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Connor JJ, Brady SS, Chaisson N, Mohamed FS, Robinson BBE. Understanding Women's Responses to Sexual Pain After Female Genital Cutting: An Integrative Psychological Pain Response Model. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1859-1869. [PMID: 31011992 PMCID: PMC8240838 DOI: 10.1007/s10508-019-1422-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 02/05/2019] [Accepted: 02/07/2019] [Indexed: 05/05/2023]
Abstract
The World Health Organization estimates that over 200 million women and girls have experienced female genital cutting (FGC). Many women and girls who have undergone FGC have migrated to areas of the world where providers are unfamiliar with the health needs associated with FGC. Both providers in Western healthcare systems and female immigrant and refugee patients report communication difficulties leading to distrust of providers by women who have experienced FGC. Sexual pain is one common problem requiring discussion with healthcare providers and possible intervention. Yet, existing clinical and research literature provides little guidance for assessment and intervention when sexual pain is a result of FGC. Several conceptual frameworks have been developed to conceptualize and guide treatments for other types of pain, such as back pain and headaches. In this article, we integrate four prominent models-the fear avoidance model, eustress endurance model, distress endurance model, and pain resilience model-to conceptualize sexual pain in women who have experienced FGC. The resulting integrative psychological pain response model will aid in providing culturally responsive clinical management of sexual pain to women who have experienced FGC. This integrative model also provides a theoretical foundation for future research in this population.
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Affiliation(s)
- Jennifer Jo Connor
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, 1300 South Second Street, Suite 300, Minneapolis, MN, 55454, USA.
| | - Sonya S Brady
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Nicole Chaisson
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Beatrice Bean E Robinson
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, 1300 South Second Street, Suite 300, Minneapolis, MN, 55454, USA
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52
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Abdulcadir J, Catania L. Conceptualizing Sexual Pain in Women with Female Genital Mutilation/Cutting. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1871-1874. [PMID: 32279168 DOI: 10.1007/s10508-020-01691-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Jasmine Abdulcadir
- Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, 30 Bld de la Cluse, 1211, Geneva, Switzerland.
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Gebhardt A, Langius-Eklöf A, Andermo S, Arman M. Health and suffering are associated with social support: a cross-sectional study of women and mothers with exhaustion and pain. BMC Womens Health 2021; 21:259. [PMID: 34174840 PMCID: PMC8235816 DOI: 10.1186/s12905-021-01398-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite women are generally overrepresented in behavioral, mental, and musculoskeletal disorders, motherhood as a central part of women's life is poorly understood in relation to exhaustion and long-lasting pain. Mothers' health impairments imply suffering both for herself and her family. A profound understanding of health is needed taking mothers' subjective health experience, their suffering and life situation into account to give women, their families and society better prerequisites to alleviate exhaustion and long-lasting pain. The aim of the study was to describe health and suffering of women and mothers undergoing rehabilitation for long-lasting pain and exhaustion and its correlation with perceived social support. METHODS The study had a cross-sectional design with an exploratory approach. A main sample consisted of 166 women undergoing rehabilitation for exhaustion and long-lasting pain and a reference sample included 129 women working and studying within health care professions. Both samples included women with and without children. Women's subjective health and suffering was assessed from a caring science perspective using the recently developed and validated Health and Suffering Scale. Two additional scales measuring exhaustion and social support were distributed among the two samples. Descriptive statistics and multiple linear regression models, including health and suffering and perceived social support, were analyzed. RESULTS Mothers undergoing rehabilitation for pain and exhaustion reported significantly poorer health and more suffering compared to healthy mothers, but similar health and suffering when compared with childless women in rehabilitation. Health and suffering were correlated with perceived social support among both healthy and exhausted mothers. In both samples, the correlation between health and suffering and social support was stronger among mothers than among women without children. CONCLUSIONS Women and mothers living with exhaustion and long-lasting pain show signs of unbearable suffering and perceived insufficient social support. Social support from various sources particularly helps mothers to create meaning in life and make their suffering bearable. Hence, health care must address the fact that mothers are dependent on their immediate social environment and that this dependency interacts with their health and suffering on an existential level.
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Affiliation(s)
- Anja Gebhardt
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden.
| | - Ann Langius-Eklöf
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden
| | - Susanne Andermo
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden
- Department of Global Public Health, Karolinska Institutet, 17165, Solna, Sweden
| | - Maria Arman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden
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Yu W, Wu X, Chen Y, Liang Z, Jiang J, Misrani A, Su Y, Peng Y, Chen J, Tang B, Sun M, Long C, Shen J, Yang L. Pelvic Pain Alters Functional Connectivity Between Anterior Cingulate Cortex and Hippocampus in Both Humans and a Rat Model. Front Syst Neurosci 2021; 15:642349. [PMID: 34149369 PMCID: PMC8210850 DOI: 10.3389/fnsys.2021.642349] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/26/2021] [Indexed: 01/06/2023] Open
Abstract
The anterior cingulate cortex (ACC) and hippocampus (HIPP) are two key brain regions associated with pain and pain-related affective processing. However, whether and how pelvic pain alters the neural activity and connectivity of the ACC and HIPP under baseline and during social pain, and the underlying cellular and molecular mechanisms, remain unclear. Using functional magnetic resonance imaging (fMRI) combined with electrophysiology and biochemistry, we show that pelvic pain, particularly, primary dysmenorrhea (PDM), causes an increase in the functional connectivity between ACC and HIPP in resting-state fMRI, and a smaller reduction in connectivity during social exclusion in PDM females with periovulatory phase. Similarly, model rats demonstrate significantly increased ACC-HIPP synchronization in the gamma band, associating with reduced modulation by ACC-theta on HIPP-gamma and increased levels of receptor proteins and excitation. This study brings together human fMRI and animal research and enables improved therapeutic strategies for ameliorating pain and pain-related affective processing.
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Affiliation(s)
- Wenjun Yu
- Precise Genome Engineering Center, School of Life Sciences, Guangzhou University, Guangzhou, China.,Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,College of Education, Jinggangshan University, Ji'an, China
| | - Xiaoyan Wu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,School of Psychology, South China Normal University, Guangzhou, China
| | - Yunan Chen
- School of Life Sciences, South China Normal University, Guangzhou, China
| | - Zhiying Liang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jinxiang Jiang
- Precise Genome Engineering Center, School of Life Sciences, Guangzhou University, Guangzhou, China
| | - Afzal Misrani
- Precise Genome Engineering Center, School of Life Sciences, Guangzhou University, Guangzhou, China
| | - Yun Su
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yigang Peng
- School of Life Sciences, South China Normal University, Guangzhou, China
| | - Jian Chen
- School of Life Sciences, South China Normal University, Guangzhou, China
| | - Binliang Tang
- School of Life Sciences, South China Normal University, Guangzhou, China
| | - Mengyao Sun
- School of Life Sciences, South China Normal University, Guangzhou, China
| | - Cheng Long
- School of Life Sciences, South China Normal University, Guangzhou, China
| | - Jun Shen
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Li Yang
- Precise Genome Engineering Center, School of Life Sciences, Guangzhou University, Guangzhou, China
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Mardian AS, Hanson ER, Villarroel L, Karnik AD, Sollenberger JG, Okvat HA, Dhanjal-Reddy A, Rehman S. Flipping the Pain Care Model: A Sociopsychobiological Approach to High-Value Chronic Pain Care. PAIN MEDICINE 2021; 21:1168-1180. [PMID: 31909793 DOI: 10.1093/pm/pnz336] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Much of the pain care in the United States is costly and associated with limited benefits and significant harms, representing a crisis of value. We explore the current factors that lead to low-value pain care within the United States and provide an alternate model for pain care, as well as an implementation example for this model that is expected to produce high-value pain care. METHODS From the perspective of aiming for high-value care (defined as care that maximizes clinical benefit while minimizing harm and cost), we describe the current evidence practice gap (EPG) for pain care in the United States, which has developed as current clinical care diverges from existing evidence. A discussion of the biomedical, biopsychosocial, and sociopsychobiological (SPB) models of pain care is used to elucidate the origins of the current EPG and the unconscious factors that perpetuate pain care systems despite poor results. RESULTS An interprofessional pain team within the Veterans Health Administration is described as an example of a pain care system that has been designed to deliver high-value pain care and close the EPG by implementing the SPB model. CONCLUSIONS Adopting and implementing a sociopsychobiological model may be an effective approach to address the current evidence practice gap and deliver high-value pain care in the United States. The Phoenix VA Health Care System's Chronic Pain Wellness Center may serve as a template for providing high-value, evidence-based pain care for patients with high-impact chronic pain who also have medical, mental health, and opioid use disorder comorbidities.
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Affiliation(s)
- Aram S Mardian
- Phoenix VA Health Care System, Phoenix, Arizona.,University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| | - Eric R Hanson
- Phoenix VA Health Care System, Phoenix, Arizona.,University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| | - Lisa Villarroel
- Arizona Department of Health Services, Phoenix, Arizona, USA
| | - Anita D Karnik
- Phoenix VA Health Care System, Phoenix, Arizona.,University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| | - John G Sollenberger
- Phoenix VA Health Care System, Phoenix, Arizona.,University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| | | | - Amrita Dhanjal-Reddy
- Phoenix VA Health Care System, Phoenix, Arizona.,University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
| | - Shakaib Rehman
- Phoenix VA Health Care System, Phoenix, Arizona.,University of Arizona College of Medicine-Phoenix, Phoenix, Arizona
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Nwankwo VC, Jiranek WA, Green CL, Allen KD, George SZ, Bettger JP. Resilience and pain catastrophizing among patients with total knee arthroplasty: a cohort study to examine psychological constructs as predictors of post-operative outcomes. Health Qual Life Outcomes 2021; 19:136. [PMID: 33933091 PMCID: PMC8088639 DOI: 10.1186/s12955-021-01772-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 04/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background Patients’ psychological health may influence recovery and functional outcomes after total knee arthroplasty (TKA). Pain catastrophizing, known to be associated with poor function following TKA, encompasses rumination, magnification, and helplessness that patients feel toward their pain. Resilience, however, is an individual's ability to adapt to adversity and may be an important psychological construct that supersedes the relationship between pain catastrophizing and recovery. In this study we sought to identify whether pre-operative resilience is predictive of 3-month postoperative outcomes after adjusting for pain catastrophizing and other covariates. Methods Patients undergoing TKA between January 2019 and November 2019 were included in this longitudinal cohort study. Demographics and questionnaires [Brief Resilience Scale (BRS), Pain Catastrophizing Scale (PCS), Knee injury and Osteoarthritis Outcome Score, Junior (KOOS, JR.) and Patient-Reported Outcomes Measurement Information System Physical and Mental Health (PROMIS PH and MH, respectively)] were collected preoperatively and 3 months postoperatively. Multivariable regression was used to test associations of preoperative BRS with postoperative outcomes, adjusting for PCS and other patient-level sociodemographic and clinical characteristics. Results The study cohort included 117 patients with a median age of 67.0 years (Q1–Q3: 59.0–72.0). Fifty-three percent of patients were women and 70.1% were white. Unadjusted analyses identified an association between resilience and post-operative outcomes and the relationship persisted for physical function after adjusting for PCS and other covariates; in multivariable linear regression analyses, higher baseline resilience was positively associated with better postoperative knee function (β = 0.24, p = 0.019) and better general physical health (β = 0.24, p = 0.013) but not general mental health (β = 0.04, p = 0.738).
