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Borthwick C, Penlington C, Robinson L. Associations Between Adult Attachment, Pain Catastrophizing, Psychological Inflexibility and Disability in Adults with Chronic Pain. J Clin Psychol Med Settings 2024; 31:571-584. [PMID: 38180697 DOI: 10.1007/s10880-023-09989-7] [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] [Accepted: 11/20/2023] [Indexed: 01/06/2024]
Abstract
We investigated whether attachment insecurity (anxiety and avoidance) moderated the association between satisfaction with social support and pain disability. We also tested whether the relationship between insecure attachment and pain disability was serially mediated by pain catastrophising and psychological inflexibility. A large-scale cross-sectional correlational design was employed. Data were collected using an online survey. Correlation, serial mediation and moderated regression analyses were used. Data from 894 people with self-reported chronic pain were analysed. Based on correlations, age, depression, and pain intensity were included as covariates. No direct effect of satisfaction with social support on pain disability was observed in the moderation. Attachment anxiety was positively associated with pain disability (b = 1.20, t = 2.03, p < .05), but attachment avoidance was not (b = -0.08, t = -0.13, p = .90). The association between attachment anxiety and pain disability was partially mediated by pain catastrophising and psychological inflexibility (c = 1.21, t = 4.37, p < .001; a1db2 = 0.33, t = 5.15, p < .001). The relationship between attachment avoidance and pain disability was fully mediated by pain catastrophising and psychological inflexibility (c = 0.15, t = 0.54, p = .59; a1db2 = 0.13, t = 2.24, p < .05). This study provided initial evidence that pain catastrophising and psychological inflexibility mediate the association between insecure attachment and pain disability. Follow-up research using a longitudinal design is recommended.
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Affiliation(s)
- Claire Borthwick
- School of Psychology, Newcastle University, 4th Floor, Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE2 4DR, UK.
| | - Chris Penlington
- School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Lucy Robinson
- School of Psychology, Newcastle University, 4th Floor, Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE2 4DR, UK
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Austin RR, Ang O, Haley A, Hanson L, Kennedy D, Mendenhall H, Schulz C, Thorpe D, Evans R. Examining Resilient Pain Behaviors for Chronic Low Back Pain: A Scoping Review. Pain Manag Nurs 2024; 25:417-424. [PMID: 38724425 DOI: 10.1016/j.pmn.2024.04.010] [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: 12/10/2023] [Revised: 03/27/2024] [Accepted: 04/07/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVES The objective of this scoping review was to examine resilience and resilient pain behaviors for those with CLBP in relation to resilience definitions, operationalization (e.g. trait or behavior), and application of theoretical frameworks. DESIGN This scoping review examined resilience and resilient pain behaviors for those with CLBP in relation to resilience definitions, operationalization (e.g. trait or behavior), and application of theoretical frameworks. DATA SOURCES To gather data, we used five databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Ovid MEDLINE, PsycInfo, and Scopus. REVIEW/ANALYSIS METHODS Authors used a systematic data charting spreadsheet (Microsoft Excel) to review and analyze the extracted data. RESULTS A total of 26 articles, from 2011-2021, were included in the final analysis. A majority of articles were conducted in the United States (11) and cross-sectional secondary data analysis design (13). Resilience definitions varied across the studies. Three studies operationalized resilience as a trait and only one as a behavior. Most studies (20) did not include a theoretical framework. CONCLUSION The majority cross-sectional design and heterogeneity of a resilience definition indicates resilience research is still emerging. The lack of operationalized resilience, specifically as a behavior, and the limited use of theoretical frameworks suggest advancements in resilience pain research are needed. NURSING PRACTICE IMPLICATIONS This research has implications for nursing practice to support nurse's holistic perspective and the ability to incorporate resilience within nursing care. This research provides the initial steps to developing standard resilience definitions and frameworks to guide nursing practice.
