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Mingels S, Granitzer M, Schmid A, Graven-Nielsen T, Dankaerts W. Cross-sectional experimental assessment of pain modulation as part of multidimensional profiling of people with cervicogenic headache: protocol for a feasibility study. BMJ Open 2024; 14:e074743. [PMID: 38890144 PMCID: PMC11191774 DOI: 10.1136/bmjopen-2023-074743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/05/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND An endogenous pain modulation profile, reflecting antinociceptive and pronociceptive mechanisms, may help to direct management by targeting the involved pain mechanism. For individuals with cervicogenic headache (CeH), the characteristics of such profiles were never investigated. However, the individual nature of experiencing pain demands profiling within a multidimensional framework including psychosocial lifestyle characteristics. The objective of the current protocol is to assess the pain modulation profile, which includes psychosocial lifestyle characteristics among people with CeH. METHODS AND ANALYSIS A protocol is described to map pain modulation profiles in people with CeH. A cross-sectional non-randomised experimental design will be used to assess feasibility of mapping these profiles. The pain modulation profile is composed based on results on the Depression, Anxiety, Stress Scale, Pittsburgh Sleep Quality Index, Headache Impact Test and on responses to temporal summation of pain (pinprick), conditioned pain modulation and widespread hyperalgesia (mechanical pressure pain threshold and cuff algometry). Primary analyses will report results relating to outcomes on feasibility. Secondary analyses will involve an analysis of proportions (%) of the different psychosocial lifestyle profiles and pain profiles. ETHICS AND DISSEMINATION Ethical approval was granted by the Ethics Committee Research UZ/KU Leuven (Registration number B3222024001434) on 30 May 2024. Results will be published in peer-reviewed journals, at scientific conferences and, through press releases. Protocol V.3. protocol date: 3 June 2024.
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Affiliation(s)
- Sarah Mingels
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Marita Granitzer
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Annina Schmid
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium
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Jenkins LC, Chang WJ, Humburg P, Wasinger VC, Stone LS, Dorsey SG, Renn C, Starkweather A, Schabrun SM. Sex Differences in the Serum Proteomic Profile During Acute Low Back Pain-A Preliminary Study of the Relationship to Future Low Back Pain. THE JOURNAL OF PAIN 2024; 25:104426. [PMID: 37989405 DOI: 10.1016/j.jpain.2023.11.009] [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: 08/17/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
The molecular processes driving the transition from acute to chronic low back pain (LBP) remain poorly understood and are likely to be sexually dimorphic. This study aimed to explore sex differences in the serum proteomic profile of people experiencing an acute LBP episode and determine if serum protein concentrations were associated with three-month outcome. Serum samples were collected through venepuncture from 30 female and 29 male participants experiencing an acute LBP episode. Serum samples underwent trypsin digestion and fractionation using hydrophobic interaction chromatography and were then analysed using mass-spectrometry. Mass-spectrometry spectra were searched in the Swissprot database for protein identification. Sex differences in protein abundance changes were evident upon inspection of fold changes. Multivariable data analysis identified 21 serum proteins during the acute episode that correctly classified 93% of males and 23 serum proteins that correctly classified 90% of females with ongoing LBP at 3 months. Pathway analysis suggested the differentially expressed proteins during acute LBP were frequently involved in immune, inflammatory, complement, or coagulation responses. This data provides preliminary evidence that biological processes during an acute LBP episode may contribute to the resolution, or persistence, of LBP symptoms at 3 months, however, these processes differ between males and females. PERSPECTIVE: Differential expression of serum proteins was observed between male and female participants during an acute LBP episode. This preliminary work provides a foundation for future research targeting distinct immune system processes in males and females that may interfere with the transition from acute to chronic LBP.
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Affiliation(s)
- Luke C Jenkins
- Centre for Pain IMPACT, Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia; School of Health Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Wei-Ju Chang
- Centre for Pain IMPACT, Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia; School of Health Sciences, College of Medicine, Health and Wellbeing, University of Newcastle, New South Wales, Australia
| | - Peter Humburg
- Centre for Pain IMPACT, Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia; Mark Wainwright Analytical Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Valerie C Wasinger
- Bioanalytical Mass Spectrometry Facility, Mark Wainwright Analytical Centre, UNSW, Kensington, NSW, Australia; School of Medical Science, UNSW, Kensington, NSW, Australia
| | - Laura S Stone
- Department of Anesthesiology, Faculty of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Susan G Dorsey
- Department of Pain & Translational Symptom Science, University of Maryland Baltimore, Baltimore
| | - Cynthia Renn
- Department of Pain & Translational Symptom Science, University of Maryland Baltimore, Baltimore
| | - Angela Starkweather
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, Florida
| | - Siobhan M Schabrun
- Centre for Pain IMPACT, Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia; The Gray Centre for Mobility and Activity, Parkwood Institute, London, Ontario, Canada; School of Physical Therapy, University of Western Ontario, London, Ontario, Canada
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Abberger B, Kieselbach K. Rasch analysis of the Depression, Anxiety, and Stress Scale in patients with chronic pain. J Psychosom Res 2024; 178:111597. [PMID: 38277894 DOI: 10.1016/j.jpsychores.2024.111597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/02/2024] [Accepted: 01/20/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVE Questionnaires are commonly used to assess and screen pain-related, psychological symptoms in patients with chronic pain. In Germany, the "German pain questionnaire" provided by the German Pain Society used for this purpose includes the Depression, Anxiety, and Stress Scale (DASS). This study aims to analyze the DASS by fitting its data to the Rasch model to test the psychometric quality. STUDY DESIGN AND SETTING In this cross-sectional study, 932 patients with chronic pain answered the DASS. The 21-item short version was tested via Rasch analysis using the parameters threshold order, fit to the model, Differential Item Functioning, unidimensionality and reliability. RESULTS The Rasch analysis results showed a low reliability, misfitting items, Differential Item Functioning or multidimensionality. It was necessary to remove items from the subscales to improve fit to the Rasch model. A revised depression subscale of the DASS-21 was the only scale that achieved all the required psychometric parameters. The summation of all items to a total scale was not supported. CONCLUSION More research is required on somatic free measurement of psychological symptoms in patients with chronic pain. The results demonstrate that the development of a new instrument or a revision of existing instruments for screening of psychological symptoms in chronic pain are needed.
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Affiliation(s)
- Birgit Abberger
- Interdisciplinary Pain Center, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
| | - Kristin Kieselbach
- Interdisciplinary Pain Center, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
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Mingels S, Granitzer M, Schmid AB, Dankaerts W. Individual endogenous pain modulation profiles within a multidimensional context of people with cervicogenic headache - A retrospective exploratory study. Musculoskelet Sci Pract 2023; 67:102855. [PMID: 37683308 PMCID: PMC10560891 DOI: 10.1016/j.msksp.2023.102855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/21/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND One in four individuals with cervicogenic headache (CeH) are unresponsive to therapy. Such therapy involves predominantly biomedical interventions targeting the upper-cervical spine. A recurring theme within musculoskeletal practice is the multidimensional nature and substantial heterogeneity of the condition. Such heterogeneity might be a reason for failure of a biomedical approach. Therefore, future studies investigating efficacy of managing CeH should ideally be based on identification, and better understanding of the heterogeneity of this population based on a comprehensive evaluation of clinically relevant contributing factors. OBJECTIVES The objective was to map profiles of individuals with CeH based on pain modulation within a multidimensional context. DESIGN Pain Modulation Profiles (PMPs) of 18 adults (29-51 years) with CeH were mapped retrospectively. METHOD The PMPs consisted of a Pain-Profile (bilateral suboccipital, erector spinae, anterior tibialis pressure pain thresholds), a Psycho-Social-Lifestyle-Profile (Depression, Anxiety, Stress Scale, Headache Impact test, Pittsburgh Sleep Quality Index), or a combination of both. Individual results were compared to normative data. Two Pain-Profiles were defined: normal or altered. Psycho-Social-Lifestyle-Profiles were categorized based on the number of altered psycho-social-lifestyle factors (range 0-5). RESULTS Mapping PMPs in individuals with CeH resulted in 50% presenting with a dominant altered Pain-Profile, 16.7% with a dominant altered Psycho-Social-Lifestyle-Profile, and 5.6% with dominant alterations in both Pain-Profile and Psycho-Social-Lifestyle-Profile. CONCLUSION Our results indicate heterogeneity of PMPs within the CeH population. Replication of these results is needed through dynamic assessment of the Pain-Profile before evaluating if these profiles can help patient-stratification.
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Affiliation(s)
- Sarah Mingels
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium; REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
| | - Marita Granitzer
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Annina B Schmid
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom. https://twitter.com/AnninaBSchmid
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium. https://twitter.com/WimDankaerts
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Cao CH, Liao XL, Gamble JH, Li LL, Jiang XY, Li XD, Griffiths MD, Chen IH, Lin CY. Evaluating the psychometric properties of the Chinese Depression Anxiety Stress Scale for Youth (DASS-Y) and DASS-21. Child Adolesc Psychiatry Ment Health 2023; 17:106. [PMID: 37679819 PMCID: PMC10486035 DOI: 10.1186/s13034-023-00655-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND In recognizing the need for a reliable and valid instrument to assess psychological distress among children and adolescents, the present study translated the newly developed Depression Anxiety Stress Scale for Youth (DASS-Y) into Chinese, while also comparing its psychometric properties with those of the well-established DASS-21 within a primary and middle school demographic. METHODS Utilizing a combination of convenience sampling and purposive sampling, a cohort comprising 1,507 primary and 1,131 middle school students was recruited. Rasch analysis, confirmatory factor analysis (CFA), and structural equation modeling (SEM) were used in the data analysis. RESULTS Significant differences were observed between the DASS-Y and the DASS-21, notably within the anxiety subscale. The proportions of individuals with clinical mood disorders identified by the two scales demonstrated a significant disparity. Both scales, following an adjustment of responses, exhibited satisfactory internal consistency and convergent validity, with the acceptance of a three-factor structure. Furthermore, the DASS-Y showed superior discriminant validity relative to the DASS-21, providing more compelling evidence regarding concurrent validity. CONCLUSION Overall, the Chinese version of the DASS-Y demonstrated superior robustness to the DASS-21 in terms of psychometric properties. The findings provide initial evidence for the psychometric properties of the DASS-Y from another culture.
