273 Social Exclusion and Pain Among Severe Burn Survivors
Bibliographic record
Abstract
Individuals with acquired alterations in appearance can be at a disadvantage when returning to duty/work, home, and community. Stigmatizing reactions to residual changes in appearance due to a burn may involve social exclusion. This rejection, can cause “social pain” when “one is being excluded from desired relationships or groups” (MacDonald, 2005) and recent research shows social and physical pain are related. This study examines the relationship of social pain with physical pain in burn survivors, and, tests whether avoidance or acceptance coping behaviors are moderators of that relationship. Participants (n= 125) were consenting admissions to a regional burn center with major burns. The sample was predominantly male (70%), Caucasian (65%), mean age= 39 years. Most frequent mechanism of injury was fire (47%). Study measures were completed at discharge (N=130), 6- (N=87) and 12- months (N=81) post-discharge. Satisfaction with Appearance Scale provided social exclusion measures: Social Discomfort, Social Impact (Social Impact). McGill Pain Questionnaire yielded sensory and affective pain scores. The Brief COPE avoidance and acceptance subscales were used. Linear mixed regression models tested prospective relation of social exclusion with pain. We examined cross-sectional links of social pain and physical pain to test whether acceptance or avoidance moderated their relationships. All analyses controlled for %TBSA and gender. Longitudinal effects: Social Discomfort had significant longitudinal impact on sensory (γ01= .20, p=.03) and affective (γ01= .10, p=.006) pain. Social Impact had a significant longitudinal effect on sensory (γ01= .43, p<.001) and affective (γ01= .15, p<.001) pain. The associations of Social Discomfort and Social Impact with affective and sensory pain remained stable over time. Moderation analysis: At discharge, avoidance significantly moderated the effect of Social Impact (B=.051, p=.008) on affective pain. High Social Impact correlated more strongly with high affective pain among people who avoid more versus less often. Acceptance significantly moderated the effect of Social Discomfort on affective (B= -.065, p=.029) and sensory pain (B= -.15, p=.045) - greater Social Discomfort correlated more strongly with affective and sensory pain among people low versus high on acceptance. Social pain (Discomfort; Impact) predicted physical pain (affective, sensory). Avoidance and acceptance moderated the social and physical pain relationship - that is, higher avoidance and lower acceptance made the pain worse. Coping skills training and application may ameliorate the link between social and physical pain.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".