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Life with chronic pain during COVID-19 lockdown: the case of patients with small fibre neuropathy and chronic migraine. Neurol Sci 2020; 42:389-397. [PMID: 33205374 PMCID: PMC7670980 DOI: 10.1007/s10072-020-04890-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 11/05/2020] [Indexed: 01/03/2023]
Abstract
Objective We aimed at investigating the impact of COVID-19-related distress on patients with chronic pain, highlighting the effects of changes in individual habits and public health care reconfiguration on physical and psychological health. Methods During the pandemic, 80 participants (25 patients with small fibre neuropathy (SFN), 42 patients with chronic migraine (CM) and 13 patients’ healthy family members (HFM)) were asked to evaluate their COVID-19 complains, changes in habits and clinical management, behaviour, mood, loneliness, quality of life (QoL), physical and mental health and coping strategies. Data were analysed by Spearman rho correlations and Mann-Whitney U tests. Results Patients had lower QoL, lower physical health and higher catastrophizing attitude towards pain than HFM. During the pandemic, SFN patients referred greater decline in clinical symptoms, worries about contagion and discomfort for disease management changes than CM patients. In the SFN group, the higher levels of disability were associated with suffering from changes in neurologist-patient relationship. CM patients complained of agitation/anxiety that was related to feelings of loneliness, depressive mood and catastrophism. Discussion Despite similar complains of change in habits and worries about COVID-19 pandemic, SFN and CM patients had distinct reactions. In SFN patients, pandemic distress impacted on physical health with worsening of clinical conditions, especially suffering from changes in their care. In CM patients, pandemic distress affected behaviour, mainly with psychological frailty. This suggests the need to customize public health care for patients with distinct chronic pain conditions.
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Suicidality in Chronic Illness: An Overview of Cognitive–Affective and Interpersonal Factors. J Clin Psychol Med Settings 2020; 28:137-148. [DOI: 10.1007/s10880-020-09749-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2020] [Indexed: 12/18/2022]
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Martinez-Calderon J, Flores-Cortes M, Clavero-Cano S, Morales-Asencio JM, Jensen MP, Rondon-Ramos A, Diaz-Cerrillo JL, Ariza-Hurtado GR, Luque-Suarez A. The Role of Positive Psychological Factors in the Association between Pain Intensity and Pain Interference in Individuals with Chronic Musculoskeletal Pain: A Cross-Sectional Study. J Clin Med 2020; 9:E3252. [PMID: 33053655 PMCID: PMC7599728 DOI: 10.3390/jcm9103252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/01/2020] [Accepted: 10/08/2020] [Indexed: 12/27/2022] Open
Abstract
This study aimed to test the cross-sectional mediating and moderating role that positive psychological factors play in the association between pain intensity and pain interference in individuals with chronic musculoskeletal pain. A descriptive cross-sectional study using mediation analyses was conducted, including 186 individuals with chronic musculoskeletal pain. We conducted cross-sectional mediation and moderation analyses to determine whether the positive psychological factors mediated or moderated the association between pain intensity and pain interference. Pain acceptance, pain self-efficacy, and optimism were all significantly and weakly related to pain interference when controlling for pain intensity. Pain self-efficacy and pain acceptance partially mediated the association between pain intensity and pain interference. On the other hand, the multiple mediation model did not show significant effects. The three positive psychological factors were not found to significantly moderate the association between pain intensity and pain interference. The findings suggest that in chronic musculoskeletal pain patients, the treatments may focus on [i] what they are capable of doing to manage the pain (i.e., pain self-efficacy) and [ii] being better able to accept the pain as pain waxes and wanes might be also particularly helpful. However, these results must be tested in longitudinal studies before drawing any causal conclusion.
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, 29071 Málaga, Spain; (J.M.-C.); (M.F.-C.); (A.R.-R.); (A.L.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Malaga, Spain;
| | - Mar Flores-Cortes
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, 29071 Málaga, Spain; (J.M.-C.); (M.F.-C.); (A.R.-R.); (A.L.-S.)
| | - Susana Clavero-Cano
- Servicio Andaluz de Salud, Distrito de Atención Primaria Costa del Sol, U.G.C. Las Albarizas, 29600 Marbella, Málaga, Spain
| | - Jose Miguel Morales-Asencio
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Malaga, Spain;
- Department of Nursing, Faculty of Health Sciences, Universidad de Malaga, 29071 Malaga, Spain
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98104, USA;
| | - Antonio Rondon-Ramos
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, 29071 Málaga, Spain; (J.M.-C.); (M.F.-C.); (A.R.-R.); (A.L.-S.)
- Servicio Andaluz de Salud, Distrito de Atención Primaria Costa del Sol, U.G.C. Las Lagunas, 29650 Mijas, Málaga, Spain
| | - Juan Luis Diaz-Cerrillo
- Servicio Andaluz de Salud, Distrito de Atención Primaria Costa del Sol, U.G.C. La Carihuela, 29620 Torremolinos, Málaga, Spain;
| | - Gina Rocío Ariza-Hurtado
- Servicio Andaluz de Salud, Distrito de Atención Primaria Costa del Sol, U.G.C. San Pedro de Alcántara, 29670 Marbella, Málaga, Spain;
| | - Alejandro Luque-Suarez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, 29071 Málaga, Spain; (J.M.-C.); (M.F.-C.); (A.R.-R.); (A.L.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Malaga, Spain;
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Ramírez-Maestre C, Reyes-Pérez Á, Esteve R, López-Martínez AE, Bernardes S, Jensen MP. Opioid Pain Medication Prescription for Chronic Pain in Primary Care Centers: The Roles of Pain Acceptance, Pain Intensity, Depressive Symptoms, Pain Catastrophizing, Sex, and Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176428. [PMID: 32899359 PMCID: PMC7503487 DOI: 10.3390/ijerph17176428] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 02/05/2023]
Abstract
Background: Psychological factors of patients may influence physicians’ decisions on prescribing opioid analgesics. However, few studies have sought to identify these factors. The present study had a double objective: (1) To identify the individual factors that differentiate patients who had been prescribed opioids for the management of chronic back pain from those who had not been prescribed opioids and (2) to determine which factors make significant and independent contributions to the prediction of opioid prescribing. Methods: A total of 675 patients from four primary care centers were included in the sample. Variables included sex, age, pain intensity, depressive symptoms, pain catastrophizing, and pain acceptance. Results: Although no differences were found between men and women, participants with chronic noncancer pain who were prescribed opioids were older, reported higher levels of pain intensity and depressive symptoms, and reported lower levels of pain-acceptance. An independent association was found between pain intensity and depressive symptoms and opioid prescribing. Conclusions: The findings suggest that patient factors influence physicians’ decisions on prescribing opioids. It may be useful for primary care physicians to be aware of the potential of these factors to bias their treatment decisions.
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Affiliation(s)
- Carmen Ramírez-Maestre
- Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Andalucía Tech, Universidad de Málaga, 29071 Málaga, Spain; (Á.R.-P.); (R.E.); (A.E.L.-M.)
- Correspondence: ; Tel.: +34-952-13-23-89
| | - Ángela Reyes-Pérez
- Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Andalucía Tech, Universidad de Málaga, 29071 Málaga, Spain; (Á.R.-P.); (R.E.); (A.E.L.-M.)
| | - Rosa Esteve
- Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Andalucía Tech, Universidad de Málaga, 29071 Málaga, Spain; (Á.R.-P.); (R.E.); (A.E.L.-M.)
| | - Alicia E. López-Martínez
- Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Andalucía Tech, Universidad de Málaga, 29071 Málaga, Spain; (Á.R.-P.); (R.E.); (A.E.L.-M.)
| | - Sonia Bernardes
- Instituto Universitario de Lisboa (ISCTE-IUL), Cis-IUL, Av. das Forças Armadas, 1649-026 Lisboa, Portugal;
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, 325 9th Ave, Seattle, WA 98104, USA;
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Ramírez-Maestre C, Esteve R, López-Martínez AE, Miró J, Jensen MP, de la Vega R. Beyond pain intensity and catastrophizing: The association between self-enhancing humour style and the adaptation of individuals with chronic pain. Eur J Pain 2020; 24:1357-1367. [PMID: 32383261 DOI: 10.1002/ejp.1583] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/29/2020] [Accepted: 05/01/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Many questions regarding the process by which self-enhancing humour style has an effect on chronic pain individuals' adjustment remain unanswered. The aim of the present study was to analyse the association of self-enhancing humour style with adjustment in a sample of individuals with chronic pain, over and above the role of catastrophizing and pain intensity. Adjustment was assessed using measures of depression, pain interference and flourishing. We also examined the indirect association between self-enhancing humour style and adjustment via pain acceptance. METHODS The study included 427 patients with heterogeneous chronic pain conditions. The study hypotheses were tested using three multiple linear regression analyses, one for each of the criterion variables. RESULTS Consistent with the study hypothesis, both direct and indirect associations were found between self-enhancing humour style and depressive symptoms, pain interference and flourishing via pain acceptance. CONCLUSIONS Self-enhancing humour style could potentially help individuals with chronic pain to gain perspective and distance themselves from the situation through the acceptance of pain-related negative emotions. SIGNIFICANCE Very few studies have investigated the relationship between humour styles and adjustment in chronic pain samples. The results of the current study support the idea that adaptive dispositional traits, such as patient's self- enhancing humour style, play a role in the adaptation of individuals with chronic pain. Given that the association between self-enhancing humour style and adjustment evidenced an indirect association through pain acceptance, training in the use of humour, as individuals with self-enhancing humour style do, might be a useful addition to ACT treatment.
