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Taub R, Agmon-Levin N, Frumer L, Samuel-Magal I, Glick I, Horesh D. Mindfulness-based stress reduction (MBSR) for fibromyalgia patients: The role of pain cognitions as mechanisms of change. Complement Ther Clin Pract 2024; 56:101860. [PMID: 38692113 DOI: 10.1016/j.ctcp.2024.101860] [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: 12/20/2023] [Revised: 03/24/2024] [Accepted: 04/10/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Fibromyalgia (FM) is a pain condition characterized by physical and psychological difficulties. This randomized controlled trial aimed to evaluate the effects of a mindfulness-based stress reduction (MBSR) on FM patients and identify the role of two pain cognitions: psychological inflexibility in pain (PIPS) and pain catastrophizing (PCS), as mechanisms of change. METHODS 95 FM patients (Mean ± SD: 49.18 ± 13.26 years) were randomly assigned to MBSR group therapy (n = 49) or a waitlist (WL) control group (n = 46). An adapted MBSR protocol for FM was employed. A series of measures were taken, covering FM symptoms, depression, perceived stress (PSS), PIPS and PCS. Three measurements were conducted: pre-intervention, post-intervention and 6-months follow up. RESULTS Compared to WL controls, the MBSR group showed greater improvements in FM symptoms (F(1,78) = 2.81, p < 0.05), PSS (F(1,78) = 4.38, p < 0.05) and Depression (F(1,78) = 21.12, p < 0.001), with mostly medium effect sizes. Improvements in PSS (F(2,68) = 7.75, p < 0.05) and depression (F(2,68) = 15.68, p < 0.05) remained stable over six months. The effect of MBSR on FM and PSS was mediated by one's reported change in PIPS. The effect of MBSR on depression was mediated by one's reported change in PCS. CONCLUSIONS These results reveal the significant therapeutic potential of MBSR for FM patients, due to the emphasis on non-judging and acceptance of negative inner states. Furthermore, this research identified two important pain-related cognitions as mechanisms of change, suggesting that MBSR contributes to cognitive change, which enables the reduction of physical and psychological distress. TRIAL REGISTRATION NUMBER NCT04304664.
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Affiliation(s)
- Renen Taub
- Department of Psychology, Bar-Ilan University, Ramat Gan, 5290002, Israel.
| | - Nancy Agmon-Levin
- Clinical Immunology, Angioedema and Allergy, Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, 52621, Israel.
| | - Lee Frumer
- Department of Psychology, Bar-Ilan University, Ramat Gan, 5290002, Israel.
| | - Inbal Samuel-Magal
- Technion Israel Institute of Technology, Students Counseling Center, Haifa, 3200003, Israel.
| | - Ittai Glick
- Shachaf Clinic for Stress Reduction, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, 52621, Israel.
| | - Danny Horesh
- Department of Psychology, Bar-Ilan University, Ramat Gan, 5290002, Israel; Department of Psychiatry, New York University School of Medicine, 1 Park Ave., New York, NY, 10016, USA.
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LaRowe LR, Bakhshaie J, Vranceanu AM, Greenberg J. Anxiety, pain catastrophizing, and pain outcomes among older adults with chronic orofacial pain. J Behav Med 2024; 47:537-543. [PMID: 38383685 DOI: 10.1007/s10865-024-00473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/27/2024] [Indexed: 02/23/2024]
Abstract
Although chronic orofacial pain (COFP) is common among older adults, the role of psychological factors in pain outcomes among this population has received limited attention. This study examined the role of anxiety and pain catastrophizing, two corelates of pain in other populations, in pain intensity and interference among 166 older adults with COFP (79% female, Mage = 68.84, SD = 5.56). Participants completed an online survey including measures of anxiety, pain catastrophizing, and pain intensity/interference. We applied mediation analyses to test indirect associations between anxiety and pain outcomes via pain catastrophizing. Results indicated that anxiety was positively associated with pain intensity and pain interference (bs = .70-1.12, ps < .05). There was also an indirect association between anxiety and pain interference through pain catastrophizing (b = .35, 95% CI [.0383, .7954]), indicating pain catastrophizing partially accounts for this relationship. Assessing and addressing anxiety and pain catastrophizing has the potential to improve treatment outcomes in this population.
