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Jaltare KP, Manresa JB, Niwa S, Torta DM. Verbal Support From a Stranger Reduces the Development of Mechanical Hypersensitivity: Behavioral and Neurophysiological Evidence. THE JOURNAL OF PAIN 2024:104599. [PMID: 38866120 DOI: 10.1016/j.jpain.2024.104599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/29/2024] [Accepted: 06/04/2024] [Indexed: 06/14/2024]
Abstract
Hand-holding reduces experimentally induced acute pain and buffers against the development of mechanical secondary hypersensitivity, an indirect proxy of central sensitization. Here, we tested if verbal support from a stranger, a common occurrence in clinical contexts, exerts the same effects. In this preregistered study, 44 healthy female participants were assigned to an alone or support group whereby a supportive female stranger encouraged them through the painful procedure leading to secondary mechanical hypersensitivity. Mechanical hypersensitivity was measured via self-reports and by the size of the anteroposterior and mediolateral spread of mechanical hypersensitivity. We investigated the moderating role of attachment style on self-reports and the effects of support on skin conductance level, salivary cortisol, and pinprick-evoked potentials. We also tested whether theta/beta ratio in the resting-state electroencephalogram predicted mechanical hypersensitivity. Self-reported ratings and the late part of the pinprick-evoked potentials were reduced in the support group, but the spread of mechanical hypersensitivity was not. Attachment anxiety and avoidance moderated the self-reported intensity such that individuals with higher attachment anxiety and avoidance scores reported lower intensity ratings in the support group. No significant effect of the verbal support was observed on skin conductance level and salivary cortisol. The theta/beta ratio did not predict the extent of hypersensitivity. Our data indicate that, in women, verbal support during intense pain leading to hypersensitivity is effective on some behavioral outcomes, but altogether the lack of group differences in cortisol, self-reported stress, and skin conductance does not provide strong support for the stress-buffering hypothesis. PERSPECTIVE: Verbal support by a stranger during a painful procedure leading to secondary mechanical hypersensitivity attenuated the development of some measures of mechanical hypersensitivity and associated neural responses in healthy female participants. No evidence was found for the role of stress. DATA AVAILABILITY: The authors will make all data available upon request.
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Affiliation(s)
- Ketan Prafull Jaltare
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
| | - José Biurrun Manresa
- Institute for Research and Development in Bioengineering and Bioinformatics (IBB-CONICET-UNER), Oro Verde, Argentina
| | - Saya Niwa
- Department of Biomedical Engineering, Wrocław University of Science and Technology, Wrocław, Poland
| | - Diana M Torta
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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2
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Sullivan MD, Wilson L, Amick M, Miller-Matero LR, Chrusciel T, Salas J, Zabel C, Lustman PJ, Ahmedani B, Carpenter RW, Scherrer JF. Social support and the association between post-traumatic stress disorder and risk for long-term prescription opioid use. Pain 2024:00006396-990000000-00617. [PMID: 38833573 DOI: 10.1097/j.pain.0000000000003286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/15/2024] [Indexed: 06/06/2024]
Abstract
ABSTRACT Post-traumatic stress disorder (PTSD) is common in patients with chronic pain, adversely affects chronic pain outcomes, and is associated with opioid use and adverse opioid outcomes. Social support is a robust predictor of PTSD incidence and course as well as chronic pain outcome. We determined whether the association between PTSD and persistent opioid use was modified by emotional support in a cohort of patients receiving opioids for noncancer pain. Eligible participants were ≥18 years and had completed a new period of prescription opioid use lasting 30 to 90 days. Bivariate associations between cohort characteristics and each key variable was assessed using χ2 tests for categorical variables and t-tests for continuous variables. Interaction between PTSD and emotional support was assessed by a priori stratification on low vs high emotional support. Participants (n = 808) were 53.6 (SD ± 11.6) years of age, 69.8% female, 69.6% White, and 26.4% African American. Overall, 17.2% had probable PTSD. High emotional support was significantly (P < 0.0001) more common among those without probable PTSD. Prescription opioid use at 6-month follow-up was significantly (P = 0.0368) more common among patients with vs without probable PTSD. In fully adjusted models, PTSD was no longer associated with opioid use at 6-month follow-up among participants with high emotional support. Among those with lower emotional support, PTSD was significantly associated with opioid use at 6-month follow-up in unadjusted (odds ratio = 2.40; 95% confidence interval: 1.24-4.64) and adjusted models (odds ratio = 2.39; 95% confidence interval: 1.14-4.99). Results point to the hypothesis that improvement of emotional support in vulnerable patients with chronic pain and PTSD may help reduce sustained opioid use.
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Affiliation(s)
- Mark D Sullivan
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, United States
| | - Lauren Wilson
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Matthew Amick
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Lisa R Miller-Matero
- Center for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford Health, One Ford Place, Detroit, MI, United States
| | - Timothy Chrusciel
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, United States
- Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Celeste Zabel
- Center for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford Health, One Ford Place, Detroit, MI, United States
| | - Patrick J Lustman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Brian Ahmedani
- Center for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford Health, One Ford Place, Detroit, MI, United States
| | - Ryan W Carpenter
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, United States
| | - Jeffrey F Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, United States
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, MO, United States
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3
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AuBuchon KE, Stock ML, Mathur VA, Attey B, Bowleg L. Bystander Acknowledgment Mitigates the Psychological and Physiological Pain of Racial Discrimination for Black Young Adults: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2024:104560. [PMID: 38735424 DOI: 10.1016/j.jpain.2024.104560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 05/14/2024]
Abstract
Racism increases pain sensitization and contributes to racialized pain inequities; however, research has not tested interventions targeting racism to reduce pain. In this study, we examined whether White bystanders can act to mitigate racism's pain-sensitizing effects. To simulate racial exclusion in the laboratory, Black young adults (age 18-30; N = 92) were randomly assigned to be included or excluded by White players in a ball-tossing game (Cyberball). For half of the excluded participants, White bystanders acknowledged and apologized for the racial exclusion. Participants completed a cold pressor task to assess pain threshold, tolerance, and unpleasantness, and completed a survey assessing psychological needs (ie, belongingness, self-esteem, meaningful existence, and self-control). Participants who experienced racial exclusion reported significantly more threatened psychological needs and increased laboratory pain sensitization (ie, lower pain threshold and tolerance) than those who were included. However, when a White bystander acknowledged the racism, excluded participants reported higher levels of self-control, self-esteem, and decreased pain sensitization (pain threshold and tolerance) relative to excluded participants whose experience was not acknowledged. Our findings support that racism increased Black people's pain sensitivity and provide initial evidence for White bystander acknowledgment as a health intervention. PERSPECTIVE: Continual exposure to racism likely contributes to inequities in pain sensitization. We demonstrate that acute exposure to mild racism increases acute pain sensitization. Results suggest that a bystander acknowledging witnessed racism can buffer the acute sensitizing effects of racism on pain, pointing to the potential of interpersonal interventions targeting racism. TRIAL REGISTRATION: Clinicaltrials.gov NCT06113926.
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Affiliation(s)
- Katarina E AuBuchon
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia.
| | - Michelle L Stock
- Department of Psychological and Brain Sciences, The George Washington University, Washington, District of Columbia
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
| | - Brianna Attey
- Department of Psychological and Brain Sciences, The George Washington University, Washington, District of Columbia
| | - Lisa Bowleg
- Department of Psychological and Brain Sciences, The George Washington University, Washington, District of Columbia
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Weiß M, Gründahl M, Jachnik A, Lampe EC, Malik I, Rittner HL, Sommer C, Hein G. The Effect of Everyday-Life Social Contact on Pain. J Med Internet Res 2024; 26:e53830. [PMID: 38687594 PMCID: PMC11094601 DOI: 10.2196/53830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/01/2024] [Accepted: 03/13/2024] [Indexed: 05/02/2024] Open
Abstract
Pain is a biopsychosocial phenomenon, resulting from the interplay between physiological and psychological processes and social factors. Given that humans constantly interact with others, the effect of social factors is particularly relevant. Documenting the significance of the social modulation of pain, an increasing number of studies have investigated the effect of social contact on subjective pain intensity and pain-related physiological changes. While evidence suggests that social contact can alleviate pain, contradictory findings indicate an increase in pain intensity and a deterioration of pain coping strategies. This evidence primarily stems from studies examining the effect of social contact on pain within highly controlled laboratory conditions. Moreover, pain assessments often rely on one-time subjective reports of average pain intensity across a predefined period. Ecological momentary assessments (EMAs) can circumvent these problems, as they can capture diverse aspects of behavior and experiences multiple times a day, in real time, with high resolution, and within naturalistic and ecologically valid settings. These multiple measures allow for the examination of fluctuations of pain symptoms throughout the day in relation to affective, cognitive, behavioral, and social factors. In this opinion paper, we review the current state and future relevance of EMA-based social pain research in daily life. Specifically, we examine whether everyday-life social support reduces or enhances pain. The first part of the paper provides a comprehensive overview of the use of EMA in pain research and summarizes the main findings. The review of the relatively limited number of existing EMA studies shows that the association between pain and social contact in everyday life depends on numerous factors, including pain syndromes, temporal dynamics, the nature of social interactions, and characteristics of the interaction partners. In line with laboratory research, there is evidence that everyday-life social contact can alleviate, but also intensify pain, depending on the type of social support. Everyday-life emotional support seems to reduce pain, while extensive solicitous support was found to have opposite effects. Moreover, positive short-term effects of social support can be overshadowed by other symptoms such as fatigue. Overall, gathering and integrating experiences from a patient's social environment can offer valuable insights. These insights can help interpret dynamics in pain intensity and accompanying symptoms such as depression or fatigue. We conclude that factors determining the reducing versus enhancing effects of social contact on pain need to be investigated more thoroughly. We advocate EMA as the assessment method of the future and highlight open questions that should be addressed in future EMA studies on pain and the potential of ecological momentary interventions for pain treatment.