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Affiliation(s)
- Carmen Ramírez-Maestre
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Rosa Esteve
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Alicia E López-Martínez
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Jordi Miró
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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D’Ippolito M, Purgato A, Buzzi MG. Pain and Evil: From Local Nociception to Misery Following Social Harm. J Pain Res 2020; 13:1139-1154. [PMID: 32547177 PMCID: PMC7250527 DOI: 10.2147/jpr.s236507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/07/2020] [Indexed: 01/03/2023] Open
Abstract
Experiencing pain, especially when chronic, is an excruciating condition that should be regarded as a syndrome, if not a disease. People suffering from chronic pain tend to develop psychological discomfort mostly due to lack of acceptance, disbelief, blame. The complexity of pain pathophysiology, plus a wide range of negative psychosocial factors, leads to a more complex suffering that deserves attention and multidisciplinary treatments. The possibility that chronic pain may occur following physical aggression, torture, or persecution raises the issue of evil as a major contributor to pain in its worst representation - when individuals or groups are attacked based on racial, social, gender, religious, political, or other grounds. To explore the complex issue of chronic pain following physical or psychological harm, and to underscore the need for a multidisciplinary approach to reduce the burden of chronic pain, we discuss the biological mechanisms underlying pain state. We seek to clarify those factors leading to pain chronification, as well as personal and social attitudes that confound patients with chronic pain. The importance of family and social environment is also investigated, as well as personality traits of chronic pain patients that may further hamper successful treatment. The presence of chronic pain, modulated by, for example, acceptance of being a victim of premeditated physical and social violence, makes the issue more difficult to comprehend.
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Affiliation(s)
| | - Adriano Purgato
- National Health System, Azienda USL Roma 2, Rome00157, Italy
| | - Maria Gabriella Buzzi
- Neurorehabilitation 2, Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome00179, Italy
- Headache Centre, IRCCS Fondazione Santa Lucia, Rome00179, Italy
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Høye H, Jahnsen RB, Løvstad M, Hartveit JF, Sørli H, Tornås S, Månum G. A Mindfulness-Based Stress Reduction Program via Group Video Conferencing for Adults With Cerebral Palsy - A Pilot Study. Front Neurol 2020; 11:195. [PMID: 32318010 PMCID: PMC7146892 DOI: 10.3389/fneur.2020.00195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/04/2020] [Indexed: 01/02/2023] Open
Abstract
Purpose: Adults with cerebral palsy experience challenges related to lifelong disability, such as stress, fatigue, pain and emotional issues. E-health services can be delivered regardless of residence and level of functioning. The aim of this pilot study was to explore the potential benefits and feasibility of a mindfulness-based program delivered to adults with cerebral palsy via group video conferencing. Methods: Six adults with cerebral palsy received an 8 week mindfulness group-based program via video conferencing. A multiple single-case study design was applied, including quantitative and qualitative elements. Pain was assessed 16 times through the study period. Questionnaires were administered to gather data on pain catastrophizing, stress, fatigue, emotional distress, positive and negative affect, and quality of life. A focus group interview addressed experiences with the intervention and the mode of delivery. Results: The participants' pain levels showed varied trajectories. Pain catastrophizing and negative affect were statistically significant decreased. Qualitative data indicated benefits from mindfulness in coping and stress management. The video conferencing delivery was evaluated as feasible, with no major adverse effects. Conclusion: Since the pilot study had a small sample size, potential treatment benefits should be interpreted with caution. However, this pilot study provides important information in the planning of future larger and controlled studies on mindfulness-based interventions programs via video conferencing for adults with cerebral palsy and other persons living with long-term disability.
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Affiliation(s)
- Helene Høye
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Reidun Birgitta Jahnsen
- Department of Clinical Neurosciences for Children and Research, Oslo University Hospital, Oslo, Norway.,Center of Habilitation and Rehabilitation Models and Services (CHARM), University of Oslo, Oslo, Norway
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | | | - Hilde Sørli
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Sveinung Tornås
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Grethe Månum
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Abstract
This study was conducted with the aim of determining pain acceptance levels in patients with chronic pain attending an algology outpatients' department.The research was conducted as a descriptive and cross-sectional study. The population of the study consisted of 97 patients with chronic pain who attended the Algology Outpatients' Department of the Health Implementation and Research Center of Bursa Uludağ University. A Patient Description Form and a Chronic Pain Acceptance Questionnaire (CPAQ) were used to collect research data.The participants' mean sub-score for accomplishing activities by patients with chronic pain was found to be 31.10 ± 11.84, their mean sub-score for pain willingness was 36.65 ± 10.37, and their mean score for the total scale was 67.76 ± 18.30. A statistically significant difference was found between the participants' total score means and their sub-score means according to their education level and frequency of experiencing pain (P < .05), but no statistically significant difference was found according to such factors as age, profession, marital status, or medications used (P > .05).It was found that female sex was generally exposed to chronic pain, and factors such as age, marital status, and drug treatment did not differ in the rate of acceptance of chronic pain, and the rate of acceptance of pain in workers was higher, those with lower education level were lower. There is a need that new studies with larger sample groups regarding the factors affecting the acceptance of chronic pain.
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Affiliation(s)
- Hava Gökdere Çinar
- Department of Nursing, Faculty of Health Sciences, Bursa Uludag University, Bursa
| | - Dilek Yilmaz
- Department of Nursing, Faculty of Health Sciences, Bursa Uludag University, Bursa
| | - Esra Akin
- Department of Nursing, Faculty of Health Science, İzmir Katip Çelebi University, İzmir, Turkey
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Schmid AA, Fruhauf CA, Sharp JL, Van Puymbroeck M, Bair MJ, Portz JD. Yoga for People With Chronic Pain in a Community-Based Setting: A Feasibility and Pilot RCT. J Evid Based Integr Med 2020; 24:2515690X19863763. [PMID: 31394910 PMCID: PMC6689911 DOI: 10.1177/2515690x19863763] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The purpose of this feasibility pilot study was to assess benefits of 8 weeks of yoga in people with chronic pain. Participants completed baseline assessments and were randomized to yoga or usual care. Yoga was offered twice a week for 8 weeks. We assessed feasibility and the Brief Pain Inventory (BPI) was the primary outcome, assessing pain-severity and pain interference on daily activities. Eighty-three people were recruited; 67 people completed the study and were included in the analyses. Average age of participants was 50.78 ± 10.43 years and most participants had pain >10 years. The intervention appeared feasible and there were significant improvements (P < .05) in multiple measures for the yoga group, including a decrease in BPI interference scores from 7.15 ± 1.70 to 6.14 ± 2.21 (P = .007). There was a significant difference in body responsiveness and pain management scores between groups at 8 weeks. It appears that yoga was feasible and positively influenced multiple outcome measures for people with chronic pain.
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Affiliation(s)
| | | | | | | | - Matthew J Bair
- 3 Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jennifer Dickman Portz
- 1 Colorado State University, Fort Collins, CO, USA.,4 University of Colorado, Aurora, CO, USA
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Wormgoor MEA, Indahl A, Andersen E, Egeland J. Effectiveness of Briefer Coping-Focused Psychotherapy for Common Mental Complaints on Work-Participation and Mental Health: A Pragmatic Randomized Trial with 2-Year Follow-Up. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:22-39. [PMID: 31222615 DOI: 10.1007/s10926-019-09841-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The aim of this study was to assess short and long-term effectiveness of brief coping-focused psychotherapy (Brief-PsT) compared with short-term psychotherapy (Short-PsT) on work-participation (WP) and mental health. Both treatments were preceded by group education. Methods All participants were on, or at risk of, sick leave due to common mental complaints. Patients were selected for inclusion in this study based on levels of self-reported symptoms ('some' or 'seriously affected') of anxiety and depression. They were randomized to Brief-PsT (n = 141) or Short-PsT with a more extended focus (n = 143). Primary outcome was the transition of WP-state from baseline to 3 months follow-up. In addition, WP at 12 and 24 months follow-up were assessed. The secondary outcome, clinical recovery rate (CR-rate) was obtained from the Beck Depression and Beck Anxiety Inventories, at 2-year follow-up. In addition, self-reported mental health symptom severity, self-efficacy, subjective health complaints and life satisfaction were assessed. Results At 3 months follow-up, the increase in WP was significantly greater in Brief-PsT than in Short-PsT (p = 0.039). At 3 months, 60% in Brief-PsT and 51% in Short-PsT was at work, partial or full. Thereafter, these differences diminished, 84% and 80% were at work at 2-year follow up. The 2-year follow-up of the secondary outcome measurements was completed by 53% in Brief-PsT and 57% in Short PsT. CR-rate was significantly greater in Brief-PsT compared with the Short-PsT (69% vs. 51%, p = 0.024). Furthermore, there was a greater reduction in the number of subjective health complaints in Brief-PsT (4.0 vs. 1.9 p = 0.012). All other measurements favoured Brief-PsT as well, but did not reach statistical significance. Conclusions Brief coping-focused psychotherapy added to group education for persons with depression or anxiety complaints seemed more effective in enhancing early work participation compared with additional short-term psychotherapy of standard duration with more extended focus. Clinical recovery rate and decline of comorbid subjective health complaints at 2-year follow-up were also in favour of the brief coping-focused program.