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Affiliation(s)
- Lisa R LaRowe
- Division of Palliative Care and Geriatric Medicine, Mongan Institute Center for Aging and Serious Illness, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jafar Bakhshaie
- Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, One Bowdoin Square, 1st Floor, Suite 106, Boston, MA, 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, One Bowdoin Square, 1st Floor, Suite 106, Boston, MA, 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jonathan Greenberg
- Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, One Bowdoin Square, 1st Floor, Suite 106, Boston, MA, 02114, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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Knox PJ, Simon CB, Pohlig RT, Pugliese JM, Coyle PC, Sions JM, Hicks GE. Examining Psychological Factors as Contributors to Pain, Disability, and Physical Function in Geriatric Chronic Low Back Pain: A Prospective Analysis of the Delaware Spine Studies Cohort. THE JOURNAL OF PAIN 2024; 25:104448. [PMID: 38122878 PMCID: PMC11128354 DOI: 10.1016/j.jpain.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
In younger populations, risk factors from psychologically-focused theoretical models have become accepted as primary drivers behind the persistence of low back pain (LBP), but these risk factors have not been thoroughly assessed in older adult populations (60-85 years). To address this knowledge gap, we sought to examine longitudinal associations between both general and pain-related psychological risk factors and future pain intensity, LBP-related disability, and physical function (gait speed) outcomes in older adults with chronic LBP (n = 250). Questionnaires for general (ie, depressive symptoms) and pain-related psychological risk factors (ie, fear-avoidance beliefs, pain catastrophizing, and kinesiophobia) were collected at baseline. Questionnaire values were entered into principal component analysis to yield a combined psychological component score. LBP intensity (pain thermometers), LBP-related disability (Quebec Back Pain Disability Scale), and gait speed were measured at baseline and 12-month follow-up. Multiple linear regression was used to examine adjusted associations between baseline psychological component scores and each prospective outcome. The baseline psychological component score failed to independently predict 12-month LBP-related disability and gait speed after adjustment for baseline outcomes. Though the psychological component score was associated with 12-month LBP intensity after adjusting for baseline LBP intensity, this association diminished with full adjustment for other baseline characteristics. Cumulatively, general and pain-related psychological risk factors did not independently predict longitudinal pain, disability, and physical function outcomes in this cohort. Compared to younger populations with this condition, general and pain-related psychological risk factors may have less influence on the maintenance of chronic LBP in older adults. PERSPECTIVE: This article failed to establish consistent independent relationships between psychological factors and worse longitudinal pain, disability, and physical function outcomes in older adults with chronic LBP. The findings highlight a need to determine other age-specific biopsychosocial risk factors that may impact the maintenance of chronic pain in this patient population.
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Affiliation(s)
- Patrick J. Knox
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Corey B. Simon
- Department of Orthopaedic Surgery, Physical Therapy Division, Duke University, Durham, NC
| | - Ryan T. Pohlig
- Department of Epidemiology, University of Delaware, Newark, DE
- Biostatistics Core, University of Delaware, Newark, DE
| | | | - Peter C. Coyle
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA
| | - Jaclyn M. Sions
- Department of Physical Therapy, University of Delaware, Newark, DE
| | - Gregory E. Hicks
- Department of Physical Therapy, University of Delaware, Newark, DE
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Petrini L, Arendt-Nielsen L. Pain catastrophizing in the elderly: An experimental pain study. Scand J Pain 2024; 24:sjpain-2023-0035. [PMID: 38452201 DOI: 10.1515/sjpain-2023-0035] [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: 03/16/2023] [Accepted: 11/29/2023] [Indexed: 03/09/2024]
Abstract
OBJECTIVES Pain catastrophizing in the aging population has not been studied in great detail. Existing investigations have reported conflicting results on the effects of age on pain catastrophizing in relation to pain responses. This study investigated the relationship between pain catastrophizing, and its individual components (rumination, magnification, and helplessness), and the responses to standardized experimental pain stimuli in old and young, healthy adults. METHODS Sixty-six volunteers (32 old: 65-87, 18 females; 34 young: 20-35, 17 females) participated in the study. Pain catastrophizing including the components of rumination, magnification, and helplessness was assessed with the pain catastrophizing scale (PCS). Experimental pain was induced by applying predefined pressure stimulations to the trapezius muscle. Pain intensity and unpleasantness were assessed using numerical rating scales. Pain catastrophizing levels and pain responses were statistically compared between the two age groups. RESULTS Elderly individuals reported significantly (p = 0.028) lower scores of pain catastrophizing (Med = 5; interquartile range [IQR] = 14) than younger individuals; this difference was driven by the significantly lower components of rumination (Med = 2; IQR = 4; p = 0.017) and helplessness (Med = 2; IQR = 7; p = 0.049). A larger proportion of young (57.8%) rated pain catastrophizing at high levels, with scores above the 75th percentile (Med = 20). Additionally, elderly reported the lowest pain intensity (Med = 5; p = 0.034) and pain unpleasantness (Med = 4.5; p = 0.011) responses to the experimental pressure stimuli. In the elderly group, pain unpleasantness was positively and significantly associated with pain catastrophizing (r s = 0.416, p = 0.021), rumination (r s = 0.42, p = 0.019), and helplessness (r s = 0.434, p = 0.015), respectively. No associations were found in the young group. CONCLUSIONS Elderly reported lower PCSs than young adults. Rumination and helplessness were reduced in the elderly group. The elderly population showed positive correlations between catastrophizing levels and pain unpleasantness to standardized pressure pain stimuli. Results supported the view that elderly possess resilience over specific domains of pain catastrophizing that could counteract pain perception due to physiological decline.