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Affiliation(s)
- Martin Weiß
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Marthe Gründahl
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Annalena Jachnik
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Emilia Caya Lampe
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Ishitaa Malik
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Heike Lydia Rittner
- University Hospital Würzburg, Center for Interdisciplinary Medicine, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany
| | - Claudia Sommer
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | - Grit Hein
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
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Bouloukaki I, Christodoulakis A, Margetaki K, Aravantinou Karlatou A, Tsiligianni I. Exploring the Link between Social Support and Patient-Reported Outcomes in Chronic Obstructive Pulmonary Disease Patients: A Cross-Sectional Study in Primary Care. Healthcare (Basel) 2024; 12:544. [PMID: 38470655 PMCID: PMC10930953 DOI: 10.3390/healthcare12050544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
We aimed to explore the link between social support and various patient-reported outcome measures (PROMs) in primary care patients with COPD. This was a cross-sectional study with 168 patients with COPD from six primary care centers in Crete, Greece. We collected data on sociodemographic characteristics, medical history, disease-specific quality of life, the COPD Assessment Test (CAT), fatigue, the Fatigue Severity Scale (FSS), phycological parameters, Patient Health Questionnaire-9, General Anxiety Disorder-7, sleep complaints, the Pittsburg Sleep Quality Index, the Athens Insomnia scale (AIS), and the Epworth Sleepiness Scale. Social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS). Out of 168 patients with COPD, 114 (68.9%) exhibited low levels of social support. Low social support (MSPSS total ≤ 5) was positively associated with COPD symptoms (CAT score ≥ 10) (OR = 3.97, 95%CI:1.86-8.44; p < 0.01), fatigue (FSS ≥ 36) (OR = 2.74, 95%CI:1.31-5.74; p = 0.01), and insomnia symptoms (AIS ≥ 6) (OR = 5.17 95%CI:2.23-12.01; p < 0.01), while the association with depressive symptoms (PHQ-9 ≥ 10) was marginally significant (OR = 3.1, 95%CI:0.93-10.36; p = 0.07). Our results suggest that lower levels of social support are positively associated with PROMs in patients with COPD. Therefore, our findings show an additional way to improve the overall health of patients with COPD in primary care by putting social support at the epicenter of actions.
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Affiliation(s)
- Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
| | - Antonios Christodoulakis
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Katerina Margetaki
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
| | - Antonia Aravantinou Karlatou
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
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6
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Wall EK, Teo JN, Roth A, Chan ME, Brandt J, Hibri M, Richardson R, Baker KD. Effects of social buffering on fear extinction in adolescent rats. Behav Res Ther 2024; 173:104457. [PMID: 38134498 DOI: 10.1016/j.brat.2023.104457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/12/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
Across social species, the presence of another individual can reduce stress reactions to adverse stimuli, a phenomenon known as social buffering. The present study investigated whether social buffering influences the expression and extinction of learned fear in adolescence, a developmental period of diminished fear inhibition and increased social interaction. Quality of maternal care and degree of social investigation were examined as factors that may influence social buffering. In adolescence, male rats were fear conditioned and then given extinction training either in the presence of a same-age rat or alone. Animals were then tested alone for extinction retention. In two experiments, the presence of a conspecific robustly reduced conditioned fear responses during extinction training. Interestingly, a persistent social buffering effect was observed when the extinction and conditioning contexts had prominent differences in features (Experiment 1), but not when these contexts were relatively similar (Experiment 2). Neither quality of maternal care nor degree of social investigation predicted the effects of social buffering. These findings suggest that social buffering robustly dampens fear responses during adolescence when a peer is present and this suppression can persist, in some instances, even when the peer is absent.
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Affiliation(s)
- Emily K Wall
- School of Psychology, UNSW Sydney, NSW, 2052, Australia
| | - Jia Ni Teo
- School of Psychology, UNSW Sydney, NSW, 2052, Australia
| | | | - Mei E Chan
- School of Psychology, UNSW Sydney, NSW, 2052, Australia
| | | | - Maya Hibri
- School of Psychology, UNSW Sydney, NSW, 2052, Australia
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7
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Jaltare KP, Vanderijst L, Karos K, Torta DM. The impact of the social context on the development of secondary hyperalgesia: an experimental study. Pain 2023; 164:2711-2724. [PMID: 37433188 DOI: 10.1097/j.pain.0000000000002971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/28/2023] [Indexed: 07/13/2023]
Abstract
ABSTRACT Social support has been shown to reduce pain ratings and physiological responses to acute pain stimuli. Furthermore, this relationship is moderated by adult attachment styles. However, these effects have not been characterized in experimentally induced symptoms of chronic pain, such as secondary hyperalgesia (SH) which is characterized by an increased sensitivity of the skin surrounding an injury. We aimed to examine whether social support by handholding from a romantic partner can attenuate the development of experimentally induced SH. Thirty-seven women, along with their partners, participated in 2 experimental sessions 1 week apart. In both sessions, SH was induced using an electrical stimulation protocol. In the support condition, the partner was seated across from the participant holding the participant's hand during the electrical stimulation, whereas in the alone condition, the participant went through the stimulation alone. Heart rate variability was measured for both the participant as well as the partner before, during, and after the stimulation. We found that the width of the area of hyperalgesia was significantly smaller in the support condition. Attachment styles did not moderate this effect of social support on the area width. Increasing attachment avoidance was associated with both a smaller width of hyperalgesia and a smaller increase in the sensitivity on the stimulated arm. For the first time, we show that social support can attenuate the development of secondary hyperalgesia and that attachment avoidance may be associated with an attenuated development of secondary hyperalgesia.
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Affiliation(s)
- Ketan Prafull Jaltare
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - Laetitia Vanderijst
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - Kai Karos
- Section Experimental Health Psychology, Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maaastricht, the Netherlands
- Department of Clinical Psychology, Faculty of Psychology, Open University of the Netherlands, Heerlen, the Netherlands
| | - Diana M Torta
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
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Schwartz JA, Granger DA, Calvi JL, Jodis CA, Steiner B. The Implications of Stress Among Correctional Officers: A Summary of the Risks and Promising Intervention Strategies. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023:306624X231213316. [PMID: 38124325 DOI: 10.1177/0306624x231213316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
This paper provides a detailed summary and discussion of the concept of stress and how it relates to the health, wellbeing, and performance of corrections officers. In line with these objectives, we focus on three areas: (1) providing a more detailed definition of the concept of stress; (2) a discussion of the ways that increased exposure to stress may impact corrections officers' physical and mental health; and (3) a summary of prevention and intervention strategies that are relevant for corrections officers and have shown promise in dampening the consequences of increased stress exposure. More in-depth knowledge of the concept of stress and the underlying processes that link stress to negative outcomes will provide policy makers and corrections departments with an understanding of the characteristics of prevention and intervention strategies that are expected to be most effective in limiting the consequences of stress.
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Affiliation(s)
| | - Douglas A Granger
- The Johns Hopkins University, Baltimore, MD, USA
- University of California, Irvine, USA
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9
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Rodriguez KE, Graham DJ, Lucas-Thompson RG. The Effect of Mental Activation of One's Pet Dog on Stress Reactivity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6995. [PMID: 37947553 PMCID: PMC10648142 DOI: 10.3390/ijerph20216995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
Research suggests that mental activation of human social support may reduce stress reactivity. However, the extent to which social support from pets elicits a similar effect has been less explored. This study aims to determine whether the mental activation of one's pet dog reduces stress reactivity to a subsequent experimental stressor. In a 2 × 2 design, 132 dog-owning participants (Mage = 20.14; 80% female) were randomly assigned to one of two mental activation conditions (pet dog; general) and one of two stressor conditions (social-evaluative; cognitive). Data were analyzed with two-way ANOVAs with self-reported (positive/negative affect, negative self-evaluation) and physiological (blood pressure, heart rate) dependent variables. Results indicated that participants randomized to the pet dog mental activation condition had smaller decreases in positive affect from baseline to post-stressor compared to the general mental activation condition. However, there were no significant interactions between time and mental activation condition on negative affect, negative self-evaluation, heart rate, or blood pressure. Thus, the mental activation of one's pet dog had a minimal effect on stress reactivity to a cognitive or social-evaluative stressor. Results suggest that the physical presence of an animal may be an essential mechanism underlying the benefits of animal-derived social support.
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Affiliation(s)
- Kerri E. Rodriguez
- Human-Animal Bond in Colorado, School of Social Work, Colorado State University, Fort Collins, CO 80523, USA;
| | - Dan J. Graham
- Department of Psychology, Colorado State University, Fort Collins, CO 80523, USA;
- Colorado School of Public Health, Colorado State University, Fort Collins, CO 80523, USA
| | - Rachel G. Lucas-Thompson
- Colorado School of Public Health, Colorado State University, Fort Collins, CO 80523, USA
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA
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10
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Ellingsen DM, Isenburg K, Jung C, Lee J, Gerber J, Mawla I, Sclocco R, Grahl A, Anzolin A, Edwards RR, Kelley JM, Kirsch I, Kaptchuk TJ, Napadow V. Brain-to-brain mechanisms underlying pain empathy and social modulation of pain in the patient-clinician interaction. Proc Natl Acad Sci U S A 2023; 120:e2212910120. [PMID: 37339198 PMCID: PMC10293846 DOI: 10.1073/pnas.2212910120] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/25/2023] [Indexed: 06/22/2023] Open
Abstract
Social interactions such as the patient-clinician encounter can influence pain, but the underlying dynamic interbrain processes are unclear. Here, we investigated the dynamic brain processes supporting social modulation of pain by assessing simultaneous brain activity (fMRI hyperscanning) from chronic pain patients and clinicians during video-based live interaction. Patients received painful and nonpainful pressure stimuli either with a supportive clinician present (Dyadic) or in isolation (Solo). In half of the dyads, clinicians performed a clinical consultation and intake with the patient prior to hyperscanning (Clinical Interaction), which increased self-reported therapeutic alliance. For the other half, patient-clinician hyperscanning was completed without prior clinical interaction (No Interaction). Patients reported lower pain intensity in the Dyadic, relative to the Solo, condition. In Clinical Interaction dyads relative to No Interaction, patients evaluated their clinicians as better able to understand their pain, and clinicians were more accurate when estimating patients' pain levels. In Clinical Interaction dyads, compared to No Interaction, patients showed stronger activation of the dorsolateral and ventrolateral prefrontal cortex (dlPFC and vlPFC) and primary (S1) and secondary (S2) somatosensory areas (Dyadic-Solo contrast), and clinicians showed increased dynamic dlPFC concordance with patients' S2 activity during pain. Furthermore, the strength of S2-dlPFC concordance was positively correlated with self-reported therapeutic alliance. These findings support that empathy and supportive care can reduce pain intensity and shed light on the brain processes underpinning social modulation of pain in patient-clinician interactions. Our findings further suggest that clinicians' dlPFC concordance with patients' somatosensory processing during pain can be boosted by increasing therapeutic alliance.
