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Nascimento M, Dahllöf G, Cunha Soares F, Mayer TMADS, Kvist T, Colares V. Self-reported symptoms of temporomandibular pain and jaw dysfunction in adolescents are associated with exposure to violence. J Oral Rehabil 2021; 48:765-773. [PMID: 33774844 DOI: 10.1111/joor.13171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/17/2021] [Accepted: 03/10/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMDs) are multifactorial, and high levels of stress seem to increase symptoms. The association with exposure to violence has not been explored in adolescent populations. OBJECTIVE To examine the association of self-reported symptoms of temporomandibular pain and jaw dysfunction with child physical abuse, intimate partner violence, forced sexual intercourse, and bullying victimisation. METHODS An epidemiological, cross-sectional, school-based study was conducted in Olinda, northeast Brazil. The sample comprised 2,431 adolescents aged 14-19 years. TMD-related symptoms and exposure to violence were assessed with questions from the 3Q/TMD screener and queries on exposure to different forms of violence. Multilevel logistic regressions were conducted to evaluate how 3Q screen-positive responses are associated with self-reported exposure to violence. RESULTS Self-reported TMD-related symptoms had a prevalence of 40.5%. Significantly more females than males screened positive to all 3Q/TMD questions (p < .001). Adolescents experiencing intimate partner violence (p = .012) and bullying (p < .001) had significantly higher odds of 3Q positive responses than those who reported no exposure to violence. Significant associations of TMD-related symptoms with forced sexual intercourse (p = .014) and with bullying (p = .007) were observed. CONCLUSION Adolescents with self-reported symptoms of temporomandibular pain and jaw dysfunction were significantly more often exposed to some type of violence. The number of adolescents reporting TMD-related symptoms increased in a dose-response manner with the number of violence forms the individual had experienced.
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Affiliation(s)
- Michele Nascimento
- Division of Pediatric Dentistry, Department of Pediatric Dentistry, University of Pernambuco, Recife, Brazil.,Department of Orofacial Pain Control Center, University of Pernambuco, Recife, Brazil
| | - Göran Dahllöf
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Pediatric Oral Health Research, Stockholm, Sweden.,TkMidt - Center for Oral Health Services and Research, Trondheim, Norway
| | - Fernanda Cunha Soares
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Therese Kvist
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Pediatric Oral Health Research, Stockholm, Sweden
| | - Viviane Colares
- Division of Pediatric Dentistry, Department of Pediatric Dentistry, University of Pernambuco, Recife, Brazil.,Division of Pediatric Dentistry, Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Brazil
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A nociceptive stress model of adolescent physical abuse induces contextual fear and cingulate nociceptive neuroplasticities. Brain Struct Funct 2017; 223:429-448. [PMID: 28861709 DOI: 10.1007/s00429-017-1502-3] [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: 08/18/2016] [Accepted: 08/18/2017] [Indexed: 10/19/2022]
Abstract
Adolescent physical abuse impairs emotional development and evokes cingulate pathologies, but its neuronal and circuit substrates are unknown. Conditioning adolescent rabbits with noxious colorectal distension for only 2 h over 3 weeks simulated the human child abuse in amplitude, frequency, and duration. Thermal withdrawal thresholds were unchanged suggesting that sensitized spinal mechanisms may not be operable. Unchanged weight, stools, colorectal histology, and no evidence of abdominal pain argue against tissue injury or irritable bowel syndrome. Contextual fear was amplified as they avoided the site of their abuse. Conditioning impacted anterior cingulate and anterior midcingulate (ACC, aMCC) neuron excitability: (1) more neurons responded to cutaneous and visceral (VNox) noxious stimuli than controls engaging latent nociception (present but not manifest in controls). (2) Rear paw stimulation increased responses over forepaws with shorter onsets and longer durations, while forepaw responses were of higher amplitude. (3) There were more VNox responses with two excitatory phases and longer durations. (4) Some had unique three-phase excitatory responses. (5) Long-duration VNox stimuli did not inhibit neurons as in controls, suggesting the release of an inhibitory circuit. (6) aMCC changes in cutaneous but not visceral nociception confirmed its role in cutaneous nociception. For the first time, we report neuroplasticities that may be evoked by adolescent physical abuse and reflect psychogenic pain: i.e., no ongoing peripheral pain and altered ACC nociception. These limbic responses may be a cognitive trace of abuse and may shed light on impaired human emotional development and sexual function.
