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You B, Wen H, Jackson T. Resting-state brain activity as a biomarker of chronic pain impairment and a mediator of its association with pain resilience. Hum Brain Mapp 2024; 45:e26780. [PMID: 38984446 PMCID: PMC11234141 DOI: 10.1002/hbm.26780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 06/02/2024] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
Past cross-sectional chronic pain studies have revealed aberrant resting-state brain activity in regions involved in pain processing and affect regulation. However, there is a paucity of longitudinal research examining links of resting-state activity and pain resilience with changes in chronic pain outcomes over time. In this prospective study, we assessed the status of baseline (T1) resting-state brain activity as a biomarker of later impairment from chronic pain and a mediator of the relation between pain resilience and impairment at follow-up. One hundred forty-two adults with chronic musculoskeletal pain completed a T1 assessment comprising a resting-state functional magnetic resonance imaging scan based on regional homogeneity (ReHo) and self-report measures of demographics, pain characteristics, psychological status, pain resilience, pain severity, and pain impairment. Subsequently, pain impairment was reassessed at a 6-month follow-up (T2). Hierarchical multiple regression and mediation analyses assessed relations of T1 ReHo and pain resilience scores with changes in pain impairment. Higher T1 ReHo values in the right caudate nucleus were associated with increased pain impairment at T2, after controlling for all other statistically significant self-report measures. ReHo also partially mediated associations of T1 pain resilience dimensions with T2 pain impairment. T1 right caudate nucleus ReHo emerged as a possible biomarker of later impairment from chronic musculoskeletal pain and a neural mechanism that may help to explain why pain resilience is related to lower levels of later chronic pain impairment. Findings provide empirical foundations for prospective extensions that assess the status of ReHo activity and self-reported pain resilience as markers for later impairment from chronic pain and targets for interventions to reduce impairment. PRACTITIONER POINTS: Resting-state markers of impairment: Higher baseline (T1) regional homogeneity (ReHo) values, localized in the right caudate nucleus, were associated with exacerbations in impairment from chronic musculoskeletal pain at a 6-month follow-up, independent of T1 demographics, pain experiences, and psychological factors. Mediating role of ReHo values: ReHo values in the right caudate nucleus also mediated the relationship between baseline pain resilience levels and later pain impairment among participants. Therapeutic implications: Findings provide empirical foundations for research extensions that evaluate (1) the use of resting-state activity in assessment to identify people at risk for later impairment from pain and (2) changes in resting-state activity as biomarkers for the efficacy of treatments designed to improve resilience and reduce impairment among those in need.
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Affiliation(s)
- Beibei You
- School of NursingGuizhou Medical UniversityGuian New DistrictChina
| | - Hongwei Wen
- Key Laboratory of Cognition and Personality (Ministry of Education), Faculty of PsychologySouthwest UniversityChongqingChina
| | - Todd Jackson
- Department of PsychologyUniversity of MacauTaipaMacau, SARChina
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Hall OT, Gunawan T, Teater J, Bryan C, Gorka S, Ramchandani VA. Withdrawal interference scale: a novel measure of withdrawal-related life disruption in opioid use disorder and alcohol use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024:1-13. [PMID: 38853684 DOI: 10.1080/00952990.2024.2350057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 04/28/2024] [Indexed: 06/11/2024]
Abstract
Background: Hyperkatifeia describes amplified emotional and motivational withdrawal due to addiction-related sensitization of brain-stress-systems. Hyperkatifeia has been proposed as a target for addiction treatment development. However, translation of basic research in this area will require new tools designed to measure hyperkatifeia and related phenomena outside of laboratory settings.Objectives: We define a novel concept, withdrawal interference, and introduce a new tool - the Withdrawal Interference Scale (WIS) - which measures the impact of withdrawal on daily life among individuals with OUD or AUD.Methods: Described are the combined results of three separate cross-sectional studies. The structural validity, convergent validity, construct validity, trans-diagnostic (AUD/OUD) configural, metric, and scalar invariance, internal consistency, and composite reliability of WIS was tested among three independent samples of 1) treatment-seeking adults with OUD (n = 132), 2) treatment-seeking adults with AUD (n = 123), and 3) non-treatment-seeking adults with OUD (n = 140). Males numbered 218 and females were 163.Results: WIS exhibited structural validity (1 factor), convergent validity (average variance extracted .670-.676), construct validity, trans-diagnostic configural (χ2/df = 2.10), metric (Δχ2 = 5.70, p = .681), and scalar invariance (Δχ2 = 12.34, p = .338), internal consistency (α .882-928), and composite reliability (.924-.925).Conclusion: These results suggest WIS is a valid and reliable instrument for measuring withdrawal-related life disruption in AUD and OUD. Further, given our findings of transdiagnostic measurement invariance, WIS scores of individuals with AUD and OUD can be meaningfully compared in future statistical analyses.
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Affiliation(s)
- Orman Trent Hall
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus, OH, USA
| | - Tommy Gunawan
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
- Intramural Science Program, Section on Human Psychopharmacology, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Julie Teater
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus, OH, USA
| | - Craig Bryan
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus, OH, USA
| | - Stephanie Gorka
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus, OH, USA
| | - Vijay A Ramchandani
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
- Intramural Science Program, Section on Human Psychopharmacology, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
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Qiu R, Bai X, Li Y, Shi X, Song D, Zhang Y. Factors Associated With Pain Catastrophizing in Patients With Chronic Neuropathic Pain: A Cross-Sectional Study. Pain Manag Nurs 2024:S1524-9042(24)00145-0. [PMID: 38704246 DOI: 10.1016/j.pmn.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/24/2024] [Accepted: 04/06/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Pain catastrophizing is a significant factor in the recovery of patients with chronic pain. This topic has not received the warranted attention in clinical practice, while the outcomes of pain interventions have been suboptimal. This study explores the current situation of pain catastrophizing in patients with chronic neuropathic pain, its influencing factors, and further analyzes the complex relationship between these factors. METHODS A cross-sectional study design was used to select preoperative patients hospitalized in the pain and spine surgery departments of two tertiary hospitals in Shandong Province, China, between February and August 2022. The Pain Catastrophizing Scale, Toronto Alexithymia Scale, Connor-Davidson Resilience Scale-Short, Somatization Sub-Scale of Symptom Checklist 90, and a sociodemographic questionnaire were used to evaluate participants' pain catastrophizing, alexithymia, psychological resilience, somatization, and relevant sociodemographic variables, respectively. Descriptive statistics, correlation, univariate, and multivariate analyses were employed throughout this process. RESULTS Pain catastrophizing in patients with chronic neuropathic pain was affected by pain severity, disease type, alexithymia, psychological resilience, and somatization (p < .05). The mediating effect values of psychological resilience and somatization between alexithymia and pain catastrophizing were both 0.05, with 95% confidence intervals of (0.02, 0.09) and (0.02, 0.07), respectively. CONCLUSIONS Pain severity, disease type, alexithymia, psychological resilience, and somatization all had a significant effect on pain catastrophizing. Healthcare workers must provide timely and accurate assessments of patients' pain levels to help prevent the onset of pain catastrophizing. Adopting measures to improve alexithymia and somatization symptoms, and focusing on enhancing patients' psychological resilience can also help reduce the level of pain catastrophizing. Cognitive behavioral therapy may be an effective treatment method for pain catastrophizing.
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Affiliation(s)
- Ruirui Qiu
- Department of Pain Management, The Second Hospital of Shandong University, Jinan, Shandong, PR China; School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, PR China
| | - Xiaoliang Bai
- Department of Pain Management, The Second Hospital of Shandong University, Jinan, Shandong, PR China
| | - Yuli Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, PR China.
| | - Xinhua Shi
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, PR China
| | - Dongyu Song
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, PR China
| | - Yanyan Zhang
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, PR China
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You B, Wen H, Jackson T. Investigating mortality salience as a potential causal influence and moderator of responses to laboratory pain. PeerJ 2024; 12:e17204. [PMID: 38584938 PMCID: PMC10998629 DOI: 10.7717/peerj.17204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/15/2024] [Indexed: 04/09/2024] Open
Abstract
Background Because pain can have profound ramifications for quality of life and daily functioning, understanding nuances in the interplay of psychosocial experiences with pain perception is vital for effective pain management. In separate lines of research, pain resilience and mortality salience have emerged as potentially important psychological correlates of reduced pain severity and increased tolerance of pain. However, to date, there has been a paucity of research examining potentially interactive effects of these factors on pain perception. To address this gap, the present experiment investigated mortality salience as a causal influence on tolerance of laboratory pain and a moderator of associations between pain resilience and pain tolerance within a Chinese sample. Methods Participants were healthy young Chinese adults (86 women, 84 men) who first completed a brief initial cold pressor test (CPT) followed by measures of demographics and pain resilience. Subsequently, participants randomly assigned to a mortality salience (MS) condition completed two open-ended essay questions in which they wrote about their death as well as a death anxiety scale while those randomly assigned to a control condition completed analogous tasks about watching television. Finally, all participants engaged in a delay task and a second CPT designed to measure post-manipulation pain tolerance and subjective pain intensity levels. Results MS condition cohorts showed greater pain tolerance than controls on the post-manipulation CPT, though pain intensity levels did not differ between groups. Moderator analyses indicated that the relationship between the behavior perseverance facet of pain resilience and pain tolerance was significantly stronger among MS condition participants than controls. Conclusions This experiment is the first to document potential causal effects of MS on pain tolerance and Ms as a moderator of the association between self-reported behavior perseverance and behavioral pain tolerance. Findings provide foundations for extensions within clinical pain samples.
