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Kinnie KR, Vance DE, Patrician PA, Billings R, Aroke EN. Chronic Pain Resilience Across Clinical Populations: A Concept Analysis. Pain Manag Nurs 2024; 25:442-450. [PMID: 38849234 DOI: 10.1016/j.pmn.2024.03.019] [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: 11/15/2023] [Revised: 03/10/2024] [Accepted: 03/31/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Chronic pain resilience is a concept that is frequently used in research but lacks theoretical clarity. Understanding chronic pain resilience is germane to developing interventions to improve it and the overall quality of life among individuals with chronic pain. AIMS To uncover and clarify the unique characteristics of the concept of chronic pain resilience. DESIGN A concept analysis using Rodgers' evolutionary method. METHODS Full-text articles published after 2000 in English were used to inform the concept analysis. Scopus, PubMed, PsychINFO, Embase, and CINAHL Plus with Full Text were utilized for literature searches. Rodgers' evolutionary approach was used to clarify the attributes, antecedents, and consequences. RESULTS The search yielded 31 articles that were used in the analysis. The key attributes of chronic pain resilience included engagement in meaningful activities despite pain, maintaining positive psychological homeostasis, buffering against negative mental outcomes, seeking support, and self-empowerment. After considering surrogate terms, antecedents, attributes, and consequences, chronic pain resilience may be defined as the development of the capacity to successfully adapt to chronic pain. This adaptation results in a move toward optimal social, physical, mental, and behavioral functioning by balancing negative and positive psychosocial factors, despite the additional challenges brought about by living with chronic pain.
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Affiliation(s)
- Kiari R Kinnie
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL.
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL
| | | | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL
| | - Edwin N Aroke
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL
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Baumermann SV, Titze C, Hasenbring MI. [Avoidance-endurance fast screen : AEFS validation with one- and two-level response scaling in healthy subjects]. Schmerz 2024:10.1007/s00482-024-00836-8. [PMID: 39302445 DOI: 10.1007/s00482-024-00836-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND AND OBJECTIVES Chronic pain affects an enormous number of patients in Germany. Therefore, early detection is important using easy, quick and reasonable screening methods. The avoidance-endurance fast screen is currently available in two different versions: one asking for pain-related behaviour in light and severe pain and the other assessing overall severe pain-related behaviour. In this study we aim to examine the agreement between both scales and for the first time describe the role of protective psychological features such as resilience and self-compassion in this model. MATERIALS AND METHODS Epidemiological cross-sectional study (n = 278) of a healthy cohort occasionally experiencing pain (< 3 months). The analysis was done using standard descriptive statistics, correlations (Spearman's rho) and deductive statistics (t-tests and one-factor ANOVA with post hoc Bonferroni correction) and effect sizes (Cohen's d). Matching of the instruments was calculated with Cohen's kappa. RESULTS The results showed a moderate agreement for the two versions. A validity check of the subgroups resulted in comparable findings. The one-level version scored higher in terms of pain persistence which caused subgroup changes from adaptive to eustress-endurance responses and from fear-avoidance to distress-endurance responses. The distress-endurance subgroup had significantly lower values of the trait self-compassion. CONCLUSIONS Based on the results of this study, the quality of agreement between the two AEFS versions is considered strong. Without the comparison between mild and strong pain, endurance behaviour was reported more often. According to these findings, overestimation of pain persistence behaviour using the one-level version might result. Therefore, future studies should re-evaluate the cut-offs. As reported in previous studies, protective psychological features showed the highest scores in the eustress-endurance subgroup.
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Affiliation(s)
- Sonja V Baumermann
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Ruhr-Universität Bochum, Universitätsstraße 150, 44801, Bochum, Deutschland.
| | - Christina Titze
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Ruhr-Universität Bochum, Universitätsstraße 150, 44801, Bochum, Deutschland
| | - Monika I Hasenbring
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Ruhr-Universität Bochum, Universitätsstraße 150, 44801, Bochum, Deutschland.
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Thomson P, Jaque SV. Risk and Protective Factors in Dancers Exposed to Trauma. J Dance Med Sci 2024:1089313X241273880. [PMID: 39143694 DOI: 10.1177/1089313x241273880] [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: 08/16/2024]
Abstract
PURPOSE This study examined risk and protective factors in dancers with/without posttraumatic stress disorder (PTSD) and with/without trauma exposure. LITERATURE REVIEW Exposure to traumatic events and developing PTSD can compromise daily functioning and performance ability. Despite exposure many dancers adapt, whereas others suffer psychopathology such as depression, anxiety, PTSD, and difficulties regulating emotions. METHODS Two hundred ninety two pre-professional/professional dancers provided informed consent (IRB approved) and completed 8 self-report measures. A subsample (66%) exposed to a significant traumatic event was evaluated for PTSD. Multivariate analyses of covariance (MANCOVA) were conducted to compare dancers with/without PTSD and with/without trauma exposure. A logistic regression analysis determined predictors of PTSD. RESULTS The MANCOVAs indicated that dancers exposed to trauma (66%) and who had PTSD (32%) had significantly more difficulty regulating emotions, engaged more emotion-oriented coping under stress, and had increased depression, trait anxiety, and cumulative trauma. In these group comparison analyses there were non-significant differences regarding flow experiences and task- and avoidance-oriented coping strategies. In the logistic regression analysis childhood physical and sexual abuse, childhood emotional neglect, mental illness within the family, and difficulty disclosing abuse experiences were predictors of PTSD. In the total sample 21% had PTSD. DISCUSSION AND CONCLUSIONS This study identified types of abuse/trauma, emotion regulation/coping, and psychopathology associated with PTSD in dancers exposed to trauma (66%) and with PTSD (32%). In the total sample 21% had PTSD. Regardless of exposure to trauma or PTSD, the non-significant findings indicated similarities for dancers for global and autotelic flow experiences and task- and avoidance-oriented coping strategies. These positive factors may mitigate trauma-related symptoms. It is recommended that dancers, educators, and clinicians understand the effects of trauma exposure and promote the development of effective coping strategies, emotion regulation, and flow states which may diminish the negative effects of PTSD.
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Affiliation(s)
- Paula Thomson
- Department of Kinesiology, California State University, Northridge, CA, USA
| | - S Victoria Jaque
- Department of Kinesiology, California State University, Northridge, CA, USA
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Shaban M, Shaban MM, Zaky ME, Alanazi MA, Ramadan OME, Ebied EMAES, Ghoneim NIA, Ali SI. Divine resilience: Unveiling the impact of religious coping mechanisms on pain endurance in arab older adults battling chronic pain. Geriatr Nurs 2024; 57:199-207. [PMID: 38696877 DOI: 10.1016/j.gerinurse.2024.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/13/2024] [Accepted: 04/19/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Chronic pain diminishes the quality of life for many Older Adults individuals. Identifying effective coping methods to enhance pain resilience is imperative as populations age. Older Adults commonly use religious faith and spiritual practices to endure pain, yet little research has explored their impact on pain tolerance. METHODS This cross-sectional study examined relationships between positive/negative religious coping styles and pain endurance in 200 Arab elders with chronic pain. Participants completed the Brief Arab Religious Coping Scale, Numeric Pain Rating Scale, WHOQOL-BREF, and demographic/medical history questionnaires. RESULTS Quantitative analysis demonstrated significant positive associations between positive religious reappraisal and active spiritual coping with higher self-reported pain endurance (p<.05). Negative religious coping styles lacked meaningful relationships with pain tolerance. Multiple regression confirmed the unique effects of reappraisal and spiritual practice on improving pain resilience, controlling for covariates. CONCLUSIONS Outcomes align with perspectives highlighting multidimensional neurocognitive, emotional, and psychosocial pain relief from religious coping. Findings underscore integrating positive faith-based resources in biopsychosocial paradigms for Older Adult's pain management. Additional research should investigate causal pathways and contextual factors influencing religious coping effects on diverse Older Adult subgroups.
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Affiliation(s)
- Mostafa Shaban
- Geriatric Nursing Department, Faculty of Nursing, Cairo University, Cairo 11562, Egypt.
| | - Marwa Mamdouh Shaban
- Community Health Nursing Department, Faculty of Nursing, Cairo University, Cairo 11562, Egypt
| | | | | | | | | | - Nagwa Ibrahim Abbas Ghoneim
- Lecturer of Critical Care and Emergency Nursing, Faculty of Nursing, Tanta University, Gharbia 31527, Egypt; Assist prof, Nursing Department, Applied Medical Sciences College, University of Hafr Al Batin, Al Jamiah, Hafar Al Batin 39524, Saudi Arabia
| | - Sayed Ibrahim Ali
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Al Hofuf 31982, Al-Ahsa, Saudi Arabia; Educational Psychology Department, College of Education, Helwan University, Cairo, Egypt
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Bilal A, Liu X, Shafiq M, Ahmed Z, Long H. NIMEQ-SACNet: A novel self-attention precision medicine model for vision-threatening diabetic retinopathy using image data. Comput Biol Med 2024; 171:108099. [PMID: 38364659 DOI: 10.1016/j.compbiomed.2024.108099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 02/18/2024]
Abstract
In the realm of precision medicine, the potential of deep learning is progressively harnessed to facilitate intricate clinical decision-making, especially when navigating multifaceted datasets encompassing Omics, Clinical, image, device, social, and environmental dimensions. This study accentuates the criticality of image data, given its instrumental role in detecting and classifying vision-threatening diabetic retinopathy (VTDR) - a predominant global contributor to vision impairment. The timely identification of VTDR is a linchpin for efficacious interventions and the mitigation of vision loss. Addressing this, This study introduces "NIMEQ-SACNet," a novel hybrid model by the prowess of the Enhanced Quantum-Inspired Binary Grey Wolf Optimizer (EQI-BGWO) with a self-attention capsule network. The proposed approach is characterized by two pivotal advancements: firstly, the augmentation of the Binary Grey Wolf Optimization through Quantum Computing methodologies, and secondly, the deployment of the enhanced EQI-BGWO to adeptly calibrate the SACNet's parameters, culminating in a notable uplift in VTDR classification accuracy. The proposed model's ability to handle binary, 5-stage, and 7-stage VTDR classifications adroitly is noteworthy. Rigorous assessments on the fundus image dataset, underscored by metrics such as Accuracy, Sensitivity, Specificity, Precision, F1-Score, and MCC, bear testament to NIMEQ-SACNet's pre-eminence over prevailing algorithms and classification frameworks.
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Affiliation(s)
- Anas Bilal
- College of Information Science and Technology, Hainan Normal University, Haikou, 571158, China
| | - Xiaowen Liu
- College of Information Science and Technology, Hainan Normal University, Haikou, 571158, China
| | - Muhammad Shafiq
- School of Information Engineering, Qujing Normal University, Sichuan, China
| | - Zohaib Ahmed
- Department of Criminology and Forensic Sciences, Lahore Garrison University, Lahore, Pakistan
| | - Haixia Long
- College of Information Science and Technology, Hainan Normal University, Haikou, 571158, China.