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Olofsson N. A Life Course Model of Self-Reported Violence Exposure and Ill-health with A Public Health Problem Perspective. AIMS Public Health 2014; 1:9-24. [PMID: 29666824 PMCID: PMC5903398 DOI: 10.3934/publichealth.2014.1.9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 01/22/2014] [Indexed: 11/24/2022] Open
Abstract
Violence has probably always been part of the human experience. Its impact can be seen, in various forms, in all parts of the world. In 1996, WHO:s Forty-Ninth World Health Assembly adopted a resolution, declaring violence a major and growing public health problem around the world. Public health work centers around health promotion and disease prevention activities in the population and public health is an expression of the health status of the population taking into account both the level and the distribution of health. Exposure to violence can have many aspects, differing throughout the life course ― deprivation of autonomy, financial exploitation, psychological and physical neglect or abuse — but all types share common characteristics: the use of destructive force to control others by depriving them of safety, freedom, health and, in too many instances, life; the epidemic proportions of the problem, particularly among vulnerable groups; a devastating impact on individuals, families, neighborhoods, communities, and society. There is considerable evidence that stressful early life events influence a variety of physical and/or psychological health problems later in life. Childhood adversity has been linked to elevated rates of morbidity and mortality from number of chronic diseases. A model outlining potential biobehavioural pathways is put forward that may be a potential explanation of how exposure to violence among both men and women work as an important risk factor for ill health and should receive greater attention in public health work.
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Affiliation(s)
- Niclas Olofsson
- Department of Research and Development, Härnösand, 871 85 Härnösand, Sweden. E-mail: ; Tel: +46-611-80-078
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Chen H, Slade G, Lim PF, Miller V, Maixner W, Diatchenko L. Relationship between temporomandibular disorders, widespread palpation tenderness, and multiple pain conditions: a case-control study. THE JOURNAL OF PAIN 2012; 13:1016-27. [PMID: 23031401 PMCID: PMC3475612 DOI: 10.1016/j.jpain.2012.07.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 07/15/2012] [Accepted: 07/25/2012] [Indexed: 01/01/2023]
Abstract
UNLABELLED The multiple bodily pain conditions in temporomandibular disorders (TMD) have been associated with generalized alterations in pain processing. The purpose of this study was to examine the relationship between the presence of widespread body palpation tenderness (WPT) and the likelihood of multiple comorbid pain conditions in TMD patients and controls. This case-control study was conducted in 76 TMD subjects with WPT, 83 TMD subjects without WPT, and 181 non-TMD matched control subjects. The study population was also characterized for clinical pain, experimental pain sensitivity, and related psychological phenotypes. Results showed that: 1) TMD subjects reported an average of 1.7 comorbid pain conditions compared to .3 reported by the control subjects (P < .001); 2) Compared to control subjects, the odds ratio (OR) for multiple comorbid pain conditions is higher for TMD subjects with WPT [OR 8.4 (95% CI 3.1-22.8) for TMD with WPT versus OR 3.3 (95% CI 1.3-8.4) for TMD without WPT]; 3) TMD subjects with WPT presented with reduced pressure pain thresholds (PPTs) in both cranial and extracranial regions compared to TMD subjects without WPT; and 4) TMD subjects with WPT reported increased somatic symptoms. These findings suggest that pain assessment outside of the orofacial region may prove valuable for the classification, diagnosis, and management of TMD patients. PERSPECTIVE TMD subjects with WPT experience a greater level of multiple comorbid pain conditions, compared to TMD subjects without WPT and non-TMD controls. Integration of bodily pain assessments can be informative for evaluation, diagnosis, and management of TMD.