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Affiliation(s)
- Laura Petrini
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
- Department of Gastroenterology & Hepatology, Mech-Sense, Clinical Institute, Aalborg University Hospital, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
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Dispositional pain catastrophising in non-clinical sample: The role of depression, perceived stress and social support. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00956-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Verriotis M, Sorger C, Peters J, Ayoub LJ, Seunarine KK, Clark CA, Walker SM, Moayedi M. Amygdalar Functional Connectivity Differences Associated With Reduced Pain Intensity in Pediatric Peripheral Neuropathic Pain. FRONTIERS IN PAIN RESEARCH 2022; 3:918766. [PMID: 35692562 PMCID: PMC9184677 DOI: 10.3389/fpain.2022.918766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background There is evidence of altered corticolimbic circuitry in adults with chronic pain, but relatively little is known of functional brain mechanisms in adolescents with neuropathic pain (NeuP). Pediatric NeuP is etiologically and phenotypically different from NeuP in adults, highlighting the need for pediatric-focused research. The amygdala is a key limbic region with important roles in the emotional-affective dimension of pain and in pain modulation. Objective To investigate amygdalar resting state functional connectivity (rsFC) in adolescents with NeuP. Methods This cross-sectional observational cohort study compared resting state functional MRI scans in adolescents aged 11–18 years with clinical features of chronic peripheral NeuP (n = 17), recruited from a tertiary clinic, relative to healthy adolescents (n = 17). We performed seed-to-voxel whole-brain rsFC analysis of the bilateral amygdalae. Next, we performed post hoc exploratory correlations with clinical variables to further explain rsFC differences. Results Adolescents with NeuP had stronger negative rsFC between right amygdala and right dorsolateral prefrontal cortex (dlPFC) and stronger positive rsFC between right amygdala and left angular gyrus (AG), compared to controls (PFDR<0.025). Furthermore, lower pain intensity correlated with stronger negative amygdala-dlPFC rsFC in males (r = 0.67, P = 0.034, n = 10), and with stronger positive amygdala-AG rsFC in females (r = −0.90, P = 0.006, n = 7). These amygdalar rsFC differences may thus be pain inhibitory. Conclusions Consistent with the considerable affective and cognitive factors reported in a larger cohort, there are rsFC differences in limbic pain modulatory circuits in adolescents with NeuP. Findings also highlight the need for assessing sex-dependent brain mechanisms in future studies, where possible.
