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Dietz T, Schiewer V, Karbach U, Kusch M. Speechlessness: a Conceptual Framework. Integr Psychol Behav Sci 2024; 58:531-562. [PMID: 37400707 PMCID: PMC11052872 DOI: 10.1007/s12124-023-09789-6] [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: 06/09/2023] [Indexed: 07/05/2023]
Abstract
The phenomenon of speechlessness has hardly been considered in the literature from a psychological point of view. Previous research on speechlessness is limited to the fields of neurology, medicine or psychopathology. The present review aims to consider speechlessness from a psychological perspective distinct from pathology, and to highlight its observability and possible connections to existing research in the context of emotional cognition and processing. Search terms were developed and a comprehensive, systematic literature search was conducted in various databases based on previous scientific work on the understanding of non-speech, silence and speechlessness. Only results that examined the phenomenon of speechlessness from a non-pathological or non-neurological perspective were included. A total of N = 7 publications matching the inclusion criteria were identified. The results were used to develop a procedual model for the phenomenological definition of speechlessness. The developed model differentiates the observable phenomenon of speechlessness into a non-intentional, unconscious form and a intentional, conscious form. The present work suggests that meaningful emotions and their perception and processing is a core element in the emergence of speechlessness and provides a first, psychological, non-pathological explanation of speechlessness.
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Affiliation(s)
- Thilo Dietz
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Kerpener Straße 62, 50937, Köln, Germany.
| | - Vera Schiewer
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Kerpener Straße 62, 50937, Köln, Germany
| | - Ute Karbach
- Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, University of Cologne, Eupener Straße 129, 50933, Köln, Germany
| | - Michael Kusch
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Kerpener Straße 62, 50937, Köln, Germany
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Bussières A, Hancock MJ, Elklit A, Ferreira ML, Ferreira PH, Stone LS, Wideman TH, Boruff JT, Al Zoubi F, Chaudhry F, Tolentino R, Hartvigsen J. Adverse childhood experience is associated with an increased risk of reporting chronic pain in adulthood: a stystematic review and meta-analysis. Eur J Psychotraumatol 2023; 14:2284025. [PMID: 38111090 PMCID: PMC10993817 DOI: 10.1080/20008066.2023.2284025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/22/2023] [Indexed: 12/20/2023] Open
Abstract
Background: Adverse childhood experiences (ACEs) have been shown to negatively affect health in adulthood. Estimates of associations between ACEs and chronic painful conditions are lacking.Objectives: This systematic review and meta-analysis aimed to evaluate associations between exposure to ACEs and chronic pain and pain-related disability in adults.Methods: We searched 10 electronic databases from inception to February 2023. We included observational studies assessing associations between direct ACEs (childhood sexual, physical, emotional abuse, or neglect) alone or in combination with indirect ACEs (witnessing domestic violence, household mental illness), and adult chronic pain (≥3 months duration) and pain-related disability (daily activities limited by chronic pain). Pairs of reviewers independently extracted data and assessed study risks of bias. Random-effect models were used to calculate pooled adjusted odds ratios [aOR]. Tau square [T2], 95% prediction intervals [95%PI] and I2 expressed the amount of heterogeneity, and meta-regressions and subgroup meta-analyses investigated sources of heterogeneity (PROSPERO: CRD42020150230).Results: We identified 85 studies including 826,452 adults of which 57 studies were included in meta-analyses. Study quality was generally good or fair (n = 70). The odds of reporting chronic pain in adulthood were significantly higher among individuals exposed to a direct ACE (aOR, 1.45, 95%CI, 1.38-1.53). Individuals reporting childhood physical abuse were significantly more likely to report both chronic pain (aOR, 1.50, 95CI, 1.39-1.64) and pain-related disability (1.46, 95CI, 1.03-2.08) during adulthood. Exposure to any ACEs alone or combined with indirect ACEs significantly increase the odds of adult chronic painful conditions (aOR, 1.53, 95%CI, 1.42-1.65) and pain-related disability (aOR, 1.29; 95%CI, 1.01-1.66). The risk of chronic pain in adulthood significantly increased from one ACE (aOR, 1.29, 95%CI, 1.22-1.37) to four or more ACEs (1.95, 95%CI, 1.73-2.19).Conclusions: Single and cumulative ACEs are significantly associated with reporting of chronic pain and pain-related disability as an adult.