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Affiliation(s)
- Hong Chen
- Center for Neurosensory Disorders, University of North Carolina-Chapel Hill, School of Dentistry, Chapel Hill, NC, USA
- Oral & Maxillofacial Pain Clinic, University of North Carolina – Chapel Hill, School of Dentistry, Chapel Hill, NC, USA
| | - Gary Slade
- Center for Neurosensory Disorders, University of North Carolina-Chapel Hill, School of Dentistry, Chapel Hill, NC, USA
- Department of Dental Ecology, University of North Carolina-Chapel Hill, School of Dentistry, Chapel Hill, NC, USA
| | - Pei Feng Lim
- Center for Neurosensory Disorders, University of North Carolina-Chapel Hill, School of Dentistry, Chapel Hill, NC, USA
- Oral & Maxillofacial Pain Clinic, University of North Carolina – Chapel Hill, School of Dentistry, Chapel Hill, NC, USA
| | - Vanessa Miller
- Center for Neurosensory Disorders, University of North Carolina-Chapel Hill, School of Dentistry, Chapel Hill, NC, USA
| | - William Maixner
- Center for Neurosensory Disorders, University of North Carolina-Chapel Hill, School of Dentistry, Chapel Hill, NC, USA
| | - Luda Diatchenko
- Center for Neurosensory Disorders, University of North Carolina-Chapel Hill, School of Dentistry, Chapel Hill, NC, USA
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Variables associated with decreasing pain among persons living with human immunodeficiency virus: a longitudinal follow-up study. Clin J Pain 2012; 28:32-8. [PMID: 21642847 DOI: 10.1097/ajp.0b013e318220199d] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pain is common among persons with human immunodeficiency virus (HIV); however, there are minimal data on its natural history, or the long-term efficacy of analgesic therapies. METHODS We performed an observational study between 2001 and 2009. Pain was defined on a 0 to 10 scale; 0=no pain; 10=worst pain possible. Patients were included if they were HIV positive, had a chronic pain diagnosis, a median pain score during the first year of observation of ≥1.0, ≥2 years of follow-up, and ≥3 recorded pain scores. Two models were used to describe decreasing pain. Model 1 defined decreasing pain as a negative slope to the best fit line through all recorded pain scores. Model 2 defined decreasing pain as a median pain score of zero during the last year of follow-up. RESULTS Using model 1, decreasing pain was negatively associated with a history of being abused (odds ratio=0.29) and positively associated with peripheral neuropathy (3.54). Using model 2, decreasing pain was positively associated with highly active antiretroviral therapy (3.71) and negatively associated with opioid analgesic use (0.24). CONCLUSIONS We found social and HIV-related variables associated with decreasing pain. We failed to show a positive association between analgesic use and decreasing pain.
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Keeshin BR, Cronholm PF, Strawn JR. Physiologic changes associated with violence and abuse exposure: an examination of related medical conditions. TRAUMA, VIOLENCE & ABUSE 2012; 13:41-56. [PMID: 22186168 DOI: 10.1177/1524838011426152] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Although the extant evidence is replete with data supporting linkages between exposure to violence or abuse and the subsequent development of medical illnesses, the underlying mechanisms of these relationships are poorly defined and understood. Physiologic changes occurring in violence- or abuse-exposed individuals point to potentially common biological pathways connecting traumatic exposures with medical outcomes. Herein, the evidence describing the long-term physiologic changes in abuse- and violence-exposed populations and associated medical illnesses are reviewed. Current data support that (a) specific neurobiochemical changes are associated with exposure to violence and abuse; (b) several biological pathways have the potential to lead to the development of future illness; and (c) common physiologic mechanisms may moderate the severity, phenomenology, or clinical course of medical illnesses in individuals with histories of exposure to violence or abuse. Importantly, additional work is needed to advance our emerging understanding of the biological mechanisms connecting exposure to violence and abuse and negative health outcomes.
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Affiliation(s)
- Brooks R Keeshin
- Mayerson Center for Safe and Healthy Children, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
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EITNER S, STINGL K, SCHLEGEL AK, WICHMANN M, NICKENIG A. Biopsychosocial correlations in patients with chronic oro-facial pain. Part II. Experiences of pain and dramatic events before the 16th year of life. J Oral Rehabil 2009; 36:408-14. [DOI: 10.1111/j.1365-2842.2009.01953.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nifosì F, Violato E, Pavan C, Sifari L, Novello G, Guarda Nardini L, Manfredini D, Semenzin M, Pavan L, Marini M. Psychopathology and clinical features in an Italian sample of patients with myofascial and temporomandibular joint pain: preliminary data. Int J Psychiatry Med 2008; 37:283-300. [PMID: 18314857 DOI: 10.2190/pm.37.3.f] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Aim of this study was to provide data on the relationships between psychopathological variables and temporomandibular disorders (TMD). Sixty-three TMD patients were investigated using clinical and anamnestical psychiatric informations and psychopathological measures. METHODS Three groups of TMD patients were recruited according to the Research Diagnostic Criteria for TMD guidelines: a group of patients presenting myofascial pain alone (RDC/TMD axis I group I), a group with temporomandibular joint (TMJ) pain alone (RDC/TMD axis I group IIIa, IIIb), and a group presenting both myofascial and TMJ pain. Two secondary groups were identified on the basis of the presence/absence of myofascial pain. The study design provided a psychiatric interview and psychometric assessment including the Symptom Check List-90-Revised (SCL-90-R), the Hamilton Depression Rating Scale (HDRS), and the Hamilton Anxiety Rating Scale (HARS). RESULTS --Psychiatric evaluation: Myofascial pain patients had higher scores for personal psychiatric history and a history of more frequent psychotropic drug use. --HDRS and HARS: The sample presented scores indicating mild depressive symptoms and moderate anxiety symptoms. --SCL-90-R: The global sample showed acute levels of psychological distress as measured by the GSI score (Global Severity Index). Myofascial pain patients scored higher than TMJ pain patients in the GSI (p = .028), PAR (paranoia; p = .015), PSY (psychoticism; p = .032), and HOS (hostility; p = .034) subscales. CONCLUSIONS TMD patients showed elevated levels of depression, somatization, and anxiety. These characteristics did not differ significantly between patients with myofascial or TMJ pain. Other specific psychopathological dimensions, detected with SCL-90-R, appeared to be closely associated to the myofascial component.