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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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Sharpley CF, Evans ID, Bitsika V, Arnold WM, Jesulola E, Agnew LL. Frontal Alpha Asymmetry Argues for the Heterogeneity of Psychological Resilience. Brain Sci 2023; 13:1354. [PMID: 37759955 PMCID: PMC10526132 DOI: 10.3390/brainsci13091354] [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: 08/30/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
Depression is associated with frontal alpha asymmetry (FAA) and Psychological Resilience (PR), although in different ways. Only cursory attention has been given to how these three constructs interact despite the possible clinical and research implications of those associations. One limitation of recent research into these associations has been conceptualising PR as a unitary construct, whereas it has been shown to be multi-component. This study investigated the underlying components of PR, their correlations with FAA, and the effect that participants' depressive status had upon those correlations in a community sample of 54 males and 46 females aged between 18 yr and 75 years. Results confirmed the overall inverse association between total PR and depression for four of the original five PR components and for one of the two components found in this sample. Similarly, there were differences between the ways that FAA and PR components were associated, depending upon the depressive status of participants. Source localisation data indicated that the PR components were not uniformly correlated with alpha activity in the same brain regions. These findings of content, efficacy, and neurophysiological differences between the five components of PR and their associations with FAA argue against consideration of PR as a unitary construct.
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Affiliation(s)
- Christopher F. Sharpley
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
- School of Science & Technology, University of New England, Queen Elizabeth Drive, Armidale, NSW 2351, Australia
| | - Ian D. Evans
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
| | - Vicki Bitsika
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
| | - Wayne M. Arnold
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
| | - Emmanuel Jesulola
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
- Department of Neurosurgery, The Alfred Hospital, Melbourne, VIC 4222, Australia
| | - Linda L. Agnew
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
- Griffith University, Nathan, QLD 4222, Australia
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Maqsood Q, Sumrin A, Waseem R, Hussain M, Imtiaz M, Hussain N. Bioengineered microbial strains for detoxification of toxic environmental pollutants. ENVIRONMENTAL RESEARCH 2023; 227:115665. [PMID: 36907340 DOI: 10.1016/j.envres.2023.115665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 05/08/2023]
Abstract
Industrialization and other anthropogenic human activities pose significant environmental risks. As a result of the hazardous pollution, numerous living organisms may suffer from undesirable diseases in their separate habitats. Bioremediation, which removes hazardous compounds from the environment using microbes or their biologically active metabolites, is one of the most successful remediation approaches. According to the United Nations Environment Program (UNEP), deteriorating soil health negatively impacts food security and human health over time. Soil health restoration is critical right now. Microbes are widely known for their importance in cleaning up toxins present in the soil, such as heavy metals, pesticides, and hydrocarbons. However, the capacity of local bacteria to digest these pollutants is limited, and the process takes an extended time. Genetically modified organisms (GMOs), whose altered metabolic pathways promote the over-secretion of a variety of proteins favorable to the bioremediation process, can speed up the breakdown process. The need for remediation procedures, degrees of soil contamination, site circumstances, broad adoptions, and numerous possibilities occurring at various cleaning stages are all studied in detail. Massive efforts to restore contaminated soils have also resulted in severe issues. This review focuses on the enzymatic removal of hazardous pollutants from the environment, such as pesticides, heavy metals, dyes, and plastics. There are also in-depth assessments of present discoveries and future plans for efficient enzymatic degradation of hazardous pollutants.
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Affiliation(s)
- Quratulain Maqsood
- Center for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Aleena Sumrin
- Center for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Rafia Waseem
- Center for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Maria Hussain
- Center for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Mehwish Imtiaz
- Center for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Nazim Hussain
- Center for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan.
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Aaron RV, McGill LS, Finan PH, Wegener ST, Campbell CM, Mun CJ. Determining Profiles of Pain-Specific and General Emotion Regulation Skills and Their Relation to 12-Month Outcomes Among People With Chronic Pain. THE JOURNAL OF PAIN 2023; 24:667-678. [PMID: 36503109 PMCID: PMC10079591 DOI: 10.1016/j.jpain.2022.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/22/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022]
Abstract
Difficulties with pain-specific emotion regulation (ER; eg, pain catastrophizing, pain acceptance) are associated with poor pain outcomes. Less is known about how general ER relates to pain outcomes, or the extent to which pain-specific and general ER interact. In a sample (N = 1,453) of adults with chronic pain, the current study used latent profile analysis to identify subgroups of people with distinct pain-specific and general ER profiles, and determined how subgroup membership at baseline related to pain severity, pain interference, depression and anxiety symptoms at 12-month follow-up. Four groups were identified: 1) general ER difficulties only (29.6%); 2) pain-specific and general ER difficulties (26.3%); 3) skillful pain-specific and general ER (24.6%); 4) pain-specific ER difficulties only (19.4%). Controlling for auto-correlation and demographic covariates, those with pain-specific and general ER difficulties had the worst outcomes in all domains. Membership to other groups did not differentiate between pain severity or interference outcomes; those skillful in pain-specific and general ER had the lowest depression and anxiety symptoms at 12 months. General ER difficulties are common among adults with chronic pain and raise relative risk when paired with pain-specific ER difficulties. Findings offer potential directions for individualizing pain psychology treatment. PERSPECTIVE: This article shows that people with chronic pain have different sets of strengths and difficulties when it comes to regulating emotions related and/or unrelated to the experience of pain itself. Understanding an individual's unique constellation of emotion regulation skills and difficulties might help personalize the psychological treatment of pain.
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Affiliation(s)
- Rachel V Aaron
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Lakeya S McGill
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Patrick H Finan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Claudia M Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Chung Jung Mun
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia; Edson College of Nursing and Health Innovation, Arizona State University, Pheonix, Arizona
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Development and Reliability of a Questionnaire Assessing Stress, Coping, and Empathy (SCOPE) in Occupational Settings: Preliminary Evidence from Veterinarians. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3040029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Workplaces can be associated with occupational stress, detrimental consequences in terms of loss of health and reduced psychosocial well-being. Importantly, employees may be particularly at risk of poorer well-being during times of adversity at work, when not able to apply adaptive coping strategies and adopt a more empathetic approach. This study aimed to develop a scale to estimate occupational stress both in terms of situational and individual components, by performing item selection, internal reliability assessment, and investigation of the ceiling/floor effect. The target population consisted of veterinarians (n = 116), based on evidence of high risk of occupational stress and related mental distress. Out of twenty initial candidate entries, exploratory factor analysis retained fifteen items consisting of three domains related to occupational stress, copying strategies, and empathy (SCOPE). The SCOPE scale demonstrated good internal consistency as a whole (Cronbach’s alpha = 0.79) and when considering the three subscales (stress, 0.85; coping, 0.77; and empathy, 0.71). On a possible range from 15 (worst adjustment) to 75 (best adjustment), the sample mean performance was 51.68 (SD, 8.50). Preliminary evidence indicated that the SCOPE questionnaire may reveal differential effects of type of work on levels of occupational stress and related coping and empathy skills.
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12
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Wang AQ, Tang CH, Song J, Fan CX, Wang WC, Chen ZM, Yin WQ. Association of individual resilience with organizational resilience, perceived social support, and job performance among healthcare professionals in township health centers of China during the COVID-19 pandemic. Front Psychol 2022; 13:1061851. [PMID: 36524161 PMCID: PMC9744941 DOI: 10.3389/fpsyg.2022.1061851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/08/2022] [Indexed: 04/03/2024] Open
Abstract
BACKGROUND Primary healthcare professionals were overworked and psychologically overwhelmed during the COVID-19 pandemic. Resilience is an important shield for individuals to cope with psychological stress and improve performance in crises. This study aims to explore the association of individual resilience with organizational resilience, perceived social support and job performance among healthcare professionals in township health centers of China during the COVID-19 pandemic. METHODS Data from 1,266 questionnaires were collected through a cross-sectional survey conducted in December 2021 in Shandong Province, China. Descriptive analysis of individual resilience, organizational resilience, perceived social support, and job performance was conducted. Pearson correlation analysis was used to examine the correlations among these variables, and structural equation modeling was performed to verify the relationships between these variables. RESULTS The score of individual resilience was 101.67 ± 14.29, ranging from 24 to 120. Organizational resilience (β = 0.409, p < 0.01) and perceived social support (β = 0.410, p < 0.01) had significant direct effects on individual resilience. Individual resilience (β = 0.709, p < 0.01) had a significant direct effect on job performance. Organizational resilience (β = 0.290, p < 0.01) and perceived social support (β = 0.291, p < 0.01) had significant indirect effects on job performance. CONCLUSION During the COVID-19 pandemic, the individual resilience of healthcare professionals in township health centers was at a moderate level. Organizational resilience and perceived social support positively affected individual resilience, and individual resilience positively affected job performance. Furthermore, individual resilience mediated the effect of organizational resilience and perceived social support on job performance. It is recommended that multiple stakeholders work together to improve the individual resilience of primary healthcare professionals.
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Affiliation(s)
- An-Qi Wang
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Chang-Hai Tang
- School of Public Affairs, Zhejiang University, Hangzhou, Zhejiang, China
- School of Business, NingboTech University, Ningbo, Zhejiang, China
| | - Jia Song
- School of Management, Weifang Medical University, Weifang, Shandong, China
| | - Cheng-Xin Fan
- School of Management, Weifang Medical University, Weifang, Shandong, China
| | - Wan-Chen Wang
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Zhong-Ming Chen
- School of Management, Weifang Medical University, Weifang, Shandong, China
| | - Wen-Qiang Yin
- School of Management, Weifang Medical University, Weifang, Shandong, China
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13
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Tobore TO. On stimulus persistence and human behavior: the stimulus persistence unification theory. Commun Integr Biol 2022; 15:240-252. [PMID: 36387583 PMCID: PMC9645252 DOI: 10.1080/19420889.2022.2141954] [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: 09/12/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022] Open
Abstract
A person trapped in a building engulfed in a raging fire, a person dealing with severe chronic disease, people dealing with a virus pandemic, and people fighting in a protracted war may appear dissimilar but are fundamentally in a similar situation and their behaviors follow a predictable and similar pattern. In this paper, the behaviors of rational people dealing with a significant persistent unpleasant, or dangerous stimulus that is inescapable are elucidated. The unique modulatory effects of stimulus persistence on human behavior as well as the role of means and interest are discussed.