Conclusions Our prospective cohort study suggests that resilience predicts postoperative knee function and general physical health in patients undergoing TKA. Exploring interventions that address preoperative mental health and resilience more specifically may improve self-reported physical function outcomes of patients undergoing TKA.
Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01772-2.
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Affiliation(s)
| | - William A Jiranek
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
| | - Cynthia L Green
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Kelli D Allen
- Center to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA.,Department of Medicine and Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | - Steven Z George
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA.,Duke Clinical Research Institute, Durham, NC, USA
| | - Janet Prvu Bettger
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA.,Duke Clinical Research Institute, Durham, NC, USA
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Benville JR, Compton P, Giordano NA, Cheatle MD. Perceived social support in patients with chronic pain with and without opioid use disorder and role of medication for opioid use disorder. Drug Alcohol Depend 2021; 221:108619. [PMID: 33667781 PMCID: PMC8796693 DOI: 10.1016/j.drugalcdep.2021.108619] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/31/2020] [Accepted: 01/26/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND A significant predictor of treatment outcomes for patients with chronic non-cancer pain (CNCP) and opioid use disorder (OUD) is the degree and quality of social support they receive. Specifically, in patients with CNCP and on long-term opioid therapy, the development of OUD tends to be associated with losses in social support, while engagement in treatment for OUD improves support networks. Delivery of the evidence-based OUD treatment medications, methadone and buprenorphine, occurs in clinical environments which patently differ with respect to social support resources. The aims of this study were to describe perceived social support in patients with CNCP without OUD (no-OUD), with OUD and on buprenorphine (OUD-BP), and with OUD and on methadone (OUD-methadone). METHODS Using the Duke Social Support Index (DSSI), perceived social support in a sample of Caucasian patients with CNCP and on opioid therapy was compared between no-OUDs (n = 834), OUD-methadone (n = 83) and OUD-BP (n = 99) therapy. Average DSSI scores were compared across groups and a linear regression model computed to describe association between group and perceived social support. RESULTS No difference was observed in DSSI scores between no-OUDs and OUD-methadone, however scores were lower among OUD-BP participants than those receiving methadone (x = -5.2; 95% CI: -7.5, -2.9) and (x = -6.5, 95% CI: -8.2, -4.9). CONCLUSIONS Patients with CNCP and OUD on methadone therapy endorse levels of social support comparable to those without OUD, however those on buprenorphine therapy report significantly less support, bringing implications for OUD treatment outcomes.
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Affiliation(s)
- Julia R Benville
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 500, Philadelphia, PA, 19104, United States; Department of Psychiatry, NYU School of Medicine, Bellevue Hospital, 462 First Avenue, Room A842, New York, NY 10016, United States.
| | - Peggy Compton
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Claire Fagin Hall, Room 402, Philadelphia, PA, 19104, United States.
| | - Nicholas A Giordano
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, United States.
| | - Martin D Cheatle
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 500, Philadelphia, PA, 19104, United States.
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Benintendi A, Kosakowski S, Lagisetty P, Larochelle M, Bohnert AS, Bazzi AR. "I felt like I had a scarlet letter": Recurring experiences of structural stigma surrounding opioid tapers among patients with chronic, non-cancer pain. Drug Alcohol Depend 2021; 222:108664. [PMID: 33757709 PMCID: PMC8058315 DOI: 10.1016/j.drugalcdep.2021.108664] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/22/2020] [Accepted: 12/25/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Efforts to address opioid-involved overdose fatalities have led to widespread implementation of various initiatives to taper (i.e., reduce or discontinue) opioid prescriptions despite a limited understanding of patients' experience. METHODS From 2019-2020, we recruited patients with chronic, non-cancer pain who had undergone a reduction in opioid daily dosage of ≥50 % in the past two years at Boston Medical Center or Michigan Medicine. Participants completed semi-structured interviews exploring health history, opioid use, and taper experiences. Inductive analysis, guided by theoretical conceptualizations of structural stigma, identified emergent themes. RESULTS Among 41 participants, three elements of structural stigma were identified across participants' lives. First, participants identified themselves as overlooked subjects of the U.S. opioid crisis, who experienced overprescribing, subsequent stigmatization and surveillance of opioid use (e.g., toxicology screening, "pill counts"), and various tapering initiatives. Second, during the course of pain treatment, participants felt stigmatized and invalidated by cultural norms linking chronic pain to stereotypes of acting disingenuously (e.g., "drug-seeking"). Finally, during and after tapers, institutional policies and programs further increased participants' feelings of marginalization, producing multiple unintended consequences, including reduced access to medical care and feeling "orphaned by the system." CONCLUSIONS Opioid tapers may exacerbate the social production and burden of stigma among patients with chronic pain, especially when processes are perceived to invalidate pain, endorse stereotypes, and label previously effective, acceptable treatment as inappropriate. Findings highlight how various tapering initiatives reinforce the devalued status of people living with chronic pain while also reducing patients' wellbeing and confidence in medical systems.
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Affiliation(s)
- Allyn Benintendi
- Clinical Addiction Research and Evaluation Unit, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA
| | - Sarah Kosakowski
- Clinical Addiction Research and Evaluation Unit, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA
| | - Pooja Lagisetty
- Michigan Medicine, Department of Internal Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA,VA Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI 48105, USA
| | - Marc Larochelle
- Clinical Addiction Research and Evaluation Unit, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA
| | - Amy S.B. Bohnert
- VA Center for Clinical Management Research, 2215 Fuller Road, Ann Arbor, MI 48105, USA,Michigan Medicine, Department of Anesthesiology, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Angela R Bazzi
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, rm 442e, Boston, MA, 02118, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
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Bui BN, Lensen SF, Gibreel A, Martins WP, Torrance H, Broekmans FJ. Endometrial injury for pregnancy following sexual intercourse or intrauterine insemination. Cochrane Database Syst Rev 2021; 3:CD011424. [PMID: 33734431 PMCID: PMC8094383 DOI: 10.1002/14651858.cd011424.pub3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Intentional endometrial injury is being proposed as a technique to improve the probability of pregnancy in women undergoing assisted reproductive technologies (ART) such as in vitro fertilisation (IVF). Endometrial injury is often performed by pipelle biopsy and is a common gynaecological procedure with established safety. However, it causes a moderate degree of discomfort/pain and requires an additional pelvic examination. The effectiveness of this procedure outside of ART, in women or couples attempting to conceive via sexual intercourse or with intrauterine insemination (IUI), remains unclear. OBJECTIVES To assess the effectiveness and safety of intentional endometrial injury performed in infertile women or couples attempting to conceive through sexual intercourse or intrauterine insemination (IUI). SEARCH METHODS The Cochrane Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, LILACS, ISI Web of Knowledge, and clinical trial registries were searched from inception to 21 May 2020, as were conference abstracts and reference lists of relevant reviews and included studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) that evaluated any kind of intentional endometrial injury in women planning to undergo IUI or attempting to conceive spontaneously (with or without ovarian stimulation (OS)) compared to no intervention, a mock intervention, or intentional endometrial injury performed at a different time or to a higher/lower degree. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. Primary outcomes were live birth/ongoing pregnancy and pain experienced during the procedure. Due to high risk of bias associated with many of the studies, primary analyses of all review outcomes were restricted to studies at low risk of bias. Sensitivity analysis including all studies was then performed. MAIN RESULTS We included 23 RCTs (4035 women). Most of these studies included women with unexplained infertility. Intentional endometrial injury versus either no intervention or a sham procedure The primary analysis was restricted to studies at low risk of bias, which left only one study included. We are uncertain whether endometrial injury has an effect on the probability of live birth, as only one study is included in the analysis and the confidence interval is wide (risk ratio (RR) 1.11, 95% confidence interval (CI) 0.78 to 1.59; 1 RCT, 210 participants). Evidence suggests that if the chance of live birth with no intervention/a sham procedure is assumed to be 34%, then the chance with endometrial injury would be 27% to 55%. When all studies were included in the sensitivity analysis, we were uncertain whether endometrial injury improves live birth/ongoing pregnancy, as the evidence was of very low quality (RR 1.71, 95% CI 1.32 to 2.21; 8 RCTs, 1522 participants; I² = 16%). Evidence suggests that if the chance of live birth/ongoing pregnancy with no intervention/a sham procedure is assumed to be 13%, then the chance with endometrial injury would be 17% to 28%. A narrative synthesis conducted for the other primary outcome of pain during the procedure included studies measuring pain on a zero-to-ten visual analogue scale (VAS) or grading pain as mild/moderate/severe, and showed that most often mild to moderate pain was reported (6 RCTs, 911 participants; very low-quality evidence). Higher versus lower degree of intentional endometrial injury Evidence was insufficient to show whether there is a difference in ongoing pregnancy rates (RR 1.29, 95% CI 0.71 to 2.35; 1 RCT, 332 participants; low-quality evidence) between hysteroscopy with endometrial injury and hysteroscopy alone. Evidence suggests that if the chance of ongoing pregnancy with hysteroscopy alone is 10%, then the chance with hysteroscopy with endometrial injury would be 7% to 24%. This study did not report the primary outcomes of live birth and pain during the procedure. Timing of intentional endometrial injury Four trials compared endometrial injury performed in the cycle before IUI to that performed in the same cycle as IUI. None of these studies reported the primary outcomes of live birth/ongoing pregnancy and pain during the procedure. One study compared endometrial injury in the early follicular phase (EFP; Day 2 to 4) to endometrial injury in the late follicular phase (LFP; Day 7 to 9), both in the same cycle as IUI. The primary outcome live birth/ongoing pregnancy was not reported, but the study did report the other primary outcome of pain during the procedure assessed by a zero-to-ten VAS. The average pain score was 3.67 (standard deviation (SD) 0.7) when endometrial injury was performed in the EFP and 3.84 (SD 0.96) when endometrial injury was performed in the LFP. The mean difference was -0.17, suggesting that on average, women undergoing endometrial injury in the EFP scored 0.17 points lower on the VAS as compared to women undergoing endometrial injury in the LFP (95% CI -0.48 to 0.14; 1 RCT, 110 participants; very low-quality evidence). AUTHORS' CONCLUSIONS Evidence is insufficient to show whether there is a difference in live birth/ongoing pregnancy between endometrial injury and no intervention/a sham procedure in women undergoing IUI or attempting to conceive via sexual intercourse. The pooled results should be interpreted with caution, as the evidence was of low to very low quality due to high risk of bias present in most included studies and an overall low level of precision. Furthermore, studies investigating the effect of timing of endometrial injury did not report the outcome live birth/ongoing pregnancy; therefore no conclusions could be drawn for this outcome. Further well-conducted RCTs that recruit large numbers of participants and minimise bias are required to confirm or refute these findings. Current evidence is insufficient to support routine use of endometrial injury in women undergoing IUI or attempting to conceive via sexual intercourse.