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Greenspan JD, Craft RM, LeResche L, Arendt-Nielsen L, Berkley KJ, Fillingim RB, Gold MS, Holdcroft A, Lautenbacher S, Mayer EA, Mogil JS, Murphy AZ, Traub RJ. Studying sex and gender differences in pain and analgesia: a consensus report. Pain 2007; 132 Suppl 1:S26-S45. [PMID: 17964077 DOI: 10.1016/j.pain.2007.10.014] [Citation(s) in RCA: 709] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2007] [Accepted: 10/09/2007] [Indexed: 12/21/2022]
Abstract
In September 2006, members of the Sex, Gender and Pain Special Interest Group of the International Association for the Study of Pain met to discuss the following: (1) what is known about sex and gender differences in pain and analgesia; (2) what are the "best practice" guidelines for pain research with respect to sex and gender; and (3) what are the crucial questions to address in the near future? The resulting consensus presented herein includes input from basic science, clinical and psychosocial pain researchers, as well as from recognized experts in sexual differentiation and reproductive endocrinology. We intend this document to serve as a utilitarian and thought-provoking guide for future research on sex and gender differences in pain and analgesia, both for those currently working in this field as well as those still wondering, "Do I really need to study females?"
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Affiliation(s)
- Joel D Greenspan
- Department of Biomedical Sciences, University of Maryland Dental School, University of Maryland, Baltimore, MD 21201-1510, USA Research Center for Neuroendocrine Influences on Pain, Baltimore, MD 21201-1510, USA Department of Psychology, Washington State University, Pullman, WA 99164-4820, USA Department of Oral Medicine, University of Washington, Seattle, WA 98195-6370, USA Laboratory for Experimental Pain Research, Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Fredrik Bajers Vej 7, DK-9220 Aalborg, Denmark Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA Department of Community Dentistry and Behavioral Science, University of Florida College of Dentistry, Gainesville, FL 32610-3628, USA Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA Division of Surgery, Oncology, Reproductive Biology and Anaesthetics, Chelsea and Westminster Hospital, Imperial College, London SW10 9NH, UK Department of Physiological Psychology, University of Bamberg, Bamberg 96045, Germany Center for Neurovisceral Sciences and Women's Health, and Departments of Medicine, Psychiatry and Biobehavioral Sciences, and Physiology, UCLA School of Medicine, Los Angeles, CA 900095-1792, USA Department of Psychology, McGill University, Montreal, Canada PQ H3A 1B1 Department of Biology, Georgia State University, Atlanta, GA 30303-0389, USA
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O’Brien EM, Atchison JW, Gremillion HA, Waxenberg LB, Robinson ME. Somatic focus/awareness: Relationship to negative affect and pain in chronic pain patients. Eur J Pain 2007; 12:104-15. [PMID: 17524684 PMCID: PMC2730152 DOI: 10.1016/j.ejpain.2007.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2006] [Revised: 04/02/2007] [Accepted: 04/03/2007] [Indexed: 11/18/2022]
Abstract
Somatic focus refers to the tendency to notice and report physical symptoms, and has been investigated in relation to chronically painful conditions. This study investigated the relationship between somatic focus, as measured by the Pennebaker Inventory of Limbic Languidness (PILL), negative affect and pain. A secondary purpose of the present study was to examine sex differences in these relationships. Participants included 280 chronic pain patients (69.6% females, 88.9% Caucasian), who completed a battery of self-report measures on somatic focus, pain, negative affect, coping, and dysfunction. Results for the overall sample revealed that the PILL shares considerable variance with measures of negative affect, particularly with the physiological components of anxiety and depression. When the results were analyzed separately for male and female patients, it was found that several components of negative affect and cognitive factors play a stronger role in predicting somatic focus among men compared to women. Additional analyses then examined whether somatic focus was predictive of male and female patients' pain reports. Results indicated that somatic focus explained a small, but unique amount of variance in female patients' pain reports, which differed from the relationship observed among male patients.