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Affiliation(s)
- Dan-Mikael Ellingsen
- Department of Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo0372, Norway
- Department of Psychology, Pedagogy and Law, School of Health Sciences, Kristiania University College, Oslo0107, Norway
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
| | - Kylie Isenburg
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
| | - Changjin Jung
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- KM Research Science Division, Korea Institute of Oriental Medicine, Daejeon461-24, Republic of Korea
| | - Jeungchan Lee
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA02129
| | - Jessica Gerber
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
| | - Ishtiaq Mawla
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
| | - Roberta Sclocco
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Radiology, Logan University, Chesterfield, MO63017
| | - Arvina Grahl
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA02129
| | - Alessandra Anzolin
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA02129
| | - Robert R. Edwards
- Department of Anesthesiology, Brigham and Women’s Hospital, Boston, MA02115
| | - John M. Kelley
- School of Social Sciences, Communication, and Humanities, Endicott College, Beverley, MA02115
- Program in Placebo Studies & Therapeutic Encounter, Harvard Medical School, Boston, MA02215
| | - Irving Kirsch
- Program in Placebo Studies & Therapeutic Encounter, Harvard Medical School, Boston, MA02215
| | - Ted J. Kaptchuk
- Program in Placebo Studies & Therapeutic Encounter, Harvard Medical School, Boston, MA02215
| | - Vitaly Napadow
- Athinoula A. Martinos Center for Biomedical Imaging, Massa, chusetts General Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA02129
- Department of Radiology, Logan University, Chesterfield, MO63017
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11
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Neumann I, Käthner I, Gromer D, Pauli P. Impact of perceived social support on pain perception in virtual reality. COMPUTERS IN HUMAN BEHAVIOR 2023. [DOI: 10.1016/j.chb.2022.107490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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12
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Kim SY, Park SY, Mathai B, Daheim J, France C, Delgado B. Cultural dimensions of individualism and collectivism and risk of opioid misuse: A test of Social Cognitive Theory. J Clin Psychol 2022; 78:2341-2356. [PMID: 35881671 PMCID: PMC9796527 DOI: 10.1002/jclp.23425] [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: 08/20/2021] [Revised: 07/08/2022] [Accepted: 07/17/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite the critical role social and cultural contexts play in pain experience, limited theoretical and empirical attention has been devoted to the interplay between social, cognitive, cultural, and psychological factors in chronic pain management and the risk of opioid misuse. METHODS Using structural equation modeling, the present study tested the Social Cognitive Theory (SCT) of chronic pain management and risk of opioid misuse in the context of intraindividual cultural dimensions of individualism and collectivism among 316 ethnically diverse adults with chronic pain in the United States. RESULTS Social cognitive predictors account for a significant amount of variance in pain dysfunction and risk of opioid misuse in adults with chronic pain. Satisfaction with pain support was positively associated with both greater pain acceptance and greater pain self-efficacy. Individualism was found to be positively associated with satisfaction with pain support, pain self-efficacy, and pain acceptance but negatively associated with the risk of opioid misuse. Collectivism was positively associated with the risk of opioid misuse. CONCLUSIONS The study findings not only empirically support using SCT for adults with chronic pain, but also provide a more thorough conceptual framework that highlights the intracultural diversity and interplay among social, cognitive, and psychological factors that affect pain experience and the risk of opioid misuse among adults with chronic pain.
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Affiliation(s)
- Shin Ye Kim
- Department of Counseling PsychologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Sung Yong Park
- Department of PsychologyKeimyung UniversityDaeguSouth Korea
| | - Babetta Mathai
- Department of Clinical and Health PsychologyUniversity of Florida Health Science CenterGainesvilleFloridaUSA
| | - Jacob Daheim
- Department of Psychological SciencesTexas Tech UniversityLubbockTexasUSA
| | | | - Betsaida Delgado
- Department of Psychological SciencesTexas Tech UniversityLubbockTexasUSA
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13
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Sailer LL, Patel PP, Park AH, Moon J, Hanadari-Levy A, Ophir AG. Synergistic consequences of early-life social isolation and chronic stress impact coping and neural mechanisms underlying male prairie vole susceptibility and resilience. Front Behav Neurosci 2022; 16:931549. [PMID: 35957922 PMCID: PMC9358287 DOI: 10.3389/fnbeh.2022.931549] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic stress can be challenging, lead to maladaptive coping strategies, and cause negative mental and physical health outcomes. Early-life adversity exposes developing young to physical or psychological experiences that risks surpassing their capacity to effectively cope, thereby impacting their lifetime physical and mental wellbeing. Sensitivity to stressful events, like social isolation, has the potential to magnify stress-coping. Chronic stress through social defeat is an established paradigm that models adverse early-life experiences and can trigger enduring alterations in behavioral and neural phenotypes. To assess the degree to which stress resilience and sensitivity stemming from early-life chronic stress impact sociability, we exposed male prairie voles to chronic social defeat stress (CSDS) during adolescence. We simultaneously exposed subjects to either social isolation (CSDS+Isol) or group housing (CSDS+Soc) during this crucial time of development. On PND41, all subjects underwent a social approach test to examine the immediate impact of isolation, CSDS, or their combined effects on sociability. Unlike the CSDS+Isol group which primarily displayed social avoidance, the CSDS+Soc group was split by individuals exhibiting susceptible or resilient stress phenotypes. Notably, the Control+Soc and CSDS+Soc animals and their cage-mates significantly gained body weight between PND31 and PND40, whereas the Control+Isol and CSDS+Isol animals did not. These results suggest that the effects of early-life stress may be mitigated by having access to social support. Vasopressin, oxytocin, and opioids and their receptors (avpr1a, oxtr, oprk1, oprm1, and oprd1) are known to modulate social and stress-coping behaviors in the lateral septum (LS). Therefore, we did an mRNA expression analysis with RT-qPCR of the avpr1a, oxtr, oprk1, oprm1, and oprd1 genes to show that isolation and CSDS, or their collective influence, can potentially differentially bias sensitivity of the LS to early-life stressors. Collectively, our study supports the impact and dimensionality of early-life adversity because the type (isolation vs. CSDS), duration (acute vs. chronic), and combination (isolation + CSDS) of stressors can dynamically alter behavioral and neural outcomes.
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14
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Vitale EM, Smith AS. Neurobiology of Loneliness, Isolation, and Loss: Integrating Human and Animal Perspectives. Front Behav Neurosci 2022; 16:846315. [PMID: 35464141 PMCID: PMC9029604 DOI: 10.3389/fnbeh.2022.846315] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/21/2022] [Indexed: 12/30/2022] Open
Abstract
In social species such as humans, non-human primates, and even many rodent species, social interaction and the maintenance of social bonds are necessary for mental and physical health and wellbeing. In humans, perceived isolation, or loneliness, is not only characterized by physical isolation from peers or loved ones, but also involves negative perceptions about social interactions and connectedness that reinforce the feelings of isolation and anxiety. As a complex behavioral state, it is no surprise that loneliness and isolation are associated with dysfunction within the ventral striatum and the limbic system - brain regions that regulate motivation and stress responsiveness, respectively. Accompanying these neural changes are physiological symptoms such as increased plasma and urinary cortisol levels and an increase in stress responsivity. Although studies using animal models are not perfectly analogous to the uniquely human state of loneliness, studies on the effects of social isolation in animals have observed similar physiological symptoms such as increased corticosterone, the rodent analog to human cortisol, and also display altered motivation, increased stress responsiveness, and dysregulation of the mesocortical dopamine and limbic systems. This review will discuss behavioral and neuropsychological components of loneliness in humans, social isolation in rodent models, and the neurochemical regulators of these behavioral phenotypes with a neuroanatomical focus on the corticostriatal and limbic systems. We will also discuss social loss as a unique form of social isolation, and the consequences of bond disruption on stress-related behavior and neurophysiology.
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Affiliation(s)
- Erika M. Vitale
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS, United States
| | - Adam S. Smith
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Kansas, Lawrence, KS, United States
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15
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Wagner C, Gaab J, Locher C, Hediger K. Lack of Effects of the Presence of a Dog on Pain Perception in Healthy Participants-A Randomized Controlled Trial. FRONTIERS IN PAIN RESEARCH 2022; 2:714469. [PMID: 35295505 PMCID: PMC8915708 DOI: 10.3389/fpain.2021.714469] [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: 05/25/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Animal-assisted interventions (AAIs) have been shown to be effective in the treatment of pain. Studies suggest that relationships with animals can have comparable qualities to relationships with humans and that this enables animals to provide social support. Further, the presence of an animal can strengthen the therapeutic alliance between patients and treatment providers. This suggests that the analgesic effects of AAI might be mediated by social support from an animal or by strengthening the alliance between the patient and the treatment provider. To test these assumptions, we examined the effects of the presence of a dog on experimentally induced pain in a pain assessment and a pain therapy context. Hundred thirty-two healthy participants were randomly assigned to the conditions “pain,” “pain + dog,” “pain + placebo,” or “pain + placebo + dog.” We collected baseline and posttreatment measurements of heat-pain tolerance and the heat-pain threshold and of the corresponding subjective ratings of heat-pain intensity and unpleasantness as well as of participants' perceptions of the study investigator. The primary outcome was heat-pain tolerance. The presence of the dog did not influence the primary outcome (“pain” vs. “pain + dog”: difference = 0.04, CI = −0.66 to 0.74, p = 0.905; “pain + placebo” vs. “pain + placebo + dog”: difference = 0.43, CI = −0.02 to 0.88, p = 0.059). Participants did also not perceive the study investigator to be more trustworthy in the presence of the dog (“pain” vs. “pain + dog”: difference = 0.10, CI = −0.67 to 0.87, p = 0.796; “pain + placebo” vs. “pain + placebo + dog”: difference = 0.11, CI = −0.43 to 0.64, p = 0.695). The results indicate that the mere presence of a dog does not contribute to pain reduction and that the analgesic effects of AAI that previous studies have found is not replicated in our study as AAI did not increase perceived social support and had no effect on the alliance between the participant and the treatment provider. We assume that the animal most likely needs to be an integrated and plausible part of the treatment rationale so that participants are able to form a treatment-response expectation toward AAI. Clinical Trial Registration: This study was preregistered as a clinical trial on www.clinicaltrials.gov (Identifier: NCT0389814).