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Ernst N, Eagle S, Trbovich A, Kissinger-Knox A, Bitzer H, Kontos AP. Lower post-injury psychological resilience is associated with increased recovery time and symptom burden following sport-related concussion. APPLIED NEUROPSYCHOLOGY. CHILD 2022; 11:781-788. [PMID: 34410842 DOI: 10.1080/21622965.2021.1964966] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The purpose of this study was to compare athletes with high and low resilience scores on concussion outcomes, and identify significant predictors associated with protracted recovery (>30 days). Forty-five adolescent and young adult athletes (28 males; aged 15.13 ± 2.74; range of 11-22) were diagnosed with an SRC within 14 days of injury (M = 4.9 days) and grouped as high or low resilience based on score on the Connor-Davidson Resilience Scale-10 (CD-RISC-10). Primary dependent measures included days to full clearance, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Depression Anxiety and Stress Scale-21 (DASS-21), and Vestibular/Ocular Motor Screening (VOMS). The low resilience group (n = 22) had a longer recovery (36.0 ± 27.6 vs 17.8 ± 11.2 days), endorsed more mood symptoms (PCSS Affective cluster; 3.8 ± 0.8 vs 0.9 ± 0.7), and were more likely to have VOMS scores above cut off (p = 0.01-0.02), compared to those with high psychological resilience (n = 23). Logistic regression found low resilience scores was the only significant predictor for protracted recovery among injury characteristics and risk factors. Psychological resilience is a critical factor associated with recovery time following sport-related concussions. Low resilience was also associated with other poor clinical outcomes, greater subjective symptom report, more severe vestibular dysfunction, and elevated levels of mood symptoms following injury.
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Affiliation(s)
- Nathan Ernst
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA
| | - Shawn Eagle
- Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alicia Trbovich
- Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Orthopedics, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Hannah Bitzer
- Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anthony P Kontos
- Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Orthopedics, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Kumar A, Sakhare K, Bhattacharya D, Chattopadhyay R, Parikh P, Narayan KP, Mukherjee A. Communication in non-communicable diseases (NCDs) and role of immunomodulatory nutraceuticals in their management. Front Nutr 2022; 9:966152. [PMID: 36211513 PMCID: PMC9532975 DOI: 10.3389/fnut.2022.966152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022] Open
Abstract
Conveyance of pathogens between organisms causes communicable diseases. On the other hand, a non-communicable disease (NCD) was always thought to have no causative transmissible infective agents. Today, this clear distinction is increasingly getting blurred and NCDs are found to be associated with some transmissible components. The human microbiota carries a congregation of microbes, the majority and the most widely studied being bacteria in the gut. The adult human gut harbors ginormous inhabitant microbes, and the microbiome accommodates 150-fold more genes than the host genome. Microbial communities share a mutually beneficial relationship with the host, especially with respect to host physiology including digestion, immune responses, and metabolism. This review delineates the connection between environmental factors such as infections leading to gut dysbiosis and NCDs and explores the evidence regarding possible causal link between them. We also discuss the evidence regarding the value of appropriate therapeutic immunomodulatory nutritional interventions to reduce the development of such diseases. We behold such immunomodulatory effects have the potential to influence in various NCDs and restore homeostasis. We believe that the beginning of the era of microbiota-oriented personalized treatment modalities is not far away.
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Affiliation(s)
- Abhiram Kumar
- Esperer Onco Nutrition Pvt. Ltd., Mumbai, India
- Department of Biological Sciences, Birla Institute of Technology and Science – Pilani, Hyderabad, India
| | - Kalyani Sakhare
- Department of Biological Sciences, Birla Institute of Technology and Science – Pilani, Hyderabad, India
| | - Dwaipayan Bhattacharya
- Department of Biological Sciences, Birla Institute of Technology and Science – Pilani, Hyderabad, India
| | | | - Purvish Parikh
- Department of Clinical Haematology, Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - Kumar P. Narayan
- Department of Biological Sciences, Birla Institute of Technology and Science – Pilani, Hyderabad, India
- *Correspondence: Kumar P. Narayan,
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Sharpley CF, Christie DRH, Bitsika V. Which Aspects of Psychological Resilience Moderate the Association between Deterioration in Sleep and Depression in Patients with Prostate Cancer? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148505. [PMID: 35886356 PMCID: PMC9320600 DOI: 10.3390/ijerph19148505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 12/04/2022]
Abstract
This study aimed to investigate the moderating effect of psychological resilience on sleep-deterioration-related depression among patients with prostate cancer, in terms of the total score and individual symptoms. From a survey of 96 patients with prostate cancer, 55 who reported a deterioration in their sleep quality since diagnosis and treatment completed the Zung Self-Rating Depression Scale, Connor–Davidson Resilience Scale, and the Insomnia Severity Index. Moderation analysis was conducted for the scale total scores and for the ‘core’ symptoms of each scale within this sample, based on data analysis. Interaction analysis was used to identify key associations. The moderation analysis suggested that psychological resilience moderated the depressive effect of sleep deterioration that patients reported occurred after their diagnosis and treatment and did so at the total and ‘core’ symptom levels of being able to see the humorous side of things and to think clearly when under pressure, but there was an interaction between this moderating effect, the strength of psychological resilience, and severity of sleep deterioration. Although it appears to be a successful moderator of depression arising from sleep deterioration that was reported by patients with prostate cancer, the effectiveness of psychological resilience is conditional upon the severity of patients’ sleep difficulties and the strength of their psychological resilience. Implications for the application of resilience training and concomitant therapies for patients with prostate cancer with sleep difficulties and depression are discussed.
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Affiliation(s)
- Christopher F. Sharpley
- Brain-Behaviour Research Group, School of Science & Technology, University of New England, Armidale, NSW 2351, Australia; (D.R.H.C.); (V.B.)
- Correspondence:
| | - David R. H. Christie
- Brain-Behaviour Research Group, School of Science & Technology, University of New England, Armidale, NSW 2351, Australia; (D.R.H.C.); (V.B.)
- Genesiscare, John Flynn Private Hospital, Tugun, QLD 4224, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, School of Science & Technology, University of New England, Armidale, NSW 2351, Australia; (D.R.H.C.); (V.B.)
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17
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AI-Based Automatic Detection and Classification of Diabetic Retinopathy Using U-Net and Deep Learning. Symmetry (Basel) 2022. [DOI: 10.3390/sym14071427] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Artificial intelligence is widely applied to automate Diabetic retinopathy diagnosis. Diabetes-related retinal vascular disease is one of the world’s most common leading causes of blindness and vision impairment. Therefore, automated DR detection systems would greatly benefit the early screening and treatment of DR and prevent vision loss caused by it. Researchers have proposed several systems to detect abnormalities in retinal images in the past few years. However, Diabetic Retinopathy automatic detection methods have traditionally been based on hand-crafted feature extraction from the retinal images and using a classifier to obtain the final classification. DNN (Deep neural networks) have made several changes in the previous few years to assist overcome the problem mentioned above. We suggested a two-stage novel approach for automated DR classification in this research. Due to the low fraction of positive instances in the asymmetric Optic Disk (OD) and blood vessels (BV) detection system, preprocessing and data augmentation techniques are used to enhance the image quality and quantity. The first step uses two independent U-Net models for OD (optic disc) and BV (blood vessel) segmentation. In the second stage, the symmetric hybrid CNN-SVD model was created after preprocessing to extract and choose the most discriminant features following OD and BV extraction using Inception-V3 based on transfer learning, and detects DR by recognizing retinal biomarkers such as MA (microaneurysms), HM (hemorrhages), and exudates (EX). On EyePACS-1, Messidor-2, and DIARETDB0, the proposed methodology demonstrated state-of-the-art performance, with an average accuracy of 97.92%, 94.59%, and 93.52%, respectively. Extensive testing and comparisons with baseline approaches indicate the efficacy of the suggested methodology.
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18
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Schwab R, Stewen K, Kottmann T, Anic K, Schmidt MW, Elger T, Theis S, Kalb SR, Brenner W, Hasenburg A. Mental Health and Social Support Are Key Predictors of Resilience in German Women with Endometriosis during the COVID-19 Pandemic. J Clin Med 2022; 11:jcm11133684. [PMID: 35806968 PMCID: PMC9267240 DOI: 10.3390/jcm11133684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/11/2022] [Accepted: 06/23/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Endometriosis is a multifaceted chronic pain disorder that can have an impact on both physical and mental health. Women suffering from chronic pain may be more susceptible to various health disorders, especially during adversity, such as the COVID-19 pandemic. Previous research has identified resilience as a mediator between internal or external stressors and well-being. Methods: An online survey was conducted during the first wave of the COVID-19 pandemic in Germany through patient support groups of women with endometriosis. The Brief Resilience Score (BRS) was employed to evaluate resilience, while the PHQ-4 questionnaire was used to assess self-reported mental health. Univariate and multivariate logistic regression analyses were applied to determine resilience’s independent risk and protective parameters. Results: High educational level was found to be an independent supportive moderator of high resilience in women with a resilience score greater than the study population’s median (BRS > 2.66; OR 2.715; 95% CI 1.472−5.007; p = 0.001) but not in women in the highest resilience score quartile (BRS > 3.33). A decrease in perceived social support was detected to be the most powerful independent risk factor for low resilience: OR 0.541, 95% CI 0.307−0.952, p = 0.033 for predicting BRS > 2.66, and OR 0.397, 95% CI 0.189−0.832, p = 0.014 for predicting scores > 3.33 on the BRS scale. A high burden of mental health symptoms, as measured by the PHQ-4 scale, was negatively associated with resilience. Conclusions: Satisfying social support and good mental health were shown to be key resources for resilience. The results of this study may assist in the identification of women at risk for low resilience and the development of resilience-building strategies in patients with endometriosis.
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Affiliation(s)
- Roxana Schwab
- Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (K.A.); (M.W.S.); (T.E.); (S.T.); (S.R.K.); (W.B.); (A.H.)
- Correspondence: ; Tel.: +49-6131-17-0
| | - Kathrin Stewen
- Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (K.A.); (M.W.S.); (T.E.); (S.T.); (S.R.K.); (W.B.); (A.H.)
| | - Tanja Kottmann
- CRO Dr. med. Kottmann GmbH & Co. KG, 59077 Hamm, Germany;
| | - Katharina Anic
- Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (K.A.); (M.W.S.); (T.E.); (S.T.); (S.R.K.); (W.B.); (A.H.)
| | - Mona W. Schmidt
- Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (K.A.); (M.W.S.); (T.E.); (S.T.); (S.R.K.); (W.B.); (A.H.)
| | - Tania Elger
- Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (K.A.); (M.W.S.); (T.E.); (S.T.); (S.R.K.); (W.B.); (A.H.)
| | - Susanne Theis
- Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (K.A.); (M.W.S.); (T.E.); (S.T.); (S.R.K.); (W.B.); (A.H.)
| | - Stefanie R. Kalb
- Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (K.A.); (M.W.S.); (T.E.); (S.T.); (S.R.K.); (W.B.); (A.H.)
| | - Walburgis Brenner
- Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (K.A.); (M.W.S.); (T.E.); (S.T.); (S.R.K.); (W.B.); (A.H.)
| | - Annette Hasenburg
- Department of Obstetrics and Gynecology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (K.A.); (M.W.S.); (T.E.); (S.T.); (S.R.K.); (W.B.); (A.H.)