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Affiliation(s)
- Beibei You
- School of Nursing, Guizhou Medical University, Guiyang, China
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Hongwei Wen
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa, China
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Sturgeon JA, Zubieta C, Kaplan CM, Pierce J, Arewasikporn A, Slepian PM, Hassett AL, Trost Z. Broadening the Scope of Resilience in Chronic Pain: Methods, Social Context, and Development. Curr Rheumatol Rep 2024; 26:112-123. [PMID: 38270842 DOI: 10.1007/s11926-024-01133-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE OF REVIEW A wellspring of new research has offered varying models of resilience in chronic pain populations; however, resilience is a multifaceted and occasionally nebulous construct. The current review explores definitional and methodological issues in existing observational and clinical studies and offers new directions for future studies of pain resilience. RECENT FINDINGS Definitions of pain resilience have historically relied heavily upon self-report and from relatively narrow scientific domains (e.g., positive psychology) and in narrow demographic groups (i.e., Caucasian, affluent, or highly educated adults). Meta-analytic and systematic reviews have noted moderate overall quality of resilience-focused assessment and treatment in chronic pain, which may be attributable to these narrow definitions. Integration of research from affiliated fields (developmental models, neuroimaging, research on historically underrepresented groups, trauma psychology) has the potential to enrich current models of pain resilience and ultimately improve the empirical and clinical utility of resilience models in chronic pain.
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Affiliation(s)
- John A Sturgeon
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
| | - Caroline Zubieta
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Chelsea M Kaplan
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jennifer Pierce
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Anne Arewasikporn
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - P Maxwell Slepian
- Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, CA, USA
| | - Afton L Hassett
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Zina Trost
- Department of Psychology, Texas A&M University, College Station, TX, USA
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Moon KY, Shin D. Correlation between psychosocial stresses, stress coping ability, pain intensity and degree of disability in patients with non-specific neck pain. Physiol Behav 2024; 275:114433. [PMID: 38081405 DOI: 10.1016/j.physbeh.2023.114433] [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: 09/14/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023]
Abstract
This study was conducted to find out which factor among stress inducing factors and stress coping factors that can affect patients with non-specific neck pain has more correlation with the intensity of neck pain and the degree of disability. This study is a cross-sectional correlational study. 100 patients diagnosed with non-specific neck pain participated in this study. The characteristics of the participants in this study are as follows. There were 56 men and 44 women, with an average age of 34.11 years, height of 169.91, and weight of 66.97 kg. The participant`s pain intensity was 5.18 and disability index was 21.44. In order to evaluate the pain intensity and disability level of patients with non-specific neck pain, Numeric Pain Rating SCALE (NPRS), and Neck Disability Index (NDI) were investigated, respectively. Depression, Anxiety, Stress Scale-21 (DASS-21), and Tampa Scale of Kinesiophobia (TSK) were used to evaluate stress inducing factors. Brief Resolution Scale (BRS), Latack Coping Scale (LCS), and Pain Self-Efficacy Questionnaire (PSEQ) were used to evaluate stress coping factors. Spearman correlation coefficients were used to determine the correlation between NPRS, NDI, and DASS-21, TSK, BRS, LCS, and PSEQ in patients with non-specific neck pain. As a results of this study, the NPRS was correlated with NDI and TSK. The NPRS and NDI were found to have a moderate correlation, but they were correlated with TSK, but showed a weak correlation. The NDI was found to be correlated with TSK, DASS, BRS, and PSEQ. In addition, NDI showed a weak correlation with TSK, BRS, and PSEQ, but the DASS showed a moderate correlation, showing the strongest correlation among the factors. These outcomes suggest that psychosocial factors, particularly stress-related factors such as depression, anxiety, and fear of movement, exert a more pronounced influence on pain intensity and disability in individuals with non-specific neck pain.
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Affiliation(s)
- Ki-Young Moon
- Department of Physical Therapy, Graduate School of Kyungnam University, Changwon, Republic of Korea
| | - DooChul Shin
- Department of Physical Therapy, Kyungnam University, 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon, Gyeongsangnam-do 51767, Republic of Korea.
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Rosa DP, Dubé MO, Roy JS. Psychometric Properties of Patient-reported Outcome Measures to Assess Resilience in Individuals with Musculoskeletal Pain or Rheumatic Conditions: A COSMIN-based Systematic Review. Clin J Pain 2023; 39:695-706. [PMID: 37768873 DOI: 10.1097/ajp.0000000000001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES The objective of this systematic review was to provide a comprehensive overview of the measurement properties of patient-reported outcome measures (PROMs) used to assess resilience in individuals with musculoskeletal and rheumatic conditions. METHODS Four electronic databases (MEDLINE, CINAHL, PsycINFO, and Web of Science) were searched. Studies assessing any measurement property in the target populations were included. Two reviewers independently screened all studies and assessed the risk of bias using the COSMIN checklist. Thereafter, each measurement property of each PROM was classified as sufficient, insufficient, or inconsistent based on the COSMIN criteria for good measurement properties. RESULTS Four families of PROMs [Brief Resilient Coping Scale (BRCS); Resilience Scale (RS-18); Connor-Davidson Resilience Scale (CD-RISC-10 and CD-RISC-2); and Pain Resilience Scale (PRS-14 and PRS-12)] were identified from the 9 included studies. Even if no PROM showed sufficient evidence for all measurement properties, the PRS and CD-RISC had the most properties evaluated and showed the best measurement properties, although responsiveness still needs to be assessed for both PROMs. Both PROMs showed good levels of reliability (intraclass coefficient correlation 0.61 to 0.8) and good internal consistency (Cronbach's alpha ≥0.70). Minimal detectable change values were 24.5% for PRS and between 4.7% and 29.8% for CD-RISC. DISCUSSION Although BRCS, RS-18, CD-RISC, and PRS have been used to evaluate resilience in individuals with musculoskeletal and rheumatic conditions, the current evidence only supports the use of PRS and CD-RISC in this population. Further methodological studies are therefore needed and should prioritize the assessment of reliability and responsiveness.
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Affiliation(s)
- Dayana Patricia Rosa
- Department of Rehabilitation, Faculty of Medicine, Université Laval & Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris)
| | - Marc-Olivier Dubé
- Department of Rehabilitation, Faculty of Medicine, Université Laval & Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris)
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Université Laval & Researcher, Centre for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC, Canada
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Dickens H, Bruehl S, Rao U, Myers H, Goodin B, Huber FA, Nag S, Carter C, Karlson C, Kinney KL, Morris MC. Cognitive-Affective-Behavioral Pathways Linking Adversity and Discrimination to Daily Pain in African-American Adults. J Racial Ethn Health Disparities 2023; 10:2718-2730. [PMID: 36352344 PMCID: PMC10166769 DOI: 10.1007/s40615-022-01449-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/25/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
Abstract
The tendency to ruminate, magnify, and experience helplessness in the face of pain - known as pain catastrophizing - is a strong predictor of pain outcomes and is associated with adversity. The ability to maintain functioning despite adversity - referred to as resilience - also influences pain outcomes. Understanding the extent to which pain catastrophizing and resilience influence relations between adversity and daily pain in healthy African-American adults could improve pain risk assessment and mitigate racial disparities in the transition from acute to chronic pain. This study included 160 African-American adults (98 women). Outcome measures included daily pain intensity (sensory, affective) and pain impact on daily function (pain interference). Adversity measures included childhood trauma exposure, family adversity, chronic burden from recent stressors, and ongoing perceived stress. A measure of lifetime racial discrimination was also included. Composite scores were created to capture early-life adversity (childhood trauma, family adversity) versus recent-life adversity (perceived stress, chronic burden). Increased pain catastrophizing was correlated with increased adversity (early and recent), racial discrimination, pain intensity, and pain interference. Decreased pain resilience was correlated with increased recent-life adversity (not early-life adversity or racial discrimination) and correlated with increased pain intensity (not pain-related interference). Bootstrapped multiple mediation models revealed that relationships between all adversity/discrimination and pain outcomes were mediated by pain catastrophizing. Pain resilience, however, was not a significant mediator in these models. These findings highlight opportunities for early interventions to reduce cognitive-affective-behavioral risk factors for persisting daily pain among African-American adults with greater adversity exposure by targeting pain catastrophizing.
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Affiliation(s)
- Harrison Dickens
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Uma Rao
- Department of Psychiatry & Human Behavior and Center for the Neurobiology of Learning and Memory, University of CA - Irvine, Irvine, CA, USA
- Children's Hospital of Orange County, Orange, CA, USA
| | - Hector Myers
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Burel Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Felicitas A Huber
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Subodh Nag
- Department of Biochemistry, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, TN, USA
| | - Chelsea Carter
- Department of Biochemistry, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, TN, USA
| | - Cynthia Karlson
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
- Department of Pediatrics, Hematology/Oncology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kerry L Kinney
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Matthew C Morris
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
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Thomas S, Wang Y, Cundiff-O’Sullivan R, Massalee R, Colloca L. How negative and positive constructs and comorbid conditions contribute to disability in chronic orofacial pain. Eur J Pain 2023; 27:99-110. [PMID: 36203350 PMCID: PMC9799734 DOI: 10.1002/ejp.2042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/08/2022] [Accepted: 10/02/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) symptoms develop into chronic pain for some patients, but the reasons for this are unclear. Psychosocial factors and chronic overlapping pain conditions are believed to contribute to the development of pain-related disability. We examined the role of jaw function, negative and positive psychological factors and chronic overlapping pain conditions (COPCs) on pain-related disability whilst controlling for demographic variables. METHODS We collected demographics, medical and psychosocial history and the Graded Chronic Pain Scale, a measure of pain intensity and pain interference from 400 participants with chronic TMD. Structural equation modelling was used to assess a model of COPCs and the latent variables of psychological unease (pain catastrophizing, somatic symptoms and negative affect), positive valence factors (optimism and positive affect), jaw function (chewing, opening and expression limitation) and pain-related disability (pain intensity and pain interference) whilst controlling for demographic variables. RESULTS We achieved good fit of a parsimonious model (root-mean-square error of approximation = 0.063 [90% CI] [0.051-0.075]), comparative fit index = 0.942, standard root-mean-square residual = 0.067. Jaw function was the strongest latent variable predictor, followed by psychological unease and COPCs suggesting resources focused on improving joint function, psychosocial support and management of COPCs will improve pain-related disability in TMDs. CONCLUSIONS These findings not only increase the body of knowledge related to TMD clinical phenotypes but also, have a translational impact in further supporting the potential value of targeting physical therapy such as jaw exercise along with psychological interventions as multidisciplinary nonpharmacological therapeutic solutions.