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Affiliation(s)
- Robin R Austin
- University of Minnesota, School of Nursing, Minneapolis, MN; University of Minnesota, Earl E. Bakken Center for Spirituality and Healing, Minneapolis, MN; University of Minnesota, Integrative Health and Wellbeing Research Program, Minneapolis, MN.
| | - Oliver Ang
- University of Minnesota, School of Nursing, Minneapolis, MN; University of Minnesota, Earl E. Bakken Center for Spirituality and Healing, Minneapolis, MN; University of Minnesota, Integrative Health and Wellbeing Research Program, Minneapolis, MN
| | - Alex Haley
- University of Minnesota, School of Nursing, Minneapolis, MN; University of Minnesota, Earl E. Bakken Center for Spirituality and Healing, Minneapolis, MN; University of Minnesota, Integrative Health and Wellbeing Research Program, Minneapolis, MN
| | - Linda Hanson
- University of Minnesota, School of Nursing, Minneapolis, MN; University of Minnesota, Earl E. Bakken Center for Spirituality and Healing, Minneapolis, MN; University of Minnesota, Integrative Health and Wellbeing Research Program, Minneapolis, MN
| | - Doug Kennedy
- University of Minnesota, School of Nursing, Minneapolis, MN; University of Minnesota, Earl E. Bakken Center for Spirituality and Healing, Minneapolis, MN; University of Minnesota, Integrative Health and Wellbeing Research Program, Minneapolis, MN
| | | | - Craig Schulz
- University of Minnesota, School of Nursing, Minneapolis, MN; University of Minnesota, Earl E. Bakken Center for Spirituality and Healing, Minneapolis, MN; University of Minnesota, Integrative Health and Wellbeing Research Program, Minneapolis, MN
| | - Don Thorpe
- University of Minnesota, School of Nursing, Minneapolis, MN; University of Minnesota, Earl E. Bakken Center for Spirituality and Healing, Minneapolis, MN; University of Minnesota, Integrative Health and Wellbeing Research Program, Minneapolis, MN
| | - Roni Evans
- University of Minnesota, School of Nursing, Minneapolis, MN; University of Minnesota, Earl E. Bakken Center for Spirituality and Healing, Minneapolis, MN; University of Minnesota, Integrative Health and Wellbeing Research Program, Minneapolis, MN
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Simic K, Savic B, Knezevic NN. Pain Catastrophizing: How Far Have We Come. Neurol Int 2024; 16:483-501. [PMID: 38804476 PMCID: PMC11130925 DOI: 10.3390/neurolint16030036] [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: 03/13/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
The perception of pain is strongly influenced by various social, emotional, and cognitive factors. A psychological variable which has consistently been shown to exert its influence on pain is a cognitive process referred to as pain catastrophizing. Numerous studies have found it to be a strong predictor of pain intensity and disability across different clinical populations. It signifies a maladaptive response to pain marked by an exaggerated negative assessment, magnification of symptoms related to pain, and, in general, a tendency to experience marked pain-related worry, as well as experiencing feelings of helplessness when it comes to dealing with pain. Pain catastrophizing has been correlated to many adverse pain-related outcomes, including poor treatment response, unsatisfactory quality of life, and high disability related to both acute and chronic pain. Furthermore, there has been consistent evidence in support of a correlation between pain catastrophizing and mental health disorders, such as anxiety and depression. In this review, we aim to provide a comprehensive overview of the current state of knowledge regarding pain catastrophizing, with special emphasis on its clinical significance, and emerging treatment modalities which target it.
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Affiliation(s)
- Katarina Simic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (K.S.); (B.S.)
| | - Boris Savic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (K.S.); (B.S.)
| | - Nebojsa Nick Knezevic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (K.S.); (B.S.)
- Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA
- Department of Surgery, University of Illinois, Chicago, IL 60612, USA
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Norman-Nott N, Hesam-Shariati N, Wewege MA, Rizzo RRN, Cashin AG, Wilks CR, Quidé Y, McAuley JH, Gustin SM. Emotion regulation skills-focused interventions for chronic pain: A systematic review and meta-analysis. Eur J Pain 2024. [PMID: 38558425 DOI: 10.1002/ejp.2268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/07/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES To investigate the effect of emotion regulation skills-focused (ERSF) interventions to reduce pain intensity and improve psychological outcomes for people with chronic pain and to narratively report on safety and intervention compliance. METHODS Six databases and four registries were searched for randomized controlled trials (RCTs) up to 29 April 2022. Risk of bias was evaluated using the Cochrane RoB 2.0 tool, and certainty of evidence was assessed according to the Grading, Assessment, Development and Evaluation (GRADE). Meta-analyses for eight studies (902 participants) assessed pain intensity (primary outcome), emotion regulation, affect, symptoms of depression and anxiety, and pain interference (secondary outcomes), at two time points when available, post-intervention (closest to intervention end) and follow-up (the first measurement after the post-intervention assessment). RESULTS Compared to TAU, pain intensity improved post-intervention (weighted mean difference [WMD] = -10.86; 95% confidence interval [CI] [-17.55, -2.56]) and at follow-up (WMD = -11.38; 95% CI [-13.55, -9.21]). Emotion regulation improved post-intervention (standard mean difference [SMD] = 0.57; 95% CI [0.14, 1.01]), and depressive symptoms improved at follow-up (SMD = -0.45; 95% CI [-0.66, -0.24]). Compared to active comparators, anxiety symptoms improved favouring the comparator post-intervention (SMD = 0.10; 95% CI [0.03, 0.18]), and compared to CBT, pain interference improved post-intervention (SMD = -0.37; 95% CI [-0.69, -0.04]). Certainty of evidence ranged from very low to moderate. SIGNIFICANCE The findings provide evidence that ERSF interventions reduce pain intensity for people with chronic pain compared to usual treatment. These interventions are at least as beneficial to reduce pain intensity as the current gold standard psychological intervention, CBT. However, the limited number of studies and certainty of evidence mean further high-quality RCTs are warranted. Additionally, further research is needed to identify whether ERSF interventions may be more beneficial for specific chronic pain conditions.
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Affiliation(s)
- Nell Norman-Nott
- NeuroRecovery Research Hub, School of Psychology, Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Negin Hesam-Shariati
- NeuroRecovery Research Hub, School of Psychology, Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Michael A Wewege
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Rodrigo R N Rizzo
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Aidan G Cashin
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Chelsey R Wilks
- Department of Psychological Science, University of Missouri-St Louis, St. Louis, Missouri, USA
| | - Yann Quidé
- NeuroRecovery Research Hub, School of Psychology, Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - James H McAuley
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Sylvia M Gustin
- NeuroRecovery Research Hub, School of Psychology, Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
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Lamoureux E, Pagé MG. The Importance of Good Measurement: Development and Validation of a Measure of Disordered Eating Among Adults with Chronic Pain. Can J Pain 2024; 8:2284815. [PMID: 38425884 PMCID: PMC10900263 DOI: 10.1080/24740527.2023.2284815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- E. Lamoureux
- Research Center, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Department of Psychology, Faculty of Arts and Sciences, Université de Montréal, Montreal, Quebec, Canada
| | - M. G. Pagé
- Research Center, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Department of Psychology, Faculty of Arts and Sciences, Université de Montréal, Montreal, Quebec, Canada
- Department of Anesthesiology and Pain Medicine, Université de Montréal, Montreal, Quebec, Canada
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Yang R, Xiong B, Wang M, Wu Y, Gao Y, Xu Y, Deng H, Pan W, Wang W. Gamma Knife surgery and deep brain stimulation of the centromedian nucleus for chronic pain: A systematic review. Asian J Surg 2023; 46:3437-3446. [PMID: 37422388 DOI: 10.1016/j.asjsur.2023.06.026] [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: 11/20/2022] [Revised: 04/11/2023] [Accepted: 06/08/2023] [Indexed: 07/10/2023] Open
Abstract
Chronic pain has been a major problem in personal quality of life and social economy, causing psychological disorders in people and a larger amount of money loss in society. Some targets were adopted for chronic pain, but the efficacy of the CM nucleus for pain was still unclear. A systematic review was performed to summarize GK surgery and DBS of the CM nucleus for chronic pain. PubMed, Embase and Medline were searched to review all studies discussing GK surgery and DBS on the CM nucleus for chronic pain. Studies that were review, meet, conference, not English or not the therapy of pain were excluded. Demographic characteristics, surgery parameters and outcomes of pain relief were selected. In total, 101 patients across 12 studies were included. The median age of most patients ranged from 44.3 to 80 years when the duration of pain ranged from 5 months to 8 years. This review showed varied results of 30%-100% pain reduction across studies. The difference in the effect between GK surgery and DBS cannot be judged. Moreover, three retrospective articles related to GK surgery of the CM nucleus for trigeminal neuralgia presented an average pain relief rate of 34.6-82.5%. Four studies reported adverse effects in a small number of patients. GK surgery and DBS of the CM nucleus might be promising therapeutic approaches for chronic refractory pain. More rigorous studies and larger samples with longer follow-up periods are needed to support the effectiveness and safety.