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Affiliation(s)
- André Bussières
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Mark J. Hancock
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Ask Elklit
- National Centre for Psychotraumatology, Department of Psychology, University of Southern DenmarkOdense, Denmark
| | - Manuela L. Ferreira
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Paulo H. Ferreira
- Musculoskeletal Health, Faculty of Health Sciences, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Laura S. Stone
- Faculty of Dentistry, McGill University, Montreal, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
- Department of Anesthesiology, Faculty of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Timothy H. Wideman
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
| | - Jill T. Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Canada
| | - Fadi Al Zoubi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Fauzia Chaudhry
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Raymond Tolentino
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Chiropractic Knowledge Hub, Odense, Denmark
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Trivedi M, Dumkrieger G, Chong CD, Dodick DW, Schwedt TJ. Impact of abuse on migraine-related sensory hypersensitivity symptoms: Results from the American Registry for Migraine Research. Headache 2021; 61:740-754. [PMID: 33779989 DOI: 10.1111/head.14100] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/15/2021] [Accepted: 02/08/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Prior studies have established an association between a history of abuse and the development of migraine. This cross-sectional observational study explored the relationship between self-reported abuse history with migraine-related sensory hypersensitivity symptoms. METHODS In total, 588 adult patients with migraine from the American Registry for Migraine Research completed questionnaires: Generalized Anxiety Disorder-7, Patient Health Questionnaire-2 for depression, Photosensitivity Assessment Questionnaire, Hyperacusis Questionnaire, and Allodynia Symptom Checklist. Using four binary screening questions, patients were asked to self-report if they believed they had suffered emotional, physical, or sexual abuse in their lifetime. Differences in questionnaire scores between groups with and without a history of abuse were determined. Regression models adjusted for age, sex, and basic headache features analyzed the relationship between abuse history and sensory hypersensitivity symptoms. Moderation analysis explored the role of headache frequency in this relationship. Mediation analysis assessed the indirect (Mediated) effect (IE) of abuse on sensory hypersensitivity through depression or anxiety. Additional models analyzed relationships between sensory hypersensitivity symptoms and abuse subtypes or the number of abuse subtypes. RESULTS Of 588 participants, 222 (38%) reported a history of abuse. Patients with a history of abuse reported statistically significantly greater average headache frequency (7.6 vs. 4.7 days, p = 0.030). Patients with a history of abuse also reported higher average or median questionnaire scores: anxiety (7.6 vs. 4.7, p < 0.001, d = 0.56), depression (1.7 vs. 1.3, p = 0.009, d = 0.24), photophobia (0.54 vs. 0.44, p < 0.001, d = 0.32), hyperacusis (19.6 vs. 14.9, p < 0.001, d = 0.49), ictal allodynia (6.0 vs. 3.0, p < 0.001, d = 0.46), and interictal allodynia (1.0 vs. 0.0, p < 0.001, d = 0.30). After controlling for patient age, sex and years lived with headache, abuse maintained a significant association with every sensory hypersensitivity measure. Headache frequency significantly moderated the relationship between a history of abuse with increased ictal allodynia (p = 0.036). Anxiety significantly mediated the relationships between abuse with photophobia (IE = 0.03, 95% CI = 0.01-0.04), hyperacusis (IE = 1.51, 95% CI = 0.91-2.24), ictal allodynia (IE = 0.02, 95% CI = 0.01-0.04), and interictal allodynia (IE = 0.02, 95% CI = 0.01-0.06). Depression significantly mediated the relationship between abuse with photophobia (IE = 0.02, 95% CI = 0.01-0.03) and with hyperacusis (IE = 0.45, 95% CI = 0.11-0.88). The association between the individual subtypes of abuse and the number of subtypes of abuse with sensory hypersensitivity symptoms varied. CONCLUSION A history of abuse is associated with greater migraine-related sensory hypersensitivity symptoms. To reduce the impact of abuse on migraine symptoms, future studies should explore mechanistic connections between abuse and migraine-associated symptoms.