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Affiliation(s)
- Sharon Thomas
- Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Yang Wang
- Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
- Placebo Beyond Opinions (PBO) Center, School of Nursing, University of Maryland, Baltimore, USA
| | - Rachel Cundiff-O’Sullivan
- Placebo Beyond Opinions (PBO) Center, School of Nursing, University of Maryland, Baltimore, USA
- Program in Neuroscience, Graduate Program in Life Sciences, University of Maryland, Baltimore, MD, US
| | - Rachel Massalee
- Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
- Placebo Beyond Opinions (PBO) Center, School of Nursing, University of Maryland, Baltimore, USA
| | - Luana Colloca
- Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
- Departments of Anaesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, USA
- Placebo Beyond Opinions (PBO) Center, School of Nursing, University of Maryland, Baltimore, USA
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Gong Y, Wang Y, Wu W, Li L, Li Y, Song J, Jiang L, Hu S, Yang J, Wang A. The Relationship Between Pain Intensity and Pain-Related Activity Patterns in Older Adults with Chronic Musculoskeletal Pain: Mediating Roles of Pain Resilience and Pain Catastrophizing. J Pain Res 2023; 16:797-807. [PMID: 36925624 PMCID: PMC10013585 DOI: 10.2147/jpr.s393359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/25/2023] [Indexed: 03/12/2023] Open
Abstract
Purpose To explore the relationship between pain intensity, pain resilience, pain catastrophizing, and pain-related activity patterns in older adults with chronic musculoskeletal pain (CMP). Patients and Methods A total of 220 elderly Chinese with chronic musculoskeletal pain were recruited from a tertiary general hospital. Participants completed several measures including a demographic questionnaire, Brief Pain Inventory (BPI), Pain Resilience Scale (PRS), Pain Catastrophizing Scale (PCS), and Patterns of Activity Measure-Pain (POAM-P). Moreover, Process version 3.5 plug-in SPSS26 was used to test the mediation effect between variables. Results The scores of POAM-P in older adults with CMP from high to low were: avoidance (27.39 ± 8.10), pacing (24.25 ± 9.48), and overdoing (16.65 ± 10.95). Mediation analysis revealed that pain resilience and pain catastrophizing mediated the relationship between pain intensity and pain-related activity patterns (avoidance and pacing) in older adults with CMP. Conclusion These results provide evidence for the role of pain resilience and pain catastrophizing in the relationship between pain intensity and pain-related activity patterns. Interventions targeting these factors should be included in activity management programs for elderly CMP patients. It may be possible to reduce the negative impact of pain intensity on activity patterns by improving pain resilience and reducing pain catastrophizing.
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Affiliation(s)
- Yan Gong
- School of Nursing, Chengdu Medical College, Chengdu, People's Republic of China
| | - Yonghua Wang
- Department of Nursing, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Wei Wu
- Department of Anesthesiology and Pain Medicine, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Ling Li
- Department of Nursing, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Yunming Li
- Department of Information, Medical Support Center, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Jie Song
- Department of Nursing, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Lingli Jiang
- Department of Neurosurgery, The General Hospital of Western Theater Command, Chengdu, People's Republic of China
| | - Shibei Hu
- School of Nursing, Chengdu Medical College, Chengdu, People's Republic of China
| | - Juan Yang
- School of Nursing, Chengdu Medical College, Chengdu, People's Republic of China
| | - Aihua Wang
- School of Nursing, Chengdu Medical College, Chengdu, People's Republic of China
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Robinson EM, Clothier PJ, Slater H, Gupta A. A scoping review on the methods of assessment and role of resilience on function and movement-evoked pain when experiencing a musculoskeletal injury. BMC Musculoskelet Disord 2022; 23:1097. [PMID: 36522734 PMCID: PMC9753293 DOI: 10.1186/s12891-022-06058-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Resilience refers to an individual's ability to maintain effective functioning, by resisting, withstanding or recovering from stressors or adversity, including pain associated with physical injury (J Clin Psychol Med Settings 28:518-28, 2021). The aim of this scoping review is to determine the role of resilience in the experience of movement-evoked pain (MEP) and return to functional activity following a musculoskeletal injury. METHODS This review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and the scoping review protocol of the Joanna Briggs Institute (JBI). Five databases and one grey literature database were searched using predetermined key words and index terms to capture published and unpublished records on the topic. Two authors independently screened the title and abstract of each record, with the full-text of eligible records being reviewed. Papers were eligible for inclusion if they examined the population, concept and context of interest, were written in English and the full text was available. Data were extracted from each eligible record to guide discussion of the available literature on this topic. RESULTS Of 4771 records, 2695 articles underwent screening based on their title and abstract. After title and abstract screening 132 articles were eligible for full text review, with 24 articles included in the final analysis. This review identified that psychological resilience has primarily been investigated in the context of a range of age-related pathologies. The choice of functional and movement-evoked pain assessments in the included studies were often guided by the pathology of interest, with some being general or injury specific. CONCLUSION This scoping review identified inconsistent conclusions regarding the role of resilience in the experience of MEP and the ability to return to function for older adults with a musculoskeletal injury. This scoping review highlights the need for longitudinal research to be conducted that allows a broader age range, including younger adults, to determine if multidimensional resilience may promote recovery form musculoskeletal injury.
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Affiliation(s)
- Elise M. Robinson
- grid.1029.a0000 0000 9939 5719Western Sydney University, School of Health Sciences, PO Box 1797, Penrith, NSW 2751 Australia
| | - Peter J. Clothier
- grid.1029.a0000 0000 9939 5719Western Sydney University, School of Health Sciences, PO Box 1797, Penrith, NSW 2751 Australia
| | - Helen Slater
- grid.1032.00000 0004 0375 4078Curtin University, Curtin School of Allied Health, enAble Institute, Bentley, Australia
| | - Amitabh Gupta
- grid.1029.a0000 0000 9939 5719Western Sydney University, School of Health Sciences, PO Box 1797, Penrith, NSW 2751 Australia
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12
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Dereli M, Kahraman T, France CR. Cross-Cultural Adaptation and Psychometric Validation of the Turkish Version of Pain Resilience Scale. Eval Health Prof 2022; 46:140-151. [PMID: 36148877 DOI: 10.1177/01632787221127377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Pain Resilience Scale (PRS) is a useful tool that evaluates behavioral engagement and adaptively regulates cognitions and emotions despite the pain. This study aimed to translate the PRS to Turkish and investigate its psychometric properties. The Turkish version of PRS was completed online by 332 healthy adults, and a subset of 105 respondents was re-assessed after 7-14 days. The reliability of the adapted measure was evaluated in terms of internal consistency, relative, and absolute test-retest reliability. Validity was evaluated in terms of structural, construct, and known-group validity using positive and negative psychological scales. The Turkish version of PRS has a three-factor structure and its cumulative variance is 78.06%. The total PRS score and its subscales correlated positively with pain self-efficacy, general resilience, and quality of life, and negatively with pain catastrophizing, kinesiophobia, anxiety, depression, and disability. The PRS scores were significantly higher in those with high general resilience (p < 0.001). The PRS had high internal consistency and test-retest reliability. Standard Error of Measurement (SEM) and Minimum Detectable Difference (MDD) were calculated as 2.9 and 8.0, respectively. The Turkish version of PRS is a reliable and valid instrument for measuring pain resilience in terms of behavioral perseverance and cognitive positivity.
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Affiliation(s)
- Muge Dereli
- Department of Therapy and Rehabilitation, Aydin Vocational School of Health Services, 52943Aydin Adnan Menderes University, Aydin, Turkey.,Department of Physiotherapy and Rehabilitation, Graduate School of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, 226844Izmir Katip Celebi University, Izmir, Turkey
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13
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Ysidron DW, France CR, Yang Y, Mischkowski D. Research participants recruited using online labor markets may feign medical conditions and overreport symptoms: Caveat emptor. J Psychosom Res 2022; 159:110948. [PMID: 35644084 DOI: 10.1016/j.jpsychores.2022.110948] [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: 02/28/2022] [Revised: 04/28/2022] [Accepted: 05/19/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Over the last decade, the use of online labor markets to collect data in health science has grown exponentially. However, self-identification remains the most common method for recruiting specific clinical sub-populations, and this may adversely affect data validity among respondents motivated to feign a condition for financial gain. METHODS Online respondents who professed taking medication for a specific medical condition (sample 1: diabetes: N = 307; sample 2: pain: N = 506) were asked to upload an image of their prescribed medication. These images were then evaluated to identify authentic and inauthentic responders based on the images submitted. Authentic and inauthentic respondent groups were then compared on a series of condition-specific health measures and attention checks. RESULTS In the diabetes sample, respondents whose photos were deemed inauthentic passed fewer attention checks and reported poorer physical (e.g., number of comorbidities) and mental health (e.g., diabetes distress) across a wide variety of measures (η2 = 0.014-0.159). Similarly in the pain sample, respondents whose photos were deemed inauthentic reported poorer physical (e.g., pain interference) and mental health (e.g., depression) across a wide variety of measures (η2 = 0.008-0.129). CONCLUSIONS The present findings suggest that there may be substantial exaggeration of adverse health among online survey respondents who feign health conditions such as diabetes and chronic pain. Hence, in the absence of procedures to verify health status claims, the validity of data from online survey respondents should be viewed with skepticism.