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Affiliation(s)
- M E A Wormgoor
- Division Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway.
| | - A Indahl
- Division Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway
| | - E Andersen
- Division of Mental Health & Addiction, Vestfold Hospital Trust, Tønsberg, Norway
| | - J Egeland
- Division of Mental Health & Addiction, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
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Kim S, Whibley D, Williams DA, Kratz AL. Pain Acceptance in People With Chronic Pain and Spinal Cord Injury: Daily Fluctuation and Impacts on Physical and Psychosocial Functioning. THE JOURNAL OF PAIN 2020; 21:455-466. [DOI: 10.1016/j.jpain.2019.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/15/2019] [Accepted: 08/28/2019] [Indexed: 10/26/2022]
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The Interplay of Parent and Child Coping Responses in Understanding Child Functioning in the Context of Living With a Parent With or Without Chronic Pain. Clin J Pain 2020; 36:238-248. [PMID: 31977374 DOI: 10.1097/ajp.0000000000000801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Pain disorders tend to run in families, and children of individuals with chronic pain have been found to report lower functioning. Drawing upon a social learning perspective, the current study examined how diverse maternal pain coping responses (ie, pain catastrophizing and distraction) may, via corresponding child pain coping responses, act as a vulnerability or protective factor for child functioning in the context of parental chronic pain (CP). METHODS A cross-sectional study was conducted in mothers with CP and their pain-free child (N=100) and mothers without CP and their pain-free child (N=74). Moderated mediation analyses were performed to test whether associations between maternal coping responses and child functioning (ie, somatic symptoms, physical functioning, and psychosocial health) were mediated by corresponding child coping responses and whether these associations were moderated by the presence or absence of maternal CP. RESULTS Maternal pain catastrophizing was indirectly related to more somatic symptoms, lower physical functioning, and lower psychosocial health in their child via child pain catastrophizing. Relationships were moderated by the presence or absence of maternal CP, such that mediated relationships were only found in mothers without CP and their child. No (in)direct relationships between maternal distraction, child distraction, and child functioning were observed. DISCUSSION The current findings demonstrated that child functioning was associated with maternal and child pain catastrophizing, but only in children of mothers without CP. No evidence was found in support of maternal pain coping responses as vulnerability or protective factors in the context of parental CP.
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63
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Pinel L, Perez-Nieto MA, Redondo M, Rodríguez-Rodríguez L, León L. Anxiety, Reinforcement Sensitivity and Social Context in Accepting the Experience of Pain Among Rheumatoid Arthritis Patients. Front Psychiatry 2020; 11:554990. [PMID: 33324249 PMCID: PMC7723888 DOI: 10.3389/fpsyt.2020.554990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 10/19/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Acceptance has become one of the most widely studied processes regarding chronic pain because of its ability to influence participants' adaptation and coping responses. Leading researchers have found relationships between variables such as anxiety, reinforcement sensitivity, and the responses of the participants' environment to their behavior and acceptance. In contrast, few studies have been found that investigate the variables that predict the acceptance of pain. This study has set out to explore the relationships between pain-related anxiety, sensitivity to contingencies, and the punishment responses of significant people toward pain behaviors regarding pain acceptance. Methods: With a view to fulfilling this purpose, a cohort of 62 participants with rheumatoid arthritis was chosen, and the subjects were assessed through the following self-report measures: Chronic Pain Acceptance Questionnaire, CPAQ; Pain Anxiety Symptoms Scale, PASS-20; The Sensitivity to Punishment and Sensitivity to Reward Questionnaire, SPSRQ, and The West Haven-Yale Multidimensional Pain Inventory, WHYMPI. The study's initial objectives were achieved by means of a stepwise multiple linear regression analysis. Results: The linear regression analyses revealed a negative and significant correlation between anxiety, reinforcement sensitivity, and the significant persons' responses to pain behaviors and pain acceptance. Conclusion: The results suggest that the identification of these variables might be important for addressing these participants' pain. Finally, the discussion focuses on our findings' implications as regards their use in clinical practice.
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Affiliation(s)
- Luis Pinel
- Faculty of Education and Health, Camilo José Cela University, Madrid, Spain
| | | | - Marta Redondo
- Faculty of Education and Health, Camilo José Cela University, Madrid, Spain
| | | | - Leticia León
- Faculty of Education and Health, Camilo José Cela University, Madrid, Spain
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64
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Kapadi R, Elander J. Pain coping, pain acceptance and analgesic use as predictors of health-related quality of life among women with primary dysmenorrhea. Eur J Obstet Gynecol Reprod Biol 2019; 246:40-44. [PMID: 31931396 DOI: 10.1016/j.ejogrb.2019.12.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/09/2019] [Accepted: 12/23/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Primary dysmenorrhea causes menstrual pain that affects women's quality of life (QoL) and analgesics are only moderately effective. Pain coping and pain acceptance influence QoL among people affected by other chronic pain conditions, so we examined pain coping, pain acceptance and analgesic use as predictors of QoL among women with primary dysmenorrhea. STUDY DESIGN 145 women with primary dysmenorrhea completed an online survey including the Menstrual Symptoms Questionnaire (MSQ), the Coping Strategies Questionnaire (CSQ), the Chronic Pain Acceptance Questionnaire (CPAQ-8), questions about analgesic use, and the Short Form-12 (SF-12), a measure of physical and mental health-related QoL. RESULTS In multiple regression, pain acceptance predicted better physical and mental QoL, whereas pain coping did not predict mental or physical quality of life. Being married or cohabiting and menstrual pain that was less severe and shorter in duration predicted better physical QoL, and those effects were mediated by pain acceptance. Being older at the onset of painful periods predicted better mental QoL and that effect was also mediated by pain acceptance. More severe menstrual pain and congestive rather than spasmodic dysmenorrhea predicted worse mental QoL but those effects were not mediated by other factors. Analgesic use did not predict physical or mental QoL. CONCLUSIONS The results show the impact that menstrual pain has on women's quality of life, and suggest that initiatives to increase pain acceptance among women with menstrual pain are worthwhile. More research is needed to understand more fully the factors that influence health-related quality of life among women with menstrual pain.
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Affiliation(s)
- Romaana Kapadi
- Human Sciences Research Centre, University of Derby, Derby, UK
| | - James Elander
- Human Sciences Research Centre, University of Derby, Derby, UK.
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A Concept Analysis of Coping with Chronic Pain in Older Adults. Pain Manag Nurs 2019; 20:563-571. [DOI: 10.1016/j.pmn.2019.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 02/02/2019] [Accepted: 03/15/2019] [Indexed: 12/29/2022]
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Veillette J, Martel ME, Dionne F. A randomized controlled trial evaluating the effectiveness of an acceptance and commitment therapy-based bibliotherapy intervention among adults living with chronic pain. Can J Pain 2019; 3:209-225. [PMID: 35005411 PMCID: PMC8730660 DOI: 10.1080/24740527.2019.1678113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: Chronic pain has a significant impact on the physical and psychological functioning of those living with this condition. It is now recognized that acceptance and commitment therapy (ACT) is an effective intervention in managing chronic pain; however, several barriers limit its accessibility. Aims: The current study aimed to evaluate the effectiveness of an 8-week bibliotherapy-type self-administered psychological intervention with minimal therapeutic contact, based on ACT, in the management of chronic pain. Methods: This was a randomized controlled trial with three measurement periods (pretest, posttest, and 3 months after the intervention; ClinicalTrials.gov Identifier: NCT03924687). A total of 140 adults with chronic pain were randomly assigned to an ACT self-help condition or a wait-list control condition. Results: Two-way repeated measures analysis of variance (ANOVA) models showed statistically significant differences between pretest and posttest in terms of pain-related disability (main variable), depression (secondary variable), pain-related acceptance, and psychological inflexibility (d = 0.46–0.88) in favor of the ACT self-help condition. At the 3-month follow-up, these differences were maintained and nearly 54% of participants reported an overall improvement of their physical and mental health. Conclusion: These results suggest that a psychological intervention self-administered through ACT bibliotherapy with minimal therapeutic support can improve the physical and emotional functioning of adults from the community who live with chronic pain.