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Schubiner H. Emotional Awareness for Pain. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00102-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Özdil Demiryürek E, Demiryürek BE, Tekin A, Güzey Aras Y, Doğan Güngen B, Erdoğan S. The Association Between Childhood Traumatic Events and Headache-Related Parameters in Patients with Migraine: A Cross-Sectional Study in Turkish Population. ACTA ACUST UNITED AC 2017; 54:291-294. [PMID: 29321699 DOI: 10.5152/npa.2016.8817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction The aim of this study is to investigate the association between childhood traumatic events and headache-related clinical parameters in migraine patients. Methods 95 patients diagnosed with migraine and 50 healthy controls were included in the study. A socio-demographic form, the Childhood Trauma Questionnaire (CTQ), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) were completed by all participants. Additionally, the Visual Analog Scale (VAS) and the Migraine Disability Assessment Test (MIDAS) were applied to migraine patients. Results Positive correlations were found between emotional abuse, physical abuse, physical neglect, CTQ total scores, and headache frequency (r=0.33, r=0.24, r=0.26 and r=0.28 respectively) in migraine patients. A positive correlation was found between physical neglect and headache duration (r=0.28). Positive correlations were also found between emotional abuse and physical neglect, and MIDAS total scores (r=0.22 and r=0.23, respectively). Emotional abuse and CTQ total scores were associated with younger mean age of headache onset (r=-0.24 and r=-0.23). Conclusion Childhood traumatic events are associated with more frequent and more severe headache episodes, and younger headache onset in migraine patients.
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Affiliation(s)
- Esra Özdil Demiryürek
- Clinic of Psychiatry, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Bekir Enes Demiryürek
- Clinic of Neurology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Atilla Tekin
- Clinic of Psychiatry, Abant İzzet Baysal University İzzet Baysal Mental and Neurological Disorders Training and Research Hospital, Bolu, Turkey
| | - Yeşim Güzey Aras
- Clinic of Neurology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Belma Doğan Güngen
- Clinic of Neurology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Sebatiye Erdoğan
- Clinic of Neurology, Bağcılar Training and Research Hospital, İstanbul, Turkey
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Esposito M, Messina A, Monda V, Bitetti I, Salerno F, Precenzano F, Pisano S, Salvati T, Gritti A, Marotta R, Lavano SM, Lavano F, Maltese A, Parisi L, Salerno M, Tripi G, Gallai B, Roccella M, Bove D, Ruberto M, Toraldo R, Messina G, Carotenuto M. The Rorschach Test Evaluation in Chronic Childhood Migraine: A Preliminary Multicenter Case-Control Study. Front Neurol 2017; 8:680. [PMID: 29312117 PMCID: PMC5733029 DOI: 10.3389/fneur.2017.00680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/29/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECT About 1.2-3.2% of children at 7 years of age with increasing age up to 4-19% in adolescents are suffering from migraine without aura (MwA). The aim of the present study is investigating the personality style associated with children and adolescents affected by MwA, administrating the Rorschach test, and comparing with typical developing healthy controls (TD). METHODS 137 patients (74 males), aged 7.3-17.4 years (mean age 11.4, SD 3.02 years), affected by MwA according to the IHs-3 criteria. The Rorschach variables were treated as numerical variables and statistically tested with t-Student's analysis. RESULTS No statistical differences were found between the MwA and TD for age (p = 0.55), and gender (p = 0.804). From the comparison between the two samples, MwA group shows lower W responses (p < 0.001), good quality W responses (p < 0.001), high frequency of detailed responses (p < 0.001), the presence of even minor form of good quality responses (p < 0.001), increased presence of animals answers (A%) (p < 0.001), more frequent trivial answers (Ban%) (p < 0.001). DISCUSSION Rorschach interpretation pinpointed many interesting and, perhaps, peculiar aspects in our MwA population such as a trend predisposition for: analytical reasoning rather than synthetic, ease/practicality rather than creativity, oppositionality rather than external adaptation to the environment that may be interpreted as effect of general maladaptivity.
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Affiliation(s)
- Maria Esposito
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vincenzo Monda
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ilaria Bitetti
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Filomena Salerno
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesco Precenzano
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Simone Pisano
- Department of Child and Adolescent Neuropsychiatry, University of Salerno, Salerno, Italy
| | - Tiziana Salvati
- Faculty of Education Science, University Suor Orsola Benincasa of Naples, Naples, Italy
| | - Antonella Gritti
- Faculty of Education Science, University Suor Orsola Benincasa of Naples, Naples, Italy
| | - Rosa Marotta
- Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, Italy
| | | | - Francesco Lavano
- Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Agata Maltese
- Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy
| | - Lucia Parisi
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Margherita Salerno
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Gabriele Tripi
- Department PROSAMI, University of Palermo, Palermo, Italy
- Childhood Psychiatric Service for Neurodevelopmentals Disorders, Chinon, France
| | - Beatrice Gallai
- Centro per la Diagnosi e Cura dei Disturbi dell’apprendimento e del Comportamento Associazione per la ricerca scientifica Fusis, Alvignano, Italy
| | - Michele Roccella
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Domenico Bove
- Centro per la Diagnosi e Cura dei Disturbi dell’apprendimento e del Comportamento Associazione per la ricerca scientifica Fusis, Alvignano, Italy
| | - Maria Ruberto
- Department of Medical-Surgical and Dental Specialties, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Roberto Toraldo
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marco Carotenuto
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
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Jalava-Broman J, Mäkinen J, Sillanmäki L, Vahtera J, Rautava P. Characteristics associated with initiation of hormone replacement therapy among Finnish women: A register-linkage study. Maturitas 2016; 89:73-8. [DOI: 10.1016/j.maturitas.2016.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/19/2016] [Accepted: 04/08/2016] [Indexed: 12/12/2022]
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Brennenstuhl S, Fuller-Thomson E. The Painful Legacy of Childhood Violence: Migraine Headaches Among Adult Survivors of Adverse Childhood Experiences. Headache 2015; 55:973-83. [PMID: 26104222 DOI: 10.1111/head.12614] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Childhood adversities have been associated with adult migraine in the general population. However, most research has focused on only a few types of maltreatment and has not always controlled for factors correlated with early adversities and migraine. OBJECTIVES The aim of this study was to investigate the relationship between early adversities and migraine, while controlling for a range of potential explanatory factors. METHODS We analyzed data from the 2012 Canadian Community Health Survey - Mental Health. Using a representative sample of 10,358 men and 12,638 women, we undertook gender-specific logistic regression analyses to determine the association between number and type of self-reported childhood adversities (physical abuse, sexual abuse, and witnessing parental domestic violence) and migraine, while controlling for sociodemographics, comorbid adversities, health behaviors, depression, and anxiety. RESULTS In total, 6.5% of men and 14.2% of women reported migraines. All three adversities were significantly associated with migraine for both genders, even after controlling for a range of variables. The fully adjusted odds of migraine associated with physical abuse, parental domestic violence, and sexual abuse were 1.61 (95% confidence interval [CI] = 1.42-1.83), 1.64 (95% CI = 1.39-1.93), and 1.32 (95% CI = 1.11-1.57), respectively, for women, and 1.50 (95% CI = 1.25-1.80), 1.52 (95% CI = 1.16-1.98), and 1.70 (95% CI = 1.22-2.36) for men. Greater number of adversities was also associated with increasing odds of migraine. Men reporting all three adversities had over three times (odds ratio = 3.26; 95% CI = 2.09-5.07) and women over two times (OR = 2.85; 95% CI = 2.25-3.60) the odds of migraine compared with those without childhood adversities. CONCLUSIONS Number and type of early adversities are associated with migraine among Canadian men and women.
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Affiliation(s)
- Sarah Brennenstuhl
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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Stickley A, Koyanagi A, Kawakami N. Childhood adversities and adult-onset chronic pain: Results from the World Mental Health Survey, Japan. Eur J Pain 2015; 19:1418-27. [DOI: 10.1002/ejp.672] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2014] [Indexed: 11/06/2022]
Affiliation(s)
- A. Stickley
- Department of Human Ecology; Graduate School of Medicine; The University of Tokyo; Japan
| | - A. Koyanagi
- Stockholm Centre on Health of Societies in Transition (SCOHOST); Södertörn University; Huddinge Sweden
| | - N. Kawakami
- Department of Mental Health; Graduate School of Medicine; The University of Tokyo; Japan
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Sillanpää V, Mattila K, Sumanen M. Childhood Adversities Associated with Eating Disorders Reported by Adults. Health (London) 2015. [DOI: 10.4236/health.2015.710147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Slavin-Spenny O, Lumley MA, Thakur ER, Nevedal DC, Hijazi AM. Effects of anger awareness and expression training versus relaxation training on headaches: a randomized trial. Ann Behav Med 2014; 46:181-92. [PMID: 23620190 DOI: 10.1007/s12160-013-9500-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND AND PURPOSE Stress contributes to headaches, and effective interventions for headaches routinely include relaxation training (RT) to directly reduce negative emotions and arousal. Yet, suppressing negative emotions, particularly anger, appears to augment pain, and experimental studies suggest that expressing anger may reduce pain. Therefore, we developed and tested anger awareness and expression training (AAET) on people with headaches. METHODS Young adults with headaches (N = 147) were randomized to AAET, RT, or a wait-list control. We assessed affect during sessions, and process and outcome variables at baseline and 4 weeks after treatment. RESULTS On process measures, both interventions increased self-efficacy to manage headaches, but only AAET reduced alexithymia and increased emotional processing and assertiveness. Yet, both interventions were equally effective at improving headache outcomes relative to controls. CONCLUSIONS Enhancing anger awareness and expression may improve chronic headaches, although not more than RT. Researchers should study which patients are most likely to benefit from an emotional expression or emotional reduction approach to chronic pain.
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Affiliation(s)
- Olga Slavin-Spenny
- Department of Psychology, Wayne State University, 5057 Woodward Ave., 7th Floor, Detroit, MI, 48202, USA
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Genizi J, Srugo I, Kerem NC. Headache and physical and sexual abuse among Jewish and Arab adolescents in Israel. J Child Neurol 2014; 29:505-8. [PMID: 23533163 DOI: 10.1177/0883073813482042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of the present study was to evaluate the relationship between headaches and physical and sexual abuse. A self-administered, anonymous questionnaire was presented to 2088 tenth grade students in Northern Israel. Participants were Jews and Arabs between the ages of 15 to 16 years. Arab adolescents comprised 55% of the analyzed sample and adolescent Jews 45%. With regard to gender, 56% of participants were females. Of the Arab participants, 18.6% reported having frequent headaches, less than that reported in the Jewish group (27.9%). Jewish girls who were physically abused during childhood had a higher prevalence of frequent headaches (55% vs 33% P < .001). Jewish students who reported being sexually abused had higher headache prevalence as well (44.4% vs 27.3% P = .05). In conclusion, adolescents who reported to have been physically or sexually abused report a higher prevalence of headache compared to their peers.
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Affiliation(s)
- Jacob Genizi
- 1Pediatric Neurology Unit, Bnai Zion Medical Center, Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
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Entonen AH, Suominen SB, Korkeila K, Mantyselka PT, Sillanmaki LH, Ojanlatva A, Rautava PT, Koskenvuo MJ. Migraine predicts hypertension--a cohort study of the Finnish working-age population. Eur J Public Health 2013; 24:244-8. [DOI: 10.1093/eurpub/ckt141] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lumley MA, Sklar ER, Carty JN. Emotional disclosure interventions for chronic pain: from the laboratory to the clinic. Transl Behav Med 2013; 2:73-81. [PMID: 22905067 DOI: 10.1007/s13142-011-0085-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Life stress and the avoidance of negative emotions may contribute to chronic pain. The technique of written or spoken emotional disclosure can reverse emotional avoidance and improve health, and 18 randomized studies have tested it among people with chronic pain. We review these studies to provide guidance for the clinical use of this technique. The benefits of emotional disclosure for chronic pain are quite modest overall. Studies in rheumatoid arthritis show very limited effects, but two studies in fibromyalgia suggest that disclosure may be beneficial. Effects in other populations (headaches, cancer pain, pelvic pain, abdominal pain) are mixed. Moderator findings suggest that some patients are more likely to benefit than others. Emotional disclosure has been tested in well-controlled efficacy trials, leaving many unanswered questions related to translating this technique to practice. Issues needing further study include determining disclosure's effects outside of randomized controlled trials, identifying the optimal pain populations and specific individuals to target for disclosure, presenting a valid rationale for disclosure, selecting the location and method of disclosure, and choosing between cognitive-behavioral or emotional disclosure techniques.
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Affiliation(s)
- Mark A Lumley
- Department of Psychology, Wayne State University, 5057 Woodward Ave., 7th Floor, Detroit, MI 48202 USA
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Schubiner H. Emotional Awareness for Pain. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00084-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sumelahti ML, Mattila K, Sillanmäki L, Sumanen M. Prescription patterns in preventive and abortive migraine medication. Cephalalgia 2011; 31:1659-63. [PMID: 22116941 DOI: 10.1177/0333102411427602] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Migraine is considered a common but under-diagnosed and untreated condition. Treatment patterns have pointed at frequent over-the-counter medication use and low use of preventive therapies. Studies exploring migraine prescription practice among doctors are few. METHODS A population-based study was carried out to examine the prescription practice in the use of acute and preventive migraine medications. The data covered 4864 working-age people reporting they have been diagnosed with migraine. Data on reimbursed prescription medicines from 1 January 1998 to 31 December 2006 were drawn from the registers of the Social Insurance Institute of Finland and compared with age- and sex-matched controls. RESULTS Anti-inflammatory analgesics were prescribed for 71% of female and 62% of male migraine patients vs. 56% and 50% of controls. Triptans were prescribed for 21% of female and 10% of male patients. Combinations of analgesics and muscle relaxants were offered to 37% of female and 29% of male patients vs. 26% and 21% of controls, and antidepressants to 19% of women and 14% of men vs. 13% and 9% of controls. CONCLUSION Although use of preventive medication among migraineurs was high, the prescription patterns in acute treatments showed that NSAIDS were used more often than triptans. Assimilation of national guidelines to treat migraine published in 2002 in Finland was not reflected in the prescription patterns up to 2006.
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Cuijpers P, Smit F, Unger F, Stikkelbroek Y, Ten Have M, de Graaf R. The disease burden of childhood adversities in adults: a population-based study. CHILD ABUSE & NEGLECT 2011; 35:937-945. [PMID: 22099144 DOI: 10.1016/j.chiabu.2011.06.005] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 06/07/2011] [Accepted: 06/09/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES There is much evidence showing that childhood adversities have considerable effects on the mental and physical health of adults. It could be assumed therefore, that the disease burden of childhood adversities is high. It has not yet been examined, however, whether this is true. METHOD We used data of a large representative sample (N=7,076) of the general population in the Netherlands. We calculated the disability weight (DW) for each respondent. The DW is a weight factor that reflects the severity of a disease or condition on a scale from 0 (perfect health) to 1 (equivalent to death). We used an algorithm based on the SF-6D to estimate DW. Because the DW indicates the proportion of a healthy life year that is reduced by the specific health state of the individual, it also possible to calculate the total number of years lost due to disability (YLD) in the population. We calculated the years lived with disability (YLD) for 9 different childhood adversities (in the areas of parental psychopathology; abuse and neglect; major life events), as well as for major categories of mental disorders and general medical disorders. RESULTS All 9 adversities resulted in a significantly increased DW, except death of a parent before the age of 16. Adversities in the category of abuse and neglect are associated with the highest DWs (0.057), followed by parental psychopathology (0.031) and life events during childhood (0.012). All adversities (46.4% of the population reports one or more adversity) are associated with 20.7 YLD/1,000, which is more than all mental disorders together (12.9 YLD/1,000). The category of abuse/neglect has the highest YLD/1,000 (15.8), which is also higher than all mental disorders together. Adjustment for the presence of mental and general medical disorders resulted in comparable outcomes. CONCLUSIONS Childhood adversities are more important from a public health point of view than all common mental disorders together, and should be a priority for public health interventions.
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Affiliation(s)
- Pim Cuijpers
- EMGO Institute for Health and Care Research, VU University and VU University Medical Center, Amsterdam, The Netherlands
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Hedborg K, Anderberg UM, Muhr C. Stress in migraine: personality-dependent vulnerability, life events, and gender are of significance. Ups J Med Sci 2011; 116:187-99. [PMID: 21668386 PMCID: PMC3128723 DOI: 10.3109/03009734.2011.573883] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND AND AIM The individual's experiences of stress as well as constitutional factors, including high neuroticism and female gender, are known determinants for migraine. The present aim was to further elucidate factors of personality and stress, including life events, in relation to gender in migraine. METHODS A cross-sectional study was performed on 150 persons, 106 women and 44 men, suffering from at least two migraine attacks a month. All obtained a doctor-defined migraine diagnosis based on a structured face-to-face interview concerning their health situation and current and prior stress. All of them also answered validated questionnaires regarding personality traits (SSP), life events, and perceived ongoing stress. RESULTS The personality trait inventory showed high mean scores for stress susceptibility and low mean scores for aggressiveness and adventure seeking, both for women and for men, as well as high mean scores for psychic and somatic anxiety in women. Stress susceptibility, the overall most deviant trait, correlated strikingly with current level of stress in both sexes. In women, stress susceptibility also correlated strongly with experiences of negative life events. Tension-type headache, anxiety, and depression were approximately twice as prevalent in women compared to men. CONCLUSIONS The present study confirms previous research, showing that stress is an important factor in migraine. Stress susceptibility, life events, and concomitant psychosomatic illnesses should be considered important when evaluating individuals with migraine, and gender aspects need to be taken into account.
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Affiliation(s)
- Kerstin Hedborg
- Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Sweden.
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Lumley MA, Cohen JL, Borszcz GS, Cano A, Radcliffe AM, Porter LS, Schubiner H, Keefe FJ. Pain and emotion: a biopsychosocial review of recent research. J Clin Psychol 2011; 67:942-68. [PMID: 21647882 DOI: 10.1002/jclp.20816] [Citation(s) in RCA: 453] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE AND METHOD Research on emotion and pain has burgeoned. We review the last decade's literature, focusing on links between emotional processes and persistent pain. RESULTS Neurobiological research documents the neural processes that distinguish affective from sensory pain dimensions, link emotion and pain, and generate central nervous system pain sensitization. Psychological research demonstrates that greater pain is related to emotional stress and limited emotional awareness, expression, and processing. Social research shows the potential importance of emotional communication, empathy, attachment, and rejection. CONCLUSIONS Emotions are integral to the conceptualization, assessment, and treatment of persistent pain. Research should clarify when to eliminate or attenuate negative emotions, and when to access, experience, and express them. Theory and practice should integrate emotion into cognitive-behavioral models of persistent pain.
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Affiliation(s)
- Mark A Lumley
- Department of Psychology, Wayne State University, 5057 Woodward Ave., 7th Floor, Detroit, Michigan 48202, USA.
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Korpimäki SK, Sumanen MPT, Sillanmäki LH, Mattila KJ. Cancer in working-age is not associated with childhood adversities. Acta Oncol 2010; 49:436-40. [PMID: 20121670 DOI: 10.3109/02841860903521103] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Early life events are studied as potential causes of cancer. The objective here was to study childhood adversities in the etiology of cancer. METHODS The material comprised a population based random sample of 25 898 individuals among the Finnish working-aged population. In 1998 they were requested through six questions in a postal questionnaire to recall their childhood adversities. The cases consisted of people with cancer diagnosed 2000-2006 and registered in the Finnish Cancer Registry (n = 384). The rest of the sample consisted of cancer-free controls. RESULTS The most common adversities were prolonged financial difficulties, serious conflicts in the family and someone in the family having been seriously or chronically ill. The cancer patients reported more prolonged financial difficulties and someone seriously or chronically ill in the family. They reported less parental divorce than the controls. The associations were not statistically significant after adjusting for age, sex, education, and health behaviour. Nor was there a significant difference in the total number of childhood adversities between the study group and the controls. CONCLUSION On the whole, these cancer patients had not experienced more childhood adversities than the controls. According to our findings, there is no cause to attribute development of cancer in working age to childhood adversities. This information may also give relief to other family members.
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Fuller-Thomson E, Baker TM, Brennenstuhl S. Investigating the association between childhood physical abuse and migraine. Headache 2010; 50:749-60. [PMID: 20236339 DOI: 10.1111/j.1526-4610.2010.01626.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Recent clinical and population-based studies suggest that adults who were physically abused as children are more likely to experience migraine than those who were not abused. OBJECTIVES To investigate the relationship between childhood physical abuse and migraine while controlling for age, race, and gender, in addition to the following potential confounders: adverse childhood conditions; adult socioeconomic indicators; current health behaviors; current stressors; history of physical health conditions, and history of mood and/or anxiety disorders. METHODS Secondary analysis of the 2005 Canadian Community Health Survey was undertaken using a regional sample of 13,089 men and women from Manitoba and Saskatchewan (response rate = 83.3% and 84.1%, respectively) of which 7.4% (n = 1025) of respondents reported childhood physical abuse. A series of logistic regression models were used to determine the association between abuse and self-report of a health professional diagnosis of migraine. RESULTS Prevalence of a migraine was almost twice as high for those who reported childhood physical abuse in comparison with those who did not (17.9% vs 8.8%). The crude odds ratio was 2.27 (99% CI = 1.80, 2.86). The odds ratio of migraine was 1.77 (99% CI = 1.39, 2.25) for those who reported childhood physical abuse in comparison with those who did not when only age, gender, and race were adjusted for. When all 6 clusters of potential confounders were included in a final model the odds ratio declined but remained significant at 1.36 (99% CI = 1.04, 1.79). CONCLUSIONS This study found a stable association between childhood physical abuse and migraine that persisted when 6 clusters of potentially confounding factors were adjusted for. Future research should investigate possible mechanisms which explain the abuse-migraine association.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Sumanen MPT, Koskenvuo MJ, Sillanmäki LH, Mattila KJ. Peptic ulcer and childhood adversities experienced by working-aged people. World J Gastroenterol 2009; 15:3405-10. [PMID: 19610142 PMCID: PMC2712902 DOI: 10.3748/wjg.15.3405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To study the association between self-reported peptic ulcer and childhood adversities.