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Affiliation(s)
| | | | - Yixin Yang
- Ohio University, United States of America
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14
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Schroeter AC, MacDonald DA, Scholten-Peeters GGM, Goubert L, Kendall E, Coppieters MW. Preferred self-administered questionnaires to assess resilience, optimism, pain acceptance and social support in people with pain. A modified Delphi study. PAIN MEDICINE 2022; 23:1891-1901. [DOI: 10.1093/pm/pnac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/25/2022] [Accepted: 05/01/2022] [Indexed: 11/14/2022]
Abstract
Abstract
Objectives
The plethora of self-administered questionnaires to assess positive psychosocial factors complicates questionnaire selection. This study aimed to identify and reach consensus on the most suitable self-administered questionnaires to assess resilience, optimism, pain acceptance and social support in people with pain.
Design
A three-round modified Delphi study.
Participants
Forty international experts.
Methods
In Round 1, the experts suggested questionnaires deemed appropriate to assess resilience, optimism, pain acceptance and/or social support. In Round 2, experts indicated whether they considered the suggested questionnaires to be suitable (Yes/No/Don’t know) to assess these psychosocial factors, taking into consideration content, feasibility, personal experience and the measurement properties which we provided for each questionnaire. Questionnaires that were considered suitable by the majority of experts (≥60%) were retained for Round 3. In Round 3, the suitability of each questionnaire was rated on a 0–10 Likert scale. Consensus was reached if ≥ 75% of experts rated the questionnaire ≥7.
Results
From the 67 questionnaires suggested in Round 1, one questionnaire could be recommended per domain. For resilience: Pain Resilience Scale; for optimism: Revised Version of the Life Orientation Test; for pain acceptance: 8-item and Revised Versions of the Chronic Pain Acceptance Questionnaire; for social support: Emotional Support Item Bank of the PROMIS tool. Consensus for these questionnaires was also reached in a sensitivity analysis which excluded the ratings of experts involved in the development, translation and/or validation of relevant questionnaires.
Conclusion
We advocate the use of these recommended questionnaires so data can be compared and pooled more easily.
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Affiliation(s)
- Andrea C Schroeter
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane & Gold Coast, Australia
| | - David A MacDonald
- School of Health Sciences and Social Work, Griffith University, Brisbane & Gold Coast, Australia
| | | | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Elizabeth Kendall
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane & Gold Coast, Australia
| | - Michel W Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands
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15
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Berardi G, Frey-Law L, Sluka KA, Bayman EO, Coffey CS, Ecklund D, Vance CGT, Dailey DL, Burns J, Buvanendran A, McCarthy RJ, Jacobs J, Zhou XJ, Wixson R, Balach T, Brummett CM, Clauw D, Colquhoun D, Harte SE, Harris RE, Williams DA, Chang AC, Waljee J, Fisch KM, Jepsen K, Laurent LC, Olivier M, Langefeld CD, Howard TD, Fiehn O, Jacobs JM, Dakup P, Qian WJ, Swensen AC, Lokshin A, Lindquist M, Caffo BS, Crainiceanu C, Zeger S, Kahn A, Wager T, Taub M, Ford J, Sutherland SP, Wandner LD. Multi-Site Observational Study to Assess Biomarkers for Susceptibility or Resilience to Chronic Pain: The Acute to Chronic Pain Signatures (A2CPS) Study Protocol. Front Med (Lausanne) 2022; 9:849214. [PMID: 35547202 PMCID: PMC9082267 DOI: 10.3389/fmed.2022.849214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/17/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic pain has become a global health problem contributing to years lived with disability and reduced quality of life. Advances in the clinical management of chronic pain have been limited due to incomplete understanding of the multiple risk factors and molecular mechanisms that contribute to the development of chronic pain. The Acute to Chronic Pain Signatures (A2CPS) Program aims to characterize the predictive nature of biomarkers (brain imaging, high-throughput molecular screening techniques, or "omics," quantitative sensory testing, patient-reported outcome assessments and functional assessments) to identify individuals who will develop chronic pain following surgical intervention. The A2CPS is a multisite observational study investigating biomarkers and collective biosignatures (a combination of several individual biomarkers) that predict susceptibility or resilience to the development of chronic pain following knee arthroplasty and thoracic surgery. This manuscript provides an overview of data collection methods and procedures designed to standardize data collection across multiple clinical sites and institutions. Pain-related biomarkers are evaluated before surgery and up to 3 months after surgery for use as predictors of patient reported outcomes 6 months after surgery. The dataset from this prospective observational study will be available for researchers internal and external to the A2CPS Consortium to advance understanding of the transition from acute to chronic postsurgical pain.
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Affiliation(s)
- Giovanni Berardi
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Laura Frey-Law
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Kathleen A. Sluka
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Emine O. Bayman
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Christopher S. Coffey
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Dixie Ecklund
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Carol G. T. Vance
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Dana L. Dailey
- Department of Physical Therapy, St. Ambrose University, Davenport, IA, United States
| | - John Burns
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, United States
| | - Asokumar Buvanendran
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, United States
| | - Robert J. McCarthy
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, United States
| | - Joshua Jacobs
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Xiaohong Joe Zhou
- Departments of Radiology, Neurosurgery, and Bioengineering, University of Illinois College of Medicine at Chicago, Chicago, IL, United States
| | - Richard Wixson
- NorthShore Orthopaedic and Spine Institute, NorthShore University HealthSystem, Skokie, IL, United States
| | - Tessa Balach
- Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago, Chicago, IL, United States
| | - Chad M. Brummett
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Daniel Clauw
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
- Department of Medicine (Rheumatology), University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Douglas Colquhoun
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
- Department of Medicine (Rheumatology), University of Michigan, Ann Arbor, MI, United States
| | - Richard E. Harris
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
- Department of Medicine (Rheumatology), University of Michigan, Ann Arbor, MI, United States
| | - David A. Williams
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
- Department of Medicine (Rheumatology), University of Michigan, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
| | - Andrew C. Chang
- Section of Thoracic Surgery, University of Michigan, Ann Arbor, MI, United States
| | - Jennifer Waljee
- Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, MI, United States
| | - Kathleen M. Fisch
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Kristen Jepsen
- Institute of Genomic Medicine Genomics Center, University of California, San Diego, La Jolla, CA, United States
| | - Louise C. Laurent
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Michael Olivier
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Carl D. Langefeld
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Timothy D. Howard
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Oliver Fiehn
- West Coast Metabolomics Center, University of California, Davis, Davis, CA, United States
| | - Jon M. Jacobs
- Environmental and Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, WA, United States
| | - Panshak Dakup
- Environmental and Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, WA, United States
| | - Wei-Jun Qian
- Environmental and Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, WA, United States
| | - Adam C. Swensen
- Environmental and Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland, WA, United States
| | - Anna Lokshin
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Martin Lindquist
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Brian S. Caffo
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ciprian Crainiceanu
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Scott Zeger
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ari Kahn
- Texas Advanced Computing Center, The University of Texas at Austin, Austin, TX, United States
| | - Tor Wager
- Presidential Cluster in Neuroscience, Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Margaret Taub
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - James Ford
- Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Stephani P. Sutherland
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Laura D. Wandner
- National Institute of Neurological Disorders and Stroke, The National Institutes of Health, Bethesda, MD, United States
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16
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Brittain DR, Gyurcsik NC, Cary MA, Moser EN, Davis LS. Differences in Resilience Mechanisms and Physical Activity among Women Experiencing Chronic Pain with Higher or Lower Resilience. Womens Health Issues 2021; 32:309-316. [PMID: 34916139 DOI: 10.1016/j.whi.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 11/14/2021] [Accepted: 11/17/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chronic pain is a public health issue, with women being disproportionately impacted. Progressing from light physical activity to the recommended moderate to vigorous intensities is effective for chronic pain self-management, yet participation is low among women experiencing chronic pain. Researchers studying resilience approaches to chronic pain contend that women with higher resilience, or functioning well despite adverse life stressors including chronic pain, should have better resilience mechanisms and more physical activity participation. The purpose of this work was to examine whether women experiencing chronic pain, reporting higher versus lower resilience, differed in resilience mechanisms (pain acceptance, self-regulatory efficacy to overcome pain and related barriers to activity, and self-regulatory efficacy to schedule and plan activity) and physical activity (light, moderate-vigorous). METHODS Adult women experiencing chronic pain (N = 269; Mage = 38.35, SD = 13.13 years) completed an online survey assessing study variables. RESULTS A multivariate analysis of covariance comparing participants with higher (n = 131) and lower (n = 138) resilience, controlling for age and pain intensity, was significant (p < .001; η2partial = .17). Participants with higher resilience reported significantly higher pain acceptance, self-regulatory efficacy beliefs, and moderate-vigorous physical activity (p's < .01; η2partial = .03 to .14, small to large effects). Light activity did not differ. CONCLUSIONS Novel findings illustrated that participants with higher resilience exhibited more favorable resilience mechanisms and participation in the recommended moderate-vigorous activity. If intervening among women with lower resilience to improve their resilience mechanisms and moderate-vigorous activity is effective, then intervention adoption and delivery across communities could promote improved pain self-management among women.
