Body image, pain and level of resources among arthritis patients: the moderating role of gender

Patients With Chronic Pain: The Aspect Of Negative Body Image

OBJECTIVE

Negative body image is an increasingly important factor in chronic pain disorders; particularly because the two conditions mutually influence each other. Our study examines body-image-related attitudes and comorbid psychic symptoms in patients with chronic pain disorders.

METHODS AND MEASURES

188 patients with chronic pain answered the Dresden body image questionnaire (DKB-35), the Hospital Anxiety and Depression Scale (HADS) and the Beck's Depression Inventory (BDI).

RESULTS

The mean values of the DKB-35 subscales range between 2.24 und 3.29. The subscale "vitality" has the lowest mean value. BDI and HADS correlated significantly with the DKB-35 subscales. The subscale "body-acceptance" intercorrelated high with the two subscales "vitality" and "self-aggrandizement".

CONCLUSION

Our findings verify that chronic pain is strongly associated with negative body image. The issues of vitality and psychological symptoms seem particularly central in this complex interaction. The biopsycho-social model and the avoidance-endurance approach to chronic pain offer important ideas for explanation and treatment.

Mindfulness-based interventions for body image dissatisfaction among clinical population: A systematic review and meta-analysis

PURPOSE

Mindfulness-based interventions (MBIs) are well-validated interventions to enhance the favourable body image of individuals. Despite their wide application, the efficacy of MBIs in reducing body image dissatisfaction (BID) among various clinical populations remains unclear. This study aims to expand the literature on MBIs for BID and identify effective types of MBIs for reducing BID in diverse clinical populations for future research and practice.

METHODS

A systematic search for studies published in English on the effectiveness of MBIs for BID among the clinical population was done on APA PsycNet, PubMed, Science Direct, Web of Science and Google Scholar databases in August 2023. Of the 1962 articles initially identified, 17 were found eligible and evaluated based on the JBI checklist.

RESULTS

Random effects meta-analyses on six MBIs revealed their effectiveness in reducing BID among the clinical population (SMD = -.59 and 95% CI = -1.03 to -.15, p = .009), with Acceptance and Commitment Therapy (ACT) (SMD = -1.29, 95% CI = -2.06 to -.52, p = .001) and My Changed Body (MyCB) (SMD = -.24, 95% CI = -.46 to -.01, p = .04) reporting significant effect sizes. Among the patients with breast cancer, MyCB (SMD = -.24, 95% CI = -.46 to -.01, p = .04) showed a significant effect size.

CONCLUSIONS

MBIs appear to be promising interventions in reducing BID among the clinical population. However, findings should be considered cautiously due to the possible publication bias, high heterogeneity and fewer available studies.

Sexual and reproductive health while living with rheumatoid arthritis: The impact of the disease stage on patient perspectives

BACKGROUND

Rheumatoid arthritis (RA) is one of the most prevalent rheumatic diseases that harms all aspects of patients' lives, including sexual and reproductive health (SRH), often neglected in patients' care. The study aimed to explore the sexual and reproductive experiences of Mexican outpatients with RA from a narrative perspective.

PATIENTS AND METHODS

From July 2020 to October 2021, 30 adult patients with RA from the Department of Immunology and Rheumatology outpatient clinic of a national referral center for rheumatic diseases had in-depth interviews audiotaped, transcribed, and analyzed using a thematic analysis approach. Results are presented in a descriptive and interpretative manner and integrated into a theoretical model for the topic understanding.

RESULTS

Five intertwined major themes emerged: I) RA onset: Absence of SRH contents, II) Healthcare for RA: Emerging SRH contents, III) RA's impact: Proliferation of SRH contents, IV) Coping with the process of living with RA: SRH-related strategies, and V) The impact of the COVID-19 pandemic on patients' experiences: Increased SRH burden. SRH contents emerged through these major themes (but at RA onset), mostly when inquired and mainly when narrating the RA impact and coping. Patients identified that RA affected their couple dynamics, sexual function, and reproductive project. The SRH care was considered relevant but limited and focused on reproductive contents. It worsened during the COVID-19 pandemic. We proposed a theoretical model where patients' SRH experiences are embedded across their RA biography and integrated with the RA impact and the copy with the disease process. These intertwined experiences were also evident during the COVID-19 pandemic, which challenged participants' biopsychosocial resources.