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Affiliation(s)
- Bich Ngoc Bui
- Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, Netherlands
| | - Sarah F Lensen
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Ahmed Gibreel
- Obstetrics & Gynaecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Helen Torrance
- Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, Netherlands
| | - Frank J Broekmans
- Department of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, Netherlands
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Umeda M, Leutze TM, Inagaki TK. Replication and extension of the link between the cardiovascular system and sensitivity to social pain in healthy adults. Soc Neurosci 2021; 16:265-276. [PMID: 33648414 DOI: 10.1080/17470919.2021.1897672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Resting blood pressure (BP) and heart rate variability (HRV) are linked to physical pain. Research also shows a link between social pain and physical pain, and an inverse association between resting BP and social pain. However, little is known regarding the relationship between resting HRV and social pain. Therefore, the present study aimed to replicate the link between social pain and physical pain, and the inverse relationship between resting BP and social pain, and explore the relationship between resting HRV and social pain. One-hundred twenty three healthy adults completed 1) resting cardiovascular measurements of BP and low-frequency (LF) and high-frequency (HF) HRV powers, 2) social pain sensitivity assessment via the Brief Fear of Negative Evaluation (BFNE) and Mehrabian's Sensitivity to Rejection (MSR) scales, and 3) physical pain sensitivity assessment via subjective pain responses during cold pressor test. The results indicated that no association was observed between social pain and physical pain, whereas resting BP was inversely associated with the MSR scores. Resting LF-HRV was inversely associated with social pain, whereas resting HF-HRV was positively associated with social pain. These findings suggest that physical pain and social pain may share biological substrates that are involved in BP regulation and pain control.
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Affiliation(s)
- Masataka Umeda
- Department of Kinesiology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Teresa M Leutze
- Department of Kinesiology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Tristen K Inagaki
- Department of Psychology, San Diego State University, San Diego, CA, USA
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Valencia C, Smiley A, Giron M, Stacy J, Rodriguez I, Umucu E. Differences in Psychosocial Factors and Experimental Pain Sensitivity between Hispanics and non-Hispanic Whites from the U.S.-Mexico Border. PAIN MEDICINE 2021; 22:2627-2637. [PMID: 33690848 DOI: 10.1093/pm/pnab083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Research suggests that ethnicity is a predictor of pain-related outcomes; however, studies comparing the differences in experimental pain sensitivity between Hispanics and non-Hispanic Whites (NHW) are scarce. This study investigated these differences between Hispanics and NHW from the U.S- Mexico border. METHODS Fifty-eight healthy subjects completed the survey packet, which included a demographic and a psychosocial factors questionnaire. Participants underwent quantitative sensory testing which included heat pain threshold, heat pain tolerance, Suprathreshold Heat Pain Response (SHPR), and Conditioned Pain Modulation (CPM). SHPR was induced by repeated thermal stimuli in both thenar eminences. CPM was assessed using SHPR as the experimental stimulus, and cold pressor task as the conditioning stimulus. RESULTS Analyses showed significant differences in experimental pain measures believed to be representative of facilitatory pain processing including SHPR, and heat pain threshold, where Hispanics reported significantly higher pain ratings than NHW. Hispanics also reported higher levels of ethnic identity and acculturation. However, these factors were not significantly associated with experimental pain sensitivity. CONCLUSION The experimental pain sensitivity and psychosocial factors included in this study differed by ethnic group, where Hispanics reported significantly higher pain ratings, when compared to NHW. However, ethnic identity and acculturation were not associated with these pain-related outcomes. Overall, enhanced understanding by clinicians of pain sensitivity and disparities in the pain experience between ethnic groups allows for increased cultural sensitivity and can be used to optimize pain treatment on an individual-by-individual basis.
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Affiliation(s)
- Carolina Valencia
- Department of Rehabilitation Sciences, The University of Texas at El Paso, El Paso, TX
| | - Aaron Smiley
- Department of Rehabilitation Sciences, The University of Texas at El Paso, El Paso, TX
| | - Megan Giron
- Department of Rehabilitation Sciences, The University of Texas at El Paso, El Paso, TX
| | - Johnathan Stacy
- Department of Rehabilitation Sciences, The University of Texas at El Paso, El Paso, TX
| | - Isaac Rodriguez
- Department of Public Health, The University of Texas at El Paso, El Paso, TX
| | - Emre Umucu
- Department of Rehabilitation Sciences, The University of Texas at El Paso, El Paso, TX
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Jackson K, Wadley AL, Parker R. Managing pain in HIV/AIDS: a therapeutic relationship is as effective as an exercise and education intervention for rural amaXhosa women in South Africa. BMC Public Health 2021; 21:302. [PMID: 33546647 PMCID: PMC7866667 DOI: 10.1186/s12889-021-10309-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 01/21/2021] [Indexed: 11/28/2022] Open
Abstract
Background Pain is one of the most prevalent symptoms in people living with HIV/AIDS and is largely undermanaged. Both a peer-led exercise and education Positive Living programme (PL programme) and the PL programme workbook alone were previously found to be effective in reducing pain in urban amaXhosa Women Living With HIV/AIDS (WLWHA). A therapeutic relationship was hypothesised to have contributed to the efficacy of both interventions. The aim of the study was to determine the effectiveness of the PL programme and a therapeutic relationship, compared to a therapeutic relationship alone in managing pain amongst rural amaXhosa WLWHA on pain severity and pain interference, and secondary outcomes, symptoms of depression, health-related quality of life (HRQoL) and self-efficacy. Methods In this two-group, single-blind, pragmatic clinical trial with stratified convenience sampling, the PL programme and therapeutic relationship, was compared to a therapeutic relationship alone in rural amaXhosa WLWHA. The PL programme was a 6-week, peer-led intervention comprising education on living well with HIV, exercise and goal setting. The therapeutic relationship comprised follow-up appointments with a caring research assistant. Outcome measures included pain severity and interference (Brief Pain Inventory), depressive symptoms (Beck Depression Inventory), HRQoL (EuroQol 5-Dimensional outcome questionnaire) and self-efficacy (Self-efficacy for Managing Chronic Disease 6-Item Scale). Follow-up was conducted at 4, 8, 12, 24, and 48 weeks. Mixed model regression was used to test the effects of group, time, and group and time interactions of the interventions on outcome measures. Results Forty-nine rural amaXhosa WLWHA participated in the study: PL group n = 26; TR group n = 23. Both intervention groups were similarly effective in significantly reducing pain severity and interference and depressive symptoms, and increasing self-efficacy and HRQoL over the 48 weeks. A clinically important reduction in pain severity of 3.31 points occurred for the sample over the 48 weeks of the study. All of these clinical improvements were obtained despite low and suboptimal attendance for both interventions. Conclusions Providing a therapeutic relationship alone is sufficient for effective pain management amongst rural amaXhosa WLWHA. These findings support greater emphasis on demonstrating care and developing skills to enhance the therapeutic relationship in healthcare professionals working with rural amaXhosa WLWHA. Trial registration PACTR; PACTR201410000902600, 30th October 2014; https://pactr.samrc.ac.za. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10309-7.
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Affiliation(s)
- Kirsty Jackson
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Observatory, Cape Town, 7925, South Africa.,Zithulele Hospital, Eastern Cape Department of Health, Mqanduli, South Africa
| | - Antonia L Wadley
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Romy Parker
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, University of Cape Town, Observatory, Cape Town, 7925, South Africa. .,Pain Management Unit; Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town and Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa.