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Affiliation(s)
- Cui-Hong Cao
- School of Foreign Languages, Shandong Women's University, Jinan, 250300, China
- Faculty of Education, Qufu Normal University, Qufu, 273165, China
| | - Xiao-Ling Liao
- Faculty of Education, Jiangxi Science and Technology Normal University, Nanchang, 330031, China
| | - Jeffrey H Gamble
- Department of English, National Changhua University, Changhua, 50007, Taiwan
| | - Ling-Ling Li
- Xinjian District of Nanchang City, No.1 Senior High School, Nanchang, 330100, China
| | - Xing-Yong Jiang
- Yangan Primary School of Qionglai City, Qionglai, 611535, China
| | - Xu-Dong Li
- Gaogeng Nine-year School, Qionglai, 611533, China
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - I-Hua Chen
- Chinese Academy of Education Big Data, Qufu Normal University, Qufu, 273165, China.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
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Kraska J, Bell K, Costello S. Graded Response Model Analysis and Computer Adaptive Test Simulation of the Depression Anxiety Stress Scale 21: Evaluation and Validation Study. J Med Internet Res 2023; 25:e45334. [PMID: 37347530 PMCID: PMC10337454 DOI: 10.2196/45334] [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: 12/26/2022] [Revised: 02/06/2023] [Accepted: 04/17/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND The Depression Anxiety Stress Scale 21 (DASS-21) is a mental health screening tool with conflicting studies regarding its factor structure. No studies have yet attempted to develop a computer adaptive test (CAT) version of it. OBJECTIVE This study calibrated items for, and simulated, a DASS-21 CAT using a nonclinical sample. METHODS An evaluation sample (n=580) was used to evaluate the DASS-21 scales via confirmatory factor analysis, Mokken analysis, and graded response modeling. A CAT was simulated with a validation sample (n=248) and a simulated sample (n=10,000) to confirm the generalizability of the model developed. RESULTS A bifactor model, also known as the "quadripartite" model (1 general factor with 3 specific factors) in the context of the DASS-21, displayed good fit. All scales displayed acceptable fit with the graded response model. Simulation of 3 unidimensional (depression, anxiety, and stress) CATs resulted in an average 17% to 48% reduction in items administered when a reliability of 0.80 was acceptable. CONCLUSIONS This study clarifies previous conflicting findings regarding the DASS-21 factor structure and suggests that the quadripartite model for the DASS-21 items fits best. Item response theory modeling suggests that the items measure their respective constructs best between 0θ and 3θ (mild to moderate severity).
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Affiliation(s)
- Jake Kraska
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
| | - Karen Bell
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
| | - Shane Costello
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
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Adhia DB, Mani R, Mathew J, O'Leary F, Smith M, Vanneste S, De Ridder D. Exploring electroencephalographic infraslow neurofeedback treatment for chronic low back pain: a double-blinded safety and feasibility randomized placebo-controlled trial. Sci Rep 2023; 13:1177. [PMID: 36670176 PMCID: PMC9860016 DOI: 10.1038/s41598-023-28344-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
Chronic low back pain (CLBP) is a disabling condition worldwide. In CLBP, neuroimaging studies demonstrate abnormal activities in cortical areas responsible for pain modulation, emotional, and sensory components of pain experience [i.e., pregenual and dorsal anterior cingulate cortex (pgACC, dACC), and somatosensory cortex (SSC), respectively]. This pilot study, conducted in a university setting, evaluated the feasibility, safety, and acceptability of a novel electroencephalography-based infraslow-neurofeedback (EEG ISF-NF) technique for retraining activities in pgACC, dACC and SSC and explored its effects on pain and disability. Participants with CLBP (n = 60), recruited between July'20 to March'21, received 12 sessions of either: ISF-NF targeting pgACC, dACC + SSC, a ratio of pgACC*2/dACC + SSC, or Placebo-NF. Descriptive statistics demonstrated that ISF-NF training is feasible [recruitment rate (7 participants/month), dropouts (25%; 20-27%), and adherence (80%; 73-88%)], safe (no adverse events reported), and was moderate to highly acceptable [Mean ± SD: 7.8 ± 2.0 (pgACC), 7.5 ± 2.7 (dACC + SCC), 8.2 ± 1.9 (Ratio), and 7.7 ± 1.5 (Placebo)]. ISF-NF targeting pgACC demonstrated the most favourable clinical outcomes, with a higher proportion of participants exhibiting a clinically meaningful reduction in pain severity [53%; MD (95% CI): - 1.9 (- 2.7, - 1.0)], interference [80%; MD (95% CI): - 2.3 (- 3.5, - 1.2)], and disability [73%; MD (95% CI): - 4.5 (- 6.1, - 2.9)] at 1-month follow-up. ISF-NF training is a feasible, safe, and an acceptable treatment approach for CLBP.
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Affiliation(s)
- Divya Bharatkumar Adhia
- Department of Surgical Sciences, Otago Medical School, University of Otago, PO BOX 56, Dunedin, 9054, New Zealand. .,Pain@Otago Research Theme, University of Otago, Dunedin, New Zealand. .,Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.
| | - Ramakrishnan Mani
- Pain@Otago Research Theme, University of Otago, Dunedin, New Zealand.,Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.,Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Jerin Mathew
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.,Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Finella O'Leary
- Department of Surgical Sciences, Otago Medical School, University of Otago, PO BOX 56, Dunedin, 9054, New Zealand
| | - Mark Smith
- Neurofeedback Therapy Services of New York, New York, NY, USA
| | - Sven Vanneste
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Dirk De Ridder
- Department of Surgical Sciences, Otago Medical School, University of Otago, PO BOX 56, Dunedin, 9054, New Zealand.,Pain@Otago Research Theme, University of Otago, Dunedin, New Zealand
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Khosrokiani Z, Letafatkar A, Hadadnezhad M, Sokhanguei Y. The comparison between the effects of pain education interventions with online and face-to-face exercise and the control group received biomedical education + standardized physical therapy in patients with chronic nonspecific neck pain during COVID-19: protocol for a parallel-group randomized controlled trial. Trials 2022; 23:1031. [PMID: 36539843 PMCID: PMC9763812 DOI: 10.1186/s13063-022-06932-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 11/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Various psychological issues and serious health concerns during the imposed lockdown by coronavirus disease 2019 (COVID-19) have induced many changes in the treatment of patients. More effective self-management strategies through tele-rehabilitation are suggested to be applied for patients with chronic neck pain to reduce referrals to health cares and disability support through COVID-19. Also, the pain neuroscience education (PNE) approach is an educational method used by health professionals to assist patients in understanding the biology, physiology, and psychosocial factors affecting their pain experience and aligning with the cognitions and beliefs associated with pain and recurrent disability. PNE combined with tele-rehabilitation could be a new solution to encourage patients to manage their condition by themselves and increase the continuity of practice instead of face-to-face sessions. OBJECTIVE This randomized control trial (RCT) aims to investigate the effects of PNE with online and face-to-face exercise interventions, and the control group received biomedical education + standardized physical therapy on neck pain and disability, psychological factors, and function in non-traumatic chronic neck pain. METHODS/DESIGN Patients with non-traumatic chronic neck pain (patient-centered care and active involvement of patients and the public) will be recruited via flyers displayed in hospitals and universities to participate in an RCT with two experimental and one control group designed to investigate the effects of PNE with online and face-to-face exercise interventions, and the control group received biomedical education + standardized physical therapy on neck pain and disability, psychological factors, and function in non-traumatic chronic neck pain. The outcomes will be measured at baseline, after PNE, and after 3 months of an exercise intervention. All outcomes are presented as mean ± SD, and statistical significance was set at α level of < 0.05. The normal distribution of the variables was verified by the Kolmogorov-Smirnov test, following a descriptive analysis. DISCUSSION It seems that PNE plus online and face-to-face exercise interventions are appropriate educational models for the treatment of patients with neck pain during COVID-19. Also, online training seems to encourage patients to continue their treatment. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT20150503022068N5. Registered on 09 September 2021.