CONCLUSIONS

The sexual and reproductive experiences narrated by the RA outpatients concerning their disease-related biography showed that even when the SRH appeared as not prioritized at the disease onset, it was widely expressed during the process of living and coping with the disease and was additionally affected by the COVID-19 pandemic.

Pain mechanisms in the transgender individual: a review

Specific Aim

Provide an overview of the literature addressing major areas pertinent to pain in transgender persons and to identify areas of primary relevance for future research.

Methods

A team of scholars that have previously published on different areas of related research met periodically though zoom conferencing between April 2021 and February 2023 to discuss relevant literature with the goal of providing an overview on the incidence, phenotype, and mechanisms of pain in transgender patients. Review sections were written after gathering information from systematic literature searches of published or publicly available electronic literature to be compiled for publication as part of a topical series on gender and pain in the Frontiers in Pain Research.

Results

While transgender individuals represent a significant and increasingly visible component of the population, many researchers and clinicians are not well informed about the diversity in gender identity, physiology, hormonal status, and gender-affirming medical procedures utilized by transgender and other gender diverse patients. Transgender and cisgender people present with many of the same medical concerns, but research and treatment of these medical needs must reflect an appreciation of how differences in sex, gender, gender-affirming medical procedures, and minoritized status impact pain.

Conclusions

While significant advances have occurred in our appreciation of pain, the review indicates the need to support more targeted research on treatment and prevention of pain in transgender individuals. This is particularly relevant both for gender-affirming medical interventions and related medical care. Of particular importance is the need for large long-term follow-up studies to ascertain best practices for such procedures. A multi-disciplinary approach with personalized interventions is of particular importance to move forward.

Body image concerns in long-term head and neck cancer survivors: prevalence and role of clinical factors and patient-reported late effects

PURPOSE

Head and neck cancer (HNC) patients are at risk of long-term body image distress (BID). We aimed to investigate the severity of BID in long-term HNC survivors and to explore the associations between sociodemographic and clinical factors, patient-reported late effects, and cancer-related body image (BI) concerns.

METHODS

This cross-sectional study included quality of life and BI assessment in an 8-year (SD = 1.58) follow-up after treatment among 258 HNC survivors. Multinomial logistic regression analysis was used to investigate the relationship between three groups of BI concerns (no concerns, mild to moderate concerns, and BID) and patient-reported late effects. Sociodemographic and clinical variables were included in the model as covariates.

RESULTS

A total of 51.2% of participants had mild to moderate BI concerns, and 9.5% reported BID. Compared to those with no BI concerns, participants with BID were more likely to live without a partner, to have had radiotherapy and surgery, and to report worse emotional functioning and higher oral and throat pain. Compared to participants with no BI concerns, those with mild to moderate concerns reported higher oral and throat pain and speech problems.

CONCLUSIONS

Some level of cancer-related BI concerns persisted in the majority of HNC survivors many years after treatment, while a small proportion of survivors experienced BID. BI concerns were associated with treatment modality and patients' daily functioning and symptoms.

IMPLICATIONS FOR CANCER SURVIVORS

Insight into factors associated with BI problems may help to identify survivors at risk and may facilitate closer follow-up of survivors in need.

Endometriosis and body image: Comparing people with and without endometriosis and exploring the relationship with pelvic pain

Qualitative studies have shown that people with endometriosis report feeling discontent with their bodies relating to the visual and functional effects of the disease. However, few studies exist which compare people with endometriosis to those without, leaving it largely unknown as to whether this discontentment differs from that regularly experienced by women. The current study therefore aimed to 1) quantitatively assess body image, namely appearance satisfaction and functionality appreciation, in people with and without endometriosis, and 2) explore the relationship between endometriosis-related pelvic pain and body image. Australians aged 18 and over were recruited for two groups: those with endometriosis (n = 312, 99 % female, M_age = 30.78, SD_age = 7.40) and a control group without suspected or diagnosed endometriosis (n = 74, 100 % female, M_age = 32.38, SD_age = 8.84). Participants completed an online survey consisting of measures of appearance satisfaction, functionality appreciation, and pelvic-pain impact. The endometriosis group demonstrated significantly poorer body image when compared to the control group, and endometriosis-related pelvic pain was shown to negatively correlate with body image. These findings demonstrate the likely negative effects endometriosis and pelvic pain have on body image and provide much needed insight to help develop interventions tailored to endometriosis.