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Affiliation(s)
- Josée Veillette
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Quebec and Pain Research Network (QPRN), Montreal, Quebec, Canada
| | - Marie-Eve Martel
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Quebec and Pain Research Network (QPRN), Montreal, Quebec, Canada
| | - Frédérick Dionne
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Quebec and Pain Research Network (QPRN), Montreal, Quebec, Canada
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67
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Hamasaki T, Pelletier R, Bourbonnais D, Harris P, Choinière M. Pain-related psychological issues in hand therapy. J Hand Ther 2019; 31:215-226. [PMID: 29449064 DOI: 10.1016/j.jht.2017.12.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/16/2017] [Indexed: 02/09/2023]
Abstract
STUDY DESIGN Literature review. INTRODUCTION Pain is a subjective experience that results from the modulation of nociception conveyed to the brain via the nervous system. Perception of pain takes place when potential or actual noxious stimuli are appraised as threats of injury. This appraisal is influenced by one's cognitions and emotions based on her/his pain-related experiences, which are processed in the forebrain and limbic areas of the brain. Unarguably, patients' psychological factors such as cognitions (eg, pain catastrophizing), emotions (eg, depression), and pain-related behaviors (eg, avoidance) can influence perceived pain intensity, disability, and treatment outcomes. Therefore, hand therapists should address the patient pain experience using a biopsychosocial approach. However, in hand therapy, a biomedical perspective predominates in pain management by focusing solely on tissue healing. PURPOSE OF THE STUDY This review aims to raise awareness among hand therapists of the impact of pain-related psychological factors. METHODS AND RESULTS This literature review allowed to describe (1) how the neurophysiological mechanisms of pain can be influenced by various psychological factors, (2) several evidence-based interventions that can be integrated into hand therapy to address these psychological issues, and (3) some approaches of psychotherapy for patients with maladaptive pain experiences. DISCUSSION AND CONCLUSION Restoration of sensory and motor functions as well as alleviating pain is at the core of hand therapy. Numerous psychological factors including patients' beliefs, cognitions, and emotions alter their pain experience and may impact on their outcomes. Decoding the biopsychosocial components of the patients' pain is thus essential for hand therapists.
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Affiliation(s)
- Tokiko Hamasaki
- Research Center of the CHUM, Montreal, Québec, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada; Hand Center, CHUM, Montreal, Québec, Canada
| | - René Pelletier
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Daniel Bourbonnais
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Québec, Canada
| | - Patrick Harris
- Hand Center, CHUM, Montreal, Québec, Canada; Department of Surgery, Plastic Surgery Service, CHUM, Montreal, Québec, Canada; Department of Surgery, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Manon Choinière
- Research Center of the CHUM, Montreal, Québec, Canada; Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada.
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68
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Ravn SL, Vang ML, Vaegter HB, Andersen TE. Pain-Related Acceptance as a Mediator in the Fear Avoidance Model of Chronic Pain: A Preliminary Study. PAIN MEDICINE 2019; 19:1764-1771. [PMID: 29036699 DOI: 10.1093/pm/pnx223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective The fear avoidance model has served as a popular, heuristic model in explaining the transition from acute to chronic pain. In addition, the significance of pain-related acceptance in chronic pain development and adjustment is underlined in a vast number of empirical studies. The objective of the current preliminary study was to investigate pain-related acceptance as a mediator within the key cognitive relationships proposed by the fear avoidance model of chronic pain. Materials and Methods. In a cross-sectional design, bodily pain, pain catastrophizing, fear avoidance beliefs, and pain-related acceptance were assessed by questionnaires in 125 chronic pain patients in a Danish multidisciplinary pain center. Mediation analyses were performed to test the effect of pain-related acceptance on bodily pain, pain catastrophizing, and fear avoidance beliefs. Results Medium-sized correlations were found between all outcomes. Mediation analyses revealed that pain-related acceptance was a significant mediator between 1) bodily pain and pain catastrophizing and 2) pain catastrophizing and fear avoidance beliefs after controlling for bodily pain. Furthermore, pain-related acceptance accounted for a large proportion in both associations (82.2% and 56.1%). Conclusions The results suggest that pain-related acceptance is a prominent psychological mechanism within the key cognitive associations of the fear avoidance model, which predicts a certain path of cognitive, emotional, and behavioral factors in the development and maintenance of chronic pain. This proposes pain-related acceptance to be an important mechanism that possibly counteracts the negative reactions of pain catastrophizing and fear avoidance beliefs. These findings should be investigated further and could potentially be an important place to intervene clinically in order to counteract the development and/or maintenance of chronic pain.
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Affiliation(s)
- Sophie Lykkegaard Ravn
- Departments of Psychology.,The Specialized Hospital for Polio and Accident Victims, Roedovre, Denmark
| | | | - Henrik Bjarke Vaegter
- Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Anesthesiology and Intensive Care Medicine, Pain Research Group, Pain Center South, Odense University Hospital, Odense, Denmark
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Kanzler KE, Pugh JA, McGeary DD, Hale WJ, Mathias CW, Kilpela LS, Karns-Wright TE, Robinson PJ, Dixon SA, Bryan CJ, Moring JC, McCracken LM. Mitigating the Effect of Pain Severity on Activity and Disability in Patients with Chronic Pain: The Crucial Context of Acceptance. PAIN MEDICINE (MALDEN, MASS.) 2019; 20:1509-1518. [PMID: 30590737 PMCID: PMC6686120 DOI: 10.1093/pm/pny197] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the effect of pain severity on activity levels and physical disability in the context of high pain acceptance. We hypothesized that pain acceptance moderates the effect of pain severity on general activity and physical disability, such that at higher levels of acceptance, the deleterious effect of pain is mitigated. METHODS Two hundred seven patients with chronic pain were recruited from three clinics in a large southwestern military treatment facility. Participants completed an anonymous self-report battery of standardized measures, including the Chronic Pain Acceptance Questionnaire, modified Oswestry Disability Index, and Pain Severity and General Activity subscales of the West Haven-Yale Multidimensional Pain Inventory. RESULTS Chronic pain acceptance was found to significantly moderate relations between pain severity and general activity (b = 0.0061, t(198) = 2.75, P = 0.007, 95% confidence interval [CI] = 0.002 to 0.011) and pain severity and disability (b = 0.036, t(193) = -2.564, P = 0.011, 95% CI = -0.063 to -0.008). In the context of higher acceptance, the negative effect of pain on activity and disability appeared reduced. Conversely, in the context of low acceptance, the effect of pain on disability appeared accentuated at all levels of pain severity. CONCLUSIONS Higher acceptance mitigated both activity level and disability in a military-affiliated clinical sample of patients with chronic pain. Results further establish the role of acceptance in relation to functioning in a unique sample of people with chronic pain. These findings have implications for understanding and enhancing functioning in chronic pain populations.
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Affiliation(s)
- Kathryn E Kanzler
- Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas
- Department of Family and Community Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Jacqueline A Pugh
- South Texas Veterans Health Care System
- Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Donald D McGeary
- Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas
- Department of Family and Community Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Willie J Hale
- Department of Psychology, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Charles W Mathias
- Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Lisa S Kilpela
- Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Tara E Karns-Wright
- Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | | | - Sara A Dixon
- 81 DS/SGD Orofacial Pain, Keesler Air Force Base
| | - Craig J Bryan
- National Center for Veterans Studies and Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | | | - Lance M McCracken
- Psychology Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
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70
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Secinti E, Tometich DB, Johns SA, Mosher CE. The relationship between acceptance of cancer and distress: A meta-analytic review. Clin Psychol Rev 2019; 71:27-38. [PMID: 31078056 PMCID: PMC7010402 DOI: 10.1016/j.cpr.2019.05.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 04/23/2019] [Accepted: 05/01/2019] [Indexed: 12/15/2022]
Abstract
Acceptance of cancer has long been recognized as playing a critical role in psychological adjustment to the illness, but its associations with distress outcomes have not been quantitatively reviewed. Informed by coping theory and third wave conceptualizations of acceptance, we first propose an integrated model of acceptance of cancer. Then we examine the strength of the relationships between acceptance of cancer and general and cancer-specific distress in cancer patients and potential moderators of these relationships. CINAHL, Embase, MEDLINE, PsycINFO, PsycARTICLES, and Web of Science databases were searched. Random-effects meta-analyses were conducted on 78 records (N = 15,448). Small-to-moderate, negative, and significant relationships were found between acceptance of cancer and general distress (r = -0.31; 95% CI: -0.36 to -0.26, k = 75); cancer-specific distress (r = -0.18; 95% CI: -0.21 to -0.14, k = 13); depressive symptoms (r = -0.25; 95% CI: -0.31 to -0.19, k = 41); and anxiety symptoms (r = -0.22; 95% CI: -0.30 to -0.15, k = 29). Age, marital status, and stage of cancer were identified as significant moderators. Findings suggest that acceptance of cancer may be important to target in interventions to reduce general and cancer-specific distress in cancer patients. Future research should focus on developing multifaceted measures of acceptance and identifying theory-based psychological and social processes that lead to greater acceptance.
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Affiliation(s)
- Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN 46202, USA.
| | - Danielle B Tometich
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN 46202, USA
| | - Shelley A Johns
- Center for Health Services Research, Regenstrief Institute, 1101 West 10th Street, Indianapolis, IN 46202, USA; Department of Medicine, Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN 46202, USA; Fairbanks Center for Medical Ethics, Indiana University Health Methodist Hospital, 1800 North Capital Avenue, Noyes E649, Indianapolis, IN 46202, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN 46202, USA
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Gerdle B, Åkerblom S, Stålnacke BM, Brodda Jansen G, Enthoven P, Ernberg M, Dong HJ, Äng BO, Boersma K. The importance of emotional distress, cognitive behavioural factors and pain for life impact at baseline and for outcomes after rehabilitation – a SQRP study of more than 20,000 chronic pain patients. Scand J Pain 2019; 19:693-711. [DOI: 10.1515/sjpain-2019-0016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/02/2019] [Indexed: 11/15/2022]
Abstract
Abstract
Background and aims
Although literature concerning chronic pain patients indicates that cognitive behavioural variables, specifically acceptance and fear of movement/(re)injury, are related to life impact, the relative roles of these factors in relation to pain characteristics (e.g. intensity and spreading) and emotional distress are unclear. Moreover, how these variables affect rehabilitation outcomes in different subgroups is insufficiently understood. This study has two aims: (1) to investigate how pain, cognitive behavioural, and emotional distress variables intercorrelate and whether these variables can regress aspects of life impact and (2) to analyse whether these variables can be used to identify clinically meaningful subgroups at baseline and which subgroups benefit most from multimodal rehabilitation programs (MMRP) immediately after and at 12-month follow-up.