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63
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Ghavidel-Parsa B, Bidari A, Tohidi S, Shenavar I, Kazemnezhad Leyli E, Hosseini K, Khosousi MJ. Implication of invalidation concept in fibromyalgia diagnosis. Clin Rheumatol 2021; 40:2369-2376. [PMID: 33411140 DOI: 10.1007/s10067-020-05515-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/29/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The invalidation or social pain is an important but neglected issue in polysymptomatology of fibromyalgia (FM). This study sought whether tracing-perceived invalidation could be effective to discriminate between the presence and absence of FM in chronic pain patients with respect to five different sources, including spouses, family, colleagues, health professionals, and social services. METHODS A total of 207 consecutive chronic pain patients were evaluated for the presence of FM by rheumatologic assessment. Invalidation was measured by the Illness Invalidation Inventory (3*I). Receiver operator characteristic (ROC) analyses were used to evaluate the ability of 3*I dimensions and sources to discriminate having FM among chronic pain patients. Binary logistic regression analyses were performed. RESULTS The perceived discounting and lack of understanding from spouse and family sources were higher in FM rather than non-FM patients. ROC analyses demonstrated that invalidation dimensions stemming from spouse and family could appropriately discriminate between the presence and absence of FM. The area under the curve (AUC) for other sources showed non-significant values. Adjusted logistic regression analysis by age, education level, and work status showed that discounting by family and lack of understanding by the spouse could be significant predictors of FM (OR 2.30; 95% CI 1.29-4.11, P = 0.005; OR 1.72; 95% CI 1.08-2.74, P = 0.022, respectively). CONCLUSIONS This study elucidated the discriminatory power of invalidation in identification of FM from non-FM patients, especially when originated from spouse and family. Our results provide a basis to propose the invalidation as a salient component in the FM dictionary parallel to other famous FM symptoms. Key Points • The incorporation of newly highlighted social definition of pain seems warranted in the pain practice. • Despite proposing invalidation in painful conditions, its diagnostic role in FM remains unexplored. • Acknowledging of invalidation or social pain in polysymptomatology of FM could shift the paradigm of diagnosis of FM.
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Affiliation(s)
- Banafsheh Ghavidel-Parsa
- Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Bidari
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Sepehr Tohidi
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Irandokht Shenavar
- Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Kazem Hosseini
- Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad-Javad Khosousi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
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64
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Nacak Y, Morawa E, Erim Y. High Rejection Sensitivity in Patients With Somatoform Pain Disorder. Front Psychiatry 2021; 12:602981. [PMID: 33854447 PMCID: PMC8039454 DOI: 10.3389/fpsyt.2021.602981] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/02/2021] [Indexed: 12/17/2022] Open
Abstract
Objective: Rejection sensitivity (RS) is often associated with mental disorders but as yet has not been investigated in patients with somatoform pain disorder (SPD). The aim of the study was to explore the degree of RS in patients with SPD compared to healthy controls. In addition, we examined factors associated with RS and the moderator effect of SPD. Methods: A total of 65 patients with SPD (confirmed by Structured Clinical Interview, SCID-I) and 65 age- and gender-matched healthy controls participated. Rejection Sensitivity Questionnaire (RSQ), Patient Health Questionnaire (PHQ-9, PHQ-15), Relationship Scale (ReSQ), Essen Trauma Inventory (ETI) and the Childhood Trauma Questionnaire (CTQ) were applied. Multiple linear regression analysis was performed. Results: The level of RS was significantly higher in patients with SPD compared to healthy controls (M = 10.30, SD = 5.64; M = 6.13, SD = 2.50; p < 0.001; d = 0.95). Higher levels of depressive symptoms (p < 0.001), childhood adversities (p < 0.001) and the insecure attachment style (p = 0.007) were related to higher levels of RS. No significant moderation effect was detected. Conclusions: Patients with SPD are highly sensitive to social rejection. In addition, insecure attachment styles as well as depressive symptoms and childhood adversities are strongly associated with RS. Further studies are needed to figure out how RS is connected to SPD over lifetime.
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Affiliation(s)
- Yeliz Nacak
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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65
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Sullivan MD, Ballantyne JC. When Physical and Social Pain Coexist: Insights Into Opioid Therapy. Ann Fam Med 2021; 19:79-82. [PMID: 33355099 PMCID: PMC7800754 DOI: 10.1370/afm.2591] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/14/2020] [Accepted: 03/10/2020] [Indexed: 01/08/2023] Open
Abstract
The US opioid epidemic challenges us to rethink our understanding of the function of opioids and the nature of chronic pain. We have neatly separated opioid use and abuse as well as physical and social pain in ways that may not be consistent with the most recent neuroscientific and epidemiological research. Physical injury and social rejection activate similar brain centers. Many of the patients who use opioid medications long term for the treatment of chronic pain have both physical and social pain, but these medications may produce a state of persistent opioid dependence that suppresses the endogenous opioid system that is essential for human socialization and reward processing. Recognition of the social aspects of chronic pain and opioid action can improve our treatment of chronic pain and our use of opioid medications.
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Affiliation(s)
- Mark D Sullivan
- Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Jane C Ballantyne
- Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
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66
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Poon KT, Jiang Y, Teng F. Putting oneself in someone's shoes: The effect of observing ostracism on physical pain, social pain, negative emotion, and self-regulation. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.110217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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67
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Woodgate RL, Tennent P, Barriage S, Legras N. The lived experience of anxiety and the many facets of pain: A qualitative, arts-based approach. Can J Pain 2020; 4:6-18. [PMID: 33987507 PMCID: PMC7942822 DOI: 10.1080/24740527.2020.1720501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/10/2020] [Accepted: 01/21/2020] [Indexed: 01/22/2023]
Abstract
Background: Findings reported in this article emerged from the study titled "Youth's Voices: Their Lives and Experiences of Living with an Anxiety Disorder." Though the initial focus of this study was not on the pain experiences of youth living with an anxiety disorder, it became apparent from the very first interviews that pain and suffering was key in the youth lived experience, permeating their everyday lives and impeding their participation and functioning in the world. Aims: The aim of this article is to highlight the ways in which pain is a central experience for young people living with an anxiety disorder. Methods: The study was approached from the qualitative research design of hermeneutic phenomenology. Fifty-eight young people who were living with anxiety disorders and their parents participated in the study. Youth took part in multiple qualitative open-ended interviews and the participatory arts-based method of photovoice. Themes were developed using van Manen's method of data analysis. Results: The overall theme emerged as "anxiety is very much about pain." The four subthemes are (1) embodied experience of anxiety: physical pain; (2) a prominent symptom of anxiety: mental-emotional pain; (3) difficult interpersonal relationships: social pain; and (4) articulating their pain. Conclusions: Use of qualitative, arts-based methodologies provided the opportunity and space for youth with anxiety to articulate their multifaceted experience with pain in their own words. This work reinforces the need for use of qualitative approaches to understanding pain experiences in young people.
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Affiliation(s)
- Roberta Lynn Woodgate
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Pauline Tennent
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sarah Barriage
- School of Information Science, College of Communication & Information, University of Kentucky, Lexington, Kentucky, USA
| | - Nicole Legras
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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68
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A Social Blow: The Role of Interpersonal Relationships in Mild Traumatic Brain Injury. PSYCHOSOMATICS 2020; 61:518-526. [DOI: 10.1016/j.psym.2020.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 12/22/2022]
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69
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Lee WJ, Jung CH, Hwang JY, Seong SJ, Han CH, Park JW, Jang JH, Lee D, Kang DH. Prognostic Factors in Complex Regional Pain Syndrome Type 1 Occurring in the Korean Army. PAIN MEDICINE 2020; 20:1989-1996. [PMID: 30986307 DOI: 10.1093/pm/pnz076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES In Korea, patients diagnosed with complex regional pain syndrome (CRPS) in the army are typically discharged from the army; however, the course of the disease after discharge is not known. The purpose of this study was to investigate the course of CRPS that occurred in the army and to identify the influences of various clinical and psychosocial factors immediately before discharge on the disease course. METHODS Clinical profiles and psychosocial status were collected from the medical records of 16 patients with CRPS type 1 who were discharged during the period between March 2017 and April 2018. The degree of improvement after discharge was assessed by follow-up evaluation through telephone contact. Cox proportional hazards regression was performed to identify clinical and psychosocial predictors for the rate of recovery. RESULTS The median time to recovery after discharge was 39 weeks (95% confidence interval [CI] = 8.8-69.2 weeks). The sole predictor for time to recovery after discharge was the time period from the onset of pain to discharge. Each one-week increase in the duration of pain experienced in the military was associated with a 18.2% (95% CI = 5.3%-29.5%) reduction in the rate of recovery after discharge (P = 0.007). CONCLUSIONS Patients who experienced a short period of pain in the military demonstrated a relatively good prognosis after discharge. This may show how prolonged pain in the army could affect the experience of pain from a social point of view, in that it shows the disease course after a change in the social environment.
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Affiliation(s)
- Won Joon Lee
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea.,Department of Psychiatry, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - Cheol Hee Jung
- Department of Anesthesiology and Pain Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - Jae Yeon Hwang
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Su-Jeong Seong
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Chang Hwan Han
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Jin Woo Park
- Department of Orthopedic Surgery, Kangwon National University College of Medicine, Chuncheon, Republic of Korea
| | - Joon Hwan Jang
- Department of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Dasom Lee
- Emotional Information and Communication Technology Association, Seoul, Republic of Korea
| | - Do-Hyung Kang
- Emotional Information and Communication Technology Association, Seoul, Republic of Korea
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70
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Ghavidel-Parsa B, Bidari A. Two sides on the fibromyalgia coin: physical pain and social pain (invalidation). Clin Rheumatol 2020; 40:841-848. [PMID: 32772267 DOI: 10.1007/s10067-020-05304-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/06/2020] [Accepted: 07/20/2020] [Indexed: 01/21/2023]
Abstract
Although fibromyalgia (FM) has been traditionally defined by the extent of physical pain sites alongside other non-pain symptoms, recent evidence has highlighted the importance of social dimension in definition of pain perception. Social pain or invalidation, which denotes painful feeling following social conflicts or misunderstanding about illness legitimacy, is an important but ignored issue in the FM lexicon. While physical and social pain seem to be different and separate entities, we hypothesize that they are completely intertwined with indistinct borders in FM. Accumulating emergent neuroscience and behavioral evidence highlights the overlapping of physical and social pain in different painful conditions. However, this overlapping seems to reach its maximum in FM. This review sheds more light on the tight interconnectivity between physical and social pain in FM from the perspective of intuitional commonalities, clinical aspects, and shared neural pathways. The conceptualization of FM as an integrative physical-social pain paradigm will move us closer to necessitating the incorporation of social pain in future models of FM diagnosis and management. Key Points • Considering of social pain as one key concept is relatively mute in FM literature. • Overlapping of physical and social pain seems to be unique in FM due to its nature. • Acknowledging social pain in the FM lexicon could shift the paradigm of diagnosis and management of FM patients.
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Affiliation(s)
- Banafsheh Ghavidel-Parsa
- Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Bidari
- Department of Rheumatology, Iran University of Medical Sciences, Hazarat Rasoul Medical Complex, Sattarkhan Ave, Tehran, Iran.
