Computerized diary measurement of pain, disability and psychological adaptation was performed four times a day for 4 weeks in 80 patients with various duration of unexplained pain. Reported are (1) the temporal characteristics and stability of pain report during the 4-week measurement period, (2) the association between pain duration and pain report, disability and general psychopathology, and (3) the accordance between diary assessment versus questionnaire assessment of pain, disability and psychological adaptation. No evidence of instrument reactivity was found: pain report was stable across the 4-week period. However, pain report appeared to be highly variable both between and within days. About half the patients showed a clear increasing trend in pain during the day. Several differences were found between subgroups of patients varying in pain duration. Patients with less than 6 months of pain reported signi®cantly less pain intensity, disability and fatigue than patients whose pain persisted for more than 6 months. Pain coping and responses to pain behaviors by the spouse also differed for the subgroups: longer pain duration was associated with increased catastrophizing and solicitous responses from the spouse.Comparison of scores obtained with diary versus questionnaire assessment indicated moderate correlations for most variables. Retrospective (questionnaire) assessment of pain intensity yielded signi®cantly higher pain scores than diary assessment. q 2000 International Association for the Study of Pain. Published by Elsevier Science B.V.

Exaggerated negative interpretations of pain, and fear that movement will induce or increase pain strongly predicted CPD pain intensity. Spousal responses-assessed only when the spouse was with the patient who at that moment was in actual pain-may more strongly affect immobility due to pain than pain intensity per se (see part II of the study). The findings substantiate the importance of catastrophizing, fear and vigilance identified primarily in low back pain and extend this to other forms of chronic pain. The compelling evidence of momentary within-patients differences underscores that these must be accounted for in chronic pain research and practice.

The psychological prediction of chronic pain disorder disability was determined beyond that accounted for by pain intensity. Nonetheless, psychological functioning explained substantial variance in chronic pain disorder disability. The psychological prediction of immobility and physical impairment was stronger with longer pain duration. Patient characteristics and momentary states of disability-and in particular of immobility-should be carefully distinguished and accounted for in chronic pain disorder.

Considering the high prevalence of procrastination in academic settings and the moderate effect of existing forms of treatment (Ferrari, Johnson, & McCown, 1995), new approaches are needed. This chapter outlines the development and assessment of one such approach.At Leiden University, in the Netherlands, student counselors searched for new pathways in the counseling of procrastinators in academic settings. Procrastination is often related to anxiety, depression, or more severe forms of psychopathology (Ferrari, Johnson, & McCown, 1995). The new approach is primarily focused not on these factors, but on the question, What does a student need to do to study properly and get satisfactory academic results? The goal of treatment in this approach is not only to overcome procrastination but also to acquire productive competencies and study skills. To do this, we have developed several innovative tools based on the use of modern information communication technology (ICT), which offers opportunities for new approaches to counseling students.This chapter consists of two parts. In the first part, we describe our Web site, titled Study Support, and its use and users. The development of the Web J 33

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