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Affiliation(s)
- Zohre Khosrokiani
- grid.412265.60000 0004 0406 5813Biomechanics and Corrective Exercise Laboratory, Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport Injuries, Kharazmi University, Mirdamad Blvd., Hesari St, Tehran, 00982122258084 Iran
| | - Amir Letafatkar
- grid.412265.60000 0004 0406 5813Biomechanics and Corrective Exercise Laboratory, Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport Injuries, Kharazmi University, Mirdamad Blvd., Hesari St, Tehran, 00982122258084 Iran
| | - Malihe Hadadnezhad
- grid.412265.60000 0004 0406 5813Biomechanics and Corrective Exercise Laboratory, Faculty of Physical Education and Sport Sciences, Department of Biomechanics and Sport Injuries, Kharazmi University, Mirdamad Blvd., Hesari St, Tehran, 00982122258084 Iran
| | - Yahya Sokhanguei
- grid.472458.80000 0004 0612 774XUniversity of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Cárdenas Soriano P, Rodriguez-Blazquez C, Forjaz MJ, Ayala A, Rojo-Perez F, Fernandez-Mayoralas G, Molina-Martinez MA, de Arenaza Escribano CP, Rodriguez-Rodriguez V. Validation of the Spanish Version of the Fear of COVID-19 Scale (FCV-19S) in Long-Term Care Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16183. [PMID: 36498256 PMCID: PMC9741095 DOI: 10.3390/ijerph192316183] [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: 10/26/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Fear of coronavirus disease 2019 (COVID-19) is one of the main psychological impacts of the actual pandemic, especially among the population groups with higher mortality rates. The Fear of COVID-19 Scale (FCV-19S) has been used in different scenarios to assess fear associated with COVID-19, but this has not been done frequently in people living in long-term care (LTC) settings. The present study is aimed at measuring the psychometric properties of the Spanish version of the FCV-19S in residents in LTC settings, following both the classical test theory (CTT) and Rasch model frameworks. The participants (n = 447), aged 60 years or older, were asked to complete the FCV-19S and to report, among other issues, their levels of depression, resilience, emotional wellbeing and health-related quality of life with validated scales. The mean FCV-19S score was 18.36 (SD 8.28, range 7−35), with higher scores for women, participants with lower education (primary or less) and higher adherence to preventive measures (all, p < 0.05). The Cronbach’s alpha for the FCV-19S was 0.94. After eliminating two items due to a lack of fit, the FCV-19S showed a good fit to the Rasch model (χ2 (20) = 30.24, p = 0.019, PSI = 0.87), with unidimensionality (binomial 95% CI 0.001 to 0.045) and item local independency. Question 5 showed differential item functioning by sex. The present study shows that the FCV-19S has satisfactory reliability and validity, which supports its use to effectively measure fear in older people living in LTC settings. This tool could help identify risk groups that may need specific health education and effective communication strategies to lower fear levels. This might have a beneficial impact on adherence to preventive measures.
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Affiliation(s)
- Pilar Cárdenas Soriano
- Department of Preventive Medicine, University Hospital of Albacete, ES-02006 Albacete, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology and Network Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, ES-28029 Madrid, Spain
| | - Maria João Forjaz
- National Centre of Epidemiology and Health Service Research Network on Chronic Diseases (REDISSEC) and Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Institute of Health, ES-28029 Madrid, Spain
| | - Alba Ayala
- Department of Statistics, University Carlos III of Madrid, and Health Service Research Network on Chronic Diseases (REDISSEC), Carlos III Institute of Health, ES-28029 Madrid, Spain
| | - Fermina Rojo-Perez
- Grupo de Investigacion Sobre Envejecimiento (GIE), IEGD, CSIC, ES-28037 Madrid, Spain
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10
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Hnatešen D, Radoš I, Dimitrijević I, Budrovac D, Omrčen I, Pavić R, Gusar I, Čebohin M, Šolić K. Influence of the Cognitive and Emotional Status of Patients with Chronic Pain on Treatment Success (Reduction in Pain Intensity and Adherence to Pharmacotherapy): A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15968. [PMID: 36498036 PMCID: PMC9735997 DOI: 10.3390/ijerph192315968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
This prospective study aimed to determine the cognitive and emotional status among patients with chronic pain and to examine the potential influence on the treatment success, measured by the reduction in pain intensity and adherence to pharmacotherapy. A total of seventy patients were followed for two months. The results of the comparison between patients who did and did not follow the physician’s instructions regarding adherence to pharmacotherapy showed a significant difference in cognitive status and a reduction in pain intensity. Patients who followed the physician’s instructions on taking analgesics had significantly higher scores on the Montreal Cognitive Assessment (MoCA) of cognitive status and a substantially higher reduction in pain intensity. Scores on the MoCA test provide statistically significant indications regarding patients’ decision to follow instructions regarding adherence to pharmacotherapy. Scores on the MoCA test, anxiety, age, and pain intensity (measured with a numeric rating scale—NRS) on admission were identified as potential predictors for the reduction in pain intensity. The linear regression model was statistically significant (χ2 = 40.0, p < 0.001), explained between 43.5% and 61.1% of variance regarding the reduction in pain intensity. The findings of this study show that cognitive status, measured with MoCA, and emotional status, measured with the Depression, Anxiety, and Stress Scale (DASS-21), significantly influence the reduction in pain intensity and adherence to pharmacotherapy. The results suggest that cognitive and emotional status may be potential predictors of treatment success. This finding points to the importance of a biopsychosocial approach in the treatment of chronic pain, where an important emphasis can be placed on the psychosocial determinants of pain.
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Affiliation(s)
- Dijana Hnatešen
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Ivan Radoš
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Iva Dimitrijević
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Dino Budrovac
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Ivan Omrčen
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Roman Pavić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Hospital of Traumatology, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia
| | - Ivana Gusar
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia
| | - Maja Čebohin
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Medical School Osijek, 31000 Osijek, Croatia
| | - Krešimir Šolić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Faculty of Electrical Engineering, Computer Science and Information Technology Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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11
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Parkitny L, McAuley JH, Herbert RD, Di Pietro F, Cashin AG, Ferraro MC, Moseley GL. Post-fracture serum cytokine levels are not associated with a later diagnosis of complex regional pain syndrome: a case-control study nested in a prospective cohort study. BMC Neurol 2022; 22:385. [PMID: 36224537 PMCID: PMC9555076 DOI: 10.1186/s12883-022-02910-z] [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: 12/10/2021] [Revised: 09/01/2022] [Accepted: 09/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Complex Regional Pain Syndrome (CRPS) is a disabling pain disorder that is most common after a distal limb fracture. While the acute systemic immune response to the injury is thought to play a role in the development of CRPS, this hypothesis has never been tested directly. Thus, we evaluated whether elevated levels of circulating pro-inflammatory cytokines early after a fracture were associated with the development of CRPS. Methods We conducted a case-control study nested within a prospective cohort study. Individuals with wrist and/or hand fractures were recruited from specialist hand units. Baseline clinical data were obtained from participants within 28 days of fracture. CRPS status was determined 16 weeks after the fracture using a two-stage diagnostic process. Cytokine assays were obtained from all cases (defined using the Budapest criteria) and a random sample of those who did not have CRPS at 16 weeks. We calculated odds ratios with 95% confidence intervals to determine the risk of CRPS associated with the expression of each of 25 cytokines. Results Baseline data were collected for 702 consenting participants, of whom 535 provided blood samples. Follow-up at 16 weeks was 97.2%. 15 (2.2% of the cohort) met the Budapest CRPS criteria and 69 (including those who met the Budapest criteria; 9.8%) met the International Association for the Study of Pain (IASP) CRPS criteria. In all of the primary analyses (using Budapest criteria) and 49/50 secondary analyses (using IASP criteria), 95% confidence intervals for the association between cytokine levels and the risk of subsequently developing CRPS included the null value (OR = 1). However, the confidence intervals were wide. Conclusion There was no evidence that early post-injury expression of systemic cytokines was associated with a CRPS diagnosis 16 weeks after injury. This study does not provide support for the hypothesis that innate immune activation has a determinative role in the development of CRPS. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02910-z.
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Affiliation(s)
- Luke Parkitny
- Departments of Pediatrics-Neurology, Baylor College of Medicine, Houston, TX, USA. .,Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, Houston, TX, USA. .,Centre for Pain IMPACT Neuroscience Research Australia, University of New South Wales, Sydney, Australia.
| | - James H McAuley
- Centre for Pain IMPACT Neuroscience Research Australia, University of New South Wales, Sydney, Australia.,School of Health Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Robert D Herbert
- Centre for Pain IMPACT Neuroscience Research Australia, University of New South Wales, Sydney, Australia
| | - Flavia Di Pietro
- Curtin Medical School, Curtin University, Bentley Campus, Bentley, Australia.,Curtin Health Innovation Centre (CHIRI), Curtin University, Bentley, Australia
| | - Aidan G Cashin
- Centre for Pain IMPACT Neuroscience Research Australia, University of New South Wales, Sydney, Australia.,School of Health Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Michael C Ferraro
- Centre for Pain IMPACT Neuroscience Research Australia, University of New South Wales, Sydney, Australia.,School of Health Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia
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12
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Adhia DB, Mani R, Reynolds JN, Hall M, Vanneste S, De Ridder D. High-Definition Transcranial Infraslow Pink-Noise Stimulation Can Influence Functional and Effective Cortical Connectivity in Individuals With Chronic Low Back Pain: A Pilot Randomized Placebo-Controlled Study. Neuromodulation 2022:S1094-7159(22)01225-9. [DOI: 10.1016/j.neurom.2022.08.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/02/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
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13
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Adhia DB, Mani R, Reynolds JNJ, Vanneste S, De Ridder D. High-definition transcranial infraslow pink noise stimulation for chronic low back pain: protocol for a pilot, safety and feasibility randomised placebo-controlled trial. BMJ Open 2022; 12:e056842. [PMID: 35705354 PMCID: PMC9204463 DOI: 10.1136/bmjopen-2021-056842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Chronic low back pain (CLBP) is a common disabling health condition. Current treatments demonstrate modest effects, warranting newer therapies. Brain imaging demonstrates altered electrical activities in cortical areas responsible for pain modulation, emotional and sensory components of pain experience. Treatments targeting to change electrical activities of these key brain regions may produce clinical benefits. This pilot study aims to (1) evaluate feasibility, safety and acceptability of a novel neuromodulation technique, high-definition transcranial infraslow pink noise stimulation (HD-tIPNS), in people with CLBP, (2) explore the trend of effect of HD-tIPNS on pain and function, and (3) derive treatment estimates to support sample size calculation for a fully powered trial should trends of effectiveness be present. METHODS AND ANALYSIS A pilot, triple-blinded randomised two-arm placebo-controlled parallel trial. Participants (n=40) with CLBP will be randomised to either sham stimulation or HD-tIPNS (targeting somatosensory cortex and dorsal and pregenual anterior cingulate cortex). Primary outcomes include feasibility and safety measures, and clinical outcomes of pain (Brief Pain Inventory) and disability (Roland-Morris disability questionnaire). Secondary measures include clinical, psychological, quantitative sensory testing and electroencephalography collected at baseline, immediately postintervention, and at 1-week, 1-month and 3 months postintervention. All data will be analysed descriptively. A nested qualitative study will assess participants perceptions about acceptability of intervention and analysed thematically. ETHICS AND DISSEMINATION Ethical approval has been obtained from Health and Disability Ethics Committee (Ref:20/NTB/67). Findings will be reported to regulatory and funding bodies, presented at conferences, and published in a scientific journal. TRIAL REGISTRATION NUMBER ACTRN12620000505909p.