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71
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Moss RA. Psychotherapy in pain management: New viewpoints and treatment targets based on a brain theory. AIMS Neurosci 2020; 7:194-207. [PMID: 32995484 PMCID: PMC7519970 DOI: 10.3934/neuroscience.2020013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/30/2020] [Indexed: 11/24/2022] Open
Abstract
The current paper provides an explanation of neurophysiological pain processing based the Dimensional Systems Model (DSM), a theory of higher cortical functions in which the cortical column is considered the binary digit for all cortical functions. Within the discussion, novel views on the roles of the basal ganglia, cerebellum, and cingulate cortex are presented. Additionally, an applied Clinical Biopsychological Model (CBM) based on the DSM will be discussed as related to psychological treatment with chronic pain patients. Three specific areas that have not been adequately addressed in the psychological treatment of chronic pain patients will be discussed based on the CBM. The treatment approaches have been effectively used in a clinical setting. Conclusions focus on a call for researchers and clinicians to fully evaluate the value of both the DSM and CBM.
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Affiliation(s)
- Robert A. Moss
- North Mississippi Regional Pain Consultants, 4381 Eason Blvd., Tupelo, MS 38801 USA
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72
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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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73
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Oh GH, Yeom CW, Shim EJ, Jung D, Lee KM, Son KL, Kim WH, Moon JY, Jung S, Kim TY, Im SA, Lee KH, Hahm BJ. The effect of perceived social support on chemotherapy-related symptoms in patients with breast cancer: A prospective observational study. J Psychosom Res 2020; 130:109911. [PMID: 31923732 DOI: 10.1016/j.jpsychores.2019.109911] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/22/2019] [Accepted: 12/20/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Few studies have examined the effect of perceived social support (PSS) on chemotherapy-related symptoms (CRS). This study examined the effect of PSS on CRS in 184 patients with breast cancer. METHODS Participants were consecutively enrolled from a tertiary general hospital in Seoul, South Korea. CRS were assessed eight times, from before the first neoadjuvant chemotherapy to six months after the end of neoadjuvant chemotherapy, with the MD Anderson Symptom Inventory. PSS was evaluated once, before the first neoadjuvant chemotherapy session, using the Multidimensional Scale of Perceived Social Support (MSPSS). Two groups were formed based on MSPSS scores: the low PSS group (n = 62) and the moderate-to-high PSS group (n = 122). Linear mixed model analyses were used to compare the change in CRS severity between the two groups during chemotherapy. RESULTS Results indicated a significant group-by-time (low PSS or moderate-to-high PSS; 8 periods of chemotherapy) interaction for pain (p = .005), nausea (p = .033), insomnia (p < .001), distress (p = .003), dyspnea (p = .014), memory loss (p = .021), vomiting (p = .016), and numbness (p = .008) in which the moderate-to-high PSS group showed significantly lower levels of increase in those symptoms during chemotherapy. Moreover, the effect of PSS on CRS differed depending on the sources of PSS. CONCLUSION Patients with moderate-to-high PSS experience less severe CRS compared with patients with low PSS during chemotherapy. The current findings indicate the potential benefits of providing social support in the management of CRS.
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Affiliation(s)
- Gyu Han Oh
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chan-Woo Yeom
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Dooyoung Jung
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Kwang-Min Lee
- Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Lak Son
- Department of Neuropsychiatry, Dongguk University Ilsan Hospital, Gyeonggi-do, Republic of Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Jung Yoon Moon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sanghyup Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Validating Invalidation: Examining the Construct Validity of the Illness Invalidation Inventory Among Individuals With Chronic Low Back Pain. Clin J Pain 2020; 36:344-351. [PMID: 32068539 DOI: 10.1097/ajp.0000000000000817] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The Illness Invalidation Inventory (3*I) was designed to assess individuals' perceived invalidation regarding chronic pain experiences. However, no study has yet investigated the psychometric properties of the 3*I among individuals with chronic low back pain (CLBP). Given the personal and societal impact of CLBP and the potential for invalidation associated with this condition, the current study sought to examine the psychometric properties of the 3*I among individuals with CLBP. MATERIALS AND METHODS Community-dwelling adults with CLBP living in the Southwestern United States (N=134) completed the 3*I. In line with previous literature, current analyses focused on the 3*I "family members" subscale. Exploratory and confirmatory factor analysis was performed on participant responses. Hierarchical linear regression analyses examined the relationship between the identified factors and participant self-reported pain severity, disability, and depression. RESULTS Exploratory factor analysis conducted on the 3*I "family members" subscale found 2 factors with high internal consistency (α>0.70) that cumulatively accounted for 49.04% of the variance in scores. Consistent with previous findings, factor loadings suggested that these factors correspond to "discounting" and "lack of understanding." Subsequent confirmatory factor analysis found that this 2-factor model demonstrated a good fit with the data. Greater perceived discounting by family members was associated with greater pain severity, disability, and depression. DISCUSSION The 2-factor model of the 3*I "family members" subscale identified in the current study reflects previous findings and extends the psychometric validity of the 3*I to a US multiethnic sample of individuals with CLBP.
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Nasir M, Ahmed A. Knowledge About Postoperative Pain and Its Management in Surgical Patients. Cureus 2020; 12:e6685. [PMID: 32104622 PMCID: PMC7026863 DOI: 10.7759/cureus.6685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Research has shown that more than 50% of patients have insufficient postoperative pain relief despite the use of multiple pain management modalities. Insufficient pain relief leads to several pathophysiological effects. One of the barriers to optimal pain relief is patient’s lack of knowledge regarding the options available for pain management and their potential side effects. In this survey, we evaluated surgical patients’ knowledge about postoperative pain and its management in patients undergoing major upper abdominal surgeries at a tertiary care hospital. Methods and Material: This was a cross-sectional survey. A total of 155 patients (18-60 years of age) scheduled to undergo elective major upper abdominal surgery were included after ethical approval and informed consent. Preoperatively, patients were interviewed through a questionnaire regarding knowledge about postoperative pain and its management. Results: The average age of the patients was 42.97 ± 13.05 years. Excellent and good knowledge were observed in 11.61% and 21.94% patients, respectively, whereas fair and poor knowledge were seen in 42.58% and 23.87%, respectively. Inadequate knowledge was more marked regarding analgesic side effects and addiction risk. Education level, history of surgery, and adequate information provision about pain management plan by surgeons preoperatively were significantly associated with a higher level of knowledge about pain and its management (p-value 0.0005, 0.002, and 0.0005, respectively). Conclusion: A considerable proportion of patients have inadequate knowledge about their postoperative pain and its management, particularly in areas of side effects and addiction risk.
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Affiliation(s)
| | - Aliya Ahmed
- Anaesthesiology, Aga Khan University, Karachi, PAK
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Morese R, Lamm C, Bosco FM, Valentini MC, Silani G. Social support modulates the neural correlates underlying social exclusion. Soc Cogn Affect Neurosci 2020; 14:633-643. [PMID: 31056647 PMCID: PMC6688450 DOI: 10.1093/scan/nsz033] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/02/2019] [Accepted: 04/29/2019] [Indexed: 12/30/2022] Open
Abstract
Ostracism threatens the human need for social interactions, with negative consequences on cognition, affect and behavior. Understanding the mechanisms that can alleviate these consequences has therefore become an important research agenda. In this study, we used behavioral and fMRI measures to advance our understanding how social support can buffer the negative effects of social exclusion. We focused on two different types of support from a friend: emotional support, conveyed by gentle touch and appraisal support, implemented as informative text messages. Seventy-one female participants underwent fMRI scanning while playing a virtual ball-tossing game in the course of which they were excluded. Two consecutive runs of the game were separated according to the participant’s experimental condition (appraisal support, emotional support and no support). Results showed that the experience of social exclusion is modulated by the type of support received. Specifically, emotional support decreased negative emotions and anterior insula activity, while appraisal support increased negative emotions, with concomitant increase of subgenual anterior cingulate cortex and decrease of temporal-parietal junction activity. These divergent effects of social support point to the necessity to characterize whether and under which conditions it represents an effective and positive resource to alleviate the negative consequences of social exclusion.
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Affiliation(s)
- Rosalba Morese
- Faculty of Communication Sciences, Università della Svizzera italiana, 6900, Lugano, Switzerland
| | - Claus Lamm
- Social, Cognitive and Affective Neuroscience Unit, Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, 1010, Vienna, Austria
| | - Francesca Marina Bosco
- Department of Psychology, research Group on Inferential Processes in Social Interaction - GIPSI, University of Turin, 10124, Turin, Italy.,Neuroscience Institute of Turin, University of Turin, 10124, Turin, Italy
| | - Maria Consuelo Valentini
- Department of Neuroradiology, Hospital-Città della Salute e della Scienza di Torino, 10126, Turin, Italy
| | - Giorgia Silani
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, University of Vienna, 1010, Vienna, Austria
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Pérez Martín Y, Pérez Muñoz M, García Ares D, Fuentes Gallardo I, Rodríguez Costa I. [The body hurts, and what about social pain? Does it hurts too?]. Aten Primaria 2020; 52:267-272. [PMID: 31892425 PMCID: PMC7118561 DOI: 10.1016/j.aprim.2019.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/21/2019] [Accepted: 10/29/2019] [Indexed: 10/25/2022] Open
Abstract
This paper studies the concept of «social pain» and its relationship with physical pain. An in-depth review of its physiology has been carried out, including similarities and differences in processing with relation to physical pain, as well as the interactions between both processes. Social pain is defined as an unpleasant emotional experience which is triggered when the individual feels excluded or rejected by people or social groups with whom they wish have a relationship. This perceived situation produces the same feelings of suffering as that of physical pain. This kind of pain is processed in the same brain areas as physical pain in its affective dimension. It may be revived mentally, even though the interpersonal conflictive situation may have ended long ago. Both types of pain are sources of stress. The confluence of both situations in the same individual adds complications and more pressure to that which is already exerted separately by both stressing factors. This circumstance must be taken into account when dealing with patients with chronic pain.