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Affiliation(s)
- Danielle R Brittain
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
| | - Nancy C Gyurcsik
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Miranda A Cary
- Research & Capacity Building, Vancouver Island Health Authority, Royal Jubilee Hospital, Victoria, British Columbia, Canada
| | - Erin N Moser
- Department of Human Services, University of Northern Colorado, Greeley, Colorado
| | - Lauren S Davis
- Department of Community Health Education, Colorado School of Public Health at the University of Northern Colorado, Greeley, Colorado
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17
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Basque D, Talbot F, French D. Increasing access to pain management: Feasibility of a self-compassion psychoeducational website using a minimally monitored delivery model. Internet Interv 2021; 26:100458. [PMID: 34745907 PMCID: PMC8551074 DOI: 10.1016/j.invent.2021.100458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/11/2021] [Accepted: 09/15/2021] [Indexed: 10/27/2022] Open
Abstract
Self-compassion has been associated with several positive pain-related outcomes. However, little is known about the impact of targeting self-compassion on pain management. This study assesses the feasibility of a self-compassion psychoeducation website among adults with chronic pain using a minimally monitored delivery model. Participants (N = 26) were recruited online and a single group pre-test and post-test design with a 3-month follow-up was used. The intervention was a 6-week program comprised of a video, writing exercises, guided meditations and automated emails. Feasibility outcome measures were grouped into the following categories: study engagement (ease of recruitment, attrition, adherence, satisfaction), pain vulnerability variables (intensity, interference, catastrophizing, mood) and protective pain variables (self-compassion, resilience and acceptance). Challenges pertaining to uptake were encountered. Attrition was higher (n = 11/26; 42%) and adherence to the full treatment protocol lower (n = 6/26; 23%) than expected. Treatment satisfaction was high with nearly all study completers (93%) reporting that they would recommend the program to a friend. Intent-to-treat mixed effects models showed a significant and large increase of self-compassion (d = 0.92) and a significant impact on several outcome variables (ds from 0.24 to 1.15) with most gains either maintained or increased at follow-up. The recruitment strategy may have negatively impacted participant engagement. Methodological modifications are proposed to improve the feasibility of the program. Minimally monitored web-based programs targeting self-compassion may benefit adults with chronic pain who may have limited access to traditional psychological services or who prefer online-based interventions.
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Affiliation(s)
- D. Basque
- Université de Moncton, New Brunswick, Canada
| | - F. Talbot
- Université de Moncton, New Brunswick, Canada,Corresponding author.
| | - D.J. French
- The Atlantic Pain Clinic, New Brunswick, Canada
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18
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You B, Wen H, Jackson T. Identifying resting state differences salient for resilience to chronic pain based on machine learning multivariate pattern analysis. Psychophysiology 2021; 58:e13921. [PMID: 34383330 DOI: 10.1111/psyp.13921] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 06/27/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
Studies have documented behavior differences between more versus less resilient adults with chronic pain (CP), but the presence and nature of underlying neurophysiological differences have received scant attention. In this study, we attempted to identify regions of interest (ROIs) in which resting state (Rs) brain activity discriminated more from less resilient CP subgroups based on multiple kernel learning (MKL). More and less resilient community-dwellers with chronic musculoskeletal pain (70 women, 39 men) engaged in structural and functional magnetic resonance imaging (MRI) scans, wherein MKL assessed Rs activity based on amplitude of low frequency fluctuations (ALFF), fractional amplitudes of low frequency fluctuations (fALFF), and regional homogeneity (ReHo) modalities to identify ROIs most salient for discriminating more versus less resilient subgroups. Compared to classification based on single modalities, multi-modal classification based on combined fALFF and ReHo features achieved a substantially higher classification accuracy rate (79%). Brain regions with the best discriminative power included those implicated in pain processing, reward, executive function, goal-directed action, emotion regulation and resilience to mood disorders though variation trends were not consistent between more and less resilient subgroups. Results revealed patterns of Rs activity that serve as possible biomarkers for resilience to chronic musculoskeletal pain.
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Affiliation(s)
- Beibei You
- Key Laboratory of Cognition and Personality (Ministry of Education), Faculty of Psychology, Southwest University, Chongqing, China.,School of Nursing, Guizhou Medical University, Guizhou, China
| | - Hongwei Wen
- Key Laboratory of Cognition and Personality (Ministry of Education), Faculty of Psychology, Southwest University, Chongqing, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa, China
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19
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Chen S, Grupe DW. Trait Mindfulness Moderates the Association Between Stressor Exposure and Perceived Stress in Law Enforcement Officers. Mindfulness (N Y) 2021; 12:2325-2338. [PMID: 34377216 PMCID: PMC8339391 DOI: 10.1007/s12671-021-01707-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/04/2022]
Abstract
Objectives To test the magnitude of the relationship between self-reported stressor exposure and perceived stress in police officers using a novel measure of daily work events, and whether dispositional mindfulness and resilience moderate this relationship. Methods A total of 114 law enforcement officers from a mid-sized Midwestern US city completed daily logs of job stressors and associated perceived stress, as well as additional self-report measures of perceived stress, trait mindfulness and resilience, and demographics and work information. Principal component analysis (PCA) was used to cluster job stressors into a smaller number of components in a data-driven manner. Linear mixed-effects models were used to test the relationship between stressor exposure and perceived stress for each component, and the moderation of this relationship by trait mindfulness and resilience. Results The PCA categorized stressor exposure into three components: (1) acute or traumatic line-of-duty stressors, (2) routine daily stressors, and (3) interpersonal stressors. Results of mixed models showed robust positive relationships between self-reported stressor exposure and corresponding perceived stress across all 3 components. Dispositional mindfulness (but not resilience) moderated the association between stressor exposure and perceived stress for routine stressors, such that individuals with higher dispositional mindfulness showed a relatively attenuated relationship between exposure to routine daily stressors and resulting perceived stress. Conclusions Police officers high in dispositional mindfulness may experience daily routine stressors as less stressful, which can reduce the accumulation of general stress in the long term and which could help buffer against negative health outcomes associated with perceived stress. Trial registration Clinicaltrials.gov/ct2/show/NCT03488875 Supplementary Information The online version contains supplementary material available at 10.1007/s12671-021-01707-4.
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Affiliation(s)
- Shuanghong Chen
- Key Laboratory of Cognition & Personality, Southwest University, Chongqing, 400715 China
| | - Daniel W Grupe
- Center for Healthy Minds, University of WI-Madison, 625 W Washington Ave, Madison, WI 53703 USA
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20
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Abstract
OBJECTIVE Pain resilience, one's ability to maintain behavioral engagement and adaptively regulate cognitions and emotions despite intense or prolonged pain, has been shown to protect against negative pain-related outcomes in experimental settings. A weakness of this research, and much of experimental pain research in general, has been the lack of rationale behind the selection of noxious stimuli, which can activate different nociceptive fibers. The present study sought to determine if the relationship between pain resilience and pain ratings differed across stimuli based on the stimulated nociceptors. METHODS Healthy undergraduate students (N = 100; mean [SD] age = 19.4 [1.2] years; 60% female) completed the Pain Resilience Scale and provided continuous pain ratings during exposure to three different tasks, each selected based on their ability to stimulate specific combinations of nociceptive fibers: pinprick (Aδ fibers), cold water immersion (Aδ and C fibers), and ischemic tourniquet (C fibers). RESULTS Participants with high pain resilience reported lower pain ratings over time during cold water immersion than did those with low pain resilience (F(1, 39) = 8.526, p = .006); however, there was no relationship between pain resilience and pain ratings during either of the pinprick or ischemic tourniquet stimuli. CONCLUSIONS This study provides further support for the use of multiple pain stimuli for pain assessment given their unique characteristics and concludes that outcome variables aside from pain ratings may provide additional insight into the role of resilience on pain adaptation.
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21
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Marikar Bawa FL, Sutton JW, Mercer SW, Bond CM. "I'm empowered to look after myself" - Mindfulness as a way to manage chronic pain: An interpretative phenomenological analysis of participant experiences in Scotland. Soc Sci Med 2021; 281:114073. [PMID: 34120086 DOI: 10.1016/j.socscimed.2021.114073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/01/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PRIMARY AIM Chronic pain is a common problem that can impact on psychological and social wellbeing and activity levels. Despite pharmacological treatments, there is often a lack of improvement in physical and emotional functioning and health-related quality of life. Mindfulness meditation has become an increasingly popular self-management technique. The aim of the study was to explore the experiences of patients with chronic pain who took part in a mindfulness programme. METHODS A mixed-methods feasibility study was carried out. Participants were aged 18 years or over with non-malignant chronic pain recruited from general medical practices in Fort William, Scotland. In 2013 participants undertook an eight-week mindfulness programme based on Mindfulness-Based Stress Reduction (MBSR) and were interviewed immediately post-programme and at eight-months' post-programme. Analysis of qualitative data involved Interpretative Phenomenological Analysis (IPA). FINDINGS Thirty-four patients consented to take part in the study; twenty-four took part in the programme (14 attended four or more sessions, 10 attended one to three). Twenty-three were interviewed. Participant experiences of the programme were themed under: factors affecting experience (influence of earlier life events; the process of taking part in, and of relating to, the programme); and effects of the programme (impact on emotions, mental health, adverse events and a process of change). The process of change, resulting after better understanding the relationship between mindfulness and pain, involved learning to 'listen to the body', gaining a sense of community, learning to accept pain, and approaching life with more self-care, awareness, appreciation and empowerment. CONCLUSION Participants reported a variety of experiences. For some, these included undergoing a process of change which may have supported them in living with their painful condition. This contributes to our understanding of how mindfulness could benefit people with chronic pain.
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Affiliation(s)
- Fathima L Marikar Bawa
- Centre of Academic Primary Care, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK.
| | - Jane W Sutton
- Department of Pharmacy and Psychology, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
| | - Stewart W Mercer
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.
| | - Christine M Bond
- Centre of Academic Primary Care, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK.