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Schwab R, Stewen K, Ost L, Kottmann T, Theis S, Elger T, Schmidt MW, Anic K, Kalb SR, Brenner W, Hasenburg A. Predictors of Psychological Distress in Women with Endometriosis during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084927. [PMID: 35457794 PMCID: PMC9024970 DOI: 10.3390/ijerph19084927] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 12/14/2022]
Abstract
Background: Endometriosis is a multifaceted chronic pain condition that can have a negative impact on mental health. Patients suffering from chronic pain may face an additional psychological burden during adversity, such as the COVID-19 pandemic. The main aim of this research was to evaluate the prevalence of self-reported depression and anxiety, the influence of demographic, endometriosis-specific, pandemic-specific factors, and resilience on mental health outcomes of patients with endometriosis. Methods: An online survey was conducted through patient support groups of women suffering from endometriosis during the first wave of the COVID-19 pandemic. The PHQ-4 questionnaire, which combines two items of the Patient Health Questionnaire for Depression (PHQ-2) and two items from the Generalized Anxiety Disorder Scale (GAD-2) was used to assess self-reported mental health. The Brief Resilience Score (BRS) was employed to evaluate resilience. Independent risk and protective factors for mental health were investigated by multivariate logistic regression analyses. Results: The PHQ-4 questionnaire was completed by 274 respondents. More than 40% reached depression (PHQ-2) and anxiety (GAD-2) scores of ≥3, and more than 20% achieved PHQ-2 and GAD-2 scores of ≥5. High resilience was found to be a reliable and strong independent protector for the probability of developing adverse psychological outcomes: OR 0.295, p < 0.001 for developing generalized anxiety disorder (GAD-2 ≥ 3), and OR 0.467, p < 0.001 for having major depression (PHQ-2 ≥ 3). Conclusions: Pain-induced disability is an independent risk factor for developing major depression and anxiety, while resilience was identified as a potential protective parameter in terms of positive psychological outcomes in women with endometriosis. The results of this study may help to identify women at risk for adverse mental health outcomes and should encourage healthcare practitioners to establish strategies for the reduction of negative psychological and psychiatric impacts on patients with endometriosis.
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Affiliation(s)
- Roxana Schwab
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
- Correspondence: ; Tel.: +49-6131-17-0
| | - Kathrin Stewen
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Laura Ost
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Tanja Kottmann
- CRO Dr. Med. Kottmann GmbH & Co. KG, 59077 Hamm, Germany;
| | - Susanne Theis
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Tania Elger
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Mona Wanda Schmidt
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Katharina Anic
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Stefanie Roxana Kalb
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Walburgis Brenner
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
| | - Annette Hasenburg
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany; (K.S.); (L.O.); (S.T.); (T.E.); (M.W.S.); (K.A.); (S.R.K.); (W.B.); (A.H.)
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20
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Machine Learning Algorithms for Depression: Diagnosis, Insights, and Research Directions. ELECTRONICS 2022. [DOI: 10.3390/electronics11071111] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Over the years, stress, anxiety, and modern-day fast-paced lifestyles have had immense psychological effects on people’s minds worldwide. The global technological development in healthcare digitizes the scopious data, enabling the map of the various forms of human biology more accurately than traditional measuring techniques. Machine learning (ML) has been accredited as an efficient approach for analyzing the massive amount of data in the healthcare domain. ML methodologies are being utilized in mental health to predict the probabilities of mental disorders and, therefore, execute potential treatment outcomes. This review paper enlists different machine learning algorithms used to detect and diagnose depression. The ML-based depression detection algorithms are categorized into three classes, classification, deep learning, and ensemble. A general model for depression diagnosis involving data extraction, pre-processing, training ML classifier, detection classification, and performance evaluation is presented. Moreover, it presents an overview to identify the objectives and limitations of different research studies presented in the domain of depression detection. Furthermore, it discussed future research possibilities in the field of depression diagnosis.
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Acceptance and Commitment Therapy to Increase Resilience in Chronic Pain Patients: A Clinical Guideline. Medicina (B Aires) 2022; 58:medicina58040499. [PMID: 35454337 PMCID: PMC9025890 DOI: 10.3390/medicina58040499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/28/2022] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
Chronic pain remains a very difficult condition to manage for healthcare workers and patients. Different options are being considered and a biopsychosocial approach seems to have the most benefit, since chronic pain influences biological, psychological and social factors. A conservative approach with medication is the most common type of treatment in chronic pain patients; however, a lot of side effects are often induced. Therefore, a premium is set on novel nonpharmacological therapy options for chronic pain, such as psychological interventions. Previous research has demonstrated that resilience is a very important aspect in coping with chronic pain. A more recent type of cognitive-behavioural therapy is Acceptance and Commitment Therapy, in which psychological flexibility is intended to be the end result. In this manuscript, current evidence is used to explain why and how a comprehensive and multimodal treatment for patients with chronic pain can be applied in clinical practice. This multimodal treatment consists of a combination of pain neuroscience education and cognitive-behavioural therapy, more specifically Acceptance and Commitment Therapy. The aim is to provide a clinical guideline on how to contribute to greater flexibility and resilience in patients with chronic pain.
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22
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Kascakova N, Furstova J, Trnka R, Hasto J, Geckova AM, Tavel P. Subjective perception of life stress events affects long-term pain: the role of resilience. BMC Psychol 2022; 10:54. [PMID: 35246257 PMCID: PMC8897905 DOI: 10.1186/s40359-022-00765-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE There is evidence that experiencing childhood trauma and life stressors across the lifespan together with lower resilience is associated with chronic pain-related conditions. The aim of this study was to explore the potential mediating role of resilience in the relationship between childhood trauma and long-term pain and to explore a possible moderating role of serious life stressors in the last year. METHODS The participants, drawn from a representative sample of citizens of the Czech Republic (n = 1800, mean age: 46.6 years, 48.7% male), were asked to report various long-term pain conditions, childhood trauma (Childhood Trauma Questionnaire, CTQ), life stressors (Life Stressor Checklist Revised, LSC-R) and resilience (Brief Resilience Scale, BRS) in a cross-sectional face-to-face study conducted in 2016. A conditional process SEM model of moderated mediation was performed. RESULTS The occurrence of life stress events affecting the participant's last year moderated the relationship between childhood trauma, resilience and health. In the group of participants who experienced at least one life stress event affecting their last year, resilience fully mediated the effect of past childhood trauma on long-term pain. In participants who did not experience life stressors with an impact on the last year, the direct path from childhood trauma to health through resilience lost its significance. CONCLUSION The subjective meaning of stress events on one's life has an impact on the trajectory between childhood trauma and health and acts as a moderator. Resilience may buffer the negative effect of trauma on later long-term pain.
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Affiliation(s)
- Natalia Kascakova
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, Univerzitní 22, 771 11 Olomouc, Czech Republic
- Psychiatric-Psychotherapeutic Outpatient Clinic, Pro mente sana, Heydukova 27, 811 08 Bratislava, Slovakia
| | - Jana Furstova
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, Univerzitní 22, 771 11 Olomouc, Czech Republic
| | - Radek Trnka
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, Univerzitní 22, 771 11 Olomouc, Czech Republic
- Science and Research Department, Prague College of Psychosocial Studies, Hekrova 805, Prague 4, 149 00 Czech Republic
| | - Jozef Hasto
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, Univerzitní 22, 771 11 Olomouc, Czech Republic
- St. Elizabeth College of Health and Social Work, Palackého 1, 811 02 Bratislava, Slovakia
- Slovak Medical University, Limbova 12, 833 03 Bratislava, Slovakia
| | - Andrea Madarasova Geckova
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, Univerzitní 22, 771 11 Olomouc, Czech Republic
- Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia
| | - Peter Tavel
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, Univerzitní 22, 771 11 Olomouc, Czech Republic
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Beeckman M, Hughes S, Van der Kaap-Deeder J, Plasschaert F, Michielsen J, Moens P, Schelfaut S, Goubert L. Risk and Resilience Predictors of Recovery After Spinal Fusion Surgery in Adolescents. Clin J Pain 2021; 37:789-802. [PMID: 34419974 DOI: 10.1097/ajp.0000000000000971] [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: 09/17/2020] [Accepted: 07/20/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This prospective study examined risk and resilience predictors of pain and functional recovery in the first 6 months after spinal fusion surgery in adolescents. METHODS Adolescents with adolescent idiopathic scoliosis undergoing spinal fusion surgery (n=100, aged 12 to 18 y, 77% girls) completed assessments before surgery and at 3 weeks, 6 weeks, and 6 months after surgery. Recovery trajectories in pain, health-related quality of life (HRQOL), and objectively registered physical activity were identified. Presurgical pain catastrophizing and pain intensity (risk), and psychological flexibility, and postsurgical pain acceptance (resilience) were examined as predictors of recovery. RESULTS Latent growth class analyses revealed 4 distinct pain recovery trajectories (ie, Severe-Moderate [11%, n=9], Mild-No [58%, n=49], Moderate-Mild [24%, n=20], and Moderate-Severe [7%, n=6] pain trajectory), 2 HRQOL recovery trajectories; 2 trajectories characterizing recovery in average daily physical activity at moderate-to-vigorous intensity (MVPA); and 3 trajectories characterizing recovery in total physical activity volume characterized by the average daily number of steps. Subsequent multivariate analyses of variance revealed that presurgical pain intensity (partial η2=0.21, P<0.001) and pain catastrophizing (partial η2=0.13, P<0.01) were both predictive of poorer recovery in HRQOL, and pain catastrophizing additionally predicted poorer pain recovery (partial η2=0.15, P<0.05). Psychological flexibility (partial η2=0.25, P<0.001) and postsurgical pain acceptance (partial η2=0.07, P<0.05) were predictive of more favorable recovery trajectories in HRQOL, and psychological flexibility additionally predicted more favorable recovery trajectories in postsurgical pain (partial η2=0.15, P<0.05). Daily MVPA trajectories were not significantly predicted by any of the hypothesized factors, while presurgical pain catastrophizing levels were predictive of a delayed recovery trajectory in the daily amount of steps (partial η2=0.17 P<0.01). CONCLUSIONS Presurgical screening could include assessment of pain intensity, pain catastrophizing, psychological flexibility, and pain acceptance to identify adolescents who are at risk for poorer recovery. These are potentially modifiable factors that can be targeted in presurgical interventions to prevent poor and foster adaptive outcomes after major surgery in adolescents.
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Affiliation(s)
| | - Sean Hughes
- Experimental-Clinical and Health Psychology, Ghent University
| | | | - Frank Plasschaert
- Department of Orthopedics and Traumatology, Ghent University Hospital, Ghent
| | | | - Pierre Moens
- Department of Orthopedics, Leuven University Hospital, Leuven, Belgium
| | | | - Liesbet Goubert
- Experimental-Clinical and Health Psychology, Ghent University
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24
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Li F, Jackson T. Psychophysiological correlates of pain resilience in anticipating, experiencing, and recovering from pain. Psychophysiology 2021; 59:e13962. [PMID: 34716607 DOI: 10.1111/psyp.13962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 10/09/2021] [Accepted: 10/14/2021] [Indexed: 11/29/2022]
Abstract
Although researchers have documented behavioral and brain structure correlates of pain resilience, associated physiological responses have received little consideration. In this study, we assessed psychophysiological differences between high (HPR), moderate (MPR), and low (LPR) pain resilience subgroups during anticipation, experiencing, and recovery from laboratory pain. In an initial pain anticipation task, participants (79 women, 32 man) viewed visual cues to signal possible mild or intense shocks prior to receiving these shocks. Subsequently, in a pain recovery task, participants received uncued mild and intense shocks. Subjective appraisals were assessed during each task in tandem with continuous recording of skin conductance level (SCL), heart rate variability (HRV), and corrugator electromyography (cEMG). On physiological indexes, HPR subgroup members displayed significantly lower SCL than MPR and LPR subgroups did during anticipation and experiencing of pain while no resilience group effects were found for HRV or cEMG. During pain recovery, HPR and LPR subgroups displayed weaker SCL than the MPR subgroup did in the immediate aftermath of shock. However, HPR members continued to display lower SCL than other groups did over an extended recovery period. On self-report measures, the LPR subgroup reported higher levels of anticipatory anxiety and expected pain than HPR and MPR subgroups did during the pain anticipation task. Together, results suggested higher pain resilience is characterized, in part, by comparatively reduced SCL during the course of anticipating, experiencing and recovering from painful shock.
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Affiliation(s)
- Fenghua Li
- Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China
| | - Todd Jackson
- Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China.,Department of Psychology, University of Macau, Taipa, Macau S.A.R., China
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25
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Turan S, Eray Ș. Impact of the pandemic on the mental health of children and clinical practice in Turkey: a narrative review with recommendations. Scand J Child Adolesc Psychiatr Psychol 2021; 9:160-162. [PMID: 34386435 PMCID: PMC8351377 DOI: 10.21307/sjcapp-2021-017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/03/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Serkan Turan
- Child and Adolescent Psychiatry, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Șafak Eray
- Child and Adolescent Psychiatry, Uludag University Faculty of Medicine, Bursa, Turkey
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26
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Sturgeon JA, Kraus SW. Resilience in Women's Sexual Pain After Female Genital Cutting: Adaptation Across Time and Personal and Cultural Context. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1891-1895. [PMID: 31482425 DOI: 10.1007/s10508-019-01536-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/14/2019] [Accepted: 08/16/2019] [Indexed: 06/10/2023]
Affiliation(s)
- John A Sturgeon
- Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, 98105, USA.
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
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27
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Kazan Kızılkurt Ö, Demirkan AK, Gıynaş FE, Güleç H. Effect of childhood trauma on disease severity in patients with fibromyalgia: The mediating role of psychological resilience. Arch Rheumatol 2021; 36:538-547. [PMID: 35382365 PMCID: PMC8957767 DOI: 10.46497/archrheumatol.2021.8477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 03/06/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives
This study aims to investigate the effect of childhood traumas on the disease severity in fibromyalgia and evaluate the mediating role of psychological resilience in this effect. Patients and methods
Between June 2017 and January 2018, this study included a total of 80 female patients (mean age: 31.9±4.0 years; range, 20 to 40 years) with fibromyalgia according to the 2010 American College of Rheumatology fibromyalgia diagnostic criteria. All patients were evaluated using the sociodemographic data form, Resilience Scale for Adults (RSA), Childhood Trauma Questionnaire (CTQ), and Fibromyalgia Impact Questionnaire (FIQ). Results
A positive correlation was observed between the FIQ and CTQ total scores, emotional abuse, physical abuse, and physical neglect scores. The FIQ was negatively correlated with the RSA scores. Path analysis conducted to evaluate mediating effect of psychological resilience revealed that psychological resilience had a mediator role in the correlation between FIQ and emotional abuse, physical abuse, and physical neglect scores. Conclusion
The main finding of this study is the protective effect of psychological resilience -improvable capacity to cope with early life traumas- on fibromyalgia symptoms that leads to negative functioning of several aspects.
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Affiliation(s)
| | | | - Ferzan Ergün Gıynaş
- Department of Psychiatry, University of Health Sciences Erenköy Mental Research and Training Hospital, Istanbul, Turkey
| | - Hüseyin Güleç
- Department of Psychiatry, University of Health Sciences Erenköy Mental Research and Training Hospital, Istanbul, Turkey
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28
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Elmas B, Vatansever M, Civan Kahve A, Salman Özgü B, Asut G, Çakmak IB, Bestel A, Erkaya S. Evaluation of psychological resilience and anxiety levels of patients with hyperemesis gravidarum diagnosis and comparison with healthy pregnant women. Turk J Obstet Gynecol 2021; 18:115-123. [PMID: 34083634 PMCID: PMC8191320 DOI: 10.4274/tjod.galenos.2021.05994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: To compare the psychological resilience and anxiety levels of patients diagnosed with hyperemesis gravidarum (HG) and healthy pregnant women. Materials and Methods: A sociodemographic data form and the Resilience scale for Adults (RSA) and the State-Trait Anxiety Inventory (STAI) were administered. The sociodemographic data form was completed by the physician, and the RSA and STAI were completed by the participant. The sample of the study consisted of 60 pregnant women with HG and hospitalized and 97 healthy voluntary pregnant women with similar characteristics to the research group without any pregnancy complications. Data were evaluated using descriptive statistical analyses, the independent samples t-test, the Mann-Whitney U test and Pearson’s correlation analysis. Results: The age range was 18-42 years for HG group and 20-43 years for control group. The average age of the HG group was 28.17±5.96 years and that of the control group was 29.45±5.83 years. There was no statistically significant difference between the groups in terms of pregnancy week. Regarding the prevalence of state and trait anxiety between the groups, it was found that 66.7% of the HG group had a high level of trait anxiety and 51.7% had a high level of state anxiety. It was found that 61.9% of the control group had a high level of trait anxiety and 38.1% had a high level of state anxiety. There was no difference between the healthy pregnant group and the HG group in terms of anxiety (p=0.125). It was found that there was a significant difference between the groups in terms of only sub-dimensions of RSA, which were perception of self (U=2385.00, p=0.044) and perception of future (U=2350.50, p=0.030). The perception of self and perception of future scores of the healthy control group were higher. Conclusion: There was no difference between the healthy pregnant group and the HG group in terms of anxiety. It was observed that the HG group had a lower perception of self and future. Apart from the usual increase in anxiety levels during pregnancy, HG accompanied by stubborn nausea and vomiting does not create an extra psychological burden, either as a cause or a result.
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Affiliation(s)
- Burak Elmas
- Private Olbamed Hospital, Clinic of Obstetrics and Gynecology, Mersin, Turkey
| | - Merve Vatansever
- Ankara University Institute of Forensic Sciences, Departmant of Forensic Psychology, Ankara, Turkey
| | - Aybeniz Civan Kahve
- Ministry of Health Ankara City Hospital, Clinic of Psychiatry, Ankara, Turkey
| | - Burçin Salman Özgü
- Ministry of Health Ankara City Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
| | - Gonca Asut
- Tekirdağ State Hospital, Clinic of Psychiatry, Tekirdağ, Turkey
| | - Işık Batuhan Çakmak
- Ministry of Health Ankara City Hospital, Clinic of Psychiatry, Ankara, Turkey
| | - Ayşegül Bestel
- University of Health Sciences Turkey, Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Salim Erkaya
- University of Health Sciences Turkey, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey
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29
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Titze C, Hasenbring MI, Kristensen L, Bendix L, Vaegter HB. Patterns of Approach to Activity in 851 Patients With Severe Chronic Pain: Translation and Preliminary Validation of the 9-item Avoidance-Endurance Fast-Screen (AEFS) Into Danish. Clin J Pain 2021; 37:226-236. [PMID: 33399395 DOI: 10.1097/ajp.0000000000000912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 12/12/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The Avoidance-Endurance Fast-Screen (AEFS) is a 9-item self-report questionnaire that classifies patients with back pain into 4 activity-related subgroups, based on the Avoidance-Endurance Model of pain. The objective of this study was to translate the AEFS into Danish and investigate its discriminative abilities in a large, diverse patient sample. MATERIALS AND METHODS A total of 851 specialist care-seeking patients with severe chronic pain conditions participated in this cross-sectional study. Participants were categorized as showing a "distress-endurance" (DER), "eustress-endurance" (EER), "fear-avoidance" (FAR), or "adaptive" (AR) pattern. Principal component analysis reduced a large number of psychological variables beforehand. Construct and outcome-based validity were explored using multivariate analysis of variance. RESULTS Of the participants, 33.6% were categorized as DER, 29.4% as EER, 22% as FAR, and 15% as adaptive. Principal component analysis showed the factors activity-related pain behavior, affective distress, and dysfunctional pain thoughts. The AEFS-DK discriminated all 4 subgroups in terms or their pain behavior with EER>DER>AR>FAR. FAR showed less moderate/vigorous activity than DER and EER and more sedentary time than EER. DER and FAR showed higher affective distress, dysfunctional pain thoughts, and poorer outcomes than AR and EER. CONCLUSION The results indicate good construct validity of the AEFS-DK discriminating the 4 avoidance-endurance model-related subgroups with respect to approach to activity behavior, psychological variables, and reported physical activity. Concerning outcome-based validity, 2 subgroups DER/FAR and AR/EER could be distinguished with inconclusive results for the eustress-endurance subgroup. Future studies are warranted using longitudinal research designs investigating whether AEFS subgroups differ in terms of treatment effects and long-term prognosis.
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Affiliation(s)
- Christina Titze
- Department of Medical Psychology and Sociology, Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany
| | - Monika I Hasenbring
- Department of Medical Psychology and Sociology, Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany
| | | | - Laila Bendix
- Pain Research Group, Pain Center, Odense University Hospital
| | - Henrik B Vaegter
- Pain Research Group, Pain Center, Odense University Hospital
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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30
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Tanner JJ, Johnson AJ, Terry EL, Cardoso J, Garvan C, Staud R, Deutsch G, Deshpande H, Lai S, Addison A, Redden D, Goodin BR, Price CC, Fillingim RB, Sibille KT. Resilience, pain, and the brain: Relationships differ by sociodemographics. J Neurosci Res 2021; 99:1207-1235. [PMID: 33606287 DOI: 10.1002/jnr.24790] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/23/2020] [Accepted: 01/03/2021] [Indexed: 12/22/2022]
Abstract
Chronic musculoskeletal (MSK) pain is disabling to individuals and burdensome to society. A relationship between telomere length and resilience was reported in individuals with consideration for chronic pain intensity. While chronic pain associates with brain changes, little is known regarding the neurobiological interface of resilience. In a group of individuals with chronic MSK pain, we examined the relationships between a previously investigated resilience index, clinical pain and functioning measures, and pain-related brain structures, with consideration for sex and ethnicity/race. A cross-sectional analysis of 166 non-Hispanic Black and non-Hispanic White adults, 45-85 years of age with pain ≥ 1 body site (s) over the past 3 months was completed. Measures of clinical pain and functioning, biobehavioral and psychosocial resilience, and structural MRI were completed. Our findings indicate higher levels of resilience associate with lower levels of clinical pain and functional limitations. Significant associations between resilience, ethnicity/race, and/or sex, and pain-related brain gray matter structure were demonstrated in the right amygdaloid complex, bilateral thalamus, and postcentral gyrus. Our findings provide compelling evidence that in order to decipher the neurobiological code of chronic pain and related protective factors, it will be important to improve how chronic pain is phenotyped; to include an equal representation of females in studies including analyses stratifying by sex, and to consider other sociodemographic factors.