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Affiliation(s)
- Madeleine Verriotis
- Paediatric Pain Research Group, Developmental Neurosciences Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Department of Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- *Correspondence: Madeleine Verriotis
| | - Clarissa Sorger
- Paediatric Pain Research Group, Developmental Neurosciences Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Department of Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Judy Peters
- Paediatric Pain Research Group, Developmental Neurosciences Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Department of Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Lizbeth J. Ayoub
- Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
- University of Toronto Centre for the Study of Pain, Toronto, ON, Canada
- Division of Clinical and Computational Neuroscience, Krembil Brain Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Kiran K. Seunarine
- Developmental Imaging and Biophysics Section, Developmental Neurosciences Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Chris A. Clark
- Developmental Imaging and Biophysics Section, Developmental Neurosciences Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Suellen M. Walker
- Paediatric Pain Research Group, Developmental Neurosciences Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Department of Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Massieh Moayedi
- Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
- University of Toronto Centre for the Study of Pain, Toronto, ON, Canada
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DeMaio EL, Hunnicutt JL, Haley RM, Nazzal E, Chen Y, Premkumar A, Lamplot JD, Samady HA, Gottschalk MB, Xerogeanes JW. Liposomal Bupivacaine and Ropivacaine Adductor Canal Blocks for Anterior Cruciate Ligament Reconstruction Provide Similar Postoperative Analgesia. J Knee Surg 2022. [PMID: 35272368 DOI: 10.1055/s-0042-1743235] [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: 02/07/2023]
Abstract
The purpose of this study was to compare postoperative pain following anterior cruciate ligament (ACL) reconstruction (ACLR) in patients receiving an adductor canal block (ACB) with ropivacaine (R-ACB) or liposomal bupivacaine (LB-ACB). The secondary purpose was to compare opioid consumption. A prospective cohort study of patients undergoing ACLR at an academic medical center was conducted from November 1, 2018 to November 21, 2019. The first cohort received R-ACB and 30 tablets of 5/325 mg oxycodone/acetaminophen. After June 13, 2019, the second cohort received LB-ACB and 20 tablets of 5/325 mg oxycodone/acetaminophen with the reduction in opioids prescribed resulting from a hospital quality improvement initiative to decrease narcotic consumption. From postoperative days 0 through 6, pain was assessed thrice daily using a numeric rating scale. Total postoperative opioid consumption was reported via tablet count and converted to oral morphine equivalents (OMEs). During this period, 165 subjects underwent ACLR, and 126 met the eligibility criteria (44.4% female, 55.6% male; mean ± standard deviation: 28.7 ± 13.7 years). Sixty-six (52.4%) received LB-ACB, and 60 (47.6%) received R-ACB (p = 0.53). The most common graft utilized was quadriceps autograft (63.6% LB-ACB; 58.3% R-ACB, p = 0.76). Mean postoperative pain scores were similar between groups during the entire postoperative period (p ≥ 0.08 for POD 0-6). While postoperative opioid consumption was lower among patients receiving LB-ACB (median OME [interquartile range]: 28.6 [7.5-63.8] vs. 45.0 [15.0-75.0], p = 0.023), this only amounted to an average of 2.2 tablets. Patients receiving LB-ACB in the setting of ACLR reported similar postoperative pain compared with those receiving R-ACB. Despite the second aim of our study, we cannot make conclusions about the effect of each block on opioid consumption given that each cohort received different numbers of opioid tablets due to institutional pressure to reduce opioid prescribing. As few patients completed their opioid prescriptions or requested refills, further reduction in prescription size is warranted. Future studies are necessary to further elucidate the effect of LB-ACB versus R-ACB on postoperative pain and opioid consumption after ACLR.
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Affiliation(s)
- Emily L DeMaio
- Department of Orthopaedic Surgery, Division of Sports Medicine, Emory University, Atlanta, Georgia
| | - Jennifer L Hunnicutt
- Department of Orthopaedic Surgery, Division of Sports Medicine, Emory University, Atlanta, Georgia
| | - Rebecca M Haley
- Department of Orthopaedic Surgery, Division of Sports Medicine, Emory University, Atlanta, Georgia
| | - Ehab Nazzal
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Yunyun Chen
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ajay Premkumar
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
| | - Joseph D Lamplot
- Department of Orthopaedic Surgery, Division of Sports Medicine, Emory University, Atlanta, Georgia
| | - Heather A Samady
- Department of Orthopaedic Surgery, Division of Sports Medicine, Emory University, Atlanta, Georgia
| | - Michael B Gottschalk
- Department of Orthopaedic Surgery, Division of Sports Medicine, Emory University, Atlanta, Georgia
| | - John W Xerogeanes
- Department of Orthopaedic Surgery, Division of Sports Medicine, Emory University, Atlanta, Georgia
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Mi X, Zou B, Rashidi P, Baharloo R, Fillingim RB, Wallace MR, Crispen PL, Parvataneni HK, Prieto HA, Gray CF, Machuca TN, Hughes SJ, Murad GJA, Thomas E, Iqbal A, Tighe PJ. Effects of Patient and Surgery Characteristics on Persistent Postoperative Pain: A Mediation Analysis. Clin J Pain 2021; 37:803-811. [PMID: 34475340 PMCID: PMC8511273 DOI: 10.1097/ajp.0000000000000979] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/13/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Acute postoperative pain intensity is associated with persistent postsurgical pain (PPP) risk. However, it remains unclear whether acute postoperative pain intensity mediates the relationship between clinical factors and persistent pain. MATERIALS AND METHODS Participants from a mixed surgical population completed the Brief Pain Inventory and Pain Catastrophizing Scale before surgery, and the Brief Pain Inventory daily after surgery for 7 days and at 30 and 90 days after surgery. We considered mediation models using the mean of the worst pain intensities collected daily on each of postoperative days (PODs) 1 to 7 against outcomes of worst pain intensity at the surgical site endpoints reflecting PPP (POD 90) and subacute pain (POD 30). RESULTS The analyzed cohort included 284 participants for the POD 90 outcome. For every unit increase of maximum acute postoperative pain intensity through PODs 1 to 7, there was a statistically significant increase of mean POD 90 pain intensity by 0.287 after controlling for confounding effects. The effects of female versus male sex (m=0.212, P=0.034), pancreatic/biliary versus colorectal surgery (m=0.459, P=0.012), thoracic cardiovascular versus colorectal surgery (m=0.31, P=0.038), every minute increase of anesthesia time (m=0.001, P=0.038), every unit increase of preoperative average pain score (m=0.012, P=0.015), and every unit increase of catastrophizing (m=0.044, P=0.042) on POD 90 pain intensity were mediated through acute PODs 1 to 7 postoperative pain intensity. DISCUSSION Our results suggest the mediating relationship of acute postoperative pain on PPP may be predicated on select patient and surgical factors.
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Affiliation(s)
- Xinlei Mi
- Department of Biostatistics, Columbia University, New York, NY
| | - Baiming Zou
- Department of Biostatistics, Columbia University, New York, NY
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC
| | - Parisa Rashidi
- Department of Biomedical Engineering
- Electrical and Computer Engineering
| | | | | | | | | | | | | | | | | | | | - Gregory J A Murad
- Lillian S. Wells Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL
| | - Elizabeth Thomas
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio
| | - Atif Iqbal
- Division of General Surgery, Baylor College of Medicine, Houston, TX
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Clark CJ, Kalanaviciute G, Bartholomew V, Cheyne H, Hundley VA. Exploring pain characteristics in nulliparous women; A precursor to developing support for women in the latent phase of labour. Midwifery 2021; 104:103174. [PMID: 34753016 DOI: 10.1016/j.midw.2021.103174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/08/2020] [Accepted: 10/17/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Admission to hospital in the latent phase of labour is associated with a cascade of unnecessary intervention. Women who seek early hospital admission may have heightened fear and anxiety in relation to pain routed in their pre-pregnancy experiences. OBJECTIVE To determine the prevalence of pain catastrophising in a healthy non-pregnant population and explore previous pain experiences and fear of childbirth as characteristics that might predict pain catastrophising. DESIGN Prospective observational study across two higher education institutions in Scotland and England using a semi-structured survey administered through Bristol Online Surveys. Four validated questionnaires were used to identify the prevalence of pain catastrophising and fear of childbirth in nulliparous women of reproductive age. RESULTS The survey was completed by 122 women undertaking an undergraduate degree and aged between 18 and 23 years. A high prevalence of pain catastrophising was found: a cut-off score of 20 and above = 47.5% (58/122 participants), a cut-off score of 30 and above = 21.3% (26/122). Fear of pain (β = 0.14, t = 4.21, p <0 .001) and pain-related anxiety (β = 0.40, t = 11.39, p <0 .001) were significant predictors of pain catastrophisation. However, there was no correlation between fear of childbirth and pain catastrophisation. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE It is reasonable to hypothesise that the pain catastrophising scale may be a good tool to predict those women likely to require additional support in the latent phase of labour; however further work is needed to explore this with a group of pregnant women.
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Affiliation(s)
- Carol J Clark
- Head of Department and Professor In Physiotherapy, Department of Rehabilitation and Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University.
| | - Guste Kalanaviciute
- Psychology Graduate, