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Lores T, Kwok C, Mills J, Sherman K. A randomized feasibility trial evaluating the "My Changed Body" writing activity for people with endometriosis. Br J Health Psychol 2024. [PMID: 39187471 DOI: 10.1111/bjhp.12743] [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: 02/02/2024] [Accepted: 07/25/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVES Body image disturbance is prevalent in people with endometriosis. This study aimed to explore the feasibility, acceptability and preliminary efficacy of the My Changed Body (MyCB) writing activity for body image in people with endometriosis. DESIGN Two-arm randomized controlled pilot and feasibility study. METHODS Australian adults living with endometriosis who identified as having had a negative endometriosis-related body image experience were recruited online through Endometriosis Australia. Participants completed a baseline survey capturing demographic and health data before being randomized into the MyCB or control writing conditions. Additional assessment was administered post-activity and at 1-week follow-up. RESULTS A total of 82 participants were recruited and randomized (Mage = 32 years, SD = 7.8). MyCB participants were less likely to complete the writing tasks compared to the control group (51% vs. 83%); MyCB completers had lower self-compassion and quality of life, and higher psychological distress, compared to those who dropped out. The MyCB activity received good satisfaction rates (47%-87%). However, there was significant drop-out in the MyCB group (n = 4 vs. 13 at 1-week follow-up). Limited-efficacy testing showed an increase in the self-compassion self-identification for the MyCB group. CONCLUSIONS The MyCB writing activity may be feasible for people with endometriosis. A future larger trial will benefit from several methodology changes to enhance recruitment and retention. TRIAL REGISTRATION Australian and New Zealand Clinical Trial Registry ACTRN12622000496718; Date: 29/3/2022; retrospectively registered.
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Affiliation(s)
- Taryn Lores
- School of Psychology, Deakin University, Melbourne, Australia
| | - Christa Kwok
- School of Psychology, Deakin University, Melbourne, Australia
| | | | - Kerry Sherman
- Lifespan Health and Wellbeing Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
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Budzisz A, Jung A, Adamczyk WM, Szikszay TM, Carvalho GF, Bąbel P, Luedtke K. Body Image Measured via the Fremantle Awareness Questionnaire in Individuals With and Without Pain: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2024; 25:104530. [PMID: 38599266 DOI: 10.1016/j.jpain.2024.104530] [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: 10/31/2023] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
Research suggests that pain negatively affects body image, and body image may also influence reported pain levels. This review aims to summarize the literature on differences in body image distortion between individuals with pain compared to pain-free individuals. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 statement and an a priori preregistered protocol. The literature was searched using 5 electronic databases. Studies assessing body image with the Fremantle Awareness Questionnaire (FAQ) in individuals with and without pain were eligible for inclusion. Screening and selection of eligible studies were performed by independent reviewers. Methodological quality was assessed with the Joanna Briggs Institute critical appraisal tool. Meta-analyses, meta-correlations, and metamean analyses were performed using random-effect models. The primary outcome was the FAQ score; secondary outcomes were reported pain variables. Data from individuals with pain (n = 2277) and without pain (n = 615) were summarized. Significant body image distortions were found in individuals with pain compared to individuals without pain. Compared to pain-free individuals, the pain group rated significantly higher in the FAQ when experiencing back pain (standardized mean differences=1.33, 95% confidence interval=.88-1.77) or other body parts (standardized mean differences=1.25, 95% confidence interval=.51-1.99). The results of meta-correlation analyses confirmed the positive relationship between body image distortion and pain intensity (r = .31), pain at rest (r = .31), or pain during movement (r = .36), but not for pain duration. A difference in mean FAQ results was observed between individuals with pain in different areas (knee and back). PERSPECTIVE: This review confirms differences in body image distortion between pain and pain-free individuals. Pain intensity was correlated with altered body perception, but not pain duration. A moderate correlation was observed between body image distortion and reported pain variables. Body image was more impaired by knee pain than back pain. REGISTERED PROTOCOL AT PROSPERO: CRD42022309937; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022309937.
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Affiliation(s)
- Aleksandra Budzisz
- Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland; Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland.
| | - Andres Jung
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Waclaw M Adamczyk
- Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Tibor M Szikszay
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Luebeck, Germany
| | - Gabriela F Carvalho
- Department of Physiotherapy, Faculty of Health, Safety and Society, Furtwangen University, Furtwangen, Germany
| | - Przemysław Bąbel
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Kerstin Luedtke
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Luebeck, Germany
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van Stein K, Schubert K, Ditzen B, Weise C. Understanding Psychological Symptoms of Endometriosis from a Research Domain Criteria Perspective. J Clin Med 2023; 12:4056. [PMID: 37373749 DOI: 10.3390/jcm12124056] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Endometriosis is currently the second most common gynecological disease and is associated with severe pain, vegetative impairment, and infertility. In association, there are considerable psychological symptoms that limit the quality of life of those affected. In this narrative review, the Research Domain Criteria (RDoC) framework was utilized to display the different transdiagnostic processes involved in disease progression and maintenance in regard to psychosocial functioning. Using the RDoC framework, it becomes clear that immune/endocrinological dysregulation is interlocked with (pelvic) pain chronification processes and psychological symptoms such as depressive mood, loss of control, higher vigilance toward the onset or worsening of symptoms, social isolation, and catastrophizing. This paper will discuss and identify promising treatment approaches, in addition to medical care, as well as further research implications. Endometriosis can come with substantial psychosomatic and social burden, requiring more research to understand the interdependence of different factors involved in its chronic development pathway. However, it is already clear that standard care should be extended with multifaceted treatments addressing pain, as well as the psychological and social burden, in order to halt the cycle of aggravation of symptoms and to improve quality of life for patients.
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Affiliation(s)
- Katharina van Stein
- Heidelberg University Hospital, Institute for Medical Psychology, 69115 Heidelberg, Germany
- Faculty of Behavioral and Cultural Studies, Ruprecht Karls-University, 69115 Heidelberg, Germany
| | - Kathrin Schubert
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, 35032 Marburg, Germany
| | - Beate Ditzen
- Heidelberg University Hospital, Institute for Medical Psychology, 69115 Heidelberg, Germany
- Faculty of Behavioral and Cultural Studies, Ruprecht Karls-University, 69115 Heidelberg, Germany
| | - Cornelia Weise
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps University of Marburg, 35032 Marburg, Germany
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Wójcik M, Goździewicz T, Hudáková Z, Siatkowski I. Endometriosis and the Temporomandibular Joint-Preliminary Observations. J Clin Med 2023; 12:jcm12082862. [PMID: 37109199 PMCID: PMC10144081 DOI: 10.3390/jcm12082862] [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: 03/04/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
(1) Background: The complete picture of the disease is not fully recognized and extends far beyond the pelvis. The disease's impacts lead to systemic inflammation, in turn resulting in sensitization to pain. The aim of this study was to check whether statistical correlations exist in women with endometriosis with regard to their experience of pain: headache, pelvic pain, temporomandibular joint pain, along with teeth clenching and the treatment of the disease. We constructed contingency tables, followed by Pearson's chi-square test and Cramer's V coefficient values. (2) Methods: A survey was conducted among 128 women aged 33.43 ± 5.79 with a diagnosis of endometriosis (disease duration 6.40 ± 5.88 years). (3) Results: There was a correlation between the occurrence of pain on the right and left sides of the pelvis and pain on the right and left sides of the temporomandibular joint, p-value = 0.0397, V = 0.2350, and between the presence of pelvic pain and the treatment of endometriosis, p-value = 0.0104, V = 0.3709, and between the presence of pain outside the pelvis and the treatment of endometriosis, p-value = 0.0311, V = 0.4549. There was a highly significant correlation between teeth clenching and temporomandibular joint pain, p-value = 0.0005, V = 0.3695. (4) Conclusions: The study revealed a correlation between pelvic endometriosis symptoms and symptoms in the temporomandibular joint.
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Affiliation(s)
- Małgorzata Wójcik
- Department of Physiotherapy, Poznan University of Physical Education, Faculty of Sport Sciences in Gorzow Wlkp., 61-871 Poznan, Poland
| | - Tomasz Goździewicz
- Department of Perinatology and Gynecology, Division of Gynecology, Poznan University of Medical Sciences, 61-758 Poznan, Poland
| | - Zuzana Hudáková
- Faculty of Health, Catholic University, 034 01 Ružomberok, Slovakia
- College of Polytechnics, 586 01 Jihlava, Czech Republic
- SNP Central Military Hospital, Faculty Hospital, 034 01 Ružomberok, Slovakia
| | - Idzi Siatkowski
- Department of Mathematical and Statistical Methods, Poznan University of Life Sciences, 60-637 Poznan, Poland
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Sullivan-Myers C, Sherman KA, Beath AP, Cooper MJW, Duckworth TJ. Body image, self-compassion, and sexual distress in individuals living with endometriosis. J Psychosom Res 2023; 167:111197. [PMID: 36805454 DOI: 10.1016/j.jpsychores.2023.111197] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/12/2023] [Accepted: 02/11/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Extensive psychological burden is associated with the experience of living with endometriosis, including negative changes to body image and sexual functioning. Emerging evidence suggests that potential protective factors such as body appreciation and self-compassion may help mitigate these adverse impacts of endometriosis. This study aimed to investigate the association of body image, both positive (body appreciation) and negative (body image disturbance) dimensions, with sexual distress and the potential buffering effect of self-compassion on the body image-sexual distress link. METHODS Data were collected via an online cross-sectional survey (N = 471) assessing body image disturbance, body appreciation, self-compassion and sexual distress in individuals with endometriosis. A series of hierarchical linear regression analyses were conducted to explore the relationship between key variables. RESULTS >80% of the sample reported clinically significant sexual distress and high levels of body image disturbance. Regression analyses indicated a moderate positive effect of body image disturbance with sexual distress, and a weaker inverse effect of self-compassion with sexual distress. Body appreciation was not associated with sexual distress, and no moderating effects of self-compassion were evident. CONCLUSION The high prevalence of sexual distress identified in this sample, along with the finding that body image disturbance was strongly associated with sexual distress, suggest that psychosocial interventions addressing body image may help ameliorate sexual distress in individuals with endometriosis.
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Affiliation(s)
- C Sullivan-Myers
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - K A Sherman
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia; Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, NSW, Australia.
| | - A P Beath
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - M J W Cooper
- Department of Obstetrics and Gynaecology, The University of Sydney, Level 7 187 Macquarie St, Sydney, NSW, Australia
| | - T J Duckworth
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
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