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Affiliation(s)
- Jared J Tanner
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Alisa J Johnson
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.,Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Ellen L Terry
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.,Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Josue Cardoso
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Cynthia Garvan
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Roland Staud
- Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Georg Deutsch
- Department of Radiology, University of Alabama, Birmingham Medical Center, Birmingham, AL, USA
| | - Hrishikesh Deshpande
- Department of Radiology, University of Alabama, Birmingham Medical Center, Birmingham, AL, USA.,Department of Anesthesiology, University of Alabama, Birmingham Medical Center, Birmingham, AL, USA
| | - Song Lai
- Department of Radiation Oncology & CTSI Human Imaging Core, University of Florida, Gainesville, FL, USA
| | - Adriana Addison
- Department of Anesthesiology, University of Alabama, Birmingham Medical Center, Birmingham, AL, USA.,Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Redden
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Burel R Goodin
- Department of Anesthesiology, University of Alabama, Birmingham Medical Center, Birmingham, AL, USA.,Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Catherine C Price
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.,Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Roger B Fillingim
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.,Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Kimberly T Sibille
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.,Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, USA.,Department of Aging and Geriatric Research, College of Medicine, UF Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
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31
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Beeckman M, Simons LE, Hughes S, Loeys T, Goubert L. A Network Analysis of Potential Antecedents and Consequences of Pain-Related Activity Avoidance and Activity Engagement in Adolescents. PAIN MEDICINE 2021; 21:e89-e101. [PMID: 31498397 DOI: 10.1093/pm/pnz211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study sets out to identify potential daily antecedents and consequences of pain-related activity avoidance and engagement behavior in adolescents with chronic pain. METHODS Adolescents (N = 65, Mage = 14.41) completed baseline self-reports and a diary for 14 days. Afternoon and evening reports were used to infer a network structure of within-day associations between pain intensity, pain-related fear, pain catastrophizing, affect, and pain-related activity avoidance and engagement behavior. Baseline psychological flexibility was examined as a potential resilience factor. RESULTS Activity avoidance in the evening was predicted by pain-related fear and avoidance earlier that afternoon. Activity engagement was predicted by positive affect and activity engagement in the afternoon. Pain-related behavior in the afternoon was not related to subsequent changes in pain intensity, pain-related fear, pain catastrophizing, or affect. Pain-related fear in the afternoon was predictive of increased levels of pain and pain catastrophizing in the evening. Both pain-related fear and pain catastrophizing in the evening were predicted by negative affect in the afternoon. Psychological flexibility was associated with lower levels of daily activity avoidance and buffered the negative association between pain intensity and subsequent activity engagement. CONCLUSIONS This study provides insight into unique factors that trigger and maintain activity avoidance and engagement and into the role of psychological flexibility in pediatric pain. Future work should focus on both risk and resilience factors and examine the role of psychological flexibility in chronic pediatric pain in greater detail.
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Affiliation(s)
- Melanie Beeckman
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Laura E Simons
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Sean Hughes
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tom Loeys
- Department of Data Analysis, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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32
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Bouncing back after lumbar spine surgery: early postoperative resilience is associated with 12-month physical function, pain interference, social participation, and disability. Spine J 2021; 21:55-63. [PMID: 32736036 DOI: 10.1016/j.spinee.2020.07.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 06/09/2020] [Accepted: 07/21/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Positive psychosocial factors early after surgery, such as resilience and self-efficacy, may be important characteristics for informing individualized postoperative care. PURPOSE To examine the association of early postoperative resilience and self-efficacy on 12-month physical function, pain interference, social participation, disability, pain intensity, and physical activity after lumbar spine surgery. STUDY DESIGN/SETTING Pooled secondary analysis of prospectively collected trial data from two academic medical centers. PATIENT SAMPLE Two hundred and forty-eight patients who underwent laminectomy with or without fusion for a degenerative lumbar condition. OUTCOME MEASURES Physical function, pain inference, and social participation (ability to participate in social roles and activities) were measured using the Patient Reported Outcomes Measurement Information System. The Oswestry Disability Index, Numeric Rating Scale, and accelerometer activity counts were used to measure disability, pain intensity, and physical activity, respectively. METHODS Participants completed validated outcome questionnaires at 6 weeks (baseline) and 12 months after surgery. Baseline positive psychosocial factors included resilience (Brief Resilience Scale) and self-efficacy (Pain Self-Efficacy Questionnaire). Multivariable linear regression analyses were used to assess the associations between early postoperative psychosocial factors and 12-month outcomes adjusting for age, sex, study site, randomized group, fusion status, fear of movement (Tampa Scale for Kinesiophobia), and outcome score at baseline. This study was funded by Patient-Centered Outcomes Research Institute and Foundation for Physical Therapy Research. There are no conflicts of interest. RESULTS Resilience at 6 weeks after surgery was associated with 12-month physical function (unstandardized beta=1.85 [95% confidence interval [CI]: 0.29; 3.40]), pain interference (unstandardized beta=-1.80 [95% CI: -3.48; -0.12]), social participation (unstandardized beta=2.69 [95% CI: 0.97; 4.41]), and disability (unstandardized beta=-3.03 [95% CI: -6.04; -0.02]). Self-efficacy was associated with 12-month disability (unstandardized beta=-0.21 [95% CI: -0.37; -0.04]. CONCLUSIONS Postoperative resilience and pain self-efficacy were associated with improved 12-month patient-reported outcomes after spine surgery. Future work should consider how early postoperative screening for positive psychosocial characteristics can enhance risk stratification and targeted rehabilitation management in patients undergoing spine surgery.
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Finlay J, Lind C, Dela Cruz AM. Concept analysis: Resilience in young women with chronic pain. Nurs Forum 2020; 56:389-395. [PMID: 33345367 DOI: 10.1111/nuf.12543] [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: 09/11/2020] [Revised: 10/29/2020] [Accepted: 12/04/2020] [Indexed: 11/26/2022]
Abstract
The aim of this article is to define the concept of resilience in the context of chronic pain, while presenting a historical background of resilience. Resilience in young women with chronic pain is discussed where findings exist. Chronic pain places a considerable burden on individual and societal health; resilience is critical to chronic pain management. Enhancing understanding of the concept of resilience can promote resilience and aid in early recognition of impaired coping. Rodgers's evolutionary method of concept analysis was used. Using CINAHL, PubMed, and Google Scholar databases, articles published from 1979 to 2020 were analyzed to identify conceptual components of resilience. We reviewed included articles to determine surrogate terms, relevant uses of the concept, attributes, references of the concept, antecedents, consequences, and related concepts. Resilience in the context of chronic pain is a lifelong process of positive adaption and thriving despite adversity. Components of Rodgers's evolutionary method are identified for the concept. Further research on resilience in young women with chronic pain is needed, given the current lack of literature. Developing nursing interventions to foster resilience is important to promote long-term, effective self-management of individuals living with chronic pain.
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Affiliation(s)
- Jenise Finlay
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Candace Lind
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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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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Firouzian S, Osborne NR, Cheng JC, Kim JA, Bosma RL, Hemington KS, Rogachov A, Davis KD. Individual variability and sex differences in conditioned pain modulation and the impact of resilience, and conditioning stimulus pain unpleasantness and salience. Pain 2020; 161:1847-1860. [PMID: 32701844 DOI: 10.1097/j.pain.0000000000001863] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Distinct pain experiences are shaped both by personal attributes and characteristics of noxious stimuli. An Individual's capacity for endogenous pain inhibition (reflected by conditioned pain modulation [CPM]), their resilience, and the pain unpleasantness and salience of painful stimuli can impact their pain perception. Here, we aimed to determine how individual variability in CPM relates to sex and resilience as personal attributes, and pain unpleasantness and salience of the CPM conditioning stimulus (CS). We evaluated CPM in 106 healthy participants (51 female and 55 male) based on the change in test stimulus pain applied concurrently with a painful CS, both delivered by painful heat. The CS reduced test stimulus pain in only half of the participants (CPM subgroup), but did not do so for the other half (no-CPM subgroup), many who exhibited pain facilitation. A regression model explained CPM effects after accounting for sex, resilience, CS pain unpleasantness and salience. In the CPM subgroup regression model, the CPM effect was positively related to CS pain unpleasantness, while the CPM effect was not related to any variable in the no-CPM subgroup model. Correlation analyses revealed that the CPM effect was anticorrelated with resilience in males with no-CPM. The CPM effect was correlated with CS pain unpleasantness in males with CPM and in females with no-CPM. The CPM effect and CS salience were correlated in the whole group more strongly than in the subgroups. These data reveal that the complexity of contributors to CPM variability include both personal attributes and attributes of the CS.
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Affiliation(s)
- Shahrzad Firouzian
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Natalie R Osborne
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Joshua C Cheng
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Junseok A Kim
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Rachael L Bosma
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Kasey S Hemington
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Anton Rogachov
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Karen D Davis
- Division of Brain, Imaging, and Behaviour, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
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Goldstein P, Ashar Y, Tesarz J, Kazgan M, Cetin B, Wager TD. Emerging Clinical Technology: Application of Machine Learning to Chronic Pain Assessments Based on Emotional Body Maps. Neurotherapeutics 2020; 17:774-783. [PMID: 32767227 PMCID: PMC7609511 DOI: 10.1007/s13311-020-00886-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Depression and anxiety co-occur with chronic pain, and all three are thought to be caused by dysregulation of shared brain systems related to emotional processing associated with body sensations. Understanding the connection between emotional states, pain, and bodily sensations may help understand chronic pain conditions. We developed a mobile platform for measuring pain, emotions, and associated bodily feelings in chronic pain patients in their daily life conditions. Sixty-five chronic back pain patients reported the intensity of their pain, 11 emotional states, and the corresponding body locations. These variables were used to predict pain 2 weeks later. Applying machine learning, we developed two predictive models of future pain, emphasizing interpretability. One model excluded pain-related features as predictors of future pain, and the other included pain-related predictors. The best predictors of future pain were interactive effects of (a) body maps of fatigue with negative affect and (b) positive affect with past pain. Our findings emphasize the contribution of emotions, especially emotional experience felt in the body, to understanding chronic pain above and beyond the mere tracking of pain levels. The results may contribute to the generation of a novel artificial intelligence framework to help in the development of better diagnostic and therapeutic approaches to chronic pain.