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Affiliation(s)
- Cora Wagner
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Cosima Locher
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.,School of Psychology, University of Plymouth, Plymouth, United Kingdom.,Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States
| | - Karin Hediger
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.,Clinic for Neurorehabilitation and Paraplegiology, REHAB Basel, Basel, Switzerland.,Human and Animal Health Unit, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Faculty of Psychology, Open University, Heerlen, Netherlands
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16
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Braunwalder C, Ehrmann C, Hodel J, Müller R, von Matt D, Fekete C. Pain trajectories during initial rehabilitation after spinal cord injury: Do psychosocial resources and mental health predict trajectories? Arch Phys Med Rehabil 2022; 103:1294-1302. [DOI: 10.1016/j.apmr.2022.01.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/04/2022] [Accepted: 01/14/2022] [Indexed: 11/02/2022]
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17
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Gründahl M, Retzlaff L, Herrmann MJ, Hein G, Andreatta M. The skin conductance response indicating pain relief is independent of self or social influence on pain. Psychophysiology 2021; 59:e13978. [PMID: 34859462 PMCID: PMC9286856 DOI: 10.1111/psyp.13978] [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: 03/12/2021] [Revised: 10/13/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022]
Abstract
Pain relief is defined as the ease of pain and is thus highly relevant for clinical applications and everyday life. Given that pain relief is based on the cessation of an aversive pain experience, it is reasonable to assume that pain relief learning would also be shaped by factors that alter subjective and physiological pain responses, such as social presence or a feeling of control. To date, it remains unclear whether and how factors that shape autonomic pain responses might affect pain relief learning. Here, we investigated how pain relief learning is shaped by two important factors known to modulate pain responses, i.e. social influence and controllability of pain. Skin conductance responses (SCRs) were recorded while participants learned to associate a formerly neutral stimulus with pain relief under three different pain conditions. In the social‐influence condition (N = 34), the pain stimulation could be influenced by another person’s decisions. In the self‐influence condition (N = 31), the participants themselves could influence the pain stimulation. Finally, in the no‐influence condition (N = 32), pain stimulation was simply delivered without any influence. According to our results, the SCRs elicited by the stimulus that was associated with pain relief were significantly smaller compared to the SCRs elicited by a neutral control stimulus, indicating pain relief learning. However, there was no significant difference in the pain relief learning effect across the groups. These results suggest that physiological pain relief learning in humans is not significantly influenced by social influence and pain controllability. The contents of this page will be shown on the eTOC on the online version only. It will not be published as part of the article PDF. Subjective and physiological pain responses can be altered by social support or pain controllability. Pain relief strongly depends on the perceived pain, but we found that it is less influenceable. Neither social nor self‐influence changed the magnitude of physiological pain‐relief responses. We conclude that pain relief is a basic mechanism not easily influenced by circumstantial manipulations.
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Affiliation(s)
- Marthe Gründahl
- Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, University of Würzburg, Würzburg, Germany
| | - Leonie Retzlaff
- Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, University of Würzburg, Würzburg, Germany
| | - Martin J Herrmann
- Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, University of Würzburg, Würzburg, Germany
| | - Grit Hein
- Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, University of Würzburg, Würzburg, Germany
| | - Marta Andreatta
- Department of Psychology, Education & Child Studies/Clinical Psychology, Erasmus University of Rotterdam, Rotterdam, The Netherlands.,Department of Biological Psychology, Clinical Psychology, and Psychotherapy, University of Würzburg, Würzburg, Germany
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18
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Rassu FS, McFadden M, Aaron RV, Wegener ST, Ephraim PL, Lane E, Brennan G, Minick KI, Fritz JM, Skolasky RL. The Relationship between Neighborhood Deprivation and Perceived Changes for Pain-Related Experiences among U.S. Patients with Chronic Low Back Pain during the COVID-19 Pandemic. PAIN MEDICINE 2021; 22:2550-2565. [PMID: 34181008 DOI: 10.1093/pm/pnab179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Disruptions caused by the COVID-19 pandemic could disproportionately affect the health of vulnerable populations, including patients experiencing persistent health conditions (i.e., chronic pain), along with populations living within deprived, lower socioeconomic areas. The current cross-sectional study characterized relationships between neighborhood deprivation and perceived changes in pain-related experiences during the COVID-19 pandemic (early-September to mid-October 2020) for adult patients (N = 97) with nonspecific chronic low back pain. METHODS We collected self-report perceived experiences from participants enrolled in an ongoing pragmatic randomized trial across medical centers within the Salt Lake City, Utah and Baltimore, Maryland metropolitans. The Area Deprivation Index (composite of 17 U.S. Census deprivation metrics) reflected neighborhood deprivation based on participants' zip codes. RESULTS Although those living in the neighborhoods with greater deprivation endorsed significantly poorer physical (pain severity, pain interference, physical functioning), mental (depression, anxiety), and social health during the pandemic, there were no significant differences for perceived changes in pain-related experiences (pain severity, pain interference, sleep quality) between levels of neighborhood deprivation since the onset of the pandemic. However, those in neighborhoods with greater deprivation endorsed disproportionately worse perceived changes in pain coping, social support, and mood since the pandemic. CONCLUSIONS The current findings offer evidence that changes in pain coping during the pandemic may be disproportionately worse for those living in deprived areas. Considering poorer pain coping may contribute to long-term consequences, the current findings suggest the need for further attention and intervention to reduce the negative affect of the pandemic for such vulnerable populations.
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Affiliation(s)
- Fenan S Rassu
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Molly McFadden
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Rachel V Aaron
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patti L Ephraim
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth Lane
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Gerard Brennan
- Rehabilitation Services, Intermountain Healthcare, Salt Lake City, UT, USA
| | - Kate I Minick
- Rehabilitation Services, Intermountain Healthcare, Salt Lake City, UT, USA
| | - Julie M Fritz
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Richard L Skolasky
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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19
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Davis AJ, Crittenden B, Cohen E. Effects of social support on performance outputs and perceived difficulty during physical exercise. Physiol Behav 2021; 239:113490. [PMID: 34139269 DOI: 10.1016/j.physbeh.2021.113490] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 12/28/2022]
Abstract
Perceptions of social support influence adaptive self-regulatory processes that maintain health, produce feelings, and motivate behavior. Although associations between sociality and health are increasingly well-understood, there is little systematic research into the effects of social support on fatigue, physical discomfort, exertion, and output regulation in physical activity. We conducted an experimental study to investigate the effect of social support on performance and perceived difficulty in a handgrip force task while controlling for audience and reputational factors. Effects were compared with those of another established psychogenic performance enhancer (a placebo ergogenic supplement). During handgrip trials over varying levels of objective difficulty, participants viewed photographs of a support figure or stranger while in a placebo or control condition. Results revealed a significant main effect of the social support cue on handgrip performance outputs, and a significant interaction with objective trial difficulty - relative to the stranger cue, the support-figure cue significantly increased handgrip performance outputs and the effect was larger in more objectively difficult trials. Moreover, despite producing greater handgrip outputs, participants perceived trials to be significantly less difficult in the social support condition. Though there was a non-significant main effect of placebo (vs. control) on performance outputs, participants perceived trials in the placebo condition to be significantly less difficult. The research contributes new evidence and theory on the role of perceived social support - an important (energetic) resource - in human performance and motivates further enquiry into how cues to support alter perceived effort and performance outputs in strenuous physical challenges.
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Affiliation(s)
- Arran J Davis
- Institute of Cognitive and Evolutionary Anthropology, University of Oxford, 64 Banbury Road, Oxford, OX2 6PN, United Kingdom.
| | - Ben Crittenden
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - Emma Cohen
- Institute of Cognitive and Evolutionary Anthropology, University of Oxford, 64 Banbury Road, Oxford, OX2 6PN, United Kingdom; Wadham College, Parks Road, Oxford, OX1 3PN, United Kingdom
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20
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Riquelme I, Escobio-Prieto I, Oliva-Pascual-Vaca Á, Heredia-Rizo AM, Montoya P. Effect of Social Support in Pain Sensitivity in Children with Cerebral Palsy and Typically Developing Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094661. [PMID: 33925690 PMCID: PMC8125433 DOI: 10.3390/ijerph18094661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/25/2021] [Indexed: 12/03/2022]
Abstract
Pain and abnormal somatosensory processing are important associated conditions in children and adolescents with cerebral palsy (CP). Perceived social support is highly relevant for pain perception and coping. Aim: The aim of the present study was to assess the influence of social support on pain sensitivity in children and adolescents with cerebral palsy and healthy peers. Design: Cross-sectional study. Methods: Pressure pain thresholds were assessed in 42 children and adolescents with CP and 190 healthy peers during three different conditions: alone, with their mother and with a stranger. Results: Children with CP reported lower pain sensitivity when they were with their mother than being alone or with a stranger, whereas healthy peers did not experience different pain sensitivity related to the social condition. Sex or clinical characteristics did not affect the relationship between pain perception and social support. Conclusion: The present study shows how children with CP are highly affected by social and contextual influences for regulating pain sensitivity. Solicitous parental support may enhance pain perception in children with CP. Further research on the topic is warranted in order to attain well-founded conclusions for clinical practice.
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Affiliation(s)
- Inmaculada Riquelme
- Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Carretera de Valldemossa km 7.5, 07122 Palma de Mallorca, Spain;
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Correspondence: ; Tel.: +34-971-171-310; Fax: +34-971-172-309
| | - Isabel Escobio-Prieto
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain; (I.E.-P.); (Á.O.-P.-V.); (A.M.H.-R.)
| | - Ángel Oliva-Pascual-Vaca
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain; (I.E.-P.); (Á.O.-P.-V.); (A.M.H.-R.)
| | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain; (I.E.-P.); (Á.O.-P.-V.); (A.M.H.-R.)
| | - Pedro Montoya
- Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Carretera de Valldemossa km 7.5, 07122 Palma de Mallorca, Spain;
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21
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Morato C, Guerra P, Bublatzky F. Verbal threat learning does not spare loved ones. Sci Rep 2021; 11:5469. [PMID: 33750850 PMCID: PMC7970900 DOI: 10.1038/s41598-021-84921-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/22/2021] [Indexed: 01/31/2023] Open
Abstract
Significant others provide individuals with a sense of safety and security. However, the mechanisms that underlie attachment-induced safety are hardly understood. Recent research has shown beneficial effects when viewing pictures of the romantic partner, leading to reduced pain experience and defensive responding. Building upon this, we examined the inhibitory capacity of loved face pictures on fear learning in an instructed threat paradigm. Pictures of loved familiar or unknown individuals served as signals for either threat of electric shocks or safety, while a broad set of psychophysiological measures was recorded. We assumed that a long-term learning history of beneficial relations interferes with social threat learning. Nevertheless, results yielded a typical pattern of physiological defense activation towards threat cues, regardless of whether threat was signaled by an unknown or a loved face. These findings call into question the notion that pictures of loved individuals are shielded against becoming threat cues, with implications for attachment and trauma research.
