain, and also show greater interpersonal difficulties and physical disability. The current study examined data from 675 individuals with chronic pain during their initial visits to a tertiary care pain clinic using assessments from Stanford University's Collaborative Health Outcomes Information Registry (CHOIR). Using a path modeling analysis, the mediating roles of PROMIS Physical Function and PROMIS Satisfaction with Social Roles and Activities were tested between pain intensity and PROMIS Depression and Anger. Pain intensity significantly predicted both depression and anger, and both physical function and satisfaction with social roles mediated these relationships when modeled in separate 1-mediator models. Notably, however, when modeled together, ratings of satisfaction with social roles mediated the relationship between physical function and both anger and depression. Our results suggest that the process by which chronic pain disrupts emotional well-being involves both physical function and disrupted social functioning. However, the more salient factor in determining pain-related emotional distress appears to be disruption of social relationships, rather than global physical impairment. These results highlight the particular importance of social factors to pain-related distress, and highlight social functioning as an important target for clinical intervention in chronic pain.

    View details for DOI 10.1097/j.pain.0000000000000313

    View details for Web of Science ID 000365598300028

  • Toward the Healthiest Symbiosis. Pain medicine Darnall, B. D., Schatman, M. E. 2015; 16 (7): 1254-1255

    View details for DOI 10.1111/pme.12828_3

    View details for PubMedID 26133016

  • The Relationship Between Industry and Pain Societies, Part 1: Demystification and Legitimization of Continuing Medical Education PAIN MEDICINE Darnall, B. D., Schatman, M. E. 2015; 16 (7): 1251-1251

    View details for DOI 10.1111/pme.12828

    View details for Web of Science ID 000358017000004

    View details for PubMedID 26138746

  • Opioid use and lactation: protecting the child in the context of maternal pain care. Pain medicine Darnall, B. D., Schatman, M. E. 2015; 16 (4): 628-?

    View details for DOI 10.1111/pme.12718

    View details for PubMedID 25766069

  • Protecting the infant from unknown risks. Pain medicine Darnall, B. D., Schatman, M. E. 2015; 16 (4): 631-632

    View details for DOI 10.1111/pme.12718_4

    View details for PubMedID 25832321

  • Physical and psychological correlates of fatigue and physical function: a Collaborative Health Outcomes Information Registry (CHOIR) study. journal of pain Sturgeon, J. A., Darnall, B. D., Kao, M. J., Mackey, S. C. 2015; 16 (3): 291-8 e1


    Fatigue is a multidimensional construct that has significant implications for physical function in chronic non-cancer pain populations but remains relatively understudied. The current study characterized the independent contributions of self-reported ratings of pain intensity, sleep disturbance, depression, and fatigue to ratings of physical function and pain-related interference in a diverse sample of treatment-seeking individuals with chronic pain. Methods: These relationships were examined as a path modeling analysis of self-report scores obtained from 2,487 individuals with chronic pain from a tertiary care outpatient pain clinic.Our analyses revealed unique relationships of pain intensity, sleep disturbance, and depression with self-reported fatigue. Further, fatigue scores accounted for significant proportions of the relationships of both pain intensity and depression with physical function and pain-related interference, and accounted for the entirety of the unique statistical relationship between sleep disturbance and both physical function and pain-related interference.Fatigue is a complex construct with relationships to both physical and psychological factors that has significant implications for physical functioning in chronic non-cancer pain. The current results identify potential targets for future treatment of fatigue in chronic pain, and may provide directions for future clinical and theoretical research in the area of chronic non-cancer pain.Fatigue is an important physical and psychological variable that factors prominently in the deleterious consequences of pain intensity, sleep disturbance, and depression for physical function in chronic non-cancer pain.