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Affiliation(s)
- Pavel Goldstein
- The School of Public Health, University of Haifa, Haifa, Israel.
| | - Yoni Ashar
- Weill Cornell Medical College, New York, NY, USA
| | - Jonas Tesarz
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA.
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA.
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Bartholomew TT, A. Robbins K, Joy EE, Kang E, Maldonado Aguiñiga S. Clients’ resilience and distress in psychotherapy: a preliminary meta-analysis. COUNSELLING PSYCHOLOGY QUARTERLY 2020. [DOI: 10.1080/09515070.2020.1777389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Krista A. Robbins
- Department of Educational Studies, Purdue University, West Lafayette, USA
| | - Eileen E. Joy
- Department of Educational Studies, Purdue University, West Lafayette, USA
| | - Ellice Kang
- Department of Educational Studies, Purdue University, West Lafayette, USA
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Ditton E, Johnson S, Hodyl N, Flynn T, Pollack M, Ribbons K, Walker FR, Nilsson M. Improving Patient Outcomes Following Total Knee Arthroplasty: Identifying Rehabilitation Pathways Based on Modifiable Psychological Risk and Resilience Factors. Front Psychol 2020; 11:1061. [PMID: 32670136 PMCID: PMC7326061 DOI: 10.3389/fpsyg.2020.01061] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/27/2020] [Indexed: 12/19/2022] Open
Abstract
Total knee arthroplasty (TKA) is a commonly implemented elective surgical treatment for end-stage osteoarthritis of the knee, demonstrating high success rates when assessed by objective medical outcomes. However, a considerable proportion of TKA patients report significant dissatisfaction postoperatively, related to enduring pain, functional limitations, and diminished quality of life. In this conceptual analysis, we highlight the importance of assessing patient-centered outcomes routinely in clinical practice, as these measures provide important information regarding whether surgery and postoperative rehabilitation interventions have effectively remediated patients' real-world "quality of life" experiences. We propose a novel precision medicine approach to improving patient-centered TKA outcomes through the development of a multivariate machine-learning model. The primary aim of this model is to predict individual postoperative recovery trajectories. Uniquely, this model will be developed using an interdisciplinary methodology involving non-linear analysis of the unique contributions of a range of preoperative risk and resilience factors to patient-centered TKA outcomes. Of particular importance to the model's predictive power is the inclusion of a comprehensive assessment of modifiable psychological risk and resilience factors that have demonstrated relationships with TKA and other conditions in some studies. Despite the potential for patient psychological factors to limit recovery, they are typically not routinely assessed preoperatively in this patient group, and thus can be overlooked in rehabilitative referral and intervention decision-making. This represents a research-to-practice gap that may contribute to adverse patient-centered outcomes. Incorporating psychological risk and resilience factors into a multivariate prediction model could improve the detection of patients at risk of sub-optimal outcomes following TKA. This could provide surgeons and rehabilitation providers with a simplified tool to inform postoperative referral and intervention decision-making related to a range of interdisciplinary domains outside their usual purview. The proposed approach could facilitate the development and provision of more targeted rehabilitative interventions on the basis of identified individual needs. The roles of several modifiable psychological risk and resilience factors in recovery are summarized, and intervention options are briefly presented. While focusing on rehabilitation following TKA, we advocate for the broader utilization of multivariate prediction models to inform individually tailored interventions targeting a range of health conditions.
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Affiliation(s)
- Elizabeth Ditton
- Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Sarah Johnson
- Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Electrical Engineering and Computing, The University of Newcastle, Callaghan, NSW, Australia
| | - Nicolette Hodyl
- Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Traci Flynn
- Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Humanities and Social Science, The University of Newcastle, Callaghan, NSW, Australia
| | - Michael Pollack
- Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- John Hunter Hospital, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - Karen Ribbons
- Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Frederick Rohan Walker
- Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Biomedical Sciences and Pharmacy, Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia
- NHMRC Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia
| | - Michael Nilsson
- Centre for Rehab Innovations, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- School of Biomedical Sciences and Pharmacy, Priority Research Centre for Stroke and Brain Injury, The University of Newcastle, Callaghan, NSW, Australia
- NHMRC Centre for Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, VIC, Australia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Sharpley CF, Bitsika V, Agnew LL. Psychological resilience mediates the depressive effects of poor dyadic interaction in rural Australians: implications for couples counselling. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2020. [DOI: 10.1080/21507686.2020.1772331] [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]
Affiliation(s)
- Christopher F. Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
| | - Linda L. Agnew
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
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Levenig CG, Kellmann M, Kleinert J, Belz J, Hesselmann T, Heidari J, Hasenbring MI. Body Image in Athletes and Nonathletes With Low Back Pain: Avoidance-Endurance-Related Subgroups and Sports Status Play a Role. J Sport Rehabil 2020; 30:182-189. [PMID: 32335530 DOI: 10.1123/jsr.2019-0245] [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: 06/05/2019] [Revised: 01/08/2020] [Accepted: 02/16/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Low back pain (LBP) is a serious health problem, both in the general population as well as in athletes. Research has shown that psychosocial aspects, such as dysfunctional pain responses, play a significant role in the chronification of LBP. Recent research supports the relevance of the multidisciplinary concept of body image in the interpretation of LBP. OBJECTIVE To examine the differences in 2 psychosocial aspects, body image and pain responses, between athletes and nonathletes with LBP. DESIGN Cross-sectional design. SETTING The questionnaires were distributed in the course of LBP treatment. PARTICIPANTS Data from 163 athletes (mean age = 28.69 [9.6] y) and 75 nonathletes (mean age = 39.34 [12.63] y) were collected. INTERVENTIONS Data were collected by questionnaires assessing body image, pain behavior, training activity, and LBP. MAIN OUTCOME MEASURES To examine group differences between athletes and nonathletes regarding body image and pain behavior, the authors performed 2-way analyses of variance with Bonferroni post hoc tests. RESULTS The results showed (1) a significant main effect regarding pain responses and body image, showing that participants with eustress endurance or adaptive pain behavior revealed a more positive body image in both groups compared with participants with distress endurance or fear-avoidance behavior, and (2) a significant main effect for the factor group in the body image dimension of physical efficacy, indicating a more positive body image for athletes. CONCLUSION These results suggest that considering multiple risk factors for LBP, such as body image and dysfunctional pain behavior, as well as subgrouping, might be valuable for research and for broadening therapy options.
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Exploring Pain Management Among Asian Immigrants with Chronic Pain: Self-Management and Resilience. J Immigr Minor Health 2020; 21:1123-1136. [PMID: 30182206 DOI: 10.1007/s10903-018-0820-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Asians immigrants (AIs) are one of the fastest growing racial groups in many countries globally. Despite pain prevalence, studies on chronic pain management among AIs is limited in the literature. An integrative review was conducted exploring the current state of science on chronic pain management among AIs. Several databases were used to identify related articles and 15 studies met the inclusion criteria. Two major themes emerged: (a) self-management, pertaining to how AIs take responsibility for their pain, and (b) resilience, their adaptive behaviors indicating low levels of pain-related dysfunction and burden despite chronic pain severity. Resilience plays a significant role in the mechanism by which self-management works in pain among AIs. Chronic pain management is a complex process where challenges to effective treatments exist. Findings have significant implications to healthcare providers and the general pain population. Future research directions include the necessity for increased participation of AIs in studies.
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The Complex Interplay of Pain, Depression, and Anxiety Symptoms in Patients With Chronic Pain. Clin J Pain 2019; 36:249-259. [DOI: 10.1097/ajp.0000000000000797] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sisto A, Vicinanza F, Campanozzi LL, Ricci G, Tartaglini D, Tambone V. Towards a Transversal Definition of Psychological Resilience: A Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E745. [PMID: 31744109 PMCID: PMC6915594 DOI: 10.3390/medicina55110745] [Citation(s) in RCA: 133] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/14/2019] [Indexed: 01/25/2023]
Abstract
Background and objectives: This paper addresses psychological resilience, a multidisciplinary theoretical construct with important practical implications for health sciences. Although many definitions have been proposed in several contexts, an essential understanding of the concept is still lacking up to now. This negatively affects comparisons among research results and makes objective measurement difficult. The aim of this review is to identify shared elements in defining the construct of resilience across the literature examined in order to move toward a conceptual unification of the term. Materials and methods: A literature review was performed using the electronic databases 'PubMed' and 'PsycINFO'. Scientific studies written in English between 2002 and May 2019 were included according to the following key terms: 'Psychological', 'resilience', and 'definition'. Results: The review identifies five macro-categories that summarize what has been reported in the recent literature concerning the resilience phenomenon. They serve as a preliminary and necessary step toward a conceptual clarification of the construct. Conclusions: We propose a definition of psychological resilience as the ability to maintain the persistence of one's orientation towards existential purposes. It constitutes a transversal attitude that can be understood as the ability to overcome the difficulties experienced in the different areas of one's life with perseverance, as well as good awareness of oneself and one's own internal coherence by activating a personal growth project. The conceptual clarification proposed will contribute to improving the accuracy of research on this topic by suggesting future paths of investigation aimed at deeply exploring the issues surrounding the promotion of resilience resources.
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Affiliation(s)
- Antonella Sisto
- Clinical Psychological Service, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (A.S.); (F.V.)
| | - Flavia Vicinanza
- Clinical Psychological Service, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (A.S.); (F.V.)
| | - Laura Leondina Campanozzi
- Institute of Philosophy of Scientific and Technological Practice, Campus Bio-Medico University, 00128 Rome, Italy;
| | - Giovanna Ricci
- School of Law, Medico-Legal Section, University of Camerino, 62032 Camerino (Macerata), Italy;
| | - Daniela Tartaglini
- Department of Professional Health Care Services, Campus Bio-Medico University Hospital, 00128 Rome, Italy;
| | - Vittoradolfo Tambone
- Institute of Philosophy of Scientific and Technological Practice, Campus Bio-Medico University, 00128 Rome, Italy;
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Trompetter HR, Mols F, Westerhof GJ. Beyond Adaptive Mental Functioning With Pain as the Absence of Psychopathology: Prevalence and Correlates of Flourishing in Two Chronic Pain Samples. Front Psychol 2019; 10:2443. [PMID: 31749743 PMCID: PMC6848389 DOI: 10.3389/fpsyg.2019.02443] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/15/2019] [Indexed: 11/25/2022] Open
Abstract
Chronic pain outcomes are traditionally defined in terms of disability and illness. A definition of adaptive functioning in the context of chronic pain beyond the mere absence of negative outcomes, is the ability to flourish (i.e., experience emotional, psychological and social well-being; Keyes, 2002). We explored in two chronic pain samples the prevalence and sociodemographic, physical and psychological correlates of flourishing, and complemented this exploration with a similar examination of (being at risk for) psychopathology to help contextualize findings. Sample 1 (n = 1498) was a nationally representative sample. Subgroups included people with regular joint pain (1), regular joint pain and rheumatoid arthritis (2) and without chronic pain (3). Using chi-square tests we calculated the prevalence of both mental health outcomes and examined if people with or without chronic pain were more/less likely to flourish/at risk for psychopathology. Sample 2 (n = 238) concerned baseline data of a Randomized Controlled Trial on the effectiveness of Acceptance and Commitment Therapy for chronic pain (Trompetter et al., 2015b). We performed logistic regression analysis to identify flourishers/those at risk for depression. The Mental Health Continuum-Short Form was used to measure flourishing. The prevalence of flourishing was 34% (recurrent joint pain) and 38% (recurrent joint pain and arthritis) in sample 1, and 23% in sample 2. Compared to those without chronic pain, people with chronic pain were as likely to flourish, but more likely to be at risk for psychopathology. In sample 2, both flourishing and being at risk for depression were related foremost to psychological correlates. While engaged living was the most important correlate of flourishing, pain catastrophizing and psychological inflexibility were most important correlates of being at risk for depression. In conclusion, people with chronic pain are able to flourish. Findings suggest that positive and negative chronic pain outcomes function on two different continua, with potentially unique protective and risk factors. The Psychological Flexibility model provides pathways to explain both poor and optimal functioning in the presence of chronic pain. A better understanding of people with chronic pain who are able to flourish can be a fruitful endeavor to improve chronic pain models and interventions.