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22
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Kent M, Mardian AS, Regalado-Hustead ML, Gress-Smith JL, Ciciolla L, Kim JL, Scott BA. Adaptive Homeostatic Strategies of Resilient Intrinsic Self-Regulation in Extremes (RISE): A Randomized Controlled Trial of a Novel Behavioral Treatment for Chronic Pain. Front Psychol 2021; 12:613341. [PMID: 33912102 PMCID: PMC8074861 DOI: 10.3389/fpsyg.2021.613341] [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: 10/02/2020] [Accepted: 03/12/2021] [Indexed: 11/29/2022] Open
Abstract
Current treatments for chronic pain have limited benefit. We describe a resilience intervention for individuals with chronic pain which is based on a model of viewing chronic pain as dysregulated homeostasis and which seeks to restore homeostatic self-regulation using strategies exemplified by survivors of extreme environments. The intervention is expected to have broad effects on well-being and positive emotional health, to improve cognitive functions, and to reduce pain symptoms thus helping to transform the suffering of pain into self-growth. A total of 88 Veterans completed the pre-assessment and were randomly assigned to either the treatment intervention (n = 38) or control (n = 37). Fifty-eight Veterans completed pre- and post-testing (intervention n = 31, control = 27). The intervention covered resilience strengths organized into four modules: (1) engagement, (2) social relatedness, (3) transformation of pain and (4) building a good life. A broad set of standardized, well validated measures were used to assess three domains of functioning: health and well-being, symptoms, and cognitive functions. Two-way Analysis of Variance was used to detect group and time differences. Broadly, results indicated significant intervention and time effects across multiple domains: (1) Pain decreased in present severity [F(1, 56) = 5.02, p < 0.05, η2p = 0.08], total pain over six domains [F(1, 56) = 14.52, p < 0.01, η2p = 0.21], and pain interference [F(1, 56) = 6.82, p < 0.05, η2p = 0.11]; (2) Affect improved in pain-related negative affect [F(1, 56) = 7.44, p < 0.01, η2p = 0.12], fear [F(1, 56) = 7.70, p < 0.01, η2p = 0.12], and distress [F(1, 56) = 10.87, p < 0.01, η2p = 0.16]; (3) Well-being increased in pain mobility [F(1, 56) = 5.45, p < 0.05, η2p = 0.09], vitality [F(1, 56) = 4.54, p < 0.05, η2p = 0.07], and emotional well-being [F(1, 56) = 5.53, p < 0.05, η2p = 0.09] Mental health symptoms and the cognitive functioning domain did not reveal significant effects. This resilience intervention based on homeostatic self-regulation and survival strategies of survivors of extreme external environments may provide additional sociopsychobiological tools for treating individuals with chronic pain that may extend beyond treating pain symptoms to improving emotional well-being and self-growth. Clinical Trial Registration: Registered with ClinicalTrials.gov (NCT04693728).
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Affiliation(s)
- Martha Kent
- Research Department, Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States.,Department of Psychology, Arizona State University, Tempe, AZ, United States
| | - Aram S Mardian
- Department of Family, Community, and Preventive Medicine, College of Medicine-Phoenix, University of Arizona, Phoenix, AZ, United States.,Chronic Pain Wellness Center, Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States
| | - Morgan Lee Regalado-Hustead
- Chronic Pain Wellness Center, Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States.,Department of Educational Psychology, Northern Arizona University, Flagstaff, AZ, United States
| | - Jenna L Gress-Smith
- Department of Psychology, Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States
| | - Lucia Ciciolla
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Jinah L Kim
- Department of Psychology, University of California, San Diego, San Diego, CA, United States
| | - Brandon A Scott
- Department of Psychology, Midwestern University, Glendale, AZ, United States
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23
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You B, Jackson T. Gray Matter Volume Differences Between More Versus Less Resilient Adults with Chronic Musculoskeletal Pain: A Voxel-based Morphology Study. Neuroscience 2021; 457:155-164. [PMID: 33484820 DOI: 10.1016/j.neuroscience.2021.01.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/21/2020] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Abstract
Resilience, a personality construct that reflects capacities to persevere, maintain a positive outlook and/or thrive despite ongoing stressors, has emerged as an important focus of research on chronic pain (CP). Although behavior studies have found more resilient persons with CP experience less pain-related dysfunction than less resilient cohorts do, the presence and nature of associated brain structure differences has received scant attention. To address this gap, we examined gray matter volume (GMV) differences between more versus less resilient adults with chronic musculoskeletal pain. Participants (75 women, 43 men) were community-dwellers who reported ongoing musculoskeletal pain for at least three months. More (n = 57) and less (n = 61) resilient subgroups, respectively, were identified on the basis of scoring above and below median scores on two validated resilience questionnaires. Voxel-based morphology (VBM) undertaken to examine resilience subgroup differences in GMV indicated more resilient participants displayed significantly larger GMV in the (1) bilateral precuneus, (2) left superior and inferior parietal lobules, (3) orbital right middle frontal gyrus and medial right superior frontal gyrus, and (4) bilateral median cingulate and paracingulate gyri, even after controlling for subgroup differences on demographics and measures of pain-related distress. Together, results underscored the presence and nature of specific GMV differences underlying subjective reports of more versus less resilient responses to ongoing musculoskeletal pain.
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Affiliation(s)
- Beibei You
- Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing 400715, China; Qiannan Preschool Education College, Guizhou 551300, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa 999078, Macau, SAR, China; Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing 400715, China.
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24
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Pain resilience, pain catastrophizing, and executive functioning: performance on a short-term memory task during simultaneous ischemic pain. J Behav Med 2020; 44:104-110. [PMID: 32935284 DOI: 10.1007/s10865-020-00181-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 09/05/2020] [Indexed: 10/23/2022]
Abstract
Among pain researchers there is a growing interest in the relationship between psychological resilience and pain experience. Whereas much of this work has focused on individual differences in pain perception or sensitivity, an equally important dimension of resilience is the capacity to persist with goal-directed activity despite experiencing pain. Consistent with this latter focus, the current study examined how pain resilience and pain catastrophizing combine to moderate the effects of ischemic pain on short-term memory task performance. Using a within-subjects design, 121 healthy participants completed four trials of a Corsi block-tapping task with pain exposure during the second and fourth trials. Results indicated that a combination of high pain resilience and low pain catastrophizing was associated with better task performance during the second pain exposure. These findings confirm existing evidence that resilience can moderate performance during pain, and offer new evidence that resilience and catastrophizing interact to shape this effect.
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25
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Kolmes SK, Boerstler KR. Is There a Gender Self-Advocacy Gap? An Empiric Investigation Into the Gender Pain Gap. JOURNAL OF BIOETHICAL INQUIRY 2020; 17:383-393. [PMID: 32728800 DOI: 10.1007/s11673-020-09993-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 07/15/2020] [Indexed: 06/11/2023]
Abstract
There are documented differences in the efficacy of medical treatment for pain for men and women. Women are less likely to have their pain controlled and receive less treatment than men. We are investigating one possible explanation for this gender pain gap: that there is a difference in how women and men report their pain to physicians, and so there is a difference in how physicians understand their pain. This paper describes an exploratory study into gendered attitudes towards reporting uncontrolled pain to a physician. This exploratory study provided subjects with a vignette describing a situation in which their pain is not being treated adequately and asked them questions about their attitudes towards self-advocacy and the strategies they would likely use to express themselves. We found that women scored higher than men on measures of patient likelihood to self-advocate. Women also reported intending to use more varied self-advocacy strategies than men. This suggests it is unlikely that patient's communication styles are to blame for the gender pain gap.
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Affiliation(s)
- Sara K Kolmes
- Georgetown University, 215 New North Hall, 37th and O, NW, Washington, DC, 20057, USA.
| | - Kyle R Boerstler
- Florida State University, 151 Dodd Hall, Florida State University, Tallahassee, FL, 32306, USA
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26
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Pain Acceptance Partially Mediates the Relationship Between Perceived Injustice and Pain Outcomes Over 3 Months. Clin J Pain 2020; 36:868-873. [PMID: 32841966 DOI: 10.1097/ajp.0000000000000872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Perceived injustice is a maladaptive cognitive appraisal of pain or injury, characterized by attributions of blame, unfairness, severity of loss, and irreparability of loss. Research suggests that perceived injustice may negatively affect pain outcomes by inhibiting the development of pain-related acceptance. The current study aimed to extend cross-sectional research by testing whether pain acceptance mediates the effects of perceived injustice on pain-related outcomes longitudinally. MATERIALS AND METHODS Data was analyzed from a prospective study to examine the potential mediating role of pain acceptance on recovery 3 months after an episode of low back pain. Using Mechanical Turk, we recruited participants who experienced an episode of back pain within the preceding 2 weeks, 343 of whom completed measures of perceived injustice, pain acceptance, pain ratings, and quality of life at each of 3 timepoints (recruitment, 1 mo later, and 3 mo later). Path analyses were conducted to examine pain acceptance at 1 month as a potential mediator of the relationship between perceived injustice at recruitment and pain intensity, disability, and depressive symptoms at 3 months. RESULTS Results indicated that perceived injustice at recruitment was directly related to pain intensity, disability, and depressive symptoms 3 months later, and that pain acceptance partially mediated these relationships. DISCUSSION Although these findings provide further support for pain acceptance as a buffer for the deleterious effects of perceived injustice, they also highlight that adjunctive mechanisms should be investigated to provide more comprehensive clinical insight.