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Affiliation(s)
- Divya Bharatkumar Adhia
- Department of Surgical Sciences, and Pain@Otago Research Theme, University of Otago - Dunedin Campus, Dunedin, New Zealand
| | - Ramakrishnan Mani
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, and Pain@Otago Research Theme, University of Otago - Dunedin Campus, Dunedin, New Zealand
| | - John N J Reynolds
- Department of Anatomy and the Brain Health Research Centre, University of Otago - Dunedin Campus, Dunedin, New Zealand
| | - Sven Vanneste
- School of Psychology, Global Brain Health Institute, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Dirk De Ridder
- Department of Surgical Sciences, and Pain@Otago Research Theme, University of Otago - Dunedin Campus, Dunedin, New Zealand
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14
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Chen F, Gu X, Hou J. Research on the Formation Mechanism of Individual Food Waste Behavior from the Perspective of Image Construction. Foods 2022; 11:foods11091290. [PMID: 35564014 PMCID: PMC9105058 DOI: 10.3390/foods11091290] [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: 03/11/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 11/16/2022] Open
Abstract
The attention regarding individuals’ external appearance and social identity provides a unique perspective to reveal the cause of their behavior. This study explored the formation mechanism of individual food waste behavior in China from the perspective of appearance image construction and social image construction, especially considering the role of emotion, education level, and body mass index (BMI) in relationship transmission. This study collected data by questionnaire in 133 cities in 32 provinces of China. By using the methods of factor analysis, correlation analysis, and hierarchical regression analysis, the results show that individuals with high need for external appearance image (r = 0.242, p < 0.001) and social image construction (r = 0.31, p < 0.001) are more likely to waste food. In terms of transmission mechanisms, positive emotions (e.g., excitement) (β = 0.104~0.187, 95% confidence interval) and negative emotions (e.g., anxiety and disgust) (β = 0.08~0.177, 95% confidence interval) are the intermediary factors of image construction affecting food waste behavior, and emotional fluctuations can aggravate individuals’ food waste behavior. In terms of interaction effects, BMI significantly positively regulates the predictive effect of image construction on food waste behavior, while the level of education buffers this predictive effect. Finally, relevant policy suggestions are put forward to guide individuals to reduce food waste.
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Affiliation(s)
- Feiyu Chen
- School of Economics and Management, China University of Mining and Technology, No. 1 Daxue Road, Xuzhou 221116, China; (F.C.); (X.G.)
| | - Xiao Gu
- School of Economics and Management, China University of Mining and Technology, No. 1 Daxue Road, Xuzhou 221116, China; (F.C.); (X.G.)
| | - Jing Hou
- Business School, Jiangsu Normal University, No. 101 Shanghai Road, Xuzhou 221116, China
- Correspondence:
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15
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Mingels S, Dankaerts W, van Etten L, Bruckers L, Granitzer M. Exploring multidimensional characteristics in cervicogenic headache: Relations between pain processing, lifestyle, and psychosocial factors. Brain Behav 2021; 11:e2339. [PMID: 34473413 PMCID: PMC8553329 DOI: 10.1002/brb3.2339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/03/2021] [Accepted: 08/09/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Although multidimensional interventions including physiotherapy, psychology, and education are generally recommended in managing headache, and to prevent chronification, such approach is lacking in cervicogenic headache (CeH). Therefore, exploring CeH within a biopsychosocial framework is deemed an essential first step. METHODS Non-randomized cross-sectional design to compare pain processing, lifestyle, and psychosocial characteristics between 18 participants with CeH (CeH group) (40.2 ± 10.9 years) and 18 matched controls (control group) (39.2 ± 13.1 years). Pain processing characteristics included degree of central sensitization (Central Sensitization Inventory), and (extra)-cephalic pressure pain thresholds (kPa/cm²/s). Lifestyle characteristics included sleep quality (Pittsburgh Sleep Quality Index), physical activity, screen time, and sedentary time (hours a week). Psychosocial characteristics included degree of depression, anxiety and stress (Depression Anxiety Stress Scale-21), and quality of life (Headache Impact Test-6). RESULTS Pain processing characteristics: More (p = .04) participants in the CeH group showed higher degrees of central sensitization compared to the control group. Lower (p < .05) (extra)-cephalic pressure pain thresholds were revealed in the CeH group compared to the control group for each muscle. Lifestyle and psychosocial characteristics: Compared to the control group, sleep quality and headache-related quality of life were worse (p < .0001) in the CeH group. Severe to extreme stress was experienced by more participants in the CeH group (p = .02). Further, significant relations between pain processing and (1) lifestyle characteristics and (2) psychosocial characteristics were seen in the CeH group. CONCLUSION Exploring multidimensional characteristics in CeH exposed relations between pain processing, lifestyle, and psychosocial characteristics. These novel findings fill a gap in the current scientific literature, and highlight the need for outcome research targeting lifestyle and psychosocial factors.
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Affiliation(s)
- Sarah Mingels
- REVAL Rehabilitation Research Centre, Faculty of Rehabilitation Sciences and Physiotherapy, Hasselt University, Hasselt, Belgium
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium
| | - Ludo van Etten
- Department of Biometrics, Zuyd Hogeschool, Heerlen, The Netherlands
| | - Liesbeth Bruckers
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Hasselt, Belgium
| | - Marita Granitzer
- REVAL Rehabilitation Research Centre, Faculty of Rehabilitation Sciences and Physiotherapy, Hasselt University, Hasselt, Belgium
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16
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Mingels S, Dankaerts W, van Etten L, Bruckers L, Granitzer M. Spinal postural variability relates to biopsychosocial variables in patients with cervicogenic headache. Sci Rep 2021; 11:13783. [PMID: 34215798 PMCID: PMC8253805 DOI: 10.1038/s41598-021-93138-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/21/2021] [Indexed: 12/23/2022] Open
Abstract
Patients with cervicogenic headache (CeH) showed lower spinal postural variability (SPV). In a next step, the complex character of such SPV needs to be analysed. Therefore, variables influencing SPV need to be explored. A non-randomized repeated-measure design was applied to analyse relations between biopsychosocial variables and SPV within a CeH-group (n = 18), 29–51 years, and matched control-group (n = 18), 26–52 years. Spinal postural variability, expressed by standard deviations, was deducted from 3D-Vicon motion analysis of habitual spinal postures (degrees). Interactions between SPV and pain processing, lifestyle, psychosocial characteristics were analysed. Pain processing characteristics included symptoms of central sensitization (Central Sensitization Inventory), (extra)-cephalic pressure pain thresholds (kPa/cm2/s). Lifestyle characteristics included sleep quality (Pittsburgh Sleep Quality Index), physical activity, screen-time, sedentary-time (hours a week), position (cm) and inclination (degrees) of the laptop (= desk-setup). Psychosocial characteristics included degree of depression, anxiety and stress (Depression Anxiety Stress Scale-21), impact of headache on quality of life (Headache Impact Test-6). Spinal postural variability related significantly to intrinsic (stress, anxiety, extra-cephalic pressure pain thresholds, sleep-duration) and extrinsic (desk-setup, screen-time) variables in the CeH-group. In the control-group, SPV related significantly to extra-cephalic pressure pain thresholds. Spinal postural variability related to diverse variables in the CeH-group compared to the control-group. More research is needed into a possible causal relationship and its clinical implication.
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Affiliation(s)
- Sarah Mingels
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3500, Hasselt, Belgium. .,Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, 3000, Leuven, Belgium.
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, 3000, Leuven, Belgium
| | - Ludo van Etten
- Department of Biometrics, Zuyd Hogeschool, 6419, Heerlen, The Netherlands
| | - Liesbeth Bruckers
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, 3500, Hasselt, Belgium
| | - Marita Granitzer
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3500, Hasselt, Belgium
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17
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Alhalal EA, Alhalal IA, Alaida AM, Alhweity SM, Alshojaa AY, Alfaori AT. Effects of chronic pain on sleep quality and depression: A cross-sectional study. Saudi Med J 2021; 42:315-323. [PMID: 33632911 PMCID: PMC7989257 DOI: 10.15537/smj.42.3.20200768] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 02/09/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: To examined the impacts of chronic pain on depression and poor sleep quality dimensions as well as the mediating function of poor sleep quality in the pathway between chronic pain and depression. Methods: Between March 2019 and February 2020, we conducted a cross-sectional study on 233 chronic pain patients in 2 tertiary hospitals in Riyadh, Saudi Arabia. Results: Of the 233 patients, 36% had depression, while 66.1% had poor sleep quality. Chronic pain intensity and pain disability significantly explained 10.9% of depressed affect variance, 4.9% of anhedonia variance, 17.3% of somatic complaint variance, 4.5% of interpersonal difficulty variance, 7.4% of sleep efficiency variance, and 15% of perceived sleep quality variance. The result also showed a positive, direct effect of chronic pain on poor sleep quality, which in turn positively and directly affect depression. However, chronic pain had only indirect effect on depression. Conclusions: Among chronic pain patients, the high rates of poor sleep quality and depression requires a special attention. Chronic pain intensity and disability predict depression and sleep quality dimensions differently. The result underlines the need of managing poor sleep quality to address depression in the context of chronic pain.