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Affiliation(s)
- Cristina Morato
- Department of Personality, Assessment, and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | - Pedro Guerra
- Department of Personality, Assessment, and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain.
| | - Florian Bublatzky
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany.
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22
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Li W, Mao Y, Gu Y, Lu C, Gu X, Hua B, Pan W, Xi Q, Xu B. Effects of Hand Holding on Anxiety and Pain During Prostate Biopsies: A Pilot Randomized Controlled Trial. Patient Prefer Adherence 2021; 15:1593-1600. [PMID: 34295153 PMCID: PMC8291963 DOI: 10.2147/ppa.s321175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/10/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Effective pain management is limited for patients during prostate biopsy (PBx). Touch support, such as hand holding, has stress-buffering benefits and effective analgesic effects. We conducted a prospective, single-center randomized clinical trial to assess whether hand holding can reduce patient anxiety, pain, and dissatisfaction during PBx. METHODS Between April 2020 and October 2020, 120 male patients were randomized into three groups: a hand holding with relatives (HR) group, a hand holding with strangers (HS) group and a control group. A visual analog scale (VAS) was used for self-assessments of pain and satisfaction. Anxiety levels were quantified according to the State-Trait Anxiety Inventory (STAI). Hemodynamic changes were also measured. RESULTS The degree of pain and anxiety in the hand-holding groups was significantly better than that in the control group (P<0.001), and the patients were more willing to undergo repeat PBx (P=0.017). The anxiety levels in the HR group were significantly lower than those in the HS group (P=0.019). During PBx, the changes in systolic blood pressure and heart rate in the hand-holding groups were more stable than those in the control group (P<0.01), and the fluctuations in heart rate in the HR group were smaller than those in the HS group (P<0.01). CONCLUSION Hand holding, especially with relatives, can promote incremental reductions in anxiety, pain and dissatisfaction in patients during PBx. Hence, we recommend hand holding with relatives as an effective adjunct during PBx.
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Affiliation(s)
- Wenfeng Li
- Department of Urology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Yuanshen Mao
- Department of Urology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Yufei Gu
- Department of Urology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Chao Lu
- Department of Urology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Xin Gu
- Department of Urology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Bao Hua
- Department of Urology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Weixin Pan
- Department of Urology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Qinghong Xi
- Department of Urology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Bin Xu
- Department of Urology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- Correspondence: Bin Xu; Qinghong Xi Department of Urology, The Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of ChinaTel +862156691101 Email ;
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Goldstein P, Losin EAR, Anderson SR, Schelkun VR, Wager TD. Clinician-Patient Movement Synchrony Mediates Social Group Effects on Interpersonal Trust and Perceived Pain. THE JOURNAL OF PAIN 2020; 21:1160-1174. [PMID: 32544602 PMCID: PMC7722052 DOI: 10.1016/j.jpain.2020.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/24/2020] [Accepted: 03/22/2020] [Indexed: 12/19/2022]
Abstract
Pain is an unfortunate consequence of many medical procedures, which in some patients becomes chronic and debilitating. Among the factors affecting medical pain, clinician-patient (C-P) similarity and nonverbal communication are particularly important for pain diagnosis and treatment. Participants (N = 66) were randomly assigned to clinician and patient roles and were grouped into C-P dyads. Clinicians administered painful stimuli to patients as an analogue of a painful medical procedure. We manipulated the perceived C-P similarity of each dyad using groups ostensibly based on shared beliefs and values, and each patient was tested twice: Once with a same group clinician (concordant, CC) and once with a clinician from the other group (discordant, DC). Movement synchrony was calculated as a marker of nonverbal communication. We tested whether movement synchrony mediated the effects of group concordance on patients' pain and trust in the clinician. Movement synchrony was higher in CC than DC dyads. Higher movement synchrony predicted reduced pain and increased trust in the clinician. Movement synchrony also formally mediated the group concordance effects on pain and trust. These findings increase our understanding of the role of nonverbal C-P communication on pain and related outcomes. Interpersonal synchrony may be associated with better pain outcomes, independent of the specific treatment provided. PERSPECTIVE: This article demonstrates that movement synchrony in C-P interactions is an unobtrusive measure related to their relationship quality, trust toward the clinician, and pain. These findings suggest that interpersonal synchrony may be associated with better patient outcomes, independent of the specific treatment provided.
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Affiliation(s)
- Pavel Goldstein
- Institute of Cognitive Science, University of Colorado, Boulder, Colorado; The School of Public Health, University of Haifa, Israel
| | | | | | - Victoria R Schelkun
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire; Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado.
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Pan Y, Olsson A, Golkar A. Social safety learning: Shared safety abolishes the recovery of learned threat. Behav Res Ther 2020; 135:103733. [PMID: 33011485 DOI: 10.1016/j.brat.2020.103733] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/09/2020] [Accepted: 09/20/2020] [Indexed: 12/11/2022]
Abstract
Humans, like other social animals, learn about threats and safety in the environment through social cues. Yet, the processes that contribute to the efficacy of social safety learning during threat transmission remain unknown. Here, we developed a novel dyadic model of associative threat and extinction learning. In three separate social groups, we manipulated whether safety information during extinction was acquired via direct exposure to the conditioned stimulus (CS) in the presence of another individual (Direct exposure), via observation of other's safety behavior (Vicarious exposure), or via the combination of both (Shared exposure).These groups were contrasted against a fourth group receiving direct CS exposure alone (Asocial exposure). Based on skin conductance responses, we observed that all social groups outperformed asocial learning in inhibiting the recovery of threat, but only Shared exposure abolished threat recovery. These results suggest that social safety learning is optimized by a combination of direct exposure and vicariously transmitted safety signals. This work might help develop exposure therapies used to treat symptoms of threat and anxiety-related disorders to counteract maladaptive fears in humans.
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Affiliation(s)
- Yafeng Pan
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Armita Golkar
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden.
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Duschek S, Nassauer L, Montoro CI, Bair A, Montoya P. Dispositional empathy is associated with experimental pain reduction during provision of social support by romantic partners. Scand J Pain 2020; 20:205-209. [PMID: 31433786 DOI: 10.1515/sjpain-2019-0025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 08/02/2019] [Indexed: 11/15/2022]
Abstract
Background and aims While social interactions like verbal support and physical touch have repeatedly been shown to reduce experimental pain, analgesic effects of passive social support, i.e. the sole physical presence of a supportive other, remain unclear. Moreover, little is known about individual factors influencing the extent of pain attenuation during social support. This study investigated analgesic effects of passive support by a romantic partner and the role of partner empathy therein. Methods In 48 heterosexual couples, sensitivity to pressure pain was assessed; each participant was tested alone and in the passive presence of his/her partner. Dispositional empathy was quantified by a questionnaire. Results In the presence, as compared to absence, of their partners men and women exhibited higher pain threshold and tolerance, as well as lower sensory and affective pain ratings on constant pressure stimuli. Partner empathy was positively associated with pain tolerance and inversely associated with sensory pain experience. Conclusions The results confirm the analgesic effects of social support, which may even occur without verbal or physical contact. Partner empathy may buffer affective distress during pain exposure, thereby reducing pain sensitivity and promoting pain coping. These processes may occur solely due to a partner's physical presence and do not necessarily require direct empathetic feedback.
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Affiliation(s)
- Stefan Duschek
- UMIT - University of Health Sciences Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, 6060 Hall in Tirol, Austria
| | - Lena Nassauer
- UMIT - University of Health Sciences Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, 6060 Hall in Tirol, Austria
| | | | - Angela Bair
- UMIT - University of Health Sciences Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, 6060 Hall in Tirol, Austria
| | - Pedro Montoya
- University of the Balearic Islands, Palma, Illes Balears, Spain
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Dezfouli SMM, Khosravi S. Pain in child patients: A review on managements. Eur J Transl Myol 2020; 30:8712. [PMID: 32782752 PMCID: PMC7385698 DOI: 10.4081/ejtm.2019.8712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/15/2019] [Indexed: 12/14/2022] Open
Abstract
Pain has been known as one of the major universal health concerns about ill children, because of its morbidity and potential mortality. Pain suitable evaluation is a challenge in children because the verbalization is difficult. Low clinical information, few pediatric researches, and the worry of opioid side effects make difficult to provide satisfactory treatments. Many pharmacologic and non-pharmacologic strategies to manage pain exist for pediatric pain treatment. The purpose of this review article is to describe exhaustively pain mechanism, evaluation and management by review literature from January 2000 to January 2019 using PubMed, EMBASE, MEDLINE, LILACS databases. Pharmacological and integrative non-pharmacological therapies has been indicated in acute and chronic pain treatment. Opioids and opioid-sparing agents target nociceptive and neuropathic pain. With due attention to available results, an early combination of pharmacological and integrative non pharmacological treatments are indicated in children pain management.
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Affiliation(s)
| | - Shaqayeq Khosravi
- (1) Department of Emergency Medicine, School of Medicine, Iran University of Medical Sciences, Aliasghar children Hospital, Tehran, Iran
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27
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Stevens M, Cruwys T, Murray K. Social support facilitates physical activity by reducing pain. Br J Health Psychol 2020; 25:576-595. [DOI: 10.1111/bjhp.12424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/15/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Mark Stevens
- Research School of Psychology The Australian National University Canberra Australian Capital Territory Australia
| | - Tegan Cruwys
- Research School of Psychology The Australian National University Canberra Australian Capital Territory Australia
| | - Kristen Murray
- Research School of Psychology The Australian National University Canberra Australian Capital Territory Australia
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Abstract
Pain has been known as one of the major universal health concerns about ill children, because of its morbidity and potential mortality. Pain suitable evaluation is a challenge in children because the verbalization is difficult. Low clinical information, few pediatric researches, and the worry of opioid side effects make difficult to provide satisfactory treatments. Many pharmacologic and non-pharmacologic strategies to manage pain exist for pediatric pain treatment. The purpose of this review article is to describe exhaustively pain mechanism, evaluation and management by review literature from January 2000 to January 2019 using PubMed, EMBASE, MEDLINE, LILACS databases. Pharmacological and integrative non-pharmacological therapies has been indicated in acute and chronic pain treatment. Opioids and opioid-sparing agents target nociceptive and neuropathic pain. With due attention to available results, an early combination of pharmacological and integrative non pharmacological treatments are indicated in children pain management.