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Affiliation(s)
- Ruiqing Yang
- Department of Neurosurgery, West China Hospital, Sichuan University, China
| | - Botao Xiong
- Department of Neurosurgery, West China Hospital, Sichuan University, China
| | - Mengqi Wang
- Department of Neurosurgery, West China Hospital, Sichuan University, China
| | - Yang Wu
- Department of Neurosurgery, West China Hospital, Sichuan University, China
| | - Yuan Gao
- Department of Neurosurgery, West China Hospital, Sichuan University, China
| | - Yangyang Xu
- Department of Neurosurgery, West China Hospital, Sichuan University, China
| | - Hao Deng
- Department of Neurosurgery, West China Hospital, Sichuan University, China
| | - Wei Pan
- Department of Neurosurgery, West China Hospital, Sichuan University, China
| | - Wei Wang
- Department of Neurosurgery, West China Hospital, Sichuan University, China.
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Wingood M, Bruch KC, Franssen N, Mulpeter K, Scott L, Henry S, Gell N. Physical activity for patients with chronic low back pain: What are physical therapists prescribing? J Back Musculoskelet Rehabil 2023; 36:1335-1343. [PMID: 37458017 DOI: 10.3233/bmr-220360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Despite the extensive evidence supporting physical activity (PA) for managing chronic low back pain (CLBP), little is known about PA prescription by physical therapists treating patients with CLBP. OBJECTIVE 1) Explore how PA prescriptions provided by outpatient physical therapists treating patients with CLBP align with PA guidelines. 2) Examine the barriers and facilitators of PA prescription among physical therapists working with patients with CLBP. METHODS We conducted a qualitative study with outpatient physical therapists who treat CLBP. Semi-structured interviews provided an understanding of physical therapist experience with PA prescription among patients with CLBP. The interviews were transcribed, coded, and analyzed thematically. RESULTS The 18 participants had an average of 13.4 (6.4) years of clinical experience in outpatient physical therapy. Thematic analysis revealed: 1) Physical therapists' articulate knowledge of PA guidelines and importance of physical activity; 2) Patient factors take priority over the PA guidelines for people with CLBP; and 3) The importance of building and maintaining a strong patient-therapist relationship influences physical therapist prescription of PA for patients with CLBP. CONCLUSION When providing PA recommendations for patients with CLBP, general movement recommendations are emphasized in place of explicit PA prescriptions. Our findings highlight factors for consideration when prescribing movement and PA for patients with CLBP.
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Affiliation(s)
- Mariana Wingood
- New England Geriatric Education and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | | | | | | | | | - Sharon Henry
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Nancy Gell
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
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Tsur N, Noyman-Veksler G, Elbaz I, Weisman L, Brill S, Shalev H, Rudich Z, Shahar G. The Personification of Chronic Pain: an Examination Using the Ben-Gurion University Illness Personification Scale (BGU-IPS). Psychiatry 2022; 86:137-156. [PMID: 36315968 DOI: 10.1080/00332747.2022.2129329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Relying on anthropomorphism research, Illness Personification Theory (ILL-PERF) posits that individuals living with a chronic illness ascribe human-like characteristics to their illness. Herein we examine the personification of chronic pain using a new measure: the Ben-Gurion University Illness Personification Scale (BGU-IPS). Method: Three samples of chronic pain patients (Sample 1 and 2 are distinct samples sharing similar characteristics, collected in the context of a cross-sectional design, Ns = 259, 263; Sample 3: a 2-waves longitudinal, N =163) completed the 12-item BGU-IPS, and measures of pain and related factors. Results: An orthogonal, two-factor structure was revealed for the BGU-IPS pertaining to negative vs. positive personifications. Negative personification was associated with pain intensity and illness-related distress (e.g., depression and low adjustment to pain). Positive personification was correlated with hope, pain-related sense of control, and low depression. However, positive personification also augmented the associations between negative personification and several risk factors. Conclusions: Pain personification, particularly as assessed via the BGU-IPS, plays a major role in (mal)adaptation to chronic pain.
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Dibello V, Panza F, Mori G, Ballini A, Di Cosola M, Lozupone M, Dibello A, Santarcangelo F, Vertucci V, Dioguardi M, Cantore S. Temporomandibular Disorders as a Risk Factor for Suicidal Behavior: A Systematic Review. J Pers Med 2022; 12:jpm12111782. [PMID: 36579500 PMCID: PMC9692338 DOI: 10.3390/jpm12111782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Temporomandibular disorders (TMD) are a group of common musculoskeletal dysfunctions that affect the temporomandibular joint or masticatory muscles and related structures or are expressed as a clinical combination of these two factors. The etiology of TMD is multifactorial and features related to anxiety, depression and mental disorders can contribute to the predisposition, onset and progression of TMD. The ability to adapt and develop coping attitudes was reduced in patients presenting with chronic pain, while suicidal behavior (suicidal ideation, suicide attempts, and suicide completion) was increased. The objective of this review was therefore to investigate suicidal behavior in relation to TMD. METHODS The review was performed according to the PRISMA 2020 guidelines. Six databases (PubMed, MEDLINE, EMBASE, Scopus, Ovid, and Google Scholar) were consulted through the use of keywords related to the review topic. The study is registered on PROSPERO (CRD42022320828). RESULTS The preliminary systematic search of the literature yielded 267 records. Excluding duplicates, 15 were considered potentially relevant and kept for title and abstract analysis. Only six articles were considered admissible reporting a single exposure factor, TMD and a single outcome, suicidal behavior, although these were evaluated through different assessment tools. We found a low association of TMD with suicidal behavior in observational studies, with estimates partly provided [prevalence ratio (PR) from 1.26 to 1.35, 95% confidence intervals (CI) from 1.15 to 1.19 (lower) and from 1.37 to 1.54 (higher); and odds ratios (OR) from 1.54 to 2.56, 95% CI from 1.014 to 1.157 (lower) and 2.051 to 6.484 (higher)], a relevant sample size (n = 44,645), but a few studies included (n = 6). CONCLUSIONS The results of the included studies showed that the prevalence data of suicidal behavior were more present in young adults with TMD, with a controversial association with gender. Suicidal behavior was also correlated and aggravated by the intensity of pain.
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Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology and Research Hospital IRCCS “S. De Bellis”, Castellana Grotte, 70013 Bari, Italy
- Correspondence: (F.P.); (A.B.); (M.D.)
| | - Giorgio Mori
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy
| | - Andrea Ballini
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: (F.P.); (A.B.); (M.D.)
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Antonio Dibello
- Accident and Emergency Department (AED), Fabio Perinei Hospital, Altamura, 70022 Bari, Italy
| | | | | | - Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy
- Correspondence: (F.P.); (A.B.); (M.D.)
| | - Stefania Cantore
- Independent Researcher, Regional Dental Community Service “Sorriso & Benessere-Ricerca e Clinica”, 70129 Bari, Italy
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10
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Roy R, Sommer JL, Bolton JM, El-Gabalawy R. Understanding correlates of suicidality among those with usual pain and discomfort: A Canadian nationally representative study. J Psychosom Res 2021; 151:110651. [PMID: 34673350 DOI: 10.1016/j.jpsychores.2021.110651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/10/2021] [Accepted: 10/10/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Suicidality (ideation, plans, attempts) is elevated among those with chronic pain. However, population-based research is limited and studies primarily focus on mechanisms associated with increasing rather than decreasing risk. This study aimed to identify correlates associated with increased and decreased odds of suicidality among Canadians with usual pain/discomfort in a nationally representative sample. METHODS Cross-sectional data from the 2012 Canadian Community Health Survey-Mental Health supplement (CCHS-MH; N = 25,113) identified individuals with usual pain/discomfort (i.e., chronic pain; n = 5891). Multiple logistic regressions examined correlates that may increase (disability, activity limitations) and decrease (social support, positive mental health, spirituality) odds of suicidality among individuals endorsing usual pain/discomfort. RESULTS Among those endorsing usual pain/discomfort, between 7.1% (suicide attempt) to 21.0% (suicide ideation) endorsed suicidality, notably higher than those without (2.0% vs 9.6% for suicide attempt and ideation, respectively). Both greater social support and positive mental health were associated with decreased odds of suicide ideation and attempts (adjusted odds ratio (AOR) range = 0.94-0.97). Those whose pain prevented most activities had increased odds of suicide plans and attempts (AOR range = 1.72-1.94). Additionally, greater disability was associated with increased odds of suicide ideation (AOR = 1.01, 95% CI[1.01-1.02], p < .001). A multivariable model including all risk and protective correlates found only positive mental health as significantly associated with decreased odds of suicide ideation and attempts. CONCLUSIONS These findings may inform targeted screening, prevention, and intervention strategies to promote resilience and mitigate risk, among those with usual pain/discomfort.
