Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Arts and Sciences



First Advisor

Dr. Charles R. Carlson


Persistent pain conditions are a major health problem throughout the world and are one of the primary reasons that people seek medical treatment (Gureje, Von Korff, Simon, & Gater, 1998; Verhaak, Kerssens, Dekker, Sorbi, & Bensing, 1998). These conditions are characterized by complex interactions between cognitive, emotional, and physiological disturbances and are often associated with comorbid psychological disorders (Gatchel, 2004). Though previous studies have examined the effect of interventions targeting persistent pain, such as physical self-regulation interventions, few studies have examined the complex interaction between such interventions and other variables such as psychological and physiological functioning and presence of social support. The current study was designed to evaluate the effect of a physical self-regulation intervention (i.e. diaphragmatic breathing entrainment) on response to a brief physical stressor (i.e., mild thermal stimulation) as well as to evaluate whether presence or absence of a supportive partner influenced this relationship. Participant response was measured via self-report of pain intensity and unpleasantness and via physiological measures of respiration rate, blood pressure, heart rate, and heart rate variability. The study consisted of 154 female participants who participated in pairs (i.e., 77 pairs). Each participant was randomly assigned to training in diaphragmatic breathing or a control condition as well as being randomly assigned to complete the study with or without their supportive partner present. Analyses revealed that breathing entrainment resulted in significantly slower breathing rate during the thermal stressor task (p < .01). Presence of a supportive partner interacted with breathing entrainment to influence heart rate during the thermal stressor task (p < .05) such that participants who completed the study with a support person present had a lower heart rate when trained in diaphragmatic breathing than when trained in a control protocol and participants who did not have a support person present showed the opposite effect. Presence of a supportive partner also interacted with breathing entrainment to influence ratings of task unpleasantness (p < .05) such that participants who were trained in diaphragmatic breathing rated the task similarly regardless of presence or absence of a supportive partner, whereas participants who were trained in a control protocol rated the task as more unpleasant when accompanied by a supportive partner. In conclusion, the present study demonstrates the impact of training in diaphragmatic breathing and presence of social support on response to thermal stimuli as measured by both self-report (i.e., ratings of task unpleasantness) and physiological (i.e., respiration rate and heart rate) measures. This study highlights the usefulness of implementing a self-regulatory training strategy for treatment of pain and in considering the efficacy of incorporating a supportive partner into such training.

Digital Object Identifier (DOI)