Methods
Pain aspects, background variables, psychological distress, cognitive behavioural variables, and two life impact variables were obtained from the Swedish Quality Registry for Pain Rehabilitation (SQRP) for chronic pain patients. These data were analysed mainly using advanced multivariate methods.
Results
The study includes 22,406 chronic pain patients. Many variables, including acceptance variables, showed important contributions to the variation in clinical presentations and in life impacts. Based on the statistically important variables considering the clinical presentation, three clusters/subgroups of patients were identified at baseline; from the worst clinical situation to the relatively good situation. These clusters showed significant differences in outcomes after participating in MMRP; the subgroup with the worst situation at baseline showed the most significant improvements.
Conclusions
Pain intensity/severity, emotional distress, acceptance, and life impacts were important for the clinical presentation and were used to identify three clusters with marked differences at baseline (i.e. before MMRP). Life impacts showed complex relationships with acceptance, pain intensity/severity, and emotional distress. The most significant improvements after MMRP were seen in the subgroup with the lowest level of functioning before treatment, indicating that patients with complex problems should be offered MMRP.
Implications
This study emphasizes the need to adopt a biopsychosocial perspective when assessing patients with chronic pain. Patients with chronic pain referred to specialist clinics are not homogenous in their clinical presentation. Instead we identified three distinct subgroups of patients. The outcomes of MMRP appears to be related to the clinical presentation. Thus, patients with the most severe clinical presentation show the most prominent improvements. However, even though this group of patients improve they still after MMRP show a complex situation and there is thus a need for optimizing the content of MMRP for these patients. The subgroup of patients with a relatively good situation with respect to pain, psychological distress, coping and life impact only showed minor improvements after MMRP. Hence, there is a need to develop other complex interventions for them.
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Affiliation(s)
- Björn Gerdle
- Pain and Rehabilitation Centre, Department of Medical and Health Sciences , Linköping University , SE-581 85 Linköping , Sweden , Phone: +46763927191
| | - Sophia Åkerblom
- Department of Pain Rehabilitation , Skåne University Hospital , Lund , Sweden
- Department of Psychology , Lund University , Lund , Sweden
| | - Britt-Marie Stålnacke
- Department of Community Medicine and Rehabilitation, Rehabilitation Medicine , Umeå University , Umeå , Sweden
| | - Gunilla Brodda Jansen
- Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine , Stockholm , Sweden
| | - Paul Enthoven
- Department of Medical and Health Sciences , Linköping University , Linköping , Sweden
| | - Malin Ernberg
- Department of Dental Medicine , Karolinska Institutet , Stockholm , Sweden
- Scandinavian Center for Orofacial Neuroscience (SCON) , Huddinge , Sweden
| | - Huan-Ji Dong
- Pain and Rehabilitation Centre, Department of Medical and Health Sciences , Linköping University , Linköping , Sweden
| | - Björn O Äng
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy , Karolinska Institutet , 23100 Huddinge , Sweden
- Center for Clinical Research Dalarna – Uppsala University , Falun , Sweden
- School of Education, Health and Social Studies , Dalarna University , Falun , Sweden
| | - Katja Boersma
- School of Law, Psychology and Social Work , Örebro University , Örebro , Sweden
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Suso-Ribera C, Camacho-Guerrero L, Osma J, Suso-Vergara S, Gallardo-Pujol D. A Reduction in Pain Intensity Is More Strongly Associated With Improved Physical Functioning in Frustration Tolerant Individuals: A Longitudinal Moderation Study in Chronic Pain Patients. Front Psychol 2019; 10:907. [PMID: 31133917 PMCID: PMC6524714 DOI: 10.3389/fpsyg.2019.00907] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/04/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The onset and chronification of pain often has devastating consequences on the physical and mental functioning of individuals. Medical interventions are quite efficacious in reducing pain levels. However, changes in physical and mental health status after medical interventions are not proportional. In the past decades, rational/irrational beliefs, especially catastrophizing, have contributed to a better understanding of the pain experience. This study explores whether pain reduction efforts are more beneficial for individuals scoring high in rational thinking (moderation). METHODS The study design was longitudinal. Patients were assessed twice, 2 weeks prior to the start of medical treatment at the pain clinic and 6 months after. A total of 163 patients with heterogeneous pain (mostly low back and neck pain) participated in the study. Their mean age was 58.74 years (SD = 14.28) and 61.3% were female. RESULTS Overall, there was a reduction in pain intensity (t = 4.25, p < 0.001, d = 0.32). An improvement in physical functioning (t = 4.02, p < 0.001, d = 0.19), but not mental health (t = -0.66, p = 0.511, d = 0.11) was also observed. In the regression analyses, a decrease in pain intensity was moderately associated with improved physical health (β = 0.87, t = 4.96, p < 0.001, R 2 change = 0.177). This association was found to be moderated by frustration tolerance (β = -0.49, t = -2.80, p = 0.006, R 2 change = 0.039). Specifically, post hoc analyses indicated that changes in pain intensity only correlated with changes in physical health when patients reported high frustration tolerance levels (r = 0.47, p = 0.006, M = 7, n = 32), but not when patients were intolerant to frustration (r = 0.28, p = 0.078, M = 17, n = 41). CONCLUSION The results suggest that frustration tolerance may render adaptive by facilitating the positive effect that a reduction in pain intensity has on physical health status. The study findings are discussed in the context of personalized therapy with an emphasis on how to maximize the effectiveness of current interventions for pain.
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Affiliation(s)
- Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | | | - Jorge Osma
- Department of Psychology and Sociology, Instituto de Investigación Sanitaria de Aragón, Universidad de Zaragoza, Teruel, Spain
| | | | - David Gallardo-Pujol
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
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Medicate or Meditate? Greater Pain Acceptance is Related to Lower Pain Medication Use in Persons With Chronic Pain and Spinal Cord Injury. Clin J Pain 2019; 34:357-365. [PMID: 28877136 DOI: 10.1097/ajp.0000000000000550] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES There is little information about whether use of pain self-management skills that are common targets of psychosocial interventions for pain are associated with reduced reliance on pain medications. The aim of this study was to test whether higher chronic pain acceptance, which is a readily modified pain self-management approach, is related to lower use of pain medications (eg, opioid medications, and gabapentinoids) in a sample with chronic pain and spinal cord injury (SCI). MATERIALS AND METHODS This is a cross-sectional survey study of pain medication use, pain severity and distribution (Brief Pain Inventory [BPI]), depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), and chronic pain acceptance (Chronic Pain Acceptance Questionnaire [CPAQ]) administered to a sample of 120 adults with chronic pain and SCI. RESULTS Regression results indicated that, above and beyond the effects of pain intensity, pain distribution, and depressive symptoms, higher pain acceptance was related to lower use of all types of pain medications, and lower odds of using opioid medications or gabapentinoids. Pain intensity was not related to pain medication use, but greater pain distribution was related to using more pain medications in general and to greater odds of using gabapentinoids. DISCUSSION Findings from this study indicate that those with chronic pain and SCI who have a more accepting orientation to pain are less reliant on pain medications, and thereby experience lower risks associated with medication consumption. Longitudinal, daily process, and clinical trial studies are needed to better understand the association between pain acceptance and pain medication consumption.
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Rakhshan M, Rostami K, Zadeh SH. Chronic pain: a concept analysis. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2019. [DOI: 10.29333/ejgm/94098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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75
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Okifuji A, Neikrug A. Update and future perspective of behavioral medicine in the treatment for chronic pain. Pain Manag 2019; 9:161-173. [PMID: 30785366 DOI: 10.2217/pmt-2017-0055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Chronic pain is a biopsychosocial condition, and behavioral medicine has made significant contributions to the understanding of the phenomenon and optimization of therapeutic outcomes. The objective of this article is to provide future perspectives of behavioral medicine in pain management based upon recent development in the field. We will briefly review the mainstream approach of cognitive-behavioral therapy, its variations and new and innovative approaches that are on the horizon. We also review strategies that address potential barriers to pain management. Behavioral medicine is a promising field in pain medicine. The future growth is likely to come from addressing how we incorporate the patient heterogeneity into our treatment approaches and a better understanding of its role in a multimodal treatment.