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27
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You B, Jackson T. Factor Structure and Construct Validity of the Pain Resilience Scale Within Chinese Adult Chronic Musculoskeletal Pain Samples. J Pers Assess 2020; 103:685-694. [DOI: 10.1080/00223891.2020.1801700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Beibei You
- Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China
- Qiannan Preschool Education College, Guizhou, China
| | - Todd Jackson
- Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China
- Department of Psychology, University of Macau, Taipa, Macau, S.A.R
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28
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Liesto S, Sipilä R, Aho T, Harno H, Hietanen M, Kalso E. Psychological resilience associates with pain experience in women treated for breast cancer. Scand J Pain 2020; 20:545-553. [PMID: 32335540 DOI: 10.1515/sjpain-2019-0137] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/21/2020] [Indexed: 11/15/2022]
Abstract
Background and aims Psychological resilience refers to successful adaptation or a positive outcome in the context of significant life adversity, such as chronic pain. On the other hand, anxiety closely associates with pain. The aim of this study was to explore how anxiety and psychological resilience together associate with persistent and experimental pain. Methods In a cross-sectional design, we studied 160 patients who had previously been treated for breast cancer and who now reported at least moderate pain (NRS ≥ 4) in any area of the body. Psychological resilience was measured on the Resilience Scale-14, anxiety on the Hospital Anxiety and Depression Scale, and intensity and interference of persistent pain by means of the Brief Pain Inventory. The cold pressor test was conducted to assess sensitivity to experimental cold pain. Results The results showed that resilience associated with pain interference in persistent pain, and that anxiety moderated this effect. Higher psychological resilience was associated with lower pain interference and this association was stronger in patients with low anxiety than among patients with high anxiety. These effects were visible with regard to persistent pain but not in experimental cold pain. Conclusions These results indicate that chronic pain and experimental pain as well as pain severity and pain interference are psychologically different phenomena. Psychological resilience protects against pain interference but effectively only in patients with low anxiety. It is necessary also to consider protective factors in addition to vulnerability factors in cases of persistent pain. Implications Resilience has been considered a potential target for intervention in chronic pain. However, high levels of anxiety might diminish the protective effect of psychological resilience in clinical settings. Therefore, it is important to treat anxiety in addition to resilience enhancing interventions. Patients with low psychological distress might be more suitable for resilience enhancing interventions than patients with high anxiety.
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Affiliation(s)
- Sanna Liesto
- Division of Pain Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Clinical Neurosciences, Neuropsychology, University of Helsinki and Neurocenter, Helsinki University Hospital, Helsinki, Finland
| | - Reetta Sipilä
- Division of Pain Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tommi Aho
- Division of Pain Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Harno
- Division of Pain Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Clinical Neurosciences, Neurology, University of Helsinki and Neurocenter, Helsinki University Hospital, Helsinki, Finland
| | - Marja Hietanen
- Clinical Neurosciences, Neuropsychology, University of Helsinki and Neurocenter, Helsinki University Hospital, Helsinki, Finland
| | - Eija Kalso
- Division of Pain Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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29
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Zaorska J, Kopera M, Trucco EM, Suszek H, Kobyliński P, Jakubczyk A. Childhood Trauma, Emotion Regulation, and Pain in Individuals With Alcohol Use Disorder. Front Psychiatry 2020; 11:554150. [PMID: 33192667 PMCID: PMC7661433 DOI: 10.3389/fpsyt.2020.554150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction: Several studies have confirmed that the experience of childhood trauma, poor emotion regulation, as well as the experience of physical pain may contribute to the development and poor treatment outcomes of alcohol use disorder (AUD). However, little is known about how the joint impact of these experiences may contribute to AUD. Objectives: To analyze associations between childhood trauma, emotion regulation, and pain in individuals with AUD. Methods: The study sample included 165 individuals diagnosed with AUD. The Childhood Trauma Questionnaire (CTQ) was used to investigate different types of trauma during childhood (physical, emotional, and sexual abuse and neglect), the Brief Symptom Inventory was used to assess anxiety symptoms, the Difficulties in Emotion Regulation Scale (DERS) was used to assess emotional dysregulation, and the Pain Resilience Scale and Pain Sensitivity Questionnaire were used to measure self-reported pain tolerance and sensitivity. Results: Childhood emotional abuse (CTQ subscale score) was positively associated with anxiety, anxiety was positively associated with emotional dysregulation, and emotional dysregulation was negatively associated with pain tolerance. Accordingly, there was support for a significant indirect negative association between childhood emotional abuse and pain tolerance. The serial mediation statistical procedure demonstrated that anxiety and emotional dysregulation mediated the effect of childhood emotional abuse on pain resilience among individuals with AUD. Conclusions: Targeting emotional dysregulation and physical pain that can result from childhood trauma may have particular therapeutic utility among individuals treated for AUD.
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Affiliation(s)
- Justyna Zaorska
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M Trucco
- Department of Psychology and the Center for Children and Families, Florida International University, Miami, FL, United States.,Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, United States
| | - Hubert Suszek
- Department of Psychology, University of Warsaw, Warsaw, Poland
| | - Paweł Kobyliński
- Laboratory of Interactive Technologies, National Information Processing Institute, Warsaw, Poland
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
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30
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Slepian PM, Ankawi B, France CR. Longitudinal Analysis Supports a Fear-Avoidance Model That Incorporates Pain Resilience Alongside Pain Catastrophizing. Ann Behav Med 2019; 54:335-345. [DOI: 10.1093/abm/kaz051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Abstract
Background
The fear-avoidance model of chronic pain holds that individuals who catastrophize in response to injury are at risk for pain-related fear and avoidance behavior, and ultimately prolonged pain and disability.
Purpose
Based on the hypothesis that the predictive power of the fear-avoidance model would be enhanced by consideration of positive psychological constructs, the present study examined inclusion of pain resilience and self-efficacy in the model.
Methods
Men and women (N = 343) who experienced a recent episode of back pain were recruited in a longitudinal online survey study. Over a 3-month interval, participants repeated the Pain Resilience Scale, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Pain Self-Efficacy Questionnaire, the McGill Pain Questionnaire, and NIH-recommended measures of pain, depressive symptoms, and physical dysfunction. Structural equation modeling assessed the combined contribution of pain resilience and pain catastrophizing to 3-month outcomes through the simultaneous combination of kinesiophobia and self-efficacy.
Results
An expanded fear-avoidance model that incorporated pain resilience and self-efficacy provided a good fit to the data, Χ2 (df = 14, N = 343) = 42.09, p = .0001, RMSEA = 0.076 (90% CI: 0.05, 0.10), CFI = 0.97, SRMR = 0.03, with higher levels of pain resilience associated with improved 3-month outcomes on measures of pain intensity, physical dysfunction, and depression symptoms.
Conclusions
This study supports the notion that the predictive power of the fear-avoidance model of pain is enhanced when individual differences in both pain-related vulnerability (e.g., catastrophizing) and pain-related protective resources (e.g., resilience) are considered.
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Affiliation(s)
| | - Brett Ankawi
- Department of Psychology, Ohio University, Athens, OH, USA
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31
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Gonzalez CE, Okunbor JI, Parker R, Owens MA, White DM, Merlin JS, Goodin BR. Pain-Specific Resilience in People Living With HIV and Chronic Pain: Beneficial Associations With Coping Strategies and Catastrophizing. Front Psychol 2019; 10:2046. [PMID: 31555190 PMCID: PMC6742745 DOI: 10.3389/fpsyg.2019.02046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/22/2019] [Indexed: 12/18/2022] Open
Abstract
Objective Chronic pain is increasingly recognized as a common and disabling problem for people living with HIV (PLWH). In a recent systematic review of psychosocial factors associated with chronic pain in PLWH, it was reported that very few studies to date have examined protective psychological factors that might help mitigate chronic pain for PLWH. The current study examined pain-specific resilience in relation to clinical and experimental pain, as well as pain coping in PLWH and chronic pain. Pain-specific resilience specifically refers to the ability to maintain relatively stable, healthy levels of psychological and physical functioning in the face of ongoing and persistent pain. Methods A total of 85 PLWH (mean CD4 = 643; 13% detectable viral load ≥200; 99% on antiretroviral therapy) who met criteria for chronic pain (>3 consecutive month’s duration) were enrolled. Medical records were reviewed to confirm clinical data. All participants provided sociodemographic information prior to completing the following validated measures: Pain Resilience Scale (PRS), Coping Strategies Questionnaire-Revised (CSQ-R), Center for Epidemiologic Studies – Depression Scale (CES-D), and the Brief Pain Inventory – Short Form (BPI-SF). They then completed a quantitative sensory testing battery designed to assess tolerance for painful heat and cold stimuli. Results In adjusted multiple regression models controlling for covariates, greater pain-specific resilience was significantly associated with less pain interference (p = 0.022) on the BPI-SF, less pain catastrophizing (p = 0.002), greater use of distraction (p = 0.027) and coping self-statements (p = 0.039) on the CSQ-R, as well as significantly greater heat pain tolerance (p = 0.009). Finally, results of a parallel multiple mediation model demonstrated that the effect of pain-specific resilience on heat pain tolerance was indirectly transmitted through less pain catastrophizing (95% confidence interval:0.0042 to 0.0354), but not use of distraction (95% confidence interval: −0.0140 to 0.0137) or coping self-statements (95% confidence interval: −0.0075 to 0.0255). Conclusion The findings suggest that pain-specific resilience may promote adaptation and positive coping in PLWH and chronic pain.
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Affiliation(s)
- Cesar E Gonzalez
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jennifer I Okunbor
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Romy Parker
- Department of Anesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
| | - Michael A Owens
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Dyan M White
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jessica S Merlin
- Department of Medicine, Divisions of General Internal Medicine and Infectious Diseases, University of Pittsburgh, Pittsburgh, PA, United States
| | - Burel R Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
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32
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Applegate ME, France CR, Russ DW, Leitkam ST, Thomas JS. Sørensen test performance is driven by different physiological and psychological variables in participants with and without recurrent low back pain. J Electromyogr Kinesiol 2019; 44:1-7. [PMID: 30447543 DOI: 10.1016/j.jelekin.2018.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 10/19/2018] [Accepted: 11/08/2018] [Indexed: 11/17/2022] Open
Abstract
Time to task failure (TTF) on the Sørensen test predicts low back pain (LBP), but mechanisms driving TTF may vary in those with and without recurrent LBP. To determine the physiological and psychological predictors of TTF, 48 sex, age, and BMI matched participants (24 Healthy, 24 LBP) completed psychological surveys, maximal strength assessments, and the Sørensen test. A two-way ANOVA revealed no significant effects of group (p = 0.75) or sex (p = 0.21) on TTF. In the full sample, linear regression analyses revealed that normalized Median Power Frequency (MPF) slope of the Erector Spinae (β = 0.350, p < 0.01), the Biceps Femoris (β = 0.375, p < 0.01), and self-efficacy (β = 0.437, p < 0.01) predicted TTF. In the Healthy group, normalized MPF slope of the Erector Spinae (β = 0.470, p < 0.01), the Biceps Femoris (β = 0.437, p < 0.01), and self-efficacy (β = 0.330, p = 0.02) predicted TTF. In the LBP group, trunk mass (β = -0.369, p = 0.04) and self-efficacy (β = 0.450, p = 0.02) predicted TTF. In sum, self-efficacy consistently predicts performance, while trunk mass appears to negatively influence TTF only for those with recurrent LBP.