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Affiliation(s)
- Erin M. O’Brien
- University of Florida, Department of Clinical and Health Psychology
| | | | | | - Lori B. Waxenberg
- Associate Professor, University of Florida, Department of Clinical and Health Psychology
| | - Michael E. Robinson
- Professor, University of Florida, Department of Clinical and Health Psychology
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Plichta SB. Intimate partner violence and physical health consequences: policy and practice implications. JOURNAL OF INTERPERSONAL VIOLENCE 2004; 19:1296-1323. [PMID: 15534333 DOI: 10.1177/0886260504269685] [Citation(s) in RCA: 283] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Extensive research indicates that intimate partner violence (IPV) poses a significant risk to the physical health of women. IPV is associated with increased mortality, injury and disability, worse general health, chronic pain, substance abuse, reproductive disorders, and poorer pregnancy outcomes. IPV is also associated with an overuse of health services and unmet need for services, as well as strained relationships with providers. The body of IPV research has several critical gaps. There are almost no longitudinal studies of IPV and health. Most studies are clustered into a few specialties, with almost no research in the areas of allied health, dentistry, or management. A common definition of IPV is still not used. Finally, with some notable exceptions, there has been little success in moving the health care system to routinely screen women for IPV.
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Green CR, Anderson KO, Baker TA, Campbell LC, Decker S, Fillingim RB, Kalauokalani DA, Kaloukalani DA, Lasch KE, Myers C, Tait RC, Todd KH, Vallerand AH. The unequal burden of pain: confronting racial and ethnic disparities in pain. PAIN MEDICINE 2003; 4:277-94. [PMID: 12974827 DOI: 10.1046/j.1526-4637.2003.03034.x] [Citation(s) in RCA: 807] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CONTEXT Pain has significant socioeconomic, health, and quality-of-life implications. Racial- and ethnic-based differences in the pain care experience have been described. Racial and ethnic minorities tend to be undertreated for pain when compared with non-Hispanic Whites. OBJECTIVES To provide health care providers, researchers, health care policy analysts, government officials, patients, and the general public with pertinent evidence regarding differences in pain perception, assessment, and treatment for racial and ethnic minorities. Evidence is provided for racial- and ethnic-based differences in pain care across different types of pain (i.e., experimental pain, acute postoperative pain, cancer pain, chronic non-malignant pain) and settings (i.e., emergency department). Pertinent literature on patient, health care provider, and health care system factors that contribute to racial and ethnic disparities in pain treatment are provided. EVIDENCE A selective literature review was performed by experts in pain. The experts developed abstracts with relevant citations on racial and ethnic disparities within their specific areas of expertise. Scientific evidence was given precedence over anecdotal experience. The abstracts were compiled for this manuscript. The draft manuscript was made available to the experts for comment and review prior to submission for publication. CONCLUSIONS Consistent with the Institute of Medicine's report on health care disparities, racial and ethnic disparities in pain perception, assessment, and treatment were found in all settings (i.e., postoperative, emergency room) and across all types of pain (i.e., acute, cancer, chronic nonmalignant, and experimental). The literature suggests that the sources of pain disparities among racial and ethnic minorities are complex, involving patient (e.g., patient/health care provider communication, attitudes), health care provider (e.g., decision making), and health care system (e.g., access to pain medication) factors. There is a need for improved training for health care providers and educational interventions for patients. A comprehensive pain research agenda is necessary to address pain disparities among racial and ethnic minorities.
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Affiliation(s)
- Carmen R Green
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA.