METHODS: The Health and Social Support Study (HeSSup) population consisted of a stratified random sample drawn from the Finnish Population Register in four age groups: 20-24, 30-34, 40-44 and 50-54. The survey was carried out by postal questionnaire during 1998, with a response rate of 40.0%. A follow-up questionnaire was sent during 2003 to all those who responded to the first. Altogether 19 626 individuals returned the follow-up questionnaire; a response rate of 75.8%. The subjects were asked whether a doctor had told them that they have or have had peptic ulcer. The analyses covered those who responded affirmatively to both the baseline and the follow-up enquiries (n = 718). Those not reporting a peptic ulcer in either of the two questionnaires (n = 17 677) were taken as controls. The subjects were further requested (through six questions) to think about their childhood adversities.
RESULTS: The most common adversities mentioned were long-lasting financial difficulties in the family, serious conflicts in the family, and a family member seriously or chronically ill. All the adversities reported, except parental divorce, were more common among peptic ulcer patients than among controls (P values varied between < 0.001 and 0.003). Age- and sex-adjusted odds ratios (OR) of childhood adversities in the multivariate logistic analysis for self-reported peptic ulcer varied between 1.45 and 2.01. Adjusting for smoking, heavy drinking, stress and nonsteroidal anti-inflammatory drug use had no further influence (ORs between 1.22 and 1.73).
CONCLUSION: Our findings suggest that childhood adversities maintain a connection with and have a predictive role in the development of peptic ulcer.
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D'Souza PJ, Lumley MA, Kraft CA, Dooley JA. Relaxation training and written emotional disclosure for tension or migraine headaches: a randomized, controlled trial. Ann Behav Med 2008; 36:21-32. [PMID: 18696172 DOI: 10.1007/s12160-008-9046-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2007] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Behavioral medicine interventions that directly reduce arousal and negative emotions, such as relaxation training (RT), are conceptually different from interventions that temporarily increase negative emotions, such as written emotional disclosure (WED), but no studies have directly compared their efficacy. We compared the effects of RT and WED on people with tension or migraine headaches. METHODS College students with either tension (n = 51) or migraine (n = 90) headaches were randomized to one of three groups: RT, WED, or a neutral writing control condition; four sessions were held over 2 weeks. Mood was measured before and after each session, and outcomes (headache frequency, severity, disability, and general physical symptoms) were assessed at baseline and at 1-month and 3-month follow-ups. RESULTS As expected, RT led to an immediate increase in calmness, whereas WED led to an immediate increase in negative mood, for both headache samples. Intent-to-treat analyses showed that, for the tension headache sample, RT led to improved headache frequency and disability compared to both WED and the control group, but WED had no effect. For migraine headaches, RT improved pain severity relative to the control group, but WED again had no effect. CONCLUSIONS A brief RT protocol was effective for tension headaches, but WED had no effect on health status for either tension or migraine headaches. Modifications to WED, such as targeting people with unresolved stress, providing guidance to enhance the potency of the writing, or including additional at-home writing and exposure exercises, may improve its efficacy for people with headaches and other health problems.
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Affiliation(s)
- Pamela J D'Souza
- Department of Psychology, Wayne State University, 5057 Woodward Avenue, 7th Floor, Detroit, MI 48202, USA
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Sumanen MPT, Ojanlatva A, Rantala A, Sillanmäki LH, Mattila KJ. Gender differences in sex life issues - a population-based study of migraine sufferers. BMC FAMILY PRACTICE 2008; 9:19. [PMID: 18400102 PMCID: PMC2323009 DOI: 10.1186/1471-2296-9-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2007] [Accepted: 04/09/2008] [Indexed: 11/24/2022]
Abstract
Background Migraine is considered to have a negative influence on sex life. The present study was to analyse the perceptions of importance of and satisfaction with sex life as well as the expression of interest in sex among people having migraines in a prospective follow-up mail survey in 1998 and 2003. Methods The random sample was stratified according to gender and age in four age groups (20–24, 30–34, 40–44, and 50–54 years). Altogether 25 898 individuals responded to the baseline and 19 626 to the follow-up questionnaire (75.8% response rate). We examined as to how the perceptions of sex life of those suffering from migraine changed during a 5-year follow-up. Conditional logistic regression was used to analyse the data of the responses on self-reported migraine in the baseline and follow-up surveys (N = 2 977, 79.2% women). Each person with migraine was assigned a gender- and age-matched control in the analysis. Results All three outcome variables tended to decrease in value. Importance of sex life was higher among men with migraine than among their controls. Among women migraine lessened interest in sex life. Conclusion Our findings suggested that migraine has a different impact on sex life among women from that among men.
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