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Affiliation(s)
- Rachel Roy
- Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, MB, Canada
| | - Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, MB, Canada
| | - James M Bolton
- Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, MB, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; CancerCare Manitoba, Winnipeg, MB, Canada.
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11
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Bagheri S, Naderi A, Mirali S, Calmeiro L, Brewer BW. Adding Mindfulness Practice to Exercise Therapy for Female Recreational Runners With Patellofemoral Pain: A Randomized Controlled Trial. J Athl Train 2021; 56:902-911. [PMID: 33237990 DOI: 10.4085/1062-6050-0214.20] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Considering current models that highlight the role of psychological components in pain management, mindfulness practice may be an effective strategy in the management of pain. OBJECTIVE To examine the effects of adding an 8-week mindfulness program to exercise therapy on the perceptions of pain severity, knee function, fear of movement, and pain catastrophizing of female recreational runners with patellofemoral pain (PFP). DESIGN Randomized controlled clinical trial. SETTING University laboratory. PATIENTS OR OTHER PARTICIPANTS Thirty female runners (age = 28.3 ± 7.08 years) with PFP were randomly assigned to the exercise or mindfulness-exercise group. INTERVENTION(S) The exercise-only group followed a protocol (18 weeks, 3 sessions/wk) that featured training modifications to help control injury-related symptoms. The mindfulness-exercise group received an 8-week mindfulness intervention in addition to the exercise protocol. The mindfulness component started 4 weeks before the exercise component; therefore, the 2 components overlapped during the first 4 weeks of the intervention. MAIN OUTCOME MEASURE(S) Usual pain, pain during stepping, and pain during running were assessed using visual analog scales. Functional limitations of the knee were assessed using the Knee Outcome Survey. Fear of movement, pain catastrophizing, and coping strategies were measured via the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and the Coping Strategies Questionnaire, respectively. These outcomes were assessed at baseline, at week 9, and after 18 weeks. RESULTS Pain during running, pain during stepping, and functional limitations of the knee were less for the mindfulness-exercise group than for the exercise-only group (P values < .05). The mindfulness-exercise group reported greater perceived treatment effects than the exercise-only group (P < .05). Pain catastrophizing was less and coping strategies were more favorable for mindfulness-exercise participants than for exercise-only participants (P values < .05). CONCLUSIONS Mindfulness practice can be an effective adjunct to exercise therapy in the rehabilitation of PFP in recreational female runners.
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Affiliation(s)
| | - Aynollah Naderi
- School of Sport Sciences, Shahrood University of Technology, Iran
| | - Samira Mirali
- Department of Sport Science, University College of Omran and Tosseeh, Hamedan, Iran
| | - Luís Calmeiro
- School of Social and Health Sciences, Abertay University, Dundee, UK
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12
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The Effect of Pain Catastrophizing on Depression among Older Korean Adults with Chronic Pain: The Mediating Role of Chronic Pain Interference and Sleep Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238716. [PMID: 33255228 PMCID: PMC7727656 DOI: 10.3390/ijerph17238716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 12/13/2022]
Abstract
Pain catastrophizing is a notable concept associated with change in chronic pain interference and depression. Sleep quality is also one of the important factors affecting geriatric depression. This study examined the mediating effects of chronic pain interference and sleep quality on the relationship between pain catastrophizing and depression. This study is a secondary data analysis that analyzed a total of 138 older Korean adults with chronic pain. The participants were selected from a single elderly daycare center in a city in South Korea. Also, the multiple regression analysis and PROCESS macro with bootstrapping were used. The results revealed that chronic pain interference and sleep quality mediated the relationship between pain catastrophizing and depression, respectively. Furthermore, chronic pain interference and sleep quality sequentially and dually mediated the effect of pain catastrophizing on depression. In the management of depression in the elderly, persistent complaints of pain should not be disregarded, irrespective of the intensity of their chronic pain. Psychological intervention is needed to alleviate negative thoughts about chronic pain and to increase the ability to cope with chronic pain. In addition, it is important to assess sleep patterns and to develop interventions to improve sleep quality, because depression in the elderly could appear as a symptom of a sleep problems.