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29
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Formalin-induced and neuropathic pain altered time estimation in a temporal bisection task in rats. Sci Rep 2019; 9:18683. [PMID: 31822729 PMCID: PMC6904569 DOI: 10.1038/s41598-019-55168-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/25/2019] [Indexed: 01/31/2023] Open
Abstract
Time perception is an important ability that is related closely to humans’ and animals’ daily activities. It can be distorted by various emotional states. In human studies, experimental pain has been shown to prolong the perception of time. However, related animal studies are lacking. In this study, we used a temporal bisection task to investigate how acute inflammatory pain (induced by hind-paw formalin injection) and chronic neuropathic pain [induced by spinal nerve ligation (SNL)] affected time perception in rats. Rats were trained to recognize “short” (1200-ms) and “long” (2400-ms) anchor-duration pure tones and were rewarded for corresponding lever presses. During testing, rats perceived a series of intermediate-duration and anchor-duration pure tones, and selected levers corresponding to the “short” and “long” tones. After formalin injection, rats gave more “long” lever-press responses than after saline injection. The point of subjective equality after formalin injection also increased, suggesting that formalin-induced acute pain extended time perception. In contrast, rats that had undergone SNL gave fewer “long” lever-press responses compared with the sham surgery group. This animal study suggests that formalin-induced pain and neuropathic pain may have different effects on time perception.
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Relationships Between Psychological, Social, Physical Activity, and Sleep Measures and Somatosensory Function in Individuals With Spinal Pain: A Systematic Review and Meta-analysis. Clin J Pain 2019; 36:124-134. [PMID: 31764166 DOI: 10.1097/ajp.0000000000000775] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Somatosensory abnormalities are linked to clinical pain outcomes in individuals with spinal pain. However, a range of factors might confound the relationship between altered somatosensory function and clinical pain outcomes. This systematic review aimed to evaluate the literature to assess the level of evidence of associations between psychological, social, physical activity, and sleep measures and somatosensory function (assessed via sensory psychophysical testing) among individuals with spinal pain. METHODS A comprehensive literature search was performed in 6 electronic databases from their inception to June 2018. Two reviewers independently assessed the methodological quality using a modified Quality in Prognostic Studies (QUIPS) tool and supplemented with recommendations from the Critical Appraisal and Data Extraction for the Systematic Review of Prediction Modelling Studies (CHARMS) checklist and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The level of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. Data were pooled to evaluate the strength of the relationships of interest. RESULTS Among the 17 factors identified in the included studies, pain catastrophizing, depression, and pain-related fear have significant negative (small to fair) associations with pain thresholds. A "very low" to "moderate" quality of evidence was found for all the investigated factors. Subgroup analysis showed a smaller effect size for pain catastrophizing/fear of movement and pain thresholds in individuals with low back pain. CONCLUSIONS Psychological factors are associated negatively with pain thresholds and they need to be adjusted when establishing predictive relationships between somatosensory function and pain outcomes in individuals with spinal pain.
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31
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The dorsomedial prefrontal cortex as a flexible hub mediating behavioral as well as local and distributed neural effects of social support context on pain: A Theta Burst Stimulation and TMS-EEG study. Neuroimage 2019; 201:116053. [DOI: 10.1016/j.neuroimage.2019.116053] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 07/18/2019] [Accepted: 07/23/2019] [Indexed: 11/19/2022] Open
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Smith R, Gudleski GD, Lane RD, Lackner JM. Higher Emotional Awareness Is Associated With Reduced Pain in Irritable Bowel Syndrome Patients: Preliminary Results. Psychol Rep 2019; 123:2227-2247. [PMID: 31407944 DOI: 10.1177/0033294119868778] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Recent evidence indicates that interventions designed to improve emotional awareness reduce pain in irritable bowel syndrome. This preliminary study sought to determine whether trait emotional awareness is associated with typical pain in patients with irritable bowel syndrome. METHODS Healthy volunteers (n = 66) and irritable bowel syndrome patients (n = 50) were asked to self-report their typical levels of pain intensity and complete both the Levels of Emotional Awareness Scale and the Somatization Scale of the Brief Symptom Inventory. RESULTS Levels of Emotional Awareness Scale scores in irritable bowel syndrome patients did not differ from scores in healthy participants; however, higher Levels of Emotional Awareness Scale scores in irritable bowel syndrome patients predicted lower levels of typical pain intensity (r(45) = -.36, p = .01, 95% CI [-.59, -.08]) and lower levels of somatization (r(45)= -.31, p = .03, 95% CI [-.55, -.02]). CONCLUSIONS This inverse relationship between emotional awareness and both pain and somatization symptoms is consistent with evidence that irritable bowel syndrome patients experience reduced pain from therapies designed to improve emotional awareness. The Levels of Emotional Awareness Scale could potentially be used to identify patients who could benefit from such therapy and could potentially be a moderator of response to efficacious psychological therapies.
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Affiliation(s)
- Ryan Smith
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA; 276165Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Gregory D Gudleski
- Department of Medicine, University at Buffalo-The State University of New York, Buffalo, NY, USA
| | - Richard D Lane
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Jeffrey M Lackner
- Department of Medicine, University at Buffalo-The State University of New York, Buffalo, NY, USA
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33
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Kuerbis A, Reid MC, Lake JE, Glasner-Edwards S, Jenkins J, Liao D, Candelario J, Moore AA. Daily factors driving daily substance use and chronic pain among older adults with HIV: An exploratory study using ecological momentary assessment. Alcohol 2019; 77:31-39. [PMID: 30308287 PMCID: PMC6456439 DOI: 10.1016/j.alcohol.2018.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/13/2018] [Accepted: 10/02/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Adults 50 and older make up approximately 50% of persons living with HIV. Multiple co-morbidities are common among this group, including chronic pain and substance abuse, yet little is known about the daily factors that either enhance or inhibit these experiences or behaviors. This study explored daily drivers of substance use, pain, and relief from pain among older adults living with HIV utilizing ecological momentary assessment (EMA). METHOD Participants (N = 55), ages 49-71, completed seven consecutive days of daily EMA online surveys prior to treatment initiation within a randomized controlled trial. Multilevel modeling tested predictors of pain, substance use, and relief from pain by examining within- and between-person relationships. RESULTS Results revealed an associational, reciprocal relationship between daily worst pain and daily drinking, where greater worst pain ratings predicted heavier drinking and heavier drinking predicted greater daily and overall pain. Greater happiness and poorer quality of sleep predicted greater daily worst pain. Exercising and overall confidence to cope with pain without medication were associated with lower levels of daily worst pain. Finally, spending less time with a loved one over time and reporting any coping behavior were associated with relief from pain. CONCLUSION Investigation of daily factors that drive pain and substance use behaviors among this unique population help inform which daily factors are most risky to their health and well-being. Alcohol use emerged as the only substance associated with both driving pain and responding to pain. Findings suggest key points for prevention and intervention.
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Affiliation(s)
- Alexis Kuerbis
- Silberman School of Social Work, Hunter College at City University of New York, 2180 Third Avenue, New York 10035, United States.
| | - M Carrington Reid
- Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, United States
| | - Jordan E Lake
- Division of Infectious Diseases, University of California, Los Angeles, CA, United States
| | - Suzette Glasner-Edwards
- Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, School of Nursing, University of California, Los Angeles, CA, United States
| | - Jessica Jenkins
- Department of Psychiatry and Human Behavior, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Diana Liao
- Division of Geriatrics, Department of Medicine, University of California, Los Angeles, CA, United States
| | - Jury Candelario
- APAIT, A Division of Special Services for Groups, Los Angeles, CA, United States
| | - Alison A Moore
- Division of Geriatrics, Department of Medicine, University of California, Los Angeles, CA, United States
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34
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Ramírez-Esparza N, García-Sierra A, Rodríguez-Arauz G, Ikizer EG, Fernández-Gómez MJ. No laughing matter: Latinas' high quality of conversations relate to behavioral laughter. PLoS One 2019; 14:e0214117. [PMID: 30970019 PMCID: PMC6457494 DOI: 10.1371/journal.pone.0214117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 03/07/2019] [Indexed: 11/18/2022] Open
Abstract
Latinx in the United States have greater life expectancy than other groups, in spite of their socioeconomic and psychosocial disadvantage. This phenomenon has been described as the Latinx health paradox. This investigation observed the interplay of cultural processes and social networks to shed light on this paradox. Latina (N = 26) and White-European (N = 24) mothers wore a digital recorder as they went about their daily lives. Four conversation styles were characterized from the recordings to measure the mothers' quality of their conversations (small talk and substantive conversations) within different social networks (with the father vs. other adults). As a positive indicator of well-being, laughter was assessed during the conversations. Results demonstrated that Latina mothers tend to laugh more than White-European mothers; and that this relation is mediated by substantive conversations with others. This suggests that Latinas' cultural processes afford meaningful conversations, which relates to more behavioral laughter, a process that may have positive implications on well-being.
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Affiliation(s)
- Nairán Ramírez-Esparza
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, United States of America
- * E-mail:
| | - Adrián García-Sierra
- Department of Speech, Language and Hearing Sciences, University of Connecticut, Storrs, Connecticut, United States of America
| | | | - Elif G. Ikizer
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
| | - Maria J. Fernández-Gómez
- Department of Psychology, Indiana University of Pennsylvania, Indiana, Pennsylvania, United States of America
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35
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Du S, Hu Y, Bai Y, Hu L, Dong J, Jin S, Zhang H. Emotional Distress Correlates Among Patients With Chronic Nonspecific Low Back Pain: A Hierarchical Linear Regression Analysis. Pain Pract 2019; 19:510-521. [PMID: 30739397 DOI: 10.1111/papr.12772] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/27/2018] [Accepted: 02/05/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Chronic low back pain (CLBP) has become a worldwide health concern, and emotional distress is an important issue for CLBP management. However, it remains poorly understood how emotional distress happens and develops. This study aimed to systematically explore the correlates of emotional distress in patients with CLBP. METHODS The study was a multisite, cross-sectional survey with a sample of 252 patients with CLBP in urban communities. A battery of questionnaires was used to collect data. Univariate analysis, Pearson correlation analysis, and hierarchical linear regression analysis were performed. RESULTS The mean score of emotional distress among 252 patients with CLBP was 13.85 ± 6.50. Hierarchical regression analysis indicated that the demographic factors, psychobehavioral factors, and social support of patients with CLBP were associated with their emotional distress, uniquely explaining 16.5%, 18.4%, and 6.2% of the variance, respectively. Five factors were found to be associated with patients' emotional distress: pain intensity (β = 0.257, P < 0.001), passive coping (β = 0.297, P < 0.001), active coping (β = -0.254, P < 0.001), self-efficacy (β = -0.155, P = 0.005), and social support (β = -0.268, P < 0.001). CONCLUSIONS Patients with CLBP suffered from clinically significant emotional distress. Patients' demographics, psychobehavioral factors, and social support were all related to emotional distress. The findings help us to identify the characteristics of patients with CLBP at high risk for emotional distress and to formulate corresponding countermeasures. LAY SUMMARY This study aimed to explored the correlates of emotional distress of patients with chronic low back pain (CLBP) by hierarchical linear regression analysis. The study found that patients' demographic factors, psycho-behavioral factors, and social support were associated with their emotional distress, uniquely explaining 16.5%, 18.4%, and 6.2% of the variance, respectively. Pain intensity, passive coping, active coping, self-efficacy, and social support were detected as significant correlates.