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Affiliation(s)
- Akiko Okifuji
- Department of Anesthesiology, Division of Pain Medicine, University of Utah, Salt Lake City, UT, USA 84108
| | - Ariel Neikrug
- Department of Psychiatry, University of California Irvine, CA 92868, USA 92868
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Semeru GM, Halim MS. Acceptance versus catastrophizing in predicting quality of life in patients with chronic low back pain. Korean J Pain 2019; 32:22-29. [PMID: 30671200 PMCID: PMC6333577 DOI: 10.3344/kjp.2019.32.1.22] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/09/2018] [Accepted: 10/29/2018] [Indexed: 01/31/2023] Open
Abstract
Background The aim of this study was to investigate the relationship between pain catastrophizing, acceptance, and quality of life in relation to chronic low back pain in Jakarta, the capital city of Indonesia. We also analyze the effect of personality in catastrophizing and acceptance. Methods A total of 52 chronic low back pain patients were enrolled as participants from 2 hospitals in Jakarta (43 females, 9 males, mean age 54.38 years). Participants completed a set of self-reported questionnaires: the NEO Five Factor Inventory (NEO-FFI), Chronic Pain Acceptance Questionnaire-Revised (CPAQ-R), Pain Catastrophizing Scale (PCS), and Pain Discomfort Module (PDM). Results This study showed that acceptance increased the patient's quality of life by giving physical relief from pain. In contrast, pain catastrophizing decreased the quality of life, and increased the patients' tendency to get frustrated, irritated, and anxious about the pain. From a personality perspective, the trait neuroticism may lead to a higher level of pain catastrophizing. Conclusions This study showed that catastrophizing, compared with acceptance, had a greater impact on the patient's life by reducing its quality.
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Affiliation(s)
- Gracia Mayuni Semeru
- Department of Psychology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Magdalena S Halim
- Department of Psychology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
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Nøst TH, Steinsbekk A, Bratås O, Grønning K. Twelve-month effect of chronic pain self-management intervention delivered in an easily accessible primary healthcare service - a randomised controlled trial. BMC Health Serv Res 2018; 18:1012. [PMID: 30594190 PMCID: PMC6310959 DOI: 10.1186/s12913-018-3843-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 12/19/2018] [Indexed: 12/13/2022] Open
Abstract
Background To investigate the effects after twelve months related to patient activation and a range of secondary outcomes on persons with chronic pain of a chronic pain self-management course compared to a low-impact outdoor physical activity, delivered in an easily accessible healthcare service in public primary care. Methods An open, pragmatic, parallel group randomised controlled trial was conducted. The intervention group was offered a group-based chronic pain self-management course with 2.5-h weekly sessions for a period of six weeks comprising education that included cognitive and behavioural strategies for pain management, movement exercises, group discussions and sharing of experiences among participants. The control group was offered a drop-in, low-impact, outdoor physical activity in groups in one-hour weekly sessions that included walking and simple strength exercises for a period of six weeks. The primary outcome was patient activation assessed using the Patient Activation Measure (PAM-13). Secondary outcomes included assessments of pain, anxiety and depression, pain self-efficacy, sense of coherence, health-related quality of life, well-being and the 30-s Chair to Stand Test. Analyses were performed using a linear mixed model. Results After twelve months, there were no statistically significant differences between the intervention group (n = 60) and the control group (n = 61) for the primary or the secondary outcomes. The estimated mean difference between the groups for the primary outcome PAM was 4.0 (CI 95% -0.6 to 8.6, p = 0.085). Within both of the groups, there were statistically significant improvements in pain experienced during the previous week, the global self-rated health measure and the 30-s Chair to Stand Test. Conclusions No long-term effect of the chronic pain self-management course was found in comparison with a low-impact physical activity intervention for the primary outcome patient activation or for any secondary outcome. Trial registration ClinicalTrials.gov: NCT02531282. Registered on August 212,015
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Affiliation(s)
- Torunn Hatlen Nøst
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway. .,Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Aslak Steinsbekk
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway
| | - Ola Bratås
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway.,Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kjersti Grønning
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway.,Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
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Nøst TH, Steinsbekk A, Bratås O, Grønning K. Short-term effect of a chronic pain self-management intervention delivered by an easily accessible primary healthcare service: a randomised controlled trial. BMJ Open 2018; 8:e023017. [PMID: 30530580 PMCID: PMC6303596 DOI: 10.1136/bmjopen-2018-023017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To investigate the effects on persons with chronic pain after 3 months of a group-based chronic pain self-management course compared with a drop-in, low-impact outdoor physical group activity on patient activation and a range of secondary outcomes. DESIGN An open, pragmatic, parallel group randomised controlled trial. Analyses were performed using a two-level linear mixed model. SETTING An easily accessible healthcare service provided by Norwegian public primary healthcare. PARTICIPANTS A total of 121 participants with self-reported chronic pain for 3 months or more were randomised with 60 participants placed in the intervention group and 61 placed in the control group (mean age 53 years, 88% women, 63% pain for 10 years or more). INTERVENTIONS The intervention group was offered a group-based chronic pain self-management course with 2.5-hour weekly sessions for a period of 6 weeks. The sessions consisted of education, movement exercises and emphasised group discussions. The control group was offered a low-impact outdoor group physical activity in 1-hour weekly sessions that consisted of walking and simple strength exercises for a period of 6 weeks. MAIN OUTCOMES The primary outcome was patient activation assessed using the Patient Activation Measure. Secondary outcomes measured included assessments of pain, anxiety and depression, pain self-efficacy, sense of coherence, health-related quality of life, well-being and the 30 s chair to stand test. RESULTS There was no effect after 3 months of the group-based chronic pain self-management course compared with the control group for the primary outcome, patient activation (estimated mean difference: -0.5, 95% CI -4.8 to 3.7, p=0.802). CONCLUSIONS There was no support for the self-management course having a better effect after 3 months than a low-impact outdoor physical activity offered the control group. TRIAL REGISTRATION NUMBER NCT02531282; Results.
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Affiliation(s)
- Torunn Hatlen Nøst
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Aslak Steinsbekk
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ola Bratås
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kjersti Grønning
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
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Huneidi SA, Wright NC, Atkinson A, Bhatia S, Singh P. Factors associated with physical inactivity in adult breast cancer survivors-A population-based study. Cancer Med 2018; 7:6331-6339. [PMID: 30358141 PMCID: PMC6308073 DOI: 10.1002/cam4.1847] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Physical activity has been shown to reduce the risk of breast cancer-specific mortality. Although factors associated with physical inactivity in breast cancer survivors have been studied, a detailed examination at the population level is still lacking. METHODS We addressed this gap in 1236 women with a diagnosis of breast cancer from the 2016 Behavioral Risk Factor Surveillance System Cancer Survivorship module. Physical inactivity was defined as self-reported absence of leisure time physical activity. Factors examined in the multivariable logistic regression model included sociodemographic, behavioral factors, access to health care, health history, current cancer treatment, and pain from cancer or treatment. RESULTS Overall, older age (≥65 years: OR = 2.63, 95% CI: 1.25-5.55) and being underweight (BMI <18.5: OR = 6.11, 95% CI: 1.35-27.66), were identified as significant factors associated with physical inactivity. In models adjusting for sociodemographics (Model 1), and the prior plus behavioral factors (Model 2), pain from cancer or treatment was significantly associated with physical inactivity (Model 2: OR = 2.23, 95% CI: 1.16-4.28); however, after fully adjusting for all variables (Model 3), there was no longer evidence of a significant association between pain from cancer and physical activity in female survivors with breast cancer. CONCLUSIONS We identified demographic (older age) and physical (low BMI and pain) factors to be significantly associated with physical inactivity among breast cancer survivors. Future interventions to promote physical activity in breast cancer survivors could benefit by taking into account these factors to develop tailored recommendations for increasing activity.
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Affiliation(s)
- Salam A. Huneidi
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabama
| | - Nicole C. Wright
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabama
| | - Arnisha Atkinson
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabama
| | - Smita Bhatia
- Institute for Cancer Outcomes and SurvivorshipUniversity of Alabama at BirminghamBirminghamAlabama
| | - Purnima Singh
- Institute for Cancer Outcomes and SurvivorshipUniversity of Alabama at BirminghamBirminghamAlabama
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80
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The Relationship Between Lifestyle with Chronic Pain and Pain Acceptance in Elderly with Stroke. ARCHIVES OF NEUROSCIENCE 2018. [DOI: 10.5812/ans.83717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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81
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Lindgren I, Brogårdh C, Gard G. Pain management strategies among persons with long-term shoulder pain after stroke - a qualitative study. Clin Rehabil 2018; 33:357-364. [PMID: 30255715 DOI: 10.1177/0269215518802444] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: To explore strategies that persons with persistent shoulder pain after stroke use to manage their pain in daily life. DESIGN: A qualitative study using semi-structured face-to-face interviews, analysed by content analysis. SETTING: A university hospital. SUBJECTS: Thirteen community-dwelling persons (six women; median age: 65 years; range 57-77) with shoulder pain after stroke were interviewed median two years after the pain onset. RESULTS: An overall theme 'Managing shoulder pain by adopting various practical and cognitive strategies' emerged from the analysis. Three categories were identified: (1) practical modifications to solve daily life problems; (2) changed movement patterns and specific actions to mitigate the pain, by non-painful movements, avoidance of pain-provoking activities and various pain distracting activities and (3) learned how to deal with the pain mentally. Several strategies were used simultaneously and they were experienced successful to various degrees. CONCLUSION: The findings in the present study indicate that persons with persistent shoulder pain after stroke use both practical and cognitive strategies to manage their pain.