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Affiliation(s)
- Yolanda Pérez Martín
- Departamento de Enfermería y Fisioterapia, Universidad de Alcalá, Alcalá de Henares, Madrid, España.
| | - Milagros Pérez Muñoz
- Departamento de Enfermería y Fisioterapia, Universidad de Alcalá, Alcalá de Henares, Madrid, España; Centro de Salud Nuestra Señora del Pilar, Alcalá de Henares, Madrid, España; Centro de Salud Miguel de Cervantes, Alcalá de Henares, Madrid, España
| | - David García Ares
- Centro de Salud Nuestra Señora del Pilar, Alcalá de Henares, Madrid, España; Centro de Salud Los Cármenes, Madrid, España
| | - Isabel Fuentes Gallardo
- Centro de Salud Juan de Austria, Alcalá de Henares, Madrid, España; Clínica de Fisioterapia ALFIX, Alovera, Guadalajara, España
| | - Isabel Rodríguez Costa
- Departamento de Enfermería y Fisioterapia, Universidad de Alcalá, Alcalá de Henares, Madrid, España
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Fortuna KL, Brusilovskiy E, Snethen G, Brooks JM, Townley G, Salzer MS. Loneliness and its association with physical health conditions and psychiatric hospitalizations in people with serious mental illness. SOCIAL WORK IN MENTAL HEALTH 2020; 18:571-585. [PMID: 32973412 PMCID: PMC7508301 DOI: 10.1080/15332985.2020.1810197] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Explore the association between loneliness and psychiatric hospitalizations, functioning, and physical health conditions in people with serious mental illness. METHODS Data were included from 349 individuals with serious mental illnesses, aged 18+ years, who participated in two consecutive cross-sectional survey studies conducted between 2013 and 2018. RESULTS A higher number of psychiatric hospitalizations in the past six months was associated with greater loneliness. The Short-Form-12 mental component score was a highly significant correlate, accounting for a significant amount of variance in loneliness scores. The physical component score and the bodily pain subdomain of the Short-Form-12 were also significantly associated with loneliness, with individuals with lower physical functioning and greater bodily pain reporting more loneliness. Having a higher total number of health conditions, higher total number of conditions that cause pain, and the presence of at least one respiratory condition were found to be associated with greater loneliness. DISCUSSION Loneliness may be an important dimension of health as related to health conditions associated with pain, functioning, and psychiatric hospitalizations among people with serious mental illness. These finding reinforce the powerful role of socio-cultural and environmental factors in shaping whole health in people with serious mental illness.
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Affiliation(s)
- Karen L. Fortuna
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200 Lebanon, NH 03766
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, 03766
| | - Eugene Brusilovskiy
- Temple University, Department of Social and Behavioral Sciences, Philadelphia, PA, 19122
| | - Gretchen Snethen
- Temple University, Department of Social and Behavioral Sciences, Philadelphia, PA, 19122
| | | | - Greg Townley
- Portland State University, Department of Psychology, Portland, OR, 97207
| | - Mark S. Salzer
- Temple University, Department of Social and Behavioral Sciences, Philadelphia, PA, 19122
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Yao ZF, Hsieh S. Neurocognitive Mechanism of Human Resilience: A Conceptual Framework and Empirical Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245123. [PMID: 31847467 PMCID: PMC6950690 DOI: 10.3390/ijerph16245123] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/06/2019] [Accepted: 12/12/2019] [Indexed: 02/07/2023]
Abstract
Resilience is an innate human capacity that holds the key to uncovering why some people rebound after trauma and others never recover. Various theories have debated the mechanisms underlying resilience at the psychological level but have not yet incorporated neurocognitive concepts/findings. In this paper, we put forward the idea that cognitive flexibility moderates how well people adapt to adverse experiences, by shifting attention resources between cognition–emotion regulation and pain perception. We begin with a consensus on definitions and highlight the role of cognitive appraisals in mediating this process. Shared concepts among appraisal theories suggest that cognition–emotion, as well as pain perception, are cognitive mechanisms that underlie how people respond to adversity. Frontal brain circuitry sub-serves control of cognition and emotion, connecting the experience of physical pain. This suggests a substantial overlap between these phenomena. Empirical studies from brain imaging support this notion. We end with a discussion of how the role of the frontal brain network in regulating human resilience, including how the frontal brain network interacts with cognition–emotion–pain perception, can account for cognitive theories and why cognitive flexibilities’ role in these processes can create practical applications, analogous to the resilience process, for the recovery of neural plasticity.
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Affiliation(s)
- Zai-Fu Yao
- Brain and Cognition, Department of Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands;
- Cognitive Electrophysiology Laboratory: Control, Aging, Sleep, & Emotion (CASE), National Cheng Kung University, Tainan 701, Taiwan
| | - Shulan Hsieh
- Cognitive Electrophysiology Laboratory: Control, Aging, Sleep, & Emotion (CASE), National Cheng Kung University, Tainan 701, Taiwan
- Department of Psychology, College of Social Sciences, National Cheng Kung University, Tainan 701, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department and Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Correspondence: ; Tel.: +886-6275-7575 (ext. 56506)
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Yao M, Lei Y, Li P, Ye Q, Liu Y, Li X, Peng W. Shared Sensitivity to Physical Pain and Social Evaluation. THE JOURNAL OF PAIN 2019; 21:677-688. [PMID: 31683022 DOI: 10.1016/j.jpain.2019.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/19/2019] [Accepted: 10/20/2019] [Indexed: 12/31/2022]
Abstract
Many studies have demonstrated a link between experiences of physical pain and those of social rejection, both of which can trigger cognitive processes involved in detecting, orienting toward, or reacting to potentially threatening events. This study tested the hypothesis that healthy individuals who are more sensitive to physical pain are also more sensitive to social rejection. We recruited participants with high or low pain-sensitivity (HPS and LPS), as assessed by scores on a pain-sensitivity questionnaire and confirmed by experimental pain-sensitivity assessment. A modified social-judgment task was adopted in which participants first provided expectations about being liked/disliked by "peers", and then received "peers" feedback indicating acceptance or rejection. While both groups rated rejection as more unpleasant than acceptance, this difference was greater in the HPS group. Electroencephalographic results showed that only participants in the HPS group exhibited greater early delta/theta-oscillations (δ/θ-oscillations) in response to rejection than to acceptance, regardless of whether the feedback was expected or unexpected. However, both groups consistently exhibited greater late δ/θ-oscillations in response to rejection when the feedback was unexpected. These results suggest that participants in the HPS group were more sensitive to social cues signaling acceptance or rejection at early stages of information processing. Furthermore, neither early nor late δ/θ-oscillations following nonsocial feedback (correct or incorrect time-estimation) differed between groups. Altogether, these results supported the idea of shared sensitivity in detecting potentially physical and social threats in the environment. PERSPECTIVES: This study showed the greater emotional reactions and early-latency δ/θ-oscillations in response to social evaluation among healthy individuals with high pain sensitivity. It supports the idea of shared sensitivity to physical pain and social evaluation, which could be governed by a common system for detecting and monitoring potentially environmental threats.
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Affiliation(s)
- Manlin Yao
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China; Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, Guangdong, China
| | - Yi Lei
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China; Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu China
| | - Peng Li
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Qian Ye
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Yang Liu
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Xiaoyun Li
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China; Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, Guangdong, China
| | - Weiwei Peng
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China; Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, Guangdong, China.
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81
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Obstacles to social safeness in women with chronic pain: The role of fears of compassion. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00489-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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82
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Qutishat M, Abu Sharour L. Relationship Between Fear of Missing Out and Academic Performance Among Omani University Students: A Descriptive Correlation Study. Oman Med J 2019; 34:404-411. [PMID: 31555416 PMCID: PMC6745416 DOI: 10.5001/omj.2019.75] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objectives Smartphones and their applications play a key role in social connections, emotion expression, information transmission, and human achievements. However, the unfavorable side of such devices can lead users to develop a fear of missing out (FOMO) on what is happening around them, which may provoke adverse health, social, and academic conditions. We sought to investigate the extent of FOMO among undergraduate students in Oman and its relation to their academic performance. Methods We conducted a descriptive, correlational study of a sample of 147 undergraduate students at Sultan Qaboos University, Oman. The questionnaire consisted of the FOMO scale, the participants’ sociodemographic background (such as age, gender, and marital status), and their academic background (grade point average (GPA), academic year, and history of probation). Results A total of 147 undergraduate students participated in this study; the majority were male (59.2%) and single (95.2%), lived off-campus (55.8%), were in their third or fourth academic year (57.1%), and had a mean GPA of 75.3%. Almost three-quarters reported that they used at least one smartphone, and their main reason for using these devices was for social interaction. Students experienced a moderate level of FOMO; the mean score of their FOMO experiences was 28.9. Conclusions Prolonged and constant use of smartphones may influence students to rely on them holistically, causing them to think about, follow, and react excessively to the behavior of others.
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Affiliation(s)
- Mohammed Qutishat
- Community and Mental Health Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Loai Abu Sharour
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
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Paquet A, Plansont B, Girard M. Painful Life Events in Psychiatric Disorders: A Quantitative and Qualitative Analysis. Issues Ment Health Nurs 2019; 40:781-789. [PMID: 31135256 DOI: 10.1080/01612840.2019.1591546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We reported in a previous study the painful events experienced in the past in subjects with schizophrenia or major depression, in comparison to controls, and related them to the experimental pain sensitivity, anxiety, and the diagnosis. We present here the detailed analysis of these past painful events, with the aim of determining whether schizophrenic, depressive and control groups are qualitatively (type of painful events experienced, emotional or sensory components associated with pain) and quantitatively (duration, severity, and intensity) comparable concerning their past painful experiences. The questionnaire used relies on memory and feelings and will provide an indication about the way pain is experienced and memorized in daily life. The reported history of pain was not the same in the three groups. Depressed subjects differed from the others by the number of reported painful events. Painful events of everyday life, such as trauma without fracture and wounds, were the most highly reported painful events for all groups. Surprisingly, the daily pain events are associated to affective component of pain perception. Other kinds of event were differently reported between the groups. Experience of pain appears to be memorized and reported differently depending on the psychiatric disorder and type of event. The characteristics of each individual, their previous experience, contribute to the expression of psychiatric disorders, including in the field of pain. Past pain experience should be taken into account when attending someone for pain.
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Affiliation(s)
- Aude Paquet
- Centre Hospitalier Esquirol, Unité de recherche et de neurostimulation , Limoges , France
| | - Brigitte Plansont
- Centre Hospitalier Esquirol, Unité de recherche et de neurostimulation , Limoges , France
| | - Murielle Girard
- Centre Hospitalier Esquirol, Unité de recherche et de neurostimulation , Limoges , France
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Abstract
OBJECTIVE Couple interventions for chronic pain have been shown to more effectively reduce pain intensity for individuals with chronic pain (ICPs) than individual behavioral interventions or usual care. This systematic review identified randomized controlled trials of couple interventions to highlight strategies that could be incorporated into psychotherapy with ICPs and their romantic partners. METHODS The authors identified articles reporting randomized controlled trials of couple interventions for chronic pain. Three databases were searched (ie, PubMed, Embase, and PsycInfo), resulting in 18 studies and 22 articles. RESULTS Couple interventions resulted in statistically significant improvements in pain intensity compared with other conditions in 8% to 40% of the studies depending on the comparator group (i.e., control, individual intervention, another couple intervention), and in statistically significant improvements on a pain-related outcome compared with other conditions in 31% to 50% of the studies depending on the comparator group (ie, control, individual intervention, another couple intervention). Educating couples about pain was the most common strategy (83%). Jointly administered relaxation or meditation skills were included in nearly half of the interventions (48%). Many interventions taught cognitive-behavioral skills jointly to couples (39%) or to the ICP with partner encouragement (30%). Teaching couples how to request and provide assistance (30%), and encouraging partners to avoid reinforcing pain behaviors (39%), occurred frequently. ICPs and their partners were often asked to set goals (30%). DISCUSSION This review outlined strategies included in couple interventions for chronic pain that are derived from the cognitive-behavioral therapy, acceptance and commitment therapy, and operant behavioral traditions, but delivered relationally. Therapists working with ICPs and their partners may integrate these strategies into their practice to help couples who are managing chronic pain.
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Shijagurumayum Acharya R, Tveter AT, Grotle M, Eberhard-Gran M, Stuge B. Prevalence and severity of low back- and pelvic girdle pain in pregnant Nepalese women. BMC Pregnancy Childbirth 2019; 19:247. [PMID: 31307421 PMCID: PMC6631866 DOI: 10.1186/s12884-019-2398-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 07/04/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Low back pain (LBP) and pelvic girdle pain (PGP) are commonly reported during pregnancy and are known to affect pregnant women's well-being. Still, these conditions are often considered to be a normal part of pregnancy. This study assesses the prevalence and severity of LBP and/or PGP among pregnant Nepalese women, as well as exploring factors associated with LBP and PGP. METHODS A cross-sectional study with successive recruitment of pregnant women was conducted at two district hospitals in Nepal from May 2016 to May 2017. The data was collected using self-reported questionnaires. Univariate and multivariate logistic regression were used to assess the associations between independent variables and LBP and/or PGP. RESULTS A total of 1284 pregnant women were included in the study. The reported prevalence of pregnancy-related LBP and/or PGP was 34%. Pain intensity was high with a mean score (standard deviation) of 6 (2). The median (25th-75th percentiles) disability scores according to the total Pelvic Girdle Questionnaire and Oswestry Disability Index were 20 (10-32) and 30 (21-38), respectively. Even though only 52% of the women believed that the pain would disappear after delivery, concern about LBP and/or PGP was reported to be low (median 2 (0-4) (Numeric Rating Scale 0-10)). In the final model for women with LBP and/or PGP the adjusted odds ratios were for body mass index (20-24, 25-30, > 30) 0.7 (95% confidence interval (CI), 0.44-1.21), 1.1 (95% CI, 0.66-1.83), and 1.5 (95% CI, 0.78-2.94) respectively, for pelvic organ prolapse symptoms 6.6 (95% CI, 4.93-8.95) and for women with educated husbands (primary or secondary, higher secondary or above) 1.1 (95% CI, 0.53-2.16) and 1.7 (95% CI, 0.84-3.47), respectively. CONCLUSIONS Pregnant Nepalese women commonly report LBP and/or PGP. The women experienced low disability despite severe pain intensity and poor beliefs in recovery after delivery.
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Affiliation(s)
- Ranjeeta Shijagurumayum Acharya
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Kathmandu University Dhulikhel Hospital, Kavre, Nepal
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Anne Therese Tveter
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- FORMI, Oslo University Hospital, Oslo, Norway
| | - Malin Eberhard-Gran
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
- Department for Infant Mental Health, Regional Center for Child and Adolescent Mental Health, Oslo, Eastern and Southern Norway Norway
| | - Britt Stuge
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
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Martínez-Navarro M, Lara-Mayorga I, Negrete R, Bilecki W, Wawrzczak-Bargieła A, Gonçalves L, Dickenson A, Przewłocki R, Baños J, Maldonado R. Influence of behavioral traits in the inter-individual variability of nociceptive, emotional and cognitive manifestations of neuropathic pain. Neuropharmacology 2019; 148:291-304. [DOI: 10.1016/j.neuropharm.2019.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 01/10/2019] [Accepted: 01/11/2019] [Indexed: 12/20/2022]
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Social support buffers the negative influence of perceived injustice on pain interference in people living with HIV and chronic pain. Pain Rep 2019; 4:e710. [PMID: 31041415 PMCID: PMC6455689 DOI: 10.1097/pr9.0000000000000710] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/05/2018] [Accepted: 12/04/2018] [Indexed: 01/04/2023] Open
Abstract
Introduction: A growing literature attests to the overwhelming prevalence of disabling chronic pain among people living with HIV (PLWH), yet very little is known about psychosocial contributors to poor chronic pain outcomes in this population. Pain-related perception of injustice may promote pain interference by hindering engagement in daily activities among individuals with chronic pain. Social support has been shown to buffer the negative impact of harmful beliefs on well-being and facilitate adjustment to chronic pain. Objective: This cross-sectional study tested the buffering hypothesis of social support to determine whether increasing levels of social support mitigate the negative influence of perceived injustice on pain interference. Methods: A total of 60 PLWH with chronic pain completed measures of perceived injustice, social support, pain severity, and interference, as well as depressive symptoms. Results: In a regression-based model adjusted for age, sex, depressive symptoms, and pain severity, results indicated that social support significantly moderated (ie, buffered) the association between perceived injustice and pain interference (P = 0.028). Specifically, it was found that perceived injustice was significantly associated with greater pain interference among PLWH with low levels of social support (P = 0.047), but not those with intermediate (P = 0.422) or high levels of social support (P = 0.381). Conclusion: Pain-related injustice perception reflects harmful beliefs regarding severity of loss consequent to chronic pain development, a sense of unfairness, and irreparability of loss. Access to a social support network may provide an adaptive means of mitigating the negative effects of perceived injustice.
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Nejat H, Mozafari-Motlagh MR, Tozandehjani H, Samari AA. Effect of cognitive behavior therapy integrated with mindfulness on perceived pain and pain self-efficacy in patients with breast cancer. JOURNAL OF NURSING AND MIDWIFERY SCIENCES 2019. [DOI: 10.4103/jnms.jnms_60_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Erzar T, Yu L, Enright RD, Kompan Erzar K. Childhood Victimization, Recent Injustice, Anger, and Forgiveness in a Sample of Imprisoned Male Offenders. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:18-31. [PMID: 29926759 DOI: 10.1177/0306624x18781782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The links between childhood victimization, subsequent emotional dysregulation, and insufficient coping skills have been repeatedly documented in the scientific literature. However, there is a gap in the literature regarding the role of forgiveness as a coping strategy and relationships between offense-specific hurt, chronic anger, and early victimization. The goals of our study were (a) to explore how offenders cope with recent unjust treatment, and test the links between type of injustice, hurt experienced due to injustice, and use of forgiveness; (b) to test the links between childhood victimization, hurt, and chronic anger; and (c) to assess the mediating role of chronic anger in relation to hurt and forgiveness. The results reveal that multiplicity and severity of victimization exposure in the prison sample are positively associated with chronic anger, but not with hurt. The type of injustice affects the level of hurt and forgiveness, while chronic anger mediates the link between hurt and forgiveness. To improve coping and promote forgiving, offenders should be helped to identify everyday sources of stress and learn to express vulnerable feelings beneath anger.
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Affiliation(s)
| | - Lifan Yu
- 2 University of Wisconsin-Madison, USA
| | - Robert D Enright
- 2 University of Wisconsin-Madison, USA
- 3 International Forgiveness Institute, Inc., Madison, WI, USA
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90
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Pérez-Aranda A, Hofmann J, Feliu-Soler A, Ramírez-Maestre C, Andrés-Rodríguez L, Ruch W, Luciano JV. Laughing away the pain: A narrative review of humour, sense of humour and pain. Eur J Pain 2018; 23:220-233. [PMID: 30176100 DOI: 10.1002/ejp.1309] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 08/24/2018] [Accepted: 08/25/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVE The link between humour and sense of humour with pain has been a topic of research for decades. The purpose of the present article was to review the different studies that have been conducted to date on the association between humour and sense of humour with pain. DATABASES AND DATA TREATMENT The literature search was conducted using the PubMed, Science Direct and ProQuest databases. Forty-one studies were reviewed, and the results are summarized and structured into three sections: experimental pain, chronic pain and pain in children. RESULTS For experimental pain, the findings support the idea that humorous distractions, such as watching a comedy clip, increase pain tolerance, although most of the studies indicate that other non-humorous distractions produce similar effects. Regarding chronic pain, humour has been studied as a way of coping with pain and the emotional distress produced by chronic pain conditions. The results of correlational studies show significant associations between the use of humour and main variables such as anxiety and catastrophizing. Finally, concerning pain in children, similar findings to those described for the previous sections have been reported, with a notable presence of studies on clinic clown interventions, which promote emotional well-being among children and their parents, although their effectiveness in pain reduction is controversial. CONCLUSIONS The study of the link between humour and pain is still on an early stage, and overcoming the limitations of previous studies is required to strengthen the promising results that have been observed up to date. SIGNIFICANCE This review summarizes all main findings regarding humour, sense of humour and pain up until the first half of 2018 and offers a list of aspects to be considered in further studies regarding the link of humour and pain to contribute to a more systematic research.