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Affiliation(s)
- Eman A. Alhalal
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Eman A. Alhalal, Community and Mental Health Nursing Department, Nursing College, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: http://orcid.org0000-0001-9892-8509
| | - Ibrahim A. Alhalal
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
| | - Amani M. Alaida
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
| | - Sabreen M. Alhweity
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
| | - Asma Y. Alshojaa
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
| | - Amani T. Alfaori
- From the Community and Mental Health Nursing Department (Alhalal, E), Nursing Collage, King Saud University, Riyadh; from the Neurosurgery Department (Alhalal I), Qatif Central Hospital, Eastern Region; from King Fahad General Hospital (Alaida), Ministry of Health, Al-Madinah; from King Fahad Specialist Hospital (Alhweity), Ministry of Health, Tabuk; from Aseer Central Hospital (Alshojaa), Ministry of Health, Abha; and from Rafha Central Hospital (Alfaori), Ministry of Health, Rafha. Kingdom of Saudi Arabia.
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18
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Van Hoof W, O'Sullivan K, Verschueren S, O'Sullivan P, Dankaerts W. Evaluation of Absenteeism, Pain, and Disability in Nurses With Persistent Low Back Pain Following Cognitive Functional Therapy: A Case Series Pilot Study With 3-Year Follow-Up. Phys Ther 2021; 101:5904882. [PMID: 32949123 DOI: 10.1093/ptj/pzaa164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 09/06/2019] [Accepted: 08/20/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Persistent low back pain (PLBP) is a common and costly health problem worldwide. Better strategies to manage it are required. The purpose of this study was to longitudinally evaluate absenteeism, pain, and disability in nurses with PLBP following a cognitive functional therapy (CFT) intervention. METHODS In this case series pilot study, 33 eligible nurses with PLBP were recruited. During the baseline phase (phase A; no intervention), outcome measures were collected on 2 occasions 6 months apart (A1 and A2). During phase B, participants received an individualized CFT intervention for 14 weeks. During phase C (no intervention), outcomes were measured immediately after the intervention, as well as 3, 6, 9, 12, and 36 months after the intervention (secondary outcomes only until 12 months). LBP-related work absenteeism, pain intensity (numerical pain rating scale) and disability (Oswestry Disability Index) were the primary outcomes. Health care seeking, a range of psychological and lifestyle variables, and global perceived effect were secondary outcomes. RESULTS Days of absenteeism due to LBP were significantly reduced in the first and second calendar years after the CFT intervention but not the third and fourth. Disability was significantly reduced immediately after (-4.4; 95% CI = -6.5 to -2.2) and at 3 months (-4.3; 95% CI = -6.6 to -2.0), 9 months (-6.0; 95% CI = -8.1 to -3.9), and 12 months (-4.9; 95% CI = -7.0 to -2.8) after the intervention. Pain was significantly reduced immediately after (-1.2; 95% CI = -1.7 to -0.8) and at 3 months (-1.5; 95% CI = -2.0 to -0.9), 9 months (-1.1; 95% CI = -1.9 to -0.3), and 12 months (-0.9; 95% CI = -1.5 to -0.2) after the intervention. Total health care seeking (consults and proportion of participants) was significantly reduced after the intervention. All psychosocial variables, except for 1, demonstrated significant improvements at all follow-up assessments. CONCLUSIONS This case series pilot study demonstrated significant reductions in LBP-related absenteeism, pain intensity, disability, health care seeking, and several psychological and lifestyle behaviors until the 1-year follow-up among nurses with PLBP following an individualized CFT intervention. Further evaluation of the efficacy of CFT in high-quality randomized clinical trials among nurses is recommended.
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Affiliation(s)
- Wannes Van Hoof
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
| | - Kieran O'Sullivan
- M Manip Ther, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland, and Ageing Research Centre, Health, Research Institute, University of Limerick
| | - Sabine Verschueren
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
| | - Peter O'Sullivan
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
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19
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Park SH, Song YJC, Demetriou EA, Pepper KL, Thomas EE, Hickie IB, Guastella AJ. Validation of the 21-item Depression, Anxiety, and Stress Scales (DASS-21) in individuals with autism spectrum disorder. Psychiatry Res 2020; 291:113300. [PMID: 32763554 DOI: 10.1016/j.psychres.2020.113300] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/07/2020] [Accepted: 07/12/2020] [Indexed: 12/16/2022]
Abstract
The purpose of the study was to examine the internal consistency and validity of the 21-item Depression Anxiety Stress Scale (DASS-21) in individuals with Autism Spectrum Disorder (ASD) and without intellectual disability (IQ >= 70). Participants (NN = 123) were consecutively recruited from the Brain and Mind Centre in New South Wales, Australia. Internal consistency was determined using Cronbach's alpha. Item-total correlations were evaluated by Pearson's product-moment correlation coefficient. The convergent validity of the DASS-21 was examined by measuring its associations with quality of life and other measures of depression and anxiety. Factorial validity was assessed using confirmatory factor analysis. The DASS-21 demonstrated good internal consistency, adequate convergent validity, and all items exhibited satisfactory item-total correlations. Considering fit indices and factor loadings, the confirmatory factor analysis results provided support for the original 3-factor oblique model consisting of depression, anxiety, and stress factors. The model fit could be further improved with some modifications. Overall, the results indicate that the DASS-21 is a viable self-report screening measure for depression, anxiety, and stress in individuals with ASD and without intellectual disability.
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Affiliation(s)
- Shin Ho Park
- Autism Clinic for Translational Research, Child Development and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2050, Australia
| | - Yun Ju C Song
- Autism Clinic for Translational Research, Child Development and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2050, Australia
| | - Eleni A Demetriou
- Autism Clinic for Translational Research, Child Development and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2050, Australia
| | - Karen L Pepper
- Autism Clinic for Translational Research, Child Development and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2050, Australia
| | - Emma E Thomas
- Autism Clinic for Translational Research, Child Development and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2050, Australia
| | - Ian B Hickie
- Autism Clinic for Translational Research, Child Development and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2050, Australia; Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
| | - Adam J Guastella
- Autism Clinic for Translational Research, Child Development and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2050, Australia.
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Anghel E. Longitudinal invariance and information of the Depression, Anxiety, and Stress Scales. J Clin Psychol 2020; 76:1923-1937. [DOI: 10.1002/jclp.22968] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ella Anghel
- Department of Measurement, Evaluation, Statistics, and Assessment, Lynch School of Education and Human Development Boston College Chestnut Hill Massachusetts
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Hypertension prevalence in patients attending tertiary pain management services, a registry-based Australian cohort study. PLoS One 2020; 15:e0228173. [PMID: 31978196 PMCID: PMC6980551 DOI: 10.1371/journal.pone.0228173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/08/2020] [Indexed: 12/20/2022] Open
Abstract
Persistent pain and hypertension often co-occur, and share several biological and lifestyle risk factors. The present study aimed to provide insight into the prevalence of, and factors associated with, hypertension in the largest cohort of patients seeking treatment in 43 tertiary pain clinics in Australia. Adults aged > = 18 years registered to the electronic Persistent Pain Outcomes Collaboration registry between 2013 and 2018 were included if they had persistent non-cancer pain (N = 43,789). Risk Ratios (RRs) compared prevalence of self-reported hypertension with the general and primary care Australian populations, and logistic regression examined factors associated with hypertension. One in four (23.9%) patients had hypertension, which was higher than the Australian adult population (2014–15: RR = 5.86, 95%CI: 5.66, 6.06; 2017–18: RR = 9.40, 95%CI: 9.01, 9.80), and in primary care patients (2011–13: RR = 1.17, 95%CI: 1.15, 1.20). Adjusting for covariates, patients with higher odds of hypertension were older, lived in regions with higher socioeconomic disadvantage, had higher levels of BMI, were born outside the Oceania/Australasia region, and had comorbid arthritis, diabetes, or severe-extremely severe anxiety symptoms. Female patients and those with depression symptoms had lower adjusted odds. Unadjusted analyses showed an association between widespread pain, pain duration, pain severity and interference, and lower pain self-efficacy with hypertension; however, only pain severity remained significant in adjusted analyses. Hypertension was more prevalent in people with persistent pain than in the general community, was associated with more severe pain, and commonly co-occurred with pain-related impairments. Routine hypertension screening and treatment targeting shared mechanisms of hypertension and pain may improve treatment outcomes in the pain clinic setting.
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Jenkins LC, Chang WJ, Buscemi V, Liston M, Toson B, Nicholas M, Graven-Nielsen T, Ridding M, Hodges PW, McAuley JH, Schabrun SM. Do sensorimotor cortex activity, an individual's capacity for neuroplasticity, and psychological features during an episode of acute low back pain predict outcome at 6 months: a protocol for an Australian, multisite prospective, longitudinal cohort study. BMJ Open 2019; 9:e029027. [PMID: 31123007 PMCID: PMC6538004 DOI: 10.1136/bmjopen-2019-029027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/20/2019] [Accepted: 03/20/2019] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Low back pain (LBP) is the leading cause of disability worldwide, with prevalence doubling in the past 14 years. To date, prognostic screening tools display poor discrimination and offer no net benefit of screening over and above a 'treat all' approach. Characteristics of the primary sensory (S1) and motor (M1) cortices may predict the development of chronic LBP, yet the prognostic potential of these variables remains unknown. The Understanding persistent Pain Where it ResiDes (UPWaRD) study aims to determine whether sensorimotor cortex activity, an individual's capacity for plasticity and psychosocial factors in the acute stage of pain, predict LBP outcome at 6 months. This paper describes the methods and analysis plan for the development of the prediction model. METHODS AND ANALYSIS The study uses a multicentre prospective longitudinal cohort design with 6-month follow-up. 120 participants, aged 18 years or older, experiencing an acute episode of LBP (less than 6 weeks duration) will be included. Primary outcomes are pain and disability. ETHICS AND DISSEMINATION Ethical approval has been obtained from Western Sydney University Human Research Ethics Committee (H10465) and from Neuroscience Research Australia (SSA: 16/002). Dissemination will occur through presentations at national and international conferences and publications in international peer-reviewed journals. TRIAL REGISTRATION NUMBER ACTRN12619000002189; Pre-results.