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13
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Suicidality in Chronic Illness: An Overview of Cognitive–Affective and Interpersonal Factors. J Clin Psychol Med Settings 2020; 28:137-148. [DOI: 10.1007/s10880-020-09749-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2020] [Indexed: 12/18/2022]
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14
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Kirtley OJ, Rodham K, Crane C. Understanding suicidal ideation and behaviour in individuals with chronic pain: a review of the role of novel transdiagnostic psychological factors. Lancet Psychiatry 2020; 7:282-290. [PMID: 31982031 DOI: 10.1016/s2215-0366(19)30288-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/12/2019] [Accepted: 06/14/2019] [Indexed: 12/29/2022]
Abstract
Individuals with chronic pain are at an elevated risk of suicide, yet psychosocial factors that might be involved in increasing or decreasing vulnerability for suicidal ideation and behaviour have received little attention. Extant literature on the topic of suicide in individuals with chronic pain incorporates only a few of the wide array of known vulnerability and protective factors. This Review focuses on transdiagnostic psychological processes, (ie, those of relevance for both chronic pain and suicide). We reviewed a selection of published literature on chronic pain and suicide, concentrating on previously unexplored and underexplored lines of research, including future orientation, mental imagery, and psychological flexibility. A greater degree of crosspollination between the fields of chronic pain and suicide research is required to progress our understanding of why some people with chronic pain become suicidal and others do not.
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Affiliation(s)
| | - Karen Rodham
- Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, UK
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15
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Brown LA, Lynch KG, Cheatle M. Pain catastrophizing as a predictor of suicidal ideation in chronic pain patients with an opiate prescription. Psychiatry Res 2020; 286:112893. [PMID: 32146246 PMCID: PMC7442673 DOI: 10.1016/j.psychres.2020.112893] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/28/2022]
Abstract
Chronic pain and opioid use are associated with increased risk for suicidal ideation and behaviors (SIB) in cross-sectional studies, particularly among individuals who catastrophize about their pain. This study examined the longitudinal association between two styles of pain coping, catastrophizing and hoping/praying, as predictors of subsequent SIB, as well as possible mediators of this association among patients with chronic pain receiving long-term opioid therapy. Participants (n = 496) were adults with chronic nonmalignant pain on long-term opioid therapy who did not develop an opioid use disorder. Participants were assessed for pain coping, suicidal ideation, depression, social support and pain interference at baseline, and were reassessed for SI, depression, and pain interference at 6- and 12-month follow-ups. Catastrophizing was a significant predictor of increased subsequent SIB, whereas hoping/praying did not protect against future SIB. The relationship between catastrophizing and future SIB was mediated by depression, but not social support or pain interference. In conclusion, catastrophizing was an important predictor of subsequent SIB due to its effect on increasing depression among patients with chronic nonmalignant pain receiving long-term opioid therapy. Future research should explore the extent to which targeting catastrophizing reduces subsequent depression and suicide risk.
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Affiliation(s)
- Lily A Brown
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States; University of Pennsylvania, Department of Psychiatry, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA 19104, United States.