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Affiliation(s)
- Adrián Pérez-Aranda
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Teaching Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Jennifer Hofmann
- Department of Psychology, University of Zurich, Zurich, Switzerland.,Department of Personality and Assessment, University of Zurich, Zurich, Switzerland
| | - Albert Feliu-Soler
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Teaching Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Carmen Ramírez-Maestre
- Department of Personality, Evaluation and Psychological Treatment, University of Malaga, Malaga, Spain
| | - Laura Andrés-Rodríguez
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Teaching Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
| | - Willibald Ruch
- Department of Psychology, University of Zurich, Zurich, Switzerland.,Department of Personality and Assessment, University of Zurich, Zurich, Switzerland
| | - Juan V Luciano
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Teaching Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.,Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain
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91
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Wurm M, Anniko M, Tillfors M, Flink I, Boersma K. Musculoskeletal pain in early adolescence: A longitudinal examination of pain prevalence and the role of peer-related stress, worry, and gender. J Psychosom Res 2018; 111:76-82. [PMID: 29935758 DOI: 10.1016/j.jpsychores.2018.05.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Adolescence is a time of change during which several health problems, such as pain problems, increase. Psychosocial mechanisms involved in this development, such as interpersonal stressors and worry, are still understudied, especially longitudinally. The first aim of this study was to investigate the prevalence of musculoskeletal pain in Swedish adolescents between the ages 13 and 15 using pain grades. The second aim was to study the role of peer-related stress, worry, and gender in the development of musculoskeletal pain problems over time. METHODS Adolescents in 18 public schools were followed from 7th to 9th grade (N = 1181) and answered self-report questionnaires at three time points. Prevalence was assessed at all three time points and a moderated mediation analysis investigated if peer-related stress in 7th grade predicted musculoskeletal pain two years later and if this relationship was mediated by worry in 8th grade. Gender was entered as a moderator. RESULTS In 7th grade, 8.4% of adolescents reported musculoskeletal pain with some functional impairment. In 8th and 9th grade around 10% of adolescents reported musculoskeletal pain problems, with girls reporting a higher prevalence than boys. Peer-related stress in 7th grade predicted musculoskeletal pain problems in 9th grade, mediated by worry in 8th grade. The mediation was moderated by gender: peer-related stress predicted worry for girls, but not for boys. CONCLUSION Peer-related stress and worry seem to be involved in the development of pain over time. These factors should therefore be targeted in preventative interventions and during treatment.
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Affiliation(s)
- Matilda Wurm
- Centre of Health and Medical Psychology (CHAMP), Department of Law, Psychology and Social Work, Örebro University, Örebro, Sweden.
| | - Malin Anniko
- Centre of Health and Medical Psychology (CHAMP), Department of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Maria Tillfors
- Department of Social and Psychological Studies, Psychology, Karlstad University, Karlstad, Sweden
| | - Ida Flink
- Centre of Health and Medical Psychology (CHAMP), Department of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Katja Boersma
- Centre of Health and Medical Psychology (CHAMP), Department of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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92
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Frenkel L, Swartz L, Bantjes J. Chronic traumatic stress and chronic pain in the majority world: notes towards an integrative approach. CRITICAL PUBLIC HEALTH 2018. [DOI: 10.1080/09581596.2017.1308467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Louise Frenkel
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Leslie Swartz
- Department of Psychology, Alan J Flisher Centre for Public Mental Health, Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
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93
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Schmaling KB, Fales JL, McPherson S. Longitudinal outcomes associated with significant other responses to chronic fatigue and pain. J Health Psychol 2017; 25:692-702. [PMID: 28925285 DOI: 10.1177/1359105317731824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This study investigated significant others' behavior associated with fatigue, pain, and mental health outcomes among 68 individuals with chronic fatigue (43% also had fibromyalgia) over 18 months. More negative significant others' responses were associated with more pain, poorer physical and mental health, and more fatigue-related symptoms over time. More fibromyalgia tender points covaried with more solicitous significant others' responses over time. Better mental health covaried with more distracting significant others' responses over time. The results are discussed in terms of theoretical models of the role of perceived significant others' responses on patient outcomes and recommendations for future research.
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94
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Affiliation(s)
- John F. Gunn III
- Montclair State University, Department of Family Science and Human Development, Montclair, NJ, USA
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95
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“On their own”: social isolation, loneliness and chronic musculoskeletal pain in older adults. QUALITY IN AGEING AND OLDER ADULTS 2017. [DOI: 10.1108/qaoa-03-2017-0010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore the concepts of social isolation and loneliness in relation to people with chronic musculoskeletal pain. Through these concepts, biological, psychological and social factors will be examined to consider how we can identify people at risk of social isolation and loneliness who have chronic musculoskeletal pain and then how health professionals may intervene to reduce their effects.
Design/methodology/approach
Conceptual paper.
Findings
Social isolation and loneliness are often evident in the situation of people with chronic musculoskeletal diseases. This may be bi-directional where pains may lead to social isolation and loneliness, but equally, social isolation and loneliness may exacerbate pain. Interventions to improve the symptoms of chronic musculoskeletal pain, and also approaches around social participation and engagement should be adopted in combination to ameliorate this potentially disabling scenario.
Originality/value
There remains limited evidence around the prevalence and management of social isolation and loneliness for people with chronic musculoskeletal pain. By raising awareness of social isolation and loneliness in this population, people with chronic musculoskeletal pain may be better supported to reduce the negative impact that social isolation and loneliness can have on their health and well-being.
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96
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Goubert L, Trompetter H. Towards a science and practice of resilience in the face of pain. Eur J Pain 2017; 21:1301-1315. [PMID: 28573783 DOI: 10.1002/ejp.1062] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2017] [Indexed: 12/25/2022]
Abstract
The primary objective of this paper is to discuss how a resilience approach to (chronic) pain may advance our current understanding of (mal)adaptation to pain. Different resilience perspectives are described, and future challenges for research, prevention and treatment of (chronic) pain are discussed. Literature searches were performed in Web of Science and PubMed to identify relevant literature on risk and resilience in the context of pain. Resilience can be best defined as the ability to restore and sustain living a fulfilling life in the presence of pain. The Psychological Flexibility Model, the Broaden-and-Build Theory, and Self-Determination Theory are described as theories that may provide insight into resilience within the context of (chronic) pain. We describe how a resilience paradigm shifts the outcomes to pursue in pain research and intervention and argue the need for including positive outcomes in addition to negative outcomes. Psychological flexibility, positive affect and basic psychological needs satisfaction are described as potentially important resilience mechanisms with the potential to target both sustainability and recovery from pain. A resilience approach to chronic pain may have important implications for the prevention and treatment of chronic pain problems, as it may give specific indications on how to empower patients to continue living a fulfilling life (in the presence of pain). SIGNIFICANCE The resilience approach put forward in this review spotlights sustainability of positive outcomes (e.g. engagement in meaningful activities) in the presence of pain as an outcome to pursue beyond recovery of negative outcomes. We illuminate the evidence-base and practical application of promising resilience mechanisms (positive emotions, psychological flexibility, needs satisfaction). For this article, a commentary is available at the Wiley Online Library.
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Affiliation(s)
- L Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - H Trompetter
- Department of Psychology, Health and Technology, Center for eHealth and Wellbeing Research, University of Twente, Enschede, The Netherlands
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97
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Taylor SS, Davis MC, Yeung EW, Zautra AJ, Tennen HA. Relations between adaptive and maladaptive pain cognitions and within-day pain exacerbations in individuals with fibromyalgia. J Behav Med 2017; 40:458-467. [PMID: 27853998 PMCID: PMC5530764 DOI: 10.1007/s10865-016-9811-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 11/07/2016] [Indexed: 11/29/2022]
Abstract
The objectives of this study were to assess within-person hypotheses regarding temporal cognition-pain associations: (1) do morning pain flares predict changes in two afternoon adaptive and maladaptive pain-related cognitions, and (2) do these changes in afternoon cognitions predict changes in end-of-day pain reports, which in turn, carry over to predict next morning pain in individuals with fibromyalgia. Two hundred twenty individuals with fibromyalgia completed electronic assessments of pain intensity, pain catastrophizing, and pain coping efficacy three times a day for three weeks. Multilevel structural equation modeling established that afternoon catastrophizing and coping efficacy were parallel mediators linking late morning with end-of-day pain reports (controlling for afternoon pain), in line with prediction. Catastrophizing was a stronger mediator than coping efficacy. Moreover, afternoon cognitions and end-of-day pain reports served as sequential mediators of the relation between same-day and next-day morning pain. These findings align with assertions of cognitive-behavioral theories of pain that pain flares predict changes in pain both adaptive and maladaptive cognitions, which in turn, predict further changes in pain.
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Affiliation(s)
- Shannon Stark Taylor
- Health Services Research and Development Service, Durham VA Medical Center, 508 Fulton Street, Durham, NC, 27705, USA.
| | - Mary C Davis
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Ellen W Yeung
- Department of Psychology, Arizona State University, Tempe, AZ, USA
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Alex J Zautra
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Howard A Tennen
- Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT, USA
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98
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Examining the complexities of affective experience will enhance our understanding of pain and inform new interventions designed to bolster resilience. Pain 2017; 157:1586-1587. [PMID: 27191546 DOI: 10.1097/j.pain.0000000000000614] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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99
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Affective disturbance in rheumatoid arthritis: psychological and disease-related pathways. Nat Rev Rheumatol 2016; 12:532-42. [PMID: 27411910 DOI: 10.1038/nrrheum.2016.112] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In addition to recurrent pain, fatigue, and increased rates of physical disability, individuals with rheumatoid arthritis (RA) have an increased prevalence of some mental health disorders, particularly those involving affective or mood disturbances. This narrative Review provides an overview of mental health comorbidities in RA, and discusses how these comorbidities interact with disease processes, including dysregulation of inflammatory responses, prolonged difficulties with pain and fatigue, and the development of cognitive and behavioural responses that could exacerbate the physical and psychological difficulties associated with RA. This article describes how the social context of individuals with RA affects both their coping strategies and their psychological responses to the disease, and can also impair responses to treatment through disruption of patient-physician relationships and treatment adherence. Evidence from the literature on chronic pain suggests that the resulting alterations in neural pathways of reward processing could yield new insights into the connections between disease processes in RA and psychological distress. Finally, the role of psychological interventions in the effective and comprehensive treatment of RA is discussed.
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