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Affiliation(s)
- Luke C Jenkins
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Science and Health, The University of Western Sydney, Penrith, New South Wales, Australia
| | - Wei-Ju Chang
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Science and Health, The University of Western Sydney, Penrith, New South Wales, Australia
| | - Valentina Buscemi
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Science and Health, The University of Western Sydney, Penrith, New South Wales, Australia
| | - Matthew Liston
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Science and Health, The University of Western Sydney, Penrith, New South Wales, Australia
| | - Barbara Toson
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Michael Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, New South Wales, Australia
| | | | - Michael Ridding
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - James H McAuley
- University of New South Wales, Neuroscience Research Australia, Sydney, New South Wales, Australia
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Lee J, Lee EH, Moon SH. Systematic review of the measurement properties of the Depression Anxiety Stress Scales-21 by applying updated COSMIN methodology. Qual Life Res 2019; 28:2325-2339. [PMID: 30937732 DOI: 10.1007/s11136-019-02177-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE The Depression Anxiety Stress Scales (DASS)-21 measures emotional symptoms of depression, anxiety, and stress, is relatively short, and is freely available in the public domain, which has resulted in it being applied to various clinical and non-clinical populations in many countries. The aim of this study was to systematically review the measurement properties of the DASS-21. METHODS The MEDLINE, Embase, and CINAHL databases were searched. The methodological quality of each identified study was assessed using the updated COSMIN Risk of Bias checklist. The quality of the measurement properties of the studies was rated using the updated criteria for good measurement properties. The quality of evidence was rated using a modified version of the GRADE approach. RESULTS This study included 48 studies in its review. The content validity of the DASS-21 demonstrated sufficient moderate-quality evidence. The instrument exhibited sufficient high-quality evidence for bifactor structural validity and internal consistency. The instrument also showed sufficient high-quality evidence for hypothesis testing of construct validity. Regarding criterion validity, only the DASS-21 Depression subscale demonstrated sufficient high-quality evidence. The measurement invariance across gender demonstrated inconsistent moderate-quality evidence. There was insufficient low-quality evidence for the reliability of each subscale. For responsiveness there was sufficient low-quality evidence for depression and stress subscales, and insufficient very-low-quality evidence for anxiety subscale. CONCLUSIONS The DASS-21 demonstrated sufficient high-quality evidence for bifactor structural validity, internal consistency (bifactor), criterion validity (Depression subscale), and hypothesis testing for construct validity. Further studies are required to assess the other measurement properties of the DASS-21.
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Affiliation(s)
- Jiyeon Lee
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Eun-Hyun Lee
- Graduate School of Public Health, Ajou University, 164 World cup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea.
| | - Seung Hei Moon
- Department of Nursing, Graduate School, Inha University, Incheon, Republic of Korea
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Wilson N, Wynter K, Anderson C, Rajaratnam SMW, Fisher J, Bei B. More than depression: a multi-dimensional assessment of postpartum distress symptoms before and after a residential early parenting program. BMC Psychiatry 2019; 19:48. [PMID: 30696418 PMCID: PMC6352433 DOI: 10.1186/s12888-019-2024-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/11/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Parents are vulnerable to psychological distress symptoms in the postpartum period. It is routine to screen for depressive symptoms, but anxiety, stress, fatigue, irritability and insomnia symptoms are less often assessed despite their prevalence. This study aimed to assess multiple dimensions of psychological distress, and their reliable change and clinically significant change among women admitted to a residential program for assistance with unsettled infant behaviors (UIB). METHOD Women admitted to a five-night residential early parenting program completed self-report measures: the Depression Anxiety Stress Scale, Irritability Depression Anxiety Scale, Fatigue Severity Scale, and Insomnia Severity Index. A sub-group completed a computerized emotional Go-NoGo (EGNG) task as a measure of emotional impulsivity. RESULTS Seventy-eight women were recruited (Mage = 34.46, SDage = 4.16). On admission, 48% of women reported clinically elevated depressive symptoms and 97.5% of women not reporting elevated depressive symptoms reported clinical elevations in at least one other form of distress. Upon discharge, all self-report distress symptoms were significantly reduced (all p-values <.001), but reliable and clinically significant change only occurred in a subgroup of women. There were no significant changes in indicators of impulsivity based on the EGNG. CONCLUSIONS In addition to, and often in the absence of, depressive symptoms, women attending an early parenting program experienced a wide range of psychological distress, including fatigue, insomnia, anxiety and stress. Different forms of distress improved in different magnitudes to the treatment provided. These findings highlight the need for a multi-dimensional approach in the assessment and treatment of postpartum distress.
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Affiliation(s)
- Nathan Wilson
- Faculty of Medicine, Nursing and Health Sciences, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Clayton, VIC, 3800, Australia
| | - Karen Wynter
- Global Public Health Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
- Centre for Quality and Patient Safety Research - Western Health Partnership, School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Clare Anderson
- Faculty of Medicine, Nursing and Health Sciences, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Clayton, VIC, 3800, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, VIC, Australia
| | - Shanthakumar M W Rajaratnam
- Faculty of Medicine, Nursing and Health Sciences, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Clayton, VIC, 3800, Australia
- Cooperative Research Centre for Alertness, Safety and Productivity, Clayton, VIC, Australia
- NHMRC Centre for Sleep and Circadian Neurobiology, Sydney, NSW, Australia
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Jane Fisher
- Global Public Health Unit, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
- Masada Early Parenting Centre, Masada Private Hospital, East St Kilda, VIC, Australia
| | - Bei Bei
- Faculty of Medicine, Nursing and Health Sciences, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Clayton, VIC, 3800, Australia.
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Gómez‐Benito J, Berrío ÁI, Guilera G, Rojo E, Purdon S, Pino O. The Screen for Cognitive Impairment in Psychiatry: Proposal for a polytomous scoring system. Int J Methods Psychiatr Res 2018; 27:e1598. [PMID: 29110352 PMCID: PMC6877218 DOI: 10.1002/mpr.1598] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 01/02/2023] Open
Abstract
The Screen for Cognitive Impairment in Psychiatry is a simple, fast, and easy to administer scale that has been validated in clinical and community samples. The aim of this study was to propose a polytomous scoring system for the Screen for Cognitive Impairment in Psychiatry and to demonstrate its functioning, thus providing new and complementary information regarding the utility and precision of this screening tool. Three hundred seventy-six Spanish patients diagnosed with schizophrenia spectrum disorder were evaluated. A polytomous scoring system was generated and analyzed by means of the partial credit model. Category assessment revealed optimal functioning after collapsing the 7-category system to 1 with either 5 or 4 categories, depending on the item. The proposed polytomous scoring system shows good psychometric properties and an adequate fit to the partial credit model. These results provide further confirmation of the test's utility in clinical settings and of its suitability for detecting cognitive impairment.
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Affiliation(s)
- Juana Gómez‐Benito
- Quantitative Psychology Unit, Faculty of PsychologyUniversity of BarcelonaBarcelonaSpain
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences (NeuroUB)University of BarcelonaBarcelonaSpain
| | - Ángela I. Berrío
- Quantitative Psychology Unit, Faculty of PsychologyUniversity of BarcelonaBarcelonaSpain
| | - Georgina Guilera
- Quantitative Psychology Unit, Faculty of PsychologyUniversity of BarcelonaBarcelonaSpain
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences (NeuroUB)University of BarcelonaBarcelonaSpain
| | - Emilio Rojo
- Benito Menni CASMGermanes HospitalàriesBarcelonaSpain
- Department of PsychiatryInternational University of CataloniaBarcelonaSpain
| | - Scot Purdon
- Department of PsychiatryUniversity of AlbertaEdmontonAlbertaCanada
| | - Oscar Pino
- Quantitative Psychology Unit, Faculty of PsychologyUniversity of BarcelonaBarcelonaSpain
- Benito Menni CASMHospital General de GranollersGranollersSpain
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Esakki S, MacDermid JC, Vincent JI, Packham TL, Walton D, Grewal R. Rasch analysis of the patient-rated wrist evaluation questionnaire. Arch Physiother 2018; 8:5. [PMID: 29497563 PMCID: PMC5828063 DOI: 10.1186/s40945-018-0046-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 02/08/2018] [Indexed: 11/13/2022] Open
Abstract
Background The Patient-Rated Wrist Evaluation (PRWE) was developed as a wrist joint specific measure of pain and disability and evidence of sound validity has been accumulated through classical psychometric methods. Rasch analysis (RA) has been endorsed as a newer method for analyzing the clinical measurement properties of self-report outcome measures. The purpose of this study was to evaluate the PRWE using Rasch modeling. Methods We employed the Rasch model to assess overall fit, response scaling, individual item fit, differential item functioning (DIF), local dependency, unidimensionality and person separation index (PSI). A convenience sample of 382 patients with distal radius fracture was recruited from the hand and upper limb clinic at large academic healthcare organization, London, Ontario, Canada, 6-month post-injury scores of the PRWE was used. RA was conducted on the 3 subscales (pain, specific activities, and usual activities) of the PRWE separately. Results The pain subscale adequately fit the Rasch model when item 4 “Pain - When it is at its worst” was deleted to eliminate non-uniform DIF by age group, and item 5 “How often do you have pain” was rescored by collapsing into 8 intervals to eliminate disordered thresholds. Uniform DIF for “Use my affected hand to push up from the chair” (by work status) and “Use bathroom tissue with my affected hand” (by injured hand) was addressed by splitting the items for analysis. After background rescoring of 2 items in pain subscale, 2 items in specific activities and 3 items in usual activities, all three subscales of the PRWE were well targeted and had high reliability (PSI = 0.86). These changes provided a unidimensional, interval-level scaled measure. Conclusion Like a previous analysis of the Patient-Rated Wrist and Hand Evaluation, this study found the PRWE could be fit to the Rasch model with rescoring of multiple items. However, the modifications required to achieve fit were not the same across studies, our fit statistics also suggested one of the pain items should be deleted. This study adds to the pool of evidence supporting the PRWE, but cannot confidently provide a Rasch-based scoring algorithm. Electronic supplementary material The online version of this article (10.1186/s40945-018-0046-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saravanan Esakki
- 1School of Physical Therapy, Western University, London, ON Canada
| | - Joy C MacDermid
- 1School of Physical Therapy, Western University, London, ON Canada.,3The Hand and Upper Limb Centre, St Joseph's Health Centre, London, ON Canada
| | - Joshua I Vincent
- 1School of Physical Therapy, Western University, London, ON Canada
| | - Tara L Packham
- 2School of Rehabilitation Science, McMaster University, Hamilton, ON Canada
| | - David Walton
- 1School of Physical Therapy, Western University, London, ON Canada
| | - Ruby Grewal
- 3The Hand and Upper Limb Centre, St Joseph's Health Centre, London, ON Canada.,4Department of Surgery, University of Western Ontario, London, ON Canada
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Taylor TA, Medvedev ON, Owens RG, Siegert RJ. Development and validation of the State Contentment Measure. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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The Arabic Version of The Depression Anxiety Stress Scale-21: Cumulative scaling and discriminant-validation testing. Asian J Psychiatr 2017; 30:56-58. [PMID: 28755630 DOI: 10.1016/j.ajp.2017.07.018] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/03/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study aimed to examine the validity of the Arabic version of the Depression Anxiety Stress Scale-21 (DASS-21) in 149 illicit drug users. METHODS We calculated α coefficient, inter-item and item-total correlations, coefficients of reproducibility and scalability (CR and CS), item difficulty and discrimination indices. RESULTS The DASS-21 had an acceptable reliability; but values of the CR and the CS were less than acceptable. Items varied in difficulty and discrimination; some items are candidates for elimination. CONCLUSION The DASS-21 is a probabilistic and not a deterministic measure of distress; it has problematic items and needs further investigations.