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Affiliation(s)
- Megan E Applegate
- John A. Paulson School of Engineering and Applied Sciences, Wyss Institute for Biologically Inspired Engineering, Harvard University, USA.
| | | | - David W Russ
- School of Rehabilitation and Communication Sciences, Division of Physical Therapy, Ohio University, USA
| | - Samuel T Leitkam
- School of Physical & Occupational Therapy, Department of Kinesiology and Physical Education, McGill University, Canada
| | - James S Thomas
- School of Rehabilitation and Communication Sciences, Division of Physical Therapy, Ohio University, USA
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33
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Applegate ME, France CR, Russ DW, Leitkam ST, Thomas JS. Determining Physiological and Psychological Predictors of Time to Task Failure on a Virtual Reality Sørensen Test in Participants With and Without Recurrent Low Back Pain: Exploratory Study. JMIR Serious Games 2018; 6:e10522. [PMID: 30201604 PMCID: PMC6231892 DOI: 10.2196/10522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Sørensen trunk extension endurance test performance predicts the development of low back pain and is a strong discriminator of those with and without low back pain. Performance may greatly depend on psychological factors, such as kinesiophobia, self-efficacy, and motivation. Virtual reality video games have been used in people with low back pain to encourage physical activity that would otherwise be avoided out of fear of pain or harm. Accordingly, we developed a virtual reality video game to assess the influence of immersive gaming on the Sørensen test performance. OBJECTIVE The objective of our study was to determine the physiological and psychological predictors of time to task failure (TTF) on a virtual reality Sørensen test in participants with and without a history of recurrent low back pain. METHODS We recruited 24 individuals with a history of recurrent low back pain and 24 sex-, age-, and body mass index-matched individuals without a history of low back pain. Participants completed a series of psychological measures, including the Center for Epidemiological Studies-Depression Scale, Pain Resilience Scale, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and a self-efficacy measure. The maximal isometric strength of trunk and hip extensors and TTF on a virtual reality Sørensen test were measured. Electromyography of the erector spinae, gluteus maximus, and biceps femoris was recorded during the strength and endurance trials. RESULTS A two-way analysis of variance revealed no significant difference in TTF between groups (P=.99), but there was a trend for longer TTF in females on the virtual reality Sørensen test (P=.06). Linear regression analyses were performed to determine predictors of TTF in each group. In healthy participants, the normalized median power frequency slope of erector spinae (beta=.450, P=.01), biceps femoris (beta=.400, P=.01), and trunk mass (beta=-.32, P=.02) predicted TTF. In participants with recurrent low back pain, trunk mass (beta=-.67, P<.001), Tampa Scale for Kinesiophobia (beta=-.43, P=.01), and self-efficacy (beta=.35, P=.03) predicted TTF. CONCLUSIONS Trunk mass appears to be a consistent predictor of performance. Kinesiophobia appears to negatively influence TTF for those with a history of recurrent low back pain, but does not influence healthy individuals. Self-efficacy is associated with better performance in individuals with a history of recurrent low back pain, whereas a less steep median power frequency slope of the trunk and hip extensors is associated with better performance in individuals without a history of low back pain.
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Affiliation(s)
- Megan E Applegate
- Wyss Institute for Biologically Inspired Engineering, Cambridge, MA, United States
| | | | - David W Russ
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, United States.,Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States
| | - Samuel T Leitkam
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada
| | - James S Thomas
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, United States
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Coronado RA, George SZ. The Central Sensitization Inventory and Pain Sensitivity Questionnaire: An exploration of construct validity and associations with widespread pain sensitivity among individuals with shoulder pain. Musculoskelet Sci Pract 2018; 36:61-67. [PMID: 29751194 PMCID: PMC6671673 DOI: 10.1016/j.msksp.2018.04.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/21/2018] [Accepted: 04/30/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The Central Sensitization Inventory (CSI) and Pain Sensitivity Questionnaire (PSQ) are alternatives to quantitative sensory testing (QST) for inferring central sensitization. OBJECTIVE Explore 1) comparative validity of the CSI and PSQ with QST (construct validity) and pain-related psychological questionnaires (concurrent validity), and 2) associations with widespread pain sensitivity. METHODS Seventy-eight participants with unilateral shoulder pain less than 6 months (mean ± SD age = 39.0 ± 14.5 years, N (%) females = 36 (46.2%)) completed the CSI, PSQ, psychological questionnaires, and underwent QST for local and remote pressure pain thresholds (PPT), heat pain threshold, and suprathreshold heat pain ratings. Data from 25 age and sex-matched healthy participants (mean ± SD age = 35.2 ± 11.1 year, N (%) females = 13 (52.0%)) were used to determine a composite index for widespread pressure pain sensitivity in the shoulder pain group. Analyses included correlations between measures and between-group comparisons. RESULTS Only the PSQ was associated with remote PPT (rho range = -0.25 to -0.27). Both the CSI and PSQ were associated with resilience (rho range = -0.29 to -0.39), anxiety (rho range = 0.25 to 0.66), and negative affect (rho range = 0.27 to 0.67). Neither the CSI nor PSQ were associated with widespread pain sensitivity (p > 0.05). Resilience (adjusted OR = 0.41, 95% CI = 0.18; 0.94) was a distinctive feature for widespread pain sensitivity. CONCLUSIONS These preliminary findings challenge the exclusive use of the CSI or PSQ for inferring central sensitization among individuals with shoulder pain.
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Affiliation(s)
- Rogelio A Coronado
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21st Avenue S, MCE-South, Suite 4200, Nashville, TN 37232, USA.
| | - Steven Z George
- Duke Clinical Research Institute and Department of Orthopaedic Surgery, Duke University, 2400 Pratt Street, Room 0311 Terrace Level, Durham, NC 27705, USA.
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France CR, Thomas JS. Virtual immersive gaming to optimize recovery (VIGOR) in low back pain: A phase II randomized controlled trial. Contemp Clin Trials 2018; 69:83-91. [PMID: 29730393 PMCID: PMC5975386 DOI: 10.1016/j.cct.2018.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/01/2018] [Indexed: 10/17/2022]
Abstract
The virtual immersive gaming to optimize recovery (VIGOR) study is a randomized controlled trial of the effects of virtual reality games to encourage lumbar spine flexion among individuals with chronic low back pain and fear of movement. Whereas traditional graded activity or graded exposure therapies for chronic low back pain have high attrition and poor long-term efficacy, we believe that virtual reality games have distinct advantages that can enhance adherence and clinical outcomes. First, they are engaging and enjoyable activities that can distract from pain and fear of harm. In addition, because they gradually reinforce increases in lumbar spine flexion to achieve game objectives, continued engagement over time is expected to promote recovery through restoration of normal spinal motion. The study design includes two treatment groups which differ in the amount of lumbar flexion required to achieve the game objectives. All participants will play the games for nine weeks, and pre-treatment to 1-week post-treatment changes in pain and disability will serve as the co-primary clinical outcomes. In addition, changes in lumbar flexion and expectations of pain/harm will be examined as potential treatment outcome mediators. Maintenance of treatment outcomes will also be assessed for up to 48-weeks post-treatment. In brief, we hypothesize that the virtual reality games will reduce pain and disability by promoting spinal motion and allowing participants to develop an implicit understanding that they are capable of engaging in significant lumbar spine motion in their daily lives without a risk of injury to their back.
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Affiliation(s)
| | - James S Thomas
- Division of Physical Therapy, School of Rehabilitation and Communication Sciences, Ohio University, Athens, OH, USA
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He SL, Wang JH, Ji P. Validation of the Pain Resilience Scale in Chinese-speaking patients with temporomandibular disorders pain. J Oral Rehabil 2017; 45:191-197. [PMID: 29205436 DOI: 10.1111/joor.12591] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 11/30/2022]
Abstract
To validate the Pain Resilience Scale (PRS) for use in Chinese patients with temporomandibular disorders (TMD) pain. According to international guidelines, the original PRS was first translated and cross-culturally adapted to formulate the Chinese version of PRS (PRS-C). A total of 152 patients with TMD pain were recruited to complete series of questionnaires. Reliability of the PRS-C was investigated using internal consistency and test-retest reliability. Validity of the PRS-C was calculated using cross-cultural validity and convergent validity. Cross-cultural validity was evaluated by examining the confirmatory factor analysis (CFA). And convergent validity was examined through correlating the PRS-C scores with scores of 2 commonly used pain-related measures (the Connor-Davidson Resilience Scale [CD-RISC] and the Tampa Scale for Kinesiophobia for Temporomandibular Disorders [TSK-TMD]). The PRS-C had a high internal consistency (Cronbach's alpha = 0.92) and good test-retest reliability (intra-class correlation coefficient [ICC] = 0.81). The CFA supported a 2-factor model for the PRS-C with acceptable fit to the data. The fit indices were chi-square/DF = 2.21, GFI = 0.91, TLI = 0.97, CFI = 0.98 and RMSEA = 0.08. As regards convergent validity, the PRS-C evidenced moderate-to-good relationships with the CD-RISC and the TSK-TMD. The PRS-C shows good psychometric properties and could be considered as a reliable and valid measure to evaluate pain-related resilience in patients with TMD pain.
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Affiliation(s)
- S L He
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - J H Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - P Ji
- College of Stomatology, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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