    View details for DOI 10.1016/j.jpain.2014.12.004

    View details for PubMedID 25536536

  • Physical and Psychological Correlates of Fatigue and Physical Function: A Collaborative Health Outcomes Information Registry (CHOIR) Study JOURNAL OF PAIN Sturgeon, J. A., Darnall, B. D., Kao, M. J., Mackey, S. C. 2015; 16 (3): 291-298
  • Compassion Cultivation in Chronic Pain May Reduce Anger, Pain, and Increase Acceptance: Review and Commentary Health Care: Current Reviews Darnall, B. D. 2015; 3 (1)
  • Urine drug screening: opioid risks preclude complete patient autonomy. Pain medicine Darnall, B. D., Schatman, M. E. 2014; 15 (12): 2001-2002

    View details for DOI 10.1111/pme.12604_4

    View details for PubMedID 25376661

  • Urine drug screening: necessary or alienating? Pain medicine Darnall, B. D., Schatman, M. E. 2014; 15 (12): 1999-?

    View details for DOI 10.1111/pme.12604

    View details for PubMedID 25376375

  • Compassion meditation training for people living with chronic pain and their significant others: a pilot study and mixed-methods analysis JOURNAL OF PAIN Ruchelli, G., Chapin, H., Darnall, B., Seppala, E., Doty, J., Mackey, S. 2014; 15 (4): S117-S117
  • Proinflammatory cytokines and DHEA-S in women with fibromyalgia: impact of psychological distress and menopausal status JOURNAL OF PAIN RESEARCH Sturgeon, J. A., Darnall, B. D., Zwickey, H. L., Wood, L. J., Hanes, D. A., Zava, D. T., Mackey, S. C. 2014; 7: 707-716


    Though fibromyalgia is not traditionally considered an inflammatory disorder, evidence for elevated inflammatory processes has been noted in this disorder in multiple studies. Support for inflammatory markers in fibromyalgia has been somewhat equivocal to date, potentially due to inattention to salient patient characteristics that may affect inflammation, such as psychiatric distress and aging milestones like menopause. The current study examined the relationships between proinflammatory cytokines and hormone levels, pain intensity, and psychological distress in a sample of 34 premenopausal and postmenopausal women with fibromyalgia. Our results indicated significant relationships between interleukin-8 and ratings of pain catastrophizing (r=0.555, P<0.05), pain anxiety (r=0.559, P<0.05), and depression (r=0.551, P<0.05) for postmenopausal women but not premenopausal women (r,0.20 in all cases). Consistent with previous studies, ratios of interleukin-6 to interleukin-10 were significantly lower in individuals with greater levels of depressive symptoms (r=-0.239, P<0.05). Contrary to previous research, however, dehydroepiandrosterone sulfate did not correlate with pain intensity or psychological or biological variables. The results of the current study highlight the importance of psychological functioning and milestones of aging in the examination of inflammatory processes in fibromyalgia.

    View details for DOI 10.2147/JPR.S71344

    View details for Web of Science ID 000364591400001

    View details for PubMedID 25506243

  • Pain Characteristics and Pain Catastrophizing in Incarcerated Women with Chronic Pain JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED Darnall, B. D., Sazie, E. 2012; 23 (2): 543-556


    Chronic pain in incarcerated women is understudied and poorly described. Study objectives were to describe pain characteristics, correlates, and predictors in a convenience sample of incarcerated women with chronic pain. A survey packet that included the Brief Pain Inventory Short Form (BPI-SF) and the Pain Catastrophizing Scale (PCS) was distributed to all inmates at a state prison for women. Those who self-identified as having chronic pain ?4 on a 0-10 numeric rating scale were invited to complete the survey. Demographics and medical and psychiatric diagnoses were abstracted by chart review. Participants (N=159) rated their current and average pain intensity as severe. Pain catastrophizing was found to predict average pain intensity and level of pain-related interference in functioning. Pain catastrophizing is treatable with behavioral intervention in the general population. Findings suggest that pain catastrophizing may be an important target for research and treatment in incarcerated women with chronic pain.