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Affiliation(s)
- Ingrid Lindgren
- 1 Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.,2 Physiotherapy Research Group, Department of Health Sciences, Lund University, Lund, Sweden
| | - Christina Brogårdh
- 1 Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.,2 Physiotherapy Research Group, Department of Health Sciences, Lund University, Lund, Sweden
| | - Gunvor Gard
- 2 Physiotherapy Research Group, Department of Health Sciences, Lund University, Lund, Sweden.,3 Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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82
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Pain that does not interfere with daily life—a new focus for population epidemiology and public health? Pain 2018; 160:281-285. [DOI: 10.1097/j.pain.0000000000001374] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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83
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Carvalho SA, Gillanders D, Palmeira L, Pinto-Gouveia J, Castilho P. Mindfulness, selfcompassion, and depressive symptoms in chronic pain: The role of pain acceptance. J Clin Psychol 2018; 74:2094-2106. [PMID: 30101973 DOI: 10.1002/jclp.22689] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 07/05/2018] [Accepted: 07/13/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVE(S) The aim of this study was to test a theory driven model in which pain acceptance (both pain willingness [PW] and activity engagement [AE]) mediates the relationships of mindfulness and selfcompassion with depressive symptoms, while controlling for pain intensity. METHODS A path analysis was conducted using AMOS software to test a meditational model in a sample of women with chronic musculoskeletal pain (N = 231). RESULTS Participants with higher levels of mindful awareness and selfcompassion presented lower levels of pain intensity and depressive symptoms, and higher levels of AE. PW did not significantly correlate with any variable in study. The mediation analysis showed that AE mediated the relationship between selfcompassion and depressive symptoms, independently from pain intensity. CONCLUSIONS These findings seem to corroborate the hypothesis that selfcompassion is rooted in a motivational system, as it seems to correlate with less depressive symptoms through increasing the engagement with valued actions despite experiencing pain.
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Affiliation(s)
- Sérgio A Carvalho
- Cognitive-Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - David Gillanders
- Department of Clinical Psychology, School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK
| | - Lara Palmeira
- Cognitive-Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - José Pinto-Gouveia
- Cognitive-Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Paula Castilho
- Cognitive-Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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84
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Reductions in Perceived Injustice Are Associated with Reductions in Posttraumatic Stress Symptoms Among Individuals Receiving Treatment for Whiplash Injury. PSYCHOLOGICAL INJURY & LAW 2018. [DOI: 10.1007/s12207-018-9326-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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85
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Shim EJ, Park A, Park SP. The relationship between alexithymia and headache impact: the role of somatization and pain catastrophizing. Qual Life Res 2018; 27:2283-2294. [PMID: 29869297 DOI: 10.1007/s11136-018-1894-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE The present study compared psychological factors (i.e., alexithymia, somatization, pain catastrophizing (PC), anxiety, and depression) and QOL for headache patients and headache-free individuals, and examined whether somatization and PC mediate the relationship between alexithymia and headache impact in headache patients. METHODS Study participants consisted of 123 headache patients from an outpatient clinic at a university hospital and 124 headache-free individuals in Daegu, Korea. The survey employed the somatization and anxiety subscales of the Symptom Checklist-90-revised, the Patient Health Questionnaire-9, Pain Catastrophizing Scale, Toronto Alexithymia Scale, Short-Form Health survey-8 (SF-8), and the Headache Impact Test-6. RESULTS Headache patients showed a higher level of all psychological factors and lower level of two summary scores (physical and mental health) as well as the seven dimensions of the SF-8 compared with headache-free individuals. Examination employing the SPSS Process macro found that the direct effect of alexithymia on headache impact was not significant after controlling for somatization and PC. The total indirect effects of alexithymia on headache impact were significant without anxiety and depression as covariates with the significant indirect effects of alexithymia on headache impact via somatization or via PC as well as via somatization and PC. However, after controlling for anxiety and depression, PC was the only significant pathway through which alexithymia was related to headache impact. CONCLUSIONS Headache patients may benefit from interventions aiming at improving psychological factors in order to improve the functioning and QOL of headache patients.
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Affiliation(s)
- Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Aram Park
- Department of Psychology, Catholic University of Daegu, Daegu, Republic of Korea
| | - Sung-Pa Park
- Department of Neurology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea.
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86
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Crane MF, Louis WR, Phillips JK, Amiot CE, Steffens NK. Identity centrality moderates the relationship between acceptance of group-based stressors and well-being. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2018. [DOI: 10.1002/ejsp.2367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | - Catherine E. Amiot
- Department of Psychology; University of Québec in Montréal; Montréal Québec Canada
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87
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Lehane CM, Nielsen T, Wittich W, Langer S, Dammeyer J. Couples coping with sensory loss: A dyadic study of the roles of self- and perceived partner acceptance. Br J Health Psychol 2018; 23:646-664. [PMID: 29602197 DOI: 10.1111/bjhp.12309] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 03/01/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Hearing-, vision-, and dual-sensory loss have been linked to relational and psychological distress among adults with sensory loss (AWSLs) and their spouses. Regardless, research on factors associated with couples' adjustment is lacking. This study examined the stability and strength of associations between self-acceptance of sensory loss, perceived partner acceptance of sensory loss, and relationship satisfaction and psychological distress among AWSLs and their spouses over time. DESIGN A total of 122 AWSLs and their spouses completed an online survey at two time points over a 6-month period. METHODS A multigroup (i.e., time 1 and time 2) actor-partner interdependence model assessed the stability and strength of actor and partner effects of self-acceptance and perceived partner acceptance on each partner's relationship satisfaction and psychological distress over time. RESULTS No moderation by time was identified, indicating stability in associations over the 6-month period. Overall, both actor and partner effects were evident. Specifically, self-acceptance among AWSLs was inversely associated with own psychological distress and the relationship satisfaction of spouses. Self-acceptance by spouses was inversely associated with the psychological distress of AWSLs and spouses. Perception of spouse acceptance by AWSLs was positively associated with own and spouse relationship satisfaction. CONCLUSIONS Interventions targeting acceptance that incorporate a family systems perspective may be beneficial in alleviating psychological and relational distress among couples coping with sensory loss. Statement of contribution What is already known on this subject? The experience of hearing and/or vision loss has been linked to heightened distress both psychologically and within intimate relationships. Prior research has demonstrated a link between an individual's ability to accept their sensory loss and healthier well-being. What does this study add? This is the first dyadic study of sensory loss acceptance and its link to relationship satisfaction and distress. Acceptance operates interpersonally protecting against distress for those with sensory loss and their spouses. Perceiving that one's spouse accepts the sensory loss is important for both partner's relationship satisfaction.
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Affiliation(s)
| | - Tine Nielsen
- Department of Psychology, University of Copenhagen, Denmark
| | - Walter Wittich
- School of Optometry, University of Montreal, Quebec, Canada
| | - Shelby Langer
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
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88
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Psychological Characteristics of Chronic Pain: a Review of Current Evidence and Assessment Tools to Enhance Treatment. Curr Pain Headache Rep 2018. [DOI: 10.1007/s11916-018-0663-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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89
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Saracutu M, Rance J, Davies H, Edwards DJ. The effects of osteopathic treatment on psychosocial factors in people with persistent pain: A systematic review. INT J OSTEOPATH MED 2018. [DOI: 10.1016/j.ijosm.2017.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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90
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Catastrophizing, Acceptance, and Coping as Mediators Between Pain and Emotional Distress and Disability in Fibromyalgia. J Clin Psychol Med Settings 2018; 25:80-92. [DOI: 10.1007/s10880-018-9543-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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91
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92
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Cánovas L, Carrascosa AJ, García M, Fernández M, Calvo A, Monsalve V, Soriano JF. Impact of Empathy in the Patient-Doctor Relationship on Chronic Pain Relief and Quality of Life: A Prospective Study in Spanish Pain Clinics. PAIN MEDICINE 2017; 19:1304-1314. [DOI: 10.1093/pm/pnx160] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Luz Cánovas
- Pain Clinic, Complejo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | | | - Modesto García
- Pain Clinic and Department of Anesthesiology, Hospital San Juan, Alicante, Spain
| | - Mariano Fernández
- Department of Anesthesiology, Hospital Civil (Complejo Hosp. Regional Carlos Haya), Málaga, Spain
| | | | - Vicente Monsalve
- Pain Clinic, Consorci Hospital General Universitari de València, Valencia, Spain
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93
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Bendayan R, Ramírez-Maestre C, Ferrer E, López A, Esteve R. From acute to chronic back pain: Using linear mixed models to explore changes in pain intensity, disability, and depression. Scand J Pain 2017; 16:45-51. [PMID: 28850411 DOI: 10.1016/j.sjpain.2017.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 02/03/2017] [Accepted: 02/21/2017] [Indexed: 02/05/2023]
Abstract
Abstract
Background/aims
This longitudinal study investigated the pattern of change in pain intensity, disability, and depression in 232 chronic pain patients who were followed up for 2 years since pain onset. Most studies that have investigated changes in these variables over time have used participants who had already been in pain for more than 3 months. Few studies have followed up individuals from the acute phase onward and such studies used traditional statistical methods that cannot identify transition points over time or measure inter-individual variability.