Gender Differences in Body Appreciation and Its Associations With Psychiatric Symptoms Among Chinese College Students: A Nationwide Survey

BACKGROUND

Body appreciation (BA hereafter), which reflects approval, acceptance, and respect for one's body while also rejecting media-promoted appearance ideals as the only form of human beauty, is an important aspect of positive body image. Much of the BA literature has been conducted on samples from Western nations but less is known about BA or its correlates in Asian cultural contexts wherein concerns with body image are also common. Toward addressing this gap, we examined gender differences in BA and its associations with common psychiatric symptoms (i.e., depressive symptoms, anxiety symptoms, and suicidality) within a national college student sample from China.

METHOD

This cross-sectional, nationwide study was conducted between December 27, 2020, and January 18, 2021, based on snowball sampling. Aside from measures of demographics and background factors, Chinese versions of the Body Appreciation Scale-2 (BAS-2), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and a standard item on suicidal ideation and planning were administered to assess BA, depressive and anxiety symptoms, and suicidality, respectively.

RESULTS

In total, 2,058 college students (665 men, 1,393 women) in China were assessed. An analysis of covariance revealed that the men had a significantly higher average BA level than did women [F _(1,2058) = 13.244, P < 0.001, Cohen's d = 0.193]. Hierarchical multiple regression analyses revealed BA was negatively associated with symptoms of depression, anxiety, and suicidality within the entire sample (depressive symptoms, β = -0.129, P < 0.001; anxiety symptoms, β = -0.101, P < 0.001; suicidality, OR = 0.788 P = 0.020) and among women (depressive symptoms, β = -0.172, P < 0.001; anxiety symptoms, β = -0.131, P < 0.001; suicidality, OR = 0.639 P = 0.001) but not men.

CONCLUSION

Chinese college women reported lower BA than their male peers did. Furthermore, among women but not men, elevations in BA corresponded with protective mental health experiences including lower levels of depressive symptoms, anxiety symptoms and suicidality. Findings underscore the potential utility of including BA in mental health assessments of Chinese college students, especially women. Findings also provide foundations for continued research on interventions to increase BA among at-risk young women in China.

Affective States, Coping and Mutual Understanding in Russian Families During the Coronavirus Disease 2019 Pandemic Lockdown

The purpose of the empirical study (April–May 2020) was to determine the type and level of affect, specifics of coping styles during the coronavirus disease 2019 (COVID-19) pandemic lockdown, as well as mutual understanding between parents and children. We hypothesized that the combination of positive and negative affect magnitude is a factor in well-being and mutual understanding with children, as well as the coping style during the lockdown. The study involved 705 respondents aged 16–77, including 435 parents living with children under 16. Personal traits, positive and negative affect, coping styles, and well-being were studied by Ten-Item Personality Inventory (TIPI)-RU, Positive and Negative Affect Scale (PANAS)-RU, Brief COPE, Satisfaction with Life Scale (SWLS), respectively. Mutual understanding was studied using a self-report questionnaire. Cluster analysis (k-means method) was used to divide the sample into clusters in accordance with the combination of positive and negative affect. According to the data obtained, parents from the “positive-affective” cluster have much better mutual understanding with both younger and older children than participants from other clusters.

Severe Mental Health Symptoms during COVID-19: A Comparison of the United Kingdom and Austria

This study evaluated severe psychological symptoms in the United Kingdom and Austria after four weeks of lockdown due to COVID-19. Two cross-sectional online surveys were performed with representative population samples according to age, gender, region, and education. Depressive symptoms were measured with the Patient Health Questionnaire (PHQ-9), anxiety symptoms with the Generalized Anxiety Disorder scale (GAD-7), and insomnia symptoms with the Insomnia Severity Index (ISI). The sample size was N = 1005 for Austria (52% women) and N = 1006 (54% women) for the UK. In total, 3.2% of the Austrian sample and 12.1% of the UK sample had severe depressive symptoms (PHQ-9 ≥ 20 points; χ2(1) = 57.24; p < 0.001), 6.0% in Austria vs. 18.9% in the UK had severe anxiety symptoms (GAD-7 ≥ 15 points; χ2(1) = 76.17; p < 0.001), and 2.2% in Austria and 7.3% in the UK had severe insomnia (ISI; ≥22 points; χ2(1) = 28.89; p < 0.001). The prevalence of severe depressive, anxiety or insomnia symptoms was around three times higher in the UK than in Austria.