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Clouse RE. Managing functional bowel disorders from the top down: lessons from a well-designed treatment trial. Gastroenterology 2003; 125:249-53. [PMID: 12851889 DOI: 10.1016/s0016-5085(03)00808-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Tenenbaum HC, Mock D, Gordon AS, Goldberg MB, Grossi ML, Locker D, Davis KD. Sensory and affective components of orofacial pain: is it all in your brain? CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2002; 12:455-68. [PMID: 11806516 DOI: 10.1177/10454411010120060101] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this paper, we shall review several chronic orofacial pain conditions with emphasis on those that are essentially refractory to treatment. We shall present a review of current and past literature that describes the various pain phenomena as well as their underlying central mechanisms. New data concerning refractory pain will be used to underscore the importance of central processing of pain, with particular emphasis on neuropsychological and cognitive function and capacity that may play important roles in pain processing and maintenance of the pain state. Further, neurophysiological data showing that the anterior cingulate cortex (ACC) and other structures in the brain may play key roles in modulation of chronic pain will also be discussed. Although peripheral triggering events surely play an important role in initiating pain, the development of chronic and, in particular, refractory pain may depend on changes or malfunctions in the central nervous system. These changes may be quite subtle and require sophisticated approaches, such as functional MRI, to study them, as is now being done. New findings obtained therefore may lead to more rational and reliable treatment for orofacial pain.
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Affiliation(s)
- H C Tenenbaum
- Department of Dentistry, Wasser Pain Management Centre, Mount Sinai Hospital, Toronto, ON, Canada.
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Rollman GB, Gillespie JM. The role of psychosocial factors in temporomandibular disorders. CURRENT REVIEW OF PAIN 2001; 4:71-81. [PMID: 10998718 DOI: 10.1007/s11916-000-0012-8] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The temporomandibular disorders (TMDs) comprise a constellation of symptoms affecting the joints and muscles involved in jaw movement. Patients complain of orofacial pain, limited jaw opening, and clicking or popping sounds. Although pain is generally the defining characteristic of TMD, patients often report marked degrees of stress and interference in daily life. This article reviews recent studies on epidemiology, sex differences, pediatric TMD, classification systems, comparisons to other chronic pain disorders of uncertain etiology, psychological assessment, depression, central modulation and hypervigilance, sleep disturbances, stress, and the management of TMD by conservative physical interventions and cognitive behavioral therapy. Both the assessment and the management of TMD requires a multidisciplinary perspective with strong emphasis on psychosocial variables.
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Affiliation(s)
- G B Rollman
- Department of Psychology, University of Western Ontario, London, ON N6A 5C2, Canada.
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Abstract
This study estimates the lifetime prevalence of violent experiences and their relationship to health and the use of health services in U.S. women aged 18-64 years. The Commonwealth Fund's 1998 Survey of Women's Health provides a nationally representative sample. Use of weighted data allows projections to be made to the U.S. population. Over four of ten women in the U.S. are likely to have experienced one or more forms of violence, including child abuse (17.8%), physical assault (19.1%), rape (20.4%), and intimate partner violence (34.6%). In multivariate logistic regression models that control for sociodemographic characteristics, violence-particularly intimate sexual violence-is significantly related to poorer physical and mental health and increased problems with access to medical care. Only one-third of women who experience violence have discussed it with a physician. Health care professionals need to initiate the conversation about violence and offer referrals for needed services.
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Affiliation(s)
- S B Plichta
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
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Garimella R, Plichta SB, Houseman C, Garzon L. Physician beliefs about victims of spouse abuse and about the physician role. JOURNAL OF WOMEN'S HEALTH & GENDER-BASED MEDICINE 2000; 9:405-11. [PMID: 10868613 DOI: 10.1089/15246090050020727] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Our purpose was to measure the beliefs of physicians about victims of spouse abuse and to examine factors related to holding positive (e.g., supportive) and negative beliefs about providing services to victims of domestic violence. This was a total site sample of 150 physicians (76 responded; RR 51%), surveyed at one time, practicing in a large general hospital and the surrounding urban/periurban area. Four specialities are represented: emergency medicine, family practice, obstetrics-gynecology, and psychiatry. Three aspects of beliefs are measured: beliefs toward physician role in assisting victims of spouse abuse, beliefs about victims of spouse abuse, and beliefs about resources available to physicians to assist victims of spouse abuse. Almost all (97%) physicians believe it is part of their role to assist victims of domestic violence. Almost one third (30%) hold victim-blaming attitudes toward victims of spouse abuse, and the majority (70%) do not believe that they have the resources available to them to assist victims of domestic violence. Being female, younger, practicing obstetrics-gynecology, and having fewer years in practice are all significantly related to holding supportive (positive) beliefs. The majority of negative beliefs held are about resource availability. Hence, training programs may need to be developed locally for physicians and tailored to individual community characteristics. Training programs should also emphasize the importance of understanding the victims of spouse abuse and of not blaming the victims for the violence.
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Affiliation(s)
- R Garimella
- San Jose State University, College of Health Science, California 95192-2988, USA
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