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Affiliation(s)
- Shizheng Du
- School of Nursing, Fudan University, Shanghai, China.,School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China
| | - Yamei Bai
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lingli Hu
- Department of Clinical Laboratory, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jianshu Dong
- Shanghai Health Promotion Center, Shanghai, China
| | - Shengji Jin
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Heng Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Moment-to-moment changes in perceived social support and pain for men living with HIV: an experience sampling study. Pain 2019; 159:2503-2511. [PMID: 30074592 DOI: 10.1097/j.pain.0000000000001354] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Research suggests that people living with HIV experience levels of pain disproportionate to the general population. Pain is a stressor that can negatively impact health-related quality of life. As the number of people aging with HIV increases, we must understand the dynamics of pain experiences among people living with HIV and how to effectively harness evidence-based treatments and supportive resources to enhance adaptive coping. We used an experience sampling method (also called Ecological Momentary Assessment) to assess moment-to-moment experiences of pain and social support 3 times a day for 7 days in a sample of 109 men living with HIV. Participants also responded to questionnaires assessing attachment-related insecurity and social support. In hierarchical linear modeling analyses controlling for age, race, sexual orientation, and socioeconomic status, we found that experiences of social support were associated with lower subsequent pain within-persons. On the other hand, experiences of pain were not associated with later experiences of social support. Men with higher levels of attachment-related avoidance reported more pain on average. Attachment-related avoidance also moderated the association between moment-to-moment experiences of felt social support on pain. Results suggest that within-persons, experiences of daily social support reduce experiences of pain. Between-persons, attachment style may influence how individuals make use of social support in coping with experiences of pain. These findings imply a need to assess social well-being at the clinic level and also support tailored biopsychosocial approaches to pain management in HIV care settings.
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37
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Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Prog Neuropsychopharmacol Biol Psychiatry 2018; 87:168-182. [PMID: 29408484 PMCID: PMC6067990 DOI: 10.1016/j.pnpbp.2018.01.017] [Citation(s) in RCA: 246] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/18/2018] [Accepted: 01/29/2018] [Indexed: 12/12/2022]
Abstract
The biopsychosocial model of pain dominates the scientific community's understanding of chronic pain. Indeed, the biopsychosocial approach describes pain and disability as a multidimensional, dynamic integration among physiological, psychological, and social factors that reciprocally influence one another. In this article, we review two categories of studies that evaluate the contributions of psychosocial factors to the experience of chronic pain. First, we consider general psychosocial variables including distress, trauma, and interpersonal factors. Additionally, we discuss pain-specific psychosocial variables including catastrophizing, expectations, and pain-related coping. Together, we present a diverse array of psychological, social, and contextual factors and highlight the need to consider their roles in the development, maintenance, and treatment of chronic pain conditions.
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Affiliation(s)
- S M Meints
- Department of Anesthesiology, Pain Management Center, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, MA, USA.
| | - R R Edwards
- Department of Anesthesiology, Pain Management Center, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, MA, USA
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38
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A Systematic Review of the Processes Underlying the Main and the Buffering Effect of Social Support on the Experience of Pain. Clin J Pain 2018; 34:1061-1076. [DOI: 10.1097/ajp.0000000000000624] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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39
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Social aggravation: Understanding the complex role of social relationships on stress and health-relevant physiology. Int J Psychophysiol 2018; 131:13-23. [DOI: 10.1016/j.ijpsycho.2018.03.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/20/2018] [Accepted: 03/27/2018] [Indexed: 12/13/2022]
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40
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Che X, Cash R, Chung S, Fitzgerald PB, Fitzgibbon BM. Investigating the influence of social support on experimental pain and related physiological arousal: A systematic review and meta-analysis. Neurosci Biobehav Rev 2018; 92:437-452. [DOI: 10.1016/j.neubiorev.2018.07.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 12/25/2022]
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41
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Gaffey AE, Burns JW, Aranda F, Purim-Shem-Tov YA, Burgess HJ, Beckham JC, Bruehl S, Hobfoll SE. Social support, social undermining, and acute clinical pain in women: Mediational pathways of negative cognitive appraisal and emotion. J Health Psychol 2018; 25:2328-2339. [PMID: 30146929 DOI: 10.1177/1359105318796189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Women may be disproportionately vulnerable to acute pain, potentially due to their social landscape. We examined whether positive and negative social processes (social support and social undermining) are associated with acute pain and if the processes are linked to pain via negative cognitive appraisal and emotion (pain catastrophizing, hyperarousal, anger). Psychosocial variables were assessed in inner-city women (N = 375) presenting to an Emergency Department with acute pain. The latent cognitive-emotion variable fully mediated social undermining and support effects on pain, with undermining showing greater impact. Pain may be alleviated by limiting negative social interactions, mitigating risks of alternative pharmacological interventions.
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Affiliation(s)
- Allison E Gaffey
- Yale School of Medicine, USA.,Rush University Medical Center, USA
| | | | | | | | | | - Jean C Beckham
- Duke University School of Medicine, USA.,Durham VA Health Care System, USA
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Kreuder AK, Wassermann L, Wollseifer M, Ditzen B, Eckstein M, Stoffel-Wagner B, Hennig J, Hurlemann R, Scheele D. Oxytocin enhances the pain-relieving effects of social support in romantic couples. Hum Brain Mapp 2018; 40:242-251. [PMID: 30152573 DOI: 10.1002/hbm.24368] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/19/2018] [Accepted: 08/10/2018] [Indexed: 01/23/2023] Open
Abstract
Social support plays a vital role in physical and mental well-being. The neuropeptide hormone oxytocin (OXT) has been implicated in modulating pair-bonding and affiliative behaviors, but whether OXT contributes to the analgesic effects of a romantic partner's touch remains elusive. In the present randomized placebo-controlled, between-group, functional magnetic resonance imaging study involving 194 healthy volunteers (97 heterosexual couples), we tested the effects of intranasal OXT (24 IU) on handholding as a common mode of expressing emotional support in romantic couples. We scanned the subjects while brief electric shocks were administered. The subjects assumed that they received social support from either their romantic partner or an unfamiliar person. Unbeknown to the subject, in the partner and stranger support conditions, the same male experimenter always held the subject's left hand. Partner support was most effective in reducing the unpleasantness of electric shocks, and OXT further attenuated the unpleasantness across conditions. On the neural level, OXT significantly augmented the beneficial effects of partner support, as evidenced by a stronger decrease of neural responses to shocks in the anterior insula (AI), a stronger activity increase in the middle frontal gyrus (MFG), and a strengthened functional coupling between the AI and MFG. Our results support the notion that OXT specifically modulates the beneficial effects of social support in romantic couples by concomitantly reducing pain-associated activity and increasing activity linked to cognitive control and pain inhibition. We hypothesize that impaired OXT signaling may contribute to the experience of a lack of partner support.
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Affiliation(s)
| | - Lea Wassermann
- Division of Medical Psychology, University of Bonn, Bonn, Germany
| | | | - Beate Ditzen
- Center for Psychosocial Medicine, Institute of Medical Psychology, Heidelberg University, Heidelberg, Germany
| | - Monika Eckstein
- Center for Psychosocial Medicine, Institute of Medical Psychology, Heidelberg University, Heidelberg, Germany
| | - Birgit Stoffel-Wagner
- Department of Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn, Germany
| | - Juergen Hennig
- Division of Personality Psychology and Individual Differences, University of Giessen, Giessen, Germany
| | - René Hurlemann
- Division of Medical Psychology, University of Bonn, Bonn, Germany.,Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Dirk Scheele
- Division of Medical Psychology, University of Bonn, Bonn, Germany
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43
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Teoh AN, Hilmert C. Social support as a comfort or an encouragement: A systematic review on the contrasting effects of social support on cardiovascular reactivity. Br J Health Psychol 2018; 23:1040-1065. [PMID: 30084181 DOI: 10.1111/bjhp.12337] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 07/15/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The stress-buffering hypothesis (Cohen & McKay, 1984, Handbook of psychology and health IV: Social psychological aspects of health (pp. 253-256). Hillsdale, NJ: Lawrence Erlbaum) suggests that one way social support enhances health is by attenuating cardiovascular reactivity (CVR) to stress. Research that has tested this hypothesis has reported inconsistent findings. In this review, we systematically reviewed those findings and proposed a dual-effect model of social support and CVR as a potential explanation for the inconsistency in the literature. Specifically, we proposed that when participants are more engaged during a stressor, social support acts primarily as social comfort, attenuating CVR; and when participants are not engaged, social support acts primarily as social encouragement, elevating CVR. METHODS We reviewed 22 previous studies that (1) empirically manipulated social support in a stressful situation, (2) measured CVR, and (3) tested a moderator of social support effects on CVR. RESULTS Although a majority of studies reported a CVR-mitigating effect of social support resulting in an overall significant combined p-value, we found that there were different effects of social support on CVR when we considered high- and low-engagement contexts. That is, compared to control conditions, social support lowered CVR in more engaging situations but had no significant effect on CVR in less engaging situations. CONCLUSION Our results suggest that a dual-effect model of social support effects on CVR may better capture the nature of social support, CVR, and health associations than the buffering hypothesis and emphasize a need to better understand the health implications of physiological reactivity in various contexts. Statement of contribution What is already known on this subject? According to the stress-buffering hypothesis (Cohen & McKay, ), one pathway social support benefits health is through mitigating the physiological arousal caused by stress. However, previous studies that examined the effects of social support on blood pressure and heart rate changes were not consistently supporting the hypothesis. Some studies reported that social support causes elevations in cardiovascular reactivity (CVR) to stress (Anthony & O'Brien, ; Hilmert, Christenfeld, & Kulik, ; Hilmert, Kulik, & Christenfeld, ) and others showed no effect of social support on CVR (Christian & Stoney, ; Craig & Deichert, ; Gallo, Smith, & Kircher, ). What does this study add? When participants were in more engaging conditions, social support decreased CVR relative to no support. When participants were in less engaging conditions, social support did not have a significant effect on CVR. Provide an alternative way to explain the ways social support affects cardiac health.
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Affiliation(s)
- Ai Ni Teoh
- Heriot-Watt University Malaysia, Putrajaya, Malaysia.,James Cook University Singapore, Singapore
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44
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DiLorenzo MG, Chum GT, Weidmark LV, MacDonald G. Presence of an Attachment Figure Is Associated With Greater Sensitivity to Physical Pain Following Mild Social Exclusion. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2018. [DOI: 10.1177/1948550617720270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social exclusion has been shown to influence sensitivity to physical pain. Attachment theory suggests a primary response to rejection should be seeking out the company of a close other. Based on this prediction, we hypothesized that the presence of an attachment figure versus a stranger following rejection would permit acknowledgement of distress and thus stronger reports of physical pain. Healthy participants reported their pain sensitivity before receiving exclusion or inclusion feedback in an online chat. Participants were then randomly assigned to have access to their attachment figure or a stranger and had pain sensitivity measured again. As predicted, excluded participants who had access to their attachment figure evidenced heightened pain sensitivity (lower pain threshold and tolerance), whereas those who sat with a stranger evidenced some degree of a decrease in pain sensitivity (higher pain tolerance). These data may shed light on the impact social ties can have during painful situations.
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Affiliation(s)
| | - Giorgina T. Chum
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Lauren V. Weidmark
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Geoff MacDonald
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
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45
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Pacella ML, Girard JM, Wright AG, Suffoletto B, Callaway CW. The Association between Daily Posttraumatic Stress Symptoms and Pain over the First 14-days after Injury: An Experience Sampling Study. Acad Emerg Med 2018; 25:844-855. [PMID: 29513381 DOI: 10.1111/acem.13406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Psychosocial factors and responses to injury modify the transition from acute to chronic pain. Specifically, posttraumatic stress disorder symptoms (PTSS; reexperiencing, avoidance, and hyperarousal symptoms) exacerbate and co-occur with chronic pain. Yet no study has prospectively considered the associations among these psychological processes and pain reports using experience sampling methods (ESM) during the acute aftermath of injury. This study applied ESM via daily text messaging to monitor and detect relationships among psychosocial factors and post-injury pain across the first 14-days after emergency department (ED) discharge. METHODS We recruited 75 adults (59% male; M age = 33) who experienced a potentially traumatic injury (i.e., involving life threat or serious injury) in the past 24-hours from the EDs of two Level 1 trauma centers. Participants received 5 questions per day via text messaging from Day-1 to Day-14 post-ED discharge; three questions measured PTSS, one question measured perceived social support, and one question measured physical pain. RESULTS Sixty-seven participants provided sufficient data for inclusion in the final analyses, and the average response rate per subject was 86%. Pain severity score decreased from a mean of 7.2 to 4.4 over 14 days and 50% of the variance in daily pain scores was within-person. In multilevel structural equation models, pain scores decreased over time, and daily fluctuations of hyperarousal (b = 0.22, 95% CI [0.08, 0.36]) were uniquely associated with daily fluctuations in reported pain level within each person. CONCLUSIONS Daily hyperarousal symptoms predict same-day pain severity over the acute post-injury recovery period. We also demonstrated feasibility to screen and identify patients at risk for pain chronicity in the acute aftermath of injury. Early interventions aimed at addressing hyperarousal (e.g. anxiolytics) could potentially aid in reducing experience of pain. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Maria L. Pacella
- Department of Emergency Medicine University of Pittsburgh Pittsburgh PA
| | | | | | - Brian Suffoletto
- Department of Emergency Medicine University of Pittsburgh Pittsburgh PA
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Lozza N, Spoerri C, Ehlert U, Kesselring M, Hubmann P, Tschacher W, La Marca R. Nonverbal Synchrony and Complementarity in Unacquainted Same-Sex Dyads: A Comparison in a Competitive Context. JOURNAL OF NONVERBAL BEHAVIOR 2018. [DOI: 10.1007/s10919-018-0273-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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47
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The Effects of Social Support on Strenuous Physical Exercise. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2018; 4:171-187. [PMID: 29755928 PMCID: PMC5935032 DOI: 10.1007/s40750-017-0086-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 02/02/2023]
Abstract
In humans, socio-environmental cues play an important role in determining adaptive psychophysiological states and behaviours. In sport and exercise, cues to cohesive groups and close, supportive relationships are ubiquitous, possibly because of their effects on neurobiological mechanisms underlying physical performance. Clinical research has shown that the presence of supportive others can lead to reductions in perceptions of pain, while research from sport and exercise science has shown that pain and physical fatigue occupy ranges on a single spectrum of physical discomfort, which works to regulate outputs during strenuous physical exertion. Given the similar neurobiological underpinnings of pain and fatigue, the involvement of both in the self-regulation of strenuous physical outputs, and the effects of social support on perceptions of pain and neurophysiological stress responses more generally, we hypothesised that perceptions of social support affect outputs during strenuous physical exercise by altering activity in self-regulatory mechanisms involved in perceptions of pain and fatigue. We used a between-subjects experimental design to test this hypothesis, varying participants' social support and measuring physical outputs and perceptions of physical discomfort and exertion during a series of maximum-effort cycling bouts. Analyses showed that participants in the social support condition produced greater initial outputs and steeper declines over time, compared to controls. This effect was moderated by participant neuroticism; an important predictor of how individuals react to social support. We discuss these findings in terms of proposed causal mechanisms linking supportive, cohesive social environments with self-regulation and physical performance.
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48
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(Too) Anxious to help? Social support provider anxiety and cardiovascular function. Int J Psychophysiol 2018; 123:171-178. [DOI: 10.1016/j.ijpsycho.2017.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/31/2017] [Accepted: 09/20/2017] [Indexed: 11/22/2022]
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49
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Che X, Cash R, Fitzgerald P, Fitzgibbon BM. The Social Regulation of Pain: Autonomic and Neurophysiological Changes Associated With Perceived Threat. THE JOURNAL OF PAIN 2017; 19:496-505. [PMID: 29274393 DOI: 10.1016/j.jpain.2017.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/28/2017] [Accepted: 12/05/2017] [Indexed: 12/28/2022]
Abstract
The analgesic effect of social support is proposed as a function of social support modulating perceived threat of painful stimuli. In the current study, we directly examined the social buffering effect in the context of the threat of pain. Eighteen healthy participants were subjected to the threat of pain while they held the hand of a close other, a stranger, or not at all. Neural and autonomic responses were recorded using electroencephalogram and heart rate, respectively. Close other hand-holding reduced pain perception. This was accompanied by decreased heart rate and frontal theta oscillation (4-8 Hz) during the threat phase preceding painful stimulation. Interestingly, decreased heart rate and frontal theta in the close other hand-holding condition were uniquely associated with greater pain reduction during subsequent nociceptive stimulation. Neural changes were source-localized to the insular cortex and the rostral-ventral portions of anterior cingulate cortex, regions involved in the processing of threat and pain. Together, our data build upon work to date linking social support to pain by showing autonomic and neurophysiological changes associated with pain reduction. PERSPECTIVE Social support may reduce pain through buffering the autonomic and neurophysiological response to the threatening quality of noxious stimuli. Results implicate that in clinical settings the caregiver could help people with chronic pain reappraise pain and related conditions as less stressful.
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Affiliation(s)
- Xianwei Che
- Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia.
| | - Robin Cash
- Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia
| | - Paul Fitzgerald
- Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia; Epworth Clinic, Epworth Healthcare, Camberwell, Victoria, Australia
| | - Bernadette M Fitzgibbon
- Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School, Monash University, Melbourne, Australia
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50
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Ahn H, Weaver M, Lyon D, Choi E, Fillingim RB. Depression and Pain in Asian and White Americans With Knee Osteoarthritis. THE JOURNAL OF PAIN 2017; 18:1229-1236. [PMID: 28619697 PMCID: PMC5661986 DOI: 10.1016/j.jpain.2017.05.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 05/05/2017] [Accepted: 05/25/2017] [Indexed: 11/25/2022]
Abstract
Few studies have examined the underlying psychosocial mechanisms of pain in Asian Americans. Using the biopsychosocial model, we sought to determine whether variations in depression contribute to racial group differences in symptomatic knee osteoarthritis pain between Asian Americans and non-Hispanic white Americans. The sample consisted of 100 participants, including 50 Asian Americans (28 Korean Americans, 9 Chinese Americans, 7 Japanese Americans, 5 Filipino Americans, and 1 Indian American) and 50 age- and sex-matched non-Hispanic white Americans with symptomatic knee osteoarthritis pain. The Centers for Epidemiologic Studies Depression Scale was used to assess symptoms of depression, and the Western Ontario and McMaster Universities Osteoarthritis Index and the Graded Chronic Pain Scale were used to measure clinical pain. In addition, quantitative sensory testing was used to measure experimental sensitivity to heat- and mechanically-induced pain. The results indicated that higher levels of depression in Asian Americans may contribute to greater clinical pain and experimental pain sensitivity. These findings add to the growing literature regarding ethnic and racial differences in pain and its associated psychological conditions, and additional research is warranted to strengthen these findings. PERSPECTIVE This article shows the contribution of depression to clinical pain and experimental pain sensitivity in Asian Americans with knee osteoarthritis. Our results suggest that Asian Americans have higher levels of depressive symptoms and that depression plays a relevant role in greater clinical pain and experimental pain sensitivity in Asian Americans.
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Affiliation(s)
- Hyochol Ahn
- The University of Texas Health Science Center at Houston, School of Nursing, Department of Nursing Systems, Houston, Texas.
| | - Michael Weaver
- University of Florida College of Nursing, Department of Behavioral Nursing Science, Gainesville, Florida
| | - Debra Lyon
- University of Florida College of Nursing, Department of Behavioral Nursing Science, Gainesville, Florida
| | - Eunyoung Choi
- The University of Texas Health Science Center at Houston, School of Nursing, Department of Nursing Systems, Houston, Texas
| | - Roger B Fillingim
- University of Florida Pain Research and Intervention Center of Excellence, Gainesville, Florida
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