The Role of Body Image on Psychosocial Outcomes in People With Diabetes and People With an Amputation

Introduction

Research indicates that body image disturbance is associated with poorer psychosocial outcomes for individuals with physical health conditions, with poorest body image reported for individuals with visible bodily changes. Using White's (2000) theoretical model of body image the present paper aimed to examine the nature of these relationships in two distinct groups: individuals with an amputation and individuals with diabetes. It was hypothesized that body image disturbance would be associated with psychosocial outcomes and would mediate the relationships between self-ideal discrepancy and personal investment in psychosocial outcomes.

Methods

Individuals with diabetes (N = 212) and individuals with an amputation (N = 227) provided details regarding their medical condition, and completed measures assessing body image, investment, self-ideal discrepancy, depression, anxiety, and quality of life. Structural equation and invariance modeling were used to test the model paths and the invariance of the model.

Results

As hypothesized, body image disturbance was found to mediate the relationships between personal investment and psychosocial outcome, and between self-ideal discrepancy and psychosocial outcome. The predicted paths were invariant across groups, although the model accounted for more variance in people with an amputation than people with diabetes.

Conclusion

Body image disturbance, personal investment, and self-ideal discrepancy are important factors contributing to psychosocial outcome for individuals with diabetes and individuals with an amputation. These findings not only confirm the validity of the model in these two groups, but they emphasize the importance of targeting body image in future psychological interventions for individuals with a health condition.

Comparative study of life satisfaction among patients with psoriasis versus healthy comparison group: the explanatory role of body image and resource profiles

Purpose

The aim of the study was first to examine the heterogeneity of body image and resources, as described by the conservation of resources theory (COR), in a sample of psoriatic patients and explore whether heterogeneity within these variables explains the possible differences in levels of life satisfaction among the participants. Second, we aimed to investigate if life satisfaction level among the observed profiles of psoriatic patients, extracted on the basis of their body image and resources, differed from that of the healthy comparison group.

Methods

The sample consisted of 735 participants, including 355 adults with a medical diagnosis of psoriasis and 380 healthy adults recruited from a non-clinical general population. Participants filled the Satisfaction with Life Scale, the Multidimensional Body-Self Relations Questionnaire and the COR evaluation questionnaire.

Results

Latent profile analysis revealed four classes of psoriatic patients with different levels of resources and body image. The group with the highest level of resources and the most positive body image did not differ from the healthy comparison group regarding satisfaction with life. The group with the lowest level of resources and the most negative body image was characterized by the lowest satisfaction with life.

Conclusions

The results of our study may change the simplifying trend that highlights the traditionally very poor well-being of psoriatic patients. Moreover, the discovery of specific profiles of these patients, which differ with regard to psychological variables, can lead to rethinking contemporary forms of psychological counselling in psoriatic patients.

Post-traumatic growth among gastrointestinal oncological patients: the perspective of Stevan Hobfoll’s conservation of resources theory

Background

This study assessed the relation between social support dimensions and post-traumatic growth (PTG) among a sample of gas-trointestinal cancer patients. Particular focus was placed on the mediating role of resources based on the conservation of re-sources (COR) theory and its effect on the previously mentioned association.

Participants and procedure

A total of 190 patients comprising 87 females and 103 males with a clinical diagnosis of gastrointestinal cancer were recruited to participate in this study. This was a cross-sectional study, with social support evaluated by the Berlin Social Support Scales (BSSS). The participants’ levels of subjectively possessed resources were assessed by the Conservation of Resources Evalua-tion (COR-E) questionnaire. Posttraumatic growth was evaluated by the Post-Traumatic Growth Inventory (PTGI).

Results

No direct relation was found between social support and PTG among participants. However, a mediating role of subjectively possessed resources was detected through the COR theory on the aforementioned relationship, i.e. the link between social sup-port and PTG. More specifically, the level of economic and political resources was a mediator in the relation.

Conclusions

These results contribute to extant literature on the psychological aspects of gastrointestinal cancer. Evidently, social support may be related to positive outcomes among gastrointestinal cancer patients in the form of PTG.