| | - Kevin G Lynch
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States; Center for Clinical Epidemiology and Biostatistics (CCEB), University of Pennsylvania, Philadelphia, PA, United States; University of Pennsylvania, Department of Psychiatry, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA 19104, United States
| | - Martin Cheatle
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States; University of Pennsylvania, Department of Psychiatry, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA 19104, United States
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16
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Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Prog Neuropsychopharmacol Biol Psychiatry 2018; 87:168-182. [PMID: 29408484 PMCID: PMC6067990 DOI: 10.1016/j.pnpbp.2018.01.017] [Citation(s) in RCA: 246] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/18/2018] [Accepted: 01/29/2018] [Indexed: 12/12/2022]
Abstract
The biopsychosocial model of pain dominates the scientific community's understanding of chronic pain. Indeed, the biopsychosocial approach describes pain and disability as a multidimensional, dynamic integration among physiological, psychological, and social factors that reciprocally influence one another. In this article, we review two categories of studies that evaluate the contributions of psychosocial factors to the experience of chronic pain. First, we consider general psychosocial variables including distress, trauma, and interpersonal factors. Additionally, we discuss pain-specific psychosocial variables including catastrophizing, expectations, and pain-related coping. Together, we present a diverse array of psychological, social, and contextual factors and highlight the need to consider their roles in the development, maintenance, and treatment of chronic pain conditions.
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Affiliation(s)
- S M Meints
- Department of Anesthesiology, Pain Management Center, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, MA, USA.
| | - R R Edwards
- Department of Anesthesiology, Pain Management Center, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, MA, USA
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17
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Szigethy E, Knisely M, Drossman D. Opioid misuse in gastroenterology and non-opioid management of abdominal pain. Nat Rev Gastroenterol Hepatol 2018; 15:168-180. [PMID: 29139482 PMCID: PMC6421506 DOI: 10.1038/nrgastro.2017.141] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Opioids were one of the earliest classes of medications used for pain across a variety of conditions, but morbidity and mortality have been increasingly associated with their chronic use. Despite these negative consequences, chronic opioid use is increasing worldwide, with the USA and Canada having the highest rates. Chronic opioid use for noncancer pain can have particularly negative effects in the gastrointestinal and central nervous systems, including opioid-induced constipation, narcotic bowel syndrome, worsening psychopathology and addiction. This Review summarizes the evidence of opioid misuse in gastroenterology, including the lack of evidence of a benefit from these drugs, as well as the risk of harm and negative consequences of opioid use relative to the brain-gut axis. Guidelines for opioid management and alternative pharmacological and nonpharmacological strategies for pain management in patients with gastrointestinal disorders are also discussed. As chronic pain is complex and involves emotional and social factors, a multimodal approach targeting both pain intensity and quality of life is best.
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Affiliation(s)
- Eva Szigethy
- Departments of Psychiatry and Medicine, University of Pittsburgh, 3708 Fifth Avenue, Pittsburgh, Pennsylvania 15213, USA
| | - Mitchell Knisely
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, Pennsylvania 15261, USA
| | - Douglas Drossman
- Center for Functional GI & Motility Disorders, University of North Carolina, Bioinformatics Building, 130 Mason Farm Road, Chapel Hill, North Carolina 27599, USA
- Drossman Gastroenterology PLLC, 901 Kings Mill Road, Chapel Hill, North Carolina 27517, USA
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18
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Shahar G, Lerman SF, Topaz M, Brill S, Shalev H, Rudich Z. Depressive personality vulnerability in chronic physical pain: Centrality of sociotropy. J Pers 2017; 86:907-918. [PMID: 29222926 DOI: 10.1111/jopy.12365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/09/2017] [Accepted: 12/02/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Chronic physical pain is one of modern medicine's principal challenges. Recently, there has been a keen research interest in the role of depressive personality vulnerability (DPV) in the course of chronic pain. This is the first attempt to examine the role of three leading DPV dimensions-sociotropy, autonomy, and self-criticism-in chronic pain. METHOD Chronic pain patients (N = 428) were assessed four times as to their pain, disability, anxious depression, and pain-based catastrophizing. At Time 1, sociotropy, autonomy, and self-criticism were also assessed. The effects of sociotropy, autonomy, and self-criticism on pain, disability, anxious depression, and pain-based catastrophizing were examined using structural equation modeling analyses. RESULTS All DPV dimensions uniquely predicted Time 1, but not Time 2, anxious depression. Sociotropy predicted Time 1 pain and catastrophizing over and above anxious depression, as well as an increase in catastrophizing over time. Autonomy predicted a decrease in catastrophizing and disability, and Time 1 anxious depression predicted an increase in self-criticism. CONCLUSIONS Sociotropy appears to be a unique dimension of DPV in chronic pain.
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