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Wardenaar KJ, Wanders RBK, Jeronimus BF, de Jonge P. The Psychometric Properties of an Internet-Administered Version of the Depression Anxiety and Stress Scales (DASS) in a Sample of Dutch Adults. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017; 40:318-333. [PMID: 29937624 PMCID: PMC5978836 DOI: 10.1007/s10862-017-9626-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Psychometric work on the widely used Depression Anxiety and Stress Scales (DASS) has mostly used classical psychometrics and ignored common internet-administered versions. Therefore, the present study used not only classical, but also modern psychometrics based on item response theory (IRT) to evaluate an internet-administered version of the DASS (Dutch translation). Internet-administered DASS data were collected as part of a large internet-based study in the Dutch adult population (n = 7972). Initially, external correlates (i.e. demographics other measures) and some classical psychometrics (internal consistency, convergent/divergent validity) of the DASS scales were evaluated. Next, IRT was used to investigate the scales' dimensionality, discrimination and item-functioning. Finally, the DASS depression scale was further investigated by linking it to the more clinically-oriented Quick Inventory of Depressive Symptomatology (QIDS) using item response theory (IRT). Initial classical psychometric analyses supported the scales' internal consistency (alpha = 0.94-0.98) and convergent/divergent validity. IRT analyses showed that each of the DASS scales was only suitable to measure variations in a very narrow and rather mild severity range. Linking the DASS depression scale with the QIDS also showed that the DASS depression scale discriminated best in the mild-moderate severity range, but not at higher severity levels that were covered by the QIDS. In conclusion, the scales of the internet-administered DASS show good internal consistency and validity. However, users should be aware that the scales discriminate best at mild-moderate severity ranges in the general population.
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Affiliation(s)
- Klaas J Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen (UMCG), P.O. box 30.001, 9700RB Groningen, The Netherlands
| | - Rob B K Wanders
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen (UMCG), P.O. box 30.001, 9700RB Groningen, The Netherlands.,2Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Bertus F Jeronimus
- 2Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Peter de Jonge
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen (UMCG), P.O. box 30.001, 9700RB Groningen, The Netherlands.,2Faculty of Behavioural and Social Sciences, Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
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Chiarotto A, Terwee CB, Ostelo RW. Choosing the right outcome measurement instruments for patients with low back pain. Best Pract Res Clin Rheumatol 2017; 30:1003-1020. [PMID: 29103546 DOI: 10.1016/j.berh.2017.07.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 07/01/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
Abstract
Choosing the most fit-for-purpose outcome measurement instruments is fundamental because using inappropriate instruments can lead to detection bias and measurement inconsistency. Recent recommendations, consensus procedures and systematic reviews on existing patient-reported outcome measures (PROMs) informed this manuscript, which provides suggestions on which outcome domains and measurement instruments to use in patients with low back pain (LBP). Six domains are identified as highly relevant: (1) physical functioning, (2) pain intensity, (3) health-related quality of life, (4) work, (5) psychological functioning and (6) pain interference. For each domain, one or more PROMs are suggested for clinical research and practice, selecting among those that are most frequently used and recommended, and that have satisfactory measurement properties in patients with LBP. Further research on the measurement properties of these suggested PROMs is needed while also considering other emerging instruments, such as the PROMIS computerised adaptive testing and short forms.
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Affiliation(s)
- Alessandro Chiarotto
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Raymond W Ostelo
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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Jafari P, Nozari F, Ahrari F, Bagheri Z. Measurement invariance of the Depression Anxiety Stress Scales-21 across medical student genders. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2017; 8:116-122. [PMID: 28362630 PMCID: PMC5376494 DOI: 10.5116/ijme.58ba.7d8b] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 03/04/2017] [Indexed: 05/31/2023]
Abstract
OBJECTIVES This study aimed to assess whether male and female Iranian medical students perceived the meaning of the items in the Depression Anxiety Stress Scales-21 consistently. METHODS A convenience sample of 783 preclinical medical students from the first to sixth semester was invited to this cross-sectional study. Of the 477 respondents, 238 were male and 239 were female. All participants completed the Persian version of the Depression Anxiety Stress Scales-21. The graded response model was used to assess measurement invariance of the instrument across the gender groups. Categorical confirmatory factor analysis was used to evaluate the construct validity of the measure. Moreover, internal consistency was assessed via Cronbach's Alpha. RESULTS Statistically significant differential item functioning was flagged for just item 6 in the depression subscales (c2=6.5, df=1, p=0.011). However, removing or retaining the item 6 in the stress subscale did not change our findings significantly, when we compared stress scores across two genders. The results of categorical confirmatory factor analysis supported the fit of the three-factor model of Depression Anxiety Stress Scales-21. Moreover, Cronbach's alpha was greater than 0.7 in depression, anxiety and stress subscales. CONCLUSIONS This study revealed that Depression Anxiety Stress Scales-21 is an invariant measure across male and female medical students. Hence, this reliable and valid instrument can be used for meaningful comparison of distress scores between medical student genders. Gender comparisons of medical students' psychological profiles provide a better insight into gender influences on the outcome of medical education and medical practice.
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Affiliation(s)
- Peyman Jafari
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farnoosh Nozari
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zahra Bagheri
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
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Abstract
BACKGROUND The assessment of mental distress is a central aspect in pain research and treatment. Particularly for depression the comorbidity with pain poses methodological and conceptual challenges. This study examined the psychometric properties of the short version of the depression, anxiety and stress scale (DASS), used in both pain research and treatment and constructed to overcome the particular problems by omitting somatic items and concentrating on the psychological core aspects of depression, anxiety and stress. METHOD The psychometric properties of the DASS-21 were compared between patients with pain and various people without any pain problems (N = 950). The DASS has three subscales, depression, anxiety and stress, each with seven items. The construct validity of the DASS was examined using the hospital anxiety and depression scale (HADS) for anxiety and depression and the general depression scale (Allgemeine Depressionsskala, ADS) for depression. The sensitivity and specificity for depression were determined against a structured interview for diagnostic and statistical manual of mental disorders (DSM-IV) and compared with the Center for Epidemiological Studies depression scale (CESD) and HADS in pain patients. RESULTS Cronbach's alpha of the DASS for the depression subscale was at least 0.91, while the anxiety and stress subscales had Cronbach alphas of 0.78-0.82 and 0.81-0.89, respectively. Although the depression subscale has only 7 items, it is just as reliable as the ADS with 21 items. It also has a better sensitivity and specificity than the HADS in identifying clinical patients with depression. DISCUSSION The DASS is a reliable questionnaire, free to use and brief to administer; therefore, it is an alternative to the previously used instruments for the screening of depression. Furthermore, the subscale stress measures irritability and tension, which are important aspects of pain experience but underused in assessment procedures for the diagnosis and treatment evaluation of patients with pain.