    View details for Web of Science ID 000303427600007

    View details for PubMedID 22643606



    To test the feasibility and preliminary efficacy of self-delivered home-based mirror therapy for phantom pain.Uncontrolled prospective treatment outcome pilot study.Forty community-dwelling adults with unilateral amputation and phantom pain >?3 on a 0-10 numeric rating scale enrolled either during a one-time study visit (n?=?30) or remotely (n?=?10).Participants received an explanation of mirror therapy and were asked to self-treat for 25 min daily. Participants completed and posted back sets of outcomes questionnaires at months 1 and 2 post-treatment. Main outcome was average phantom pain intensity at post-treatment.A significant reduction in average phantom pain intensity was found at month 1 (n?=?31, p?=?0.0002) and at month 2 (n?=?26, p?=?0.002). The overall median percentage reduction at month 2 was 15.4%. Subjects with high education (>?16 years) compared with low education (

    View details for DOI 10.2340/16501977-0933

    View details for Web of Science ID 000305492600011

    View details for PubMedID 22378591

  • Self-Delivered Home-Based Mirror Therapy for Lower Limb Phantom Pain AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION Darnall, B. D. 2009; 88 (1): 78-81


    Home-based patient-delivered mirror therapy is a promising approach in the treatment of phantom limb pain. Previous studies and case reports of mirror therapy have used a therapist-guided, structured protocol of exercises. No case report has described treatment for either upper or lower limb phantom pain by using home-based patient-delivered mirror therapy. The success of this case demonstrates that home-based patient-delivered mirror therapy may be an efficacious, low-cost treatment option that would eliminate many traditional barriers to care.

    View details for DOI 10.1097/PHM.0b013e318191105b

    View details for Web of Science ID 000262027100011

    View details for PubMedID 19096290

  • Depressive symptoms and mental health service utilization among persons with limb loss: results of a national survey. Archives of physical medicine and rehabilitation Darnall, B. D., Ephraim, P., Wegener, S. T., Dillingham, T., Pezzin, L., Rossbach, P., MacKenzie, E. J. 2005; 86 (4): 650-658


    To describe the prevalence of depressive symptoms, risk factors, and mental health service utilization in a national limb-loss sample.Cross-sectional survey.Participants were interviewed by telephone.A stratified sample by etiology of 914 persons with limb loss, derived from people who contacted the Amputee Coalition of America from 1998 to 2000.Not applicable.Center for Epidemiologic Study Depression Scale (CES-D 10-item), pain bothersomeness, characteristics of the amputation, sociodemographics, and mental health service utilization.Prevalence for significant depressive symptoms (CES-D score, >/=10) was 28.7%. Risk factors included being divorced or separated, living at the near-poverty level, having comorbid conditions, being somewhat bothered or extremely bothered by back pain and phantom limb pain, and having residual limb pain for persons aged 18 to 54. Having higher education was a buffer against depressive symptoms. Almost 22% of the sample and 44.6% of persons with significant depressive symptoms received mental health service in the previous year. For persons with significant depressive symptoms, 32.9% reported needing mental health service but not receiving them, and 67.1% reported not needing mental health service.Depressive symptoms are prevalent among persons with limb loss. Proper management of pain and medical comorbidity may mitigate depressive symptoms. Education about depressive symptoms and treatment options may improve receipt of mental health service among persons with limb loss reporting significant levels of depressive symptoms.

    View details for PubMedID 15827913

  • Modification of the cognitive model for bulimia via path analysis on a Brazilian adolescent sample ADDICTIVE BEHAVIORS Darnall, B. D., Smith, J. E., Craighead, L. W., Lamounier, J. A. 1999; 24 (1): 47-57


    Eating disturbances in middle-class Brazilian adolescents attending three high schools (one Military, two Private schools) were investigated. Participants from both Private schools were similar to U.S. samples on the EAT-26. Path analysis on the Private schools revealed the following. Higher body weight leads to weight concerns most strongly through greater discrepancy from the ideal, but it also leads directly to weight concern. Thus, both the reality of being heavier and the perception that one is larger than ideal (which could be due to being heavier and/or having a thin ideal) contribute to weight concern. Greater weight concern is associated most directly with lower self-esteem, which in turn is associated with endorsing greater importance of weight and shape. Importance of weight and shape contributes most powerfully to eating pathology through dieting, but this variable has a modest direct effect as well. These paths were not significant for the Military school sample in which participants reported lower levels of weight concern, dieting, body dissatisfaction, and a larger ideal figure. However, the Military sample rated importance of weight and shape as high as did Private-school participants. The results provide support for variables identified as important in the cognitive model of bulimia and suggest the model may be enhanced by including body weight and one's perceived ideal body shape as additional variables.

    View details for Web of Science ID 000077732100004

    View details for PubMedID 10189972