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Affiliation(s)
- Hester R. Trompetter
- CoRPS – Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Floortje Mols
- CoRPS – Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Gerben J. Westerhof
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
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Sweeney L, Moss-Morris R, Czuber-Dochan W, Belotti L, Kabeli Z, Norton C. 'It's about willpower in the end. You've got to keep going': a qualitative study exploring the experience of pain in inflammatory bowel disease. Br J Pain 2019; 13:201-213. [PMID: 31656626 PMCID: PMC6791049 DOI: 10.1177/2049463719844539] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Pain is a widely experienced symptom of inflammatory bowel disease (IBD), which has significant psychological and functional impacts on patients. Understanding the aetiology and management of chronic pain is a poorly understood area of IBD research. This qualitative study aimed to explore the experiences of individuals with IBD and pain, the pain management strategies they use and any needs for future pain management interventions. METHODS In all, 14 individuals with IBD were purposively recruited and interviewed (face-to-face or telephone) using a topic guide. Interviews were transcribed and analysed using inductive thematic analysis. RESULTS Themes identified were 'vicious cycles', 'findings solutions' and 'attitudes'. The experience and impact of pain were rarely viewed in isolation, but rather within the context of a cycle of IBD symptoms. Other 'vicious cycles' identified included anxiety, avoidance and inactivity, and poor understanding and communication. Pain management included short- and long-term strategies. Searching for a solution for pain had an emotional impact on individuals. There were contrasting attitudes from participants, including defeat, tolerance and acceptance. CONCLUSION This study provides an understanding of the experience of pain in IBD. The interaction of pain with accompanying IBD symptoms has an emotional and physical impact on individuals, and creates a barrier to adequate assessment, understanding and treatment of pain. Patients rely on their own experiences, and a trial and error approach to apply helpful strategies. Adjuvant behavioural therapies may be beneficial for patients experiencing pain and psychological distress, and to facilitate self-management.
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Affiliation(s)
- Louise Sweeney
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
| | | | - Wladyslawa Czuber-Dochan
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
| | - Laure Belotti
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
| | - Zoe Kabeli
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
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Beeckman M, Simons LE, Hughes S, Loeys T, Goubert L. Investigating How Parental Instructions and Protective Responses Mediate the Relationship Between Parental Psychological Flexibility and Pain-Related Behavior in Adolescents With Chronic Pain: A Daily Diary Study. Front Psychol 2019; 10:2350. [PMID: 31681125 PMCID: PMC6811655 DOI: 10.3389/fpsyg.2019.02350] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/02/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Parental behavior can influence how well adolescents cope with chronic pain. Previous research has largely focused on how parents negatively impact adolescent functioning. Yet more recent work suggests that parents - and particularly parental psychological flexibility - can foster better adolescent pain-related functioning. In this study we examined if parental protective responses and instructions to engage in activities in the presence of pain mediate the impact of parental psychological flexibility and acceptance of adolescent pain on adolescents' daily pain-related behavior. METHOD Fifty-six adolescents with chronic pain (M age = 14.5 years, 86% girls) and one of their parents (93% mothers) were recruited at initial evaluation at two pediatric pain clinics in the US. Parents completed baseline questionnaires assessing psychologically flexible parenting and acceptance of adolescent pain. Next, parents and adolescents completed a 14-day self-report diary assessing adolescent activity-avoidance and activity-engagement in the presence of pain (adolescent report), and parental protective responses and instructions for their adolescent to engage in activities (parent report). RESULTS Psychologically flexible parenting and acceptance of adolescent pain in parents were indirectly related to lower daily adolescent activity-avoidance, via their negative association with daily parental protective responses. Positive associations also emerged between baseline psychologically flexible parenting and overall levels of adolescent activity-engagement via its negative association with overall levels of parental protectiveness across the 14-day period. Psychologically flexible parenting and parental acceptance of adolescent pain were also indirectly related to daily decreases in adolescent activity-avoidance via their association with daily increases in parental activity-engagement instructions. These baseline parental resilience factors were also positively related to overall levels of parental engagement instructions, a route via which an indirect association with both higher overall activity-engagement as well as higher overall activity-avoidance in the adolescent was observed. CONCLUSION Our findings suggest an (indirect) adaptive role of parental psychological flexibility on adolescent daily pain-related behavior via its impact on parental protective behavior. If our findings replicate, they would suggest that these parental behaviors could be targeted in pain treatments that include both adolescents and their parents. Future research could further examine the impact of parental instructions on pain-related behavior in adolescents with chronic pain.
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Affiliation(s)
- Melanie Beeckman
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Laura E. Simons
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Sean Hughes
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Tom Loeys
- Department of Data Analysis, Ghent University, Ghent, Belgium
| | - Liesbet Goubert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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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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Thomson P, Jaque SV. History of childhood adversity and coping strategies: Positive flow and creative experiences. CHILD ABUSE & NEGLECT 2019; 90:185-192. [PMID: 30802732 DOI: 10.1016/j.chiabu.2018.12.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/29/2018] [Accepted: 12/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Acquiring more complex coping strategies despite a history of childhood adversity may transpire in settings outside the family home. OBJECTIVES The objectives of this cross-sectional study included investigating coping strategies under stressful situations in a non-clinical sample of active athletes and performing artists. PARTICIPANTS AND SETTING In this community and university sample (n = 577), 40.4% had no ACEs, 43.4% had 1-3 ACEs, and 16.3% had ≥4 ACEs. METHODS A series of multivariate analyses (gender and age included as covariates) were conducted to examine differences between the three ACE groups. RESULTS Results indicated no between-subject differences between the three ACE groups for flow-like experiences during preferred activities, although gender differences were significant (p < .001). Individuals in the ≥4 ACEs group endorsed more intense creative experiences compared to the no-ACE and 1-3 ACEs groups (p = .006, η2 = .048); however, in the third MANCOVA they had heightened anxiety, internalized shame, dissociative processing, emotion-oriented coping, and cumulative trauma (p < .001, η2 = .132). There were no group differences for task-oriented and avoidant-oriented coping, a finding that highlights the ability of active individuals to engage in effective coping strategies under stressful situations. CONCLUSION Regardless of past childhood adversity history, this non-clinical high achieving sample was able to engage in a range of coping strategies under stress.
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Affiliation(s)
- Paula Thomson
- California State University, Northridge, Northridge, CA, United States.
| | - S Victoria Jaque
- California State University, Northridge, Northridge, CA, United States
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Shim M, Goodill S, Bradt J. Mechanisms of Dance/Movement Therapy for Building Resilience in People Experiencing Chronic Pain. AMERICAN JOURNAL OF DANCE THERAPY 2019. [DOI: 10.1007/s10465-019-09294-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kortlever JTP, Keulen MHF, Teunis T, Ring D, Driscoll MD, Reichel LM, Vagner GA. Does resiliency mediate the association of psychological adaptability with disability and pain in patients with an upper extremity injury or illness? J Psychosom Res 2019; 117:1-9. [PMID: 30665589 DOI: 10.1016/j.jpsychores.2018.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 12/05/2018] [Accepted: 12/07/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Symptom intensity and magnitude of limitations are highly variable for a given nociception and pathophysiology. As psychological determinants are of great influence to physical wellbeing, we assessed the influence of the protective factor measured and labelled as resilience in upper extremity illness. METHODS One hundred and six patients completed a survey of demographics, the Brief Resilience Scale (BRS), the Psychological Adaptation Scale (PAS), an 11-point ordinal measure of pain intensity, and the PROMIS Physical Function (PROMIS PF) Computer Adaptive Test (CAT). Measures of pain intensity and PROMIS PF were repeated 3 months later. We created mediation models using structural equation modeling (SEM) to assess the mediation effect of BRS on the association of PAS and other confounding variables with disability and pain at initial assessment and 3 months later. RESULTS Resiliency does not mediate the association of psychological adaptability with physical limitations and pain intensity at baseline (P = .89 and .82 respectively) or 3 months after enrollment (P = .65 and .72 respectively). CONCLUSIONS Positive and protective factors promote beneficial resilience mechanisms that strengthen coping responses to pain and disability. In future studies we should either include more patients to improve power and provide more information about the health benefits of resilience or focus more on mood and self-efficacy on symptoms and limitations in patients with musculoskeletal illness. LEVEL OF EVIDENCE Prospective, longitudinal cohort study; Level II.
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Affiliation(s)
- Joost T P Kortlever
- Department of Surgery and Perioperative Care, Dell Medical School - University of Texas at Austin, 1701 Trinity Street, 78712 Austin, TX, USA.
| | - Mark H F Keulen
- Department of Surgery and Perioperative Care, Dell Medical School - University of Texas at Austin, 1701 Trinity Street, 78712 Austin, TX, USA.
| | - Teun Teunis
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht; Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School - University of Texas at Austin, 1701 Trinity Street, 78712 Austin, TX, USA.
| | - Matt D Driscoll
- Department of Surgery and Perioperative Care, Dell Medical School - University of Texas at Austin, 1701 Trinity Street, 78712 Austin, TX, USA.
| | - Lee M Reichel
- Department of Surgery and Perioperative Care, Dell Medical School - University of Texas at Austin, 1701 Trinity Street, 78712 Austin, TX, USA.
| | - Gregg A Vagner
- Department of Surgery and Perioperative Care, Dell Medical School - University of Texas at Austin, 1701 Trinity Street, 78712 Austin, TX, USA.
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