Methods
We followed up individuals with chronic pain from pain onset up to 18 months and we examined their pain intensity, disability and depression trajectories using a modelling approach that allows to account for between and within-individual variability. We compared three patterns of change based on theoretical criterions: a simple linear growth model; a spline model with a 3-month transition point; and a spline model with a 6-month transition point. Time with pain was selected as time metric to characterise the change in these variables in the transition from acute to chronic pain. Sex and age differences were also examined.
Results
The results showed that the pain intensity trajectory was best represented by the spline model with a 3-month transition point, whereas disability and depression were best explained by linear growth models. There were sex differences at intercept level in all the models. There were age differences at baseline for pain intensity. No sex or age differences were found for the slope.
Conclusions
Pain intensity decreased in the first 3 months but underwent no further change. Disability and depression slightly but constantly decreased over time. Although women and older individuals are more likely to report higher pain intensity or pain-related disability in the first three months with pain, no differences by sex or age appear to be associated with the changes in pain intensity, depression and disability through the process of chronification.
Implications
Our findings suggest that pain chronification could be considered a continuous process and contribute to the ongoing discussion on the utility of standard classifications of pain as acute or chronic from a clinical point of view. Clinical and intervention decisions based in these standard classifications should consider the differences in the trajectories of pain related variables over time. In addition, this article illustrates a statistical procedure that can be of utility to pain researchers.
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Affiliation(s)
- Rebecca Bendayan
- Department of Psychobiology and Methodology of Behavioural Sciences, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga 29071, Spain; MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London WC1B 5JU, United Kingdom.
| | - Carmen Ramírez-Maestre
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga 29071, Spain
| | - Emilio Ferrer
- Department of Psychology, University of California, Davis, One Shields Ave., Davis, CA 95616-8686, United States
| | - Alicia López
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga 29071, Spain
| | - Rosa Esteve
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga 29071, Spain
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Zettle RD, Hocker TR, Mick KA, Scofield BE, Petersen CL, Song H, Sudarijanto RP. Differential Strategies in Coping with Pain as a Function of Level of Experiential Avoidance. PSYCHOLOGICAL RECORD 2017. [DOI: 10.1007/bf03395524] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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95
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Zettle RD, Petersen CL, Hocker TR, Provines JL. Responding to a Challenging Perceptual-Motor Task as a Function of Level of Experiential Avoidance. PSYCHOLOGICAL RECORD 2017. [DOI: 10.1007/bf03395564] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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96
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Barnes A, Sullivan J, Pappas E, Adams R, Burns J. Clinical and Functional Characteristics of People With Chronic and Recent-Onset Plantar Heel Pain. PM R 2017; 9:1128-1134. [PMID: 28461226 DOI: 10.1016/j.pmrj.2017.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 04/04/2017] [Accepted: 04/08/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Plantar heel pain is a common condition that reduces health-related quality of life. Recovery usually occurs within 12 months; however, up to 20% of people remain symptomatic beyond this time frame. The level of pain and function in this chronic heel pain group is not well described. OBJECTIVE To identify clinical and functional characteristics associated with chronic plantar heel pain compared with heel pain of recent onset. DESIGN Cross-sectional study. SETTING University research laboratory and private physiotherapy clinic. PARTICIPANTS A total of 71 people with plantar heel pain for longer than 12 months and 64 people with plantar heel pain for less than 6 months were recruited from the general public. METHODS Functional characteristics of participants in both heel pain groups were assessed with a variety of clinical measures and the Foot Health Status Questionnaire. Clinical measures included body mass index, foot and ankle muscle strength using hand-held dynamometry, as well as ankle and first metatarsophalangeal joint range of motion. The Foot Health Status Questionnaire was used to collect self-reported measures of foot pain severity, foot function and physical activity. MAIN OUTCOME MEASUREMENTS Univariate analyses of variance were performed to detect differences between the 2 groups for each of the variables measured. RESULTS The chronic heel pain group exhibited reduced ankle dorsiflexor and toe flexor strength yet better self-reported foot function. There was no difference between groups for body mass index, ankle and first metatarsophalangeal joint range of motion, inversion strength, eversion strength, calf endurance, self-reported foot pain, and physical activity. CONCLUSIONS Chronic plantar heel pain is associated with selective weakness of foot and ankle muscle groups but less affected foot function compared with heel pain of recent onset. Those with chronic symptoms may moderate or make adaptations to their daily activities, or simply accept their condition, enabling more effective coping. Strength deficits, although possibly a cause or consequence of chronic symptoms, suggest a need to include resistance exercise in the management of plantar heel pain. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Allegra Barnes
- Physiotherapy Department, Royal North Shore Hospital, New South Wales, Australia(∗)
| | - Justin Sullivan
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia 1825(†).
| | - Evangelos Pappas
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, New South Wales; Arthritis and Musculoskeletal Research Group, Faculty of Health Sciences, The University of Sydney, New South Wales, Australia(‡)
| | - Roger Adams
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, New South Wales, Australia(§)
| | - Joshua Burns
- Sydney Children's Hospitals Network (Randwick and Westmead), University of Sydney, New South Wales, Australia(¶)
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Elander J, Richardson C, Morris J, Robinson G, Schofield M. Motivational and behavioural models of change: A longitudinal analysis of change among men with chronic haemophilia-related joint pain. Eur J Pain 2017; 21:1384-1396. [DOI: 10.1002/ejp.1040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 11/07/2022]
Affiliation(s)
- J. Elander
- Centre for Psychological Research; University of Derby; UK
| | - C. Richardson
- School of Psychology; University of Central Lancashire; Preston UK
| | | | - G. Robinson
- Department of Psychology; London Metropolitan University; UK
| | - M.B. Schofield
- Centre for Psychological Research; University of Derby; UK
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98
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Zetterqvist V, Holmström L, Maathz P, Wicksell RK. Pain avoidance predicts disability and depressive symptoms three years later in individuals with whiplash complaints. Acta Anaesthesiol Scand 2017; 61:445-455. [PMID: 28233304 DOI: 10.1111/aas.12874] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 12/06/2016] [Accepted: 01/23/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Longstanding symptoms due to whiplash are commonly associated with decreased levels of emotional and physical functioning. To date, there is strong empirical support for the relationship between psychological in/flexibility and pain-related functioning, but the predictive role for future health is largely unknown. Hence, the aim of this study was to investigate if psychological in/flexibility (i.e. avoidance and cognitive fusion) predicted pain disability and depressive symptoms 3 years later in individuals with whiplash complaints. METHODS Data were collected at baseline and at a 3 year follow-up from 368 members of a national patient organization for people with whiplash-associated disorder. In a series of hierarchical regression analyses, background variables, pain related variables, psychological distress and psychological inflexibility at baseline were evaluated as predictors of levels of pain disability and depressive symptoms at follow-up. RESULTS Results showed that psychological inflexibility, and more specifically avoidance, was a unique predictor of pain disability and depressive symptoms, also when controlling for background variables, pain related variables and psychological distress. Level of education was also found to predict both pain disability and symptoms of depression. Lastly, pain variability predicted pain disability, and anxiety predicted depressive symptoms. CONCLUSION Pain avoidance significantly predicted pain disability and depressive symptoms 3 years later. Although tentative, results warrant more studies to further explore the importance of pain avoidance for future health.
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Affiliation(s)
- V. Zetterqvist
- Behavioural Medicine Pain Treatment Services; Karolinska University Hospital; Stockholm Sweden
- Department of Neuroscience; Uppsala University; Uppsala Sweden
| | - L. Holmström
- Behavioural Medicine Pain Treatment Services; Karolinska University Hospital; Stockholm Sweden
- Department of Women's and Children's Health; Karolinska Institutet; Stockholm Sweden
| | - P. Maathz
- Behavioural Medicine Pain Treatment Services; Karolinska University Hospital; Stockholm Sweden
- Department of Psychology; Uppsala University; Uppsala Sweden
| | - R. K. Wicksell
- Behavioural Medicine Pain Treatment Services; Karolinska University Hospital; Stockholm Sweden
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
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99
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Cioffi I, Farella M, Chiodini P, Ammendola L, Capuozzo R, Klain C, Vollaro S, Michelotti A. Effect of weather on temporal pain patterns in patients with temporomandibular disorders and migraine. J Oral Rehabil 2017; 44:333-339. [DOI: 10.1111/joor.12498] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/29/2022]
Affiliation(s)
- I. Cioffi
- Discipline of Orthodontics; Faculty of Dentistry; University of Toronto - University of Toronto Center for the Study of Pain; Toronto ON Canada
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - M. Farella
- Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| | - P. Chiodini
- Medical Statistics Unit; University of Campania Luigi Vanvitelli; Naples Italy
| | - L. Ammendola
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - R. Capuozzo
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - C. Klain
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - S. Vollaro
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - A. Michelotti
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
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100
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Unique Contributions of Acceptance and Catastrophizing on Chronic Pain Adaptation. Int J Behav Med 2017; 24:542-551. [DOI: 10.1007/s12529-017-9646-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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