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Affiliation(s)
- P Nilges
- DRK Schmerz-Zentrum, Auf der Steig 14, 55131, Mainz, Deutschland.
| | - C Essau
- Department of Psychology, University of Roehampton, London, England
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Differing Psychologically Derived Clusters in People With Chronic Low Back Pain are Associated With Different Multidimensional Profiles. Clin J Pain 2016; 32:1015-1027. [DOI: 10.1097/ajp.0000000000000363] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Madden VJ, Russek LN, Harvie DS, Vlaeyen JW, Moseley GL. Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. PAIN MEDICINE 2016; 18:1314-1325. [DOI: 10.1093/pm/pnw221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Berryman C, Wise V, Stanton TR, McFarlane A, Moseley GL. A case-matched study of neurophysiological correlates to attention/working memory in people with somatic hypervigilance. J Clin Exp Neuropsychol 2016; 39:84-99. [DOI: 10.1080/13803395.2016.1203869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Trindade IA, Ferreira C, Pinto-Gouveia J. Ulcerative Colitis Symptomatology and Depression: The Exacerbator Role of Maladaptive Psychological Processes. Dig Dis Sci 2015; 60:3756-63. [PMID: 26141631 DOI: 10.1007/s10620-015-3786-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 06/27/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Several studies have indicated that depressive symptomatology plays a pertinent role in the clinical recurrences of ulcerative colitis (UC). Due to the self-perpetuating cycle between UC symptomatology and depressive mood, it is considered that more investment should be given to the study of factors that influence depressive symptomatology in UC patients. AIMS This study aimed therefore at analyzing the exacerbator effect of maladaptive psychological strategies, such as cognitive fusion and brooding, on the relationship between UC symptomatology and depressive symptoms. METHODS The sample of the current study included 84 Portuguese patients with UC that completed an Internet-based survey (comprising demographic and medical questions, and self-report measures of depression, cognitive fusion, and brooding). RESULTS Results showed that UC symptomatology explained 21% of depression severity's variance. In addition, a significant interaction between UC symptomatology and cognitive fusion was found and explained 50% of depressive symptoms' severity. A similar interaction was revealed between UC symptomatology and brooding, which accounted for 42% of depression's variance. These findings demonstrated that, for the same level of UC symptomatology, those participants who revealed more cognitive fusion or more brooding presented significant higher levels of depression. CONCLUSIONS The present study revealed cognitive fusion and brooding as moderators that exacerbate the impact of UC symptomatology on reported levels of depression. Psychological interventions that focus on the promotion of adaptive emotion regulation strategies to deal with adverse and stressful events should therefore be developed and implemented in UC patients' health care.
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Affiliation(s)
- Inês A Trindade
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal.
| | - Cláudia Ferreira
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal
| | - José Pinto-Gouveia
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal
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Ross C, Juraskova I, Lee H, Parkitny L, Stanton TR, Moseley GL, McAuley JH. Psychological Distress Mediates the Relationship Between Pain and Disability in Hand or Wrist Fractures. THE JOURNAL OF PAIN 2015; 16:836-43. [PMID: 26072389 DOI: 10.1016/j.jpain.2015.05.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 05/17/2015] [Accepted: 05/28/2015] [Indexed: 11/16/2022]
Abstract
Upper limb fracture is a common musculoskeletal injury and can lead to marked pain-related disability. Unlike other common painful musculoskeletal conditions, such as low back pain, little consideration has been given to the role that psychological variables may play in explaining the relationship between pain and disability during early fracture recovery. This cross-sectional study aimed to determine if psychological distress (symptoms of depression, anxiety, and/or stress) mediate the relationship between pain and disability in acute hand/wrist fractures. Self-reported data from a consecutive sample of 594 patients with acute hand/wrist fracture were used. Mediation analyses were conducted to determine the role of depression, anxiety, and stress in the relationship between pain and disability, controlling for relevant demographic and fracture-related variables. Depression and stress, but not anxiety, significantly mediated the relationship between pain and disability. That is, although each psychological distress variable was associated with pain (P < .001), only depression (b1 = 0.27, P = .03) and stress (b3 = .23, P = .02) were significantly associated with disability and fulfilled recommended criteria for establishing a mediating variable. Increased depression and stress, but not anxiety, explain the relationship between pain and disability and may be novel targets for interventions designed to reduce pain-related disability after upper limb fracture. Perspective: This study presents the mediating effect of psychological distress on the relationship between pain and disability in acute upper limb fracture. These factors may be novel targets for interventions designed to reduce pain-related disability after acute fracture.
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Affiliation(s)
- Cassie Ross
- Neuroscience Research Australia, Sydney, Australia; University of California San Francisco, Madison Clinic for Pediatric Diabetes, San Francisco, California
| | - Ilona Juraskova
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, University of Sydney, NSW, Australia
| | - Hopin Lee
- Neuroscience Research Australia, Sydney, Australia; University of New South Wales Clinical School, Sydney, Australia
| | - Luke Parkitny
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Tasha R Stanton
- Neuroscience Research Australia, Sydney, Australia; University of South Australia, PainAdelaide, Adelaide, Australia
| | - G Lorimer Moseley
- Neuroscience Research Australia, Sydney, Australia; University of South Australia, PainAdelaide, Adelaide, Australia
| | - James H McAuley
- Neuroscience Research Australia, Sydney, Australia; University of New South Wales Clinical School, Sydney, Australia
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Abstract
This paper illustrates a sequential item development process to create a new self-report instrument of depression refined with Rasch analysis from a larger pool of potential diagnostic items elicited through a consensus approach by clinical experts according to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders criteria for major depression. A 51-item pool was administered to a sample of 529 subjects (300 healthy community-dwelling adults and 229 psychiatric outpatients). Item selection resulted in a 21-item set, named the Teate Depression Inventory, with an excellent Person Separation Index and no evidence of bias due to an item-trait interaction (χ (2)=147.71; df =168; P=0.48). Additional support for the unidimensionality, local independence, appropriateness of the response format, and discrimination ability between clinical and nonclinical subjects was provided. No substantial differential item functioning by sex was observed. The Teate Depression Inventory shows considerable promise as a unidimensional tool for the screening of depression. Finally, advantages and disadvantages of this methodology will be discussed in terms of subsequent possible mathematical analyses, statistical tests, and implications for clinical investigations.
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Affiliation(s)
- Michela Balsamo
- DiSPUTer, Department of Psychological Sciences, Humanities and Territory, “G d’Annunzio” University, Chieti-Pescara, Italy
| | - Giuseppe Giampaglia
- Department of Economics and Statistics, “Federico-II” University, Naples, Italy
| | - Aristide Saggino
- DiSPUTer, Department of Psychological Sciences, Humanities and Territory, “G d’Annunzio” University, Chieti-Pescara, Italy
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G. Tay T, L. Willcocks A, F. Chen J, Jastrzab G, Khor KE. A Descriptive Longitudinal Study of Chronic Pain Outcomes and Gender Differences in a Multidisciplinary Pain Management Centre. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/pst.2014.22010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
BACKGROUND The Pain Self-Efficacy Questionnaire (PSEQ) is used by physical therapists in clinical practice and in research. However, current understanding of the PSEQ's measurement properties is incomplete, and investigators cannot be confident that it provides unbiased information on patient self-efficacy. OBJECTIVE The aims of this study were: (1) to investigate the scale properties of the PSEQ using Rasch analysis and (2) to determine whether age, sex, pain intensity, pain duration, and pain-related disability bias function of the PSEQ. DESIGN This was a retrospective study; data were obtained from 3 existing studies. METHODS Data were combined from more than 600 patients with low back pain of varying duration. Rasch analysis was used to evaluate targeting, category ordering, unidimensionality, person fit, internal consistency, and item bias. RESULTS There was evidence of adequate category ordering, unidimensionality, and internal consistency of the PSEQ. Importantly, there was no evidence of item bias. LIMITATIONS The PSEQ did not adequately target the sample; instead, it targeted people with lower self-efficacy than this population. Item 7 was hardest for participants to endorse, showing excessive positive misfit to the Rasch model. Response strings of misfitting persons revealed older participants and those reporting high levels of disability. CONCLUSIONS The individual items of the PSEQ can be validly summed to provide a score of self-efficacy that is robust to age, sex, pain intensity, pain duration, and disability. Although item 7 is the most problematic, it may provide important clinical information and requires further investigation before its exclusion. Although the PSEQ is commonly used with people with low back pain, of whom the sample in this study was representative, the results suggest it targets patients with lower self-efficacy than that observed in the current sample.
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The value of pain coping constructs in subcategorising back pain patients according to risk of poor outcome. BIOMED RESEARCH INTERNATIONAL 2013; 2013:898573. [PMID: 24260746 PMCID: PMC3821903 DOI: 10.1155/2013/898573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 09/11/2013] [Accepted: 09/11/2013] [Indexed: 11/17/2022]
Abstract
Background. Subcategorising patients with chronic low back pain (CLBP) could improve patient outcomes and facilitate prioritisation of treatment resources. Objective. This study aimed to develop a subcategorising method for individuals with CLBP using the Coping Strategies Questionnaire 24 (CSQ24) and to investigate the methods potential validity. Methods. 196 patients were recruited from a physiotherapy outpatients department. All participants completed a battery of questionnaires before and after treatment including the CSQ24 and a measure of pain, disability, and mood. At discharge participants also completed a global subjective outcomes scale consisting of a 6-point Likert scale. All participants received usual physiotherapy. Results. Cut-off values for the CSQ24 were calculated using triangulation of the findings from three different statistical methods. Cut-off values were identified for the Catastrophising and Cognitive Coping subscales of the CSQ24. Participants were categorised into low, medium, and high risk of a poor outcome. The cut-off values for these were ≥21 on Cognitive Coping and ≤9 on Catastrophising for low risk and ≤15 on Cognitive Coping for high risk, with all other patients being classified as being at moderate risk. Conclusion. Further validation is required before this approach can be recommended for clinical practice.
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Rio E, Moseley L, Purdam C, Samiric T, Kidgell D, Pearce AJ, Jaberzadeh S, Cook J. The Pain of Tendinopathy: Physiological or Pathophysiological? Sports Med 2013; 44:9-23. [DOI: 10.1007/s40279-013-0096-z] [Citation(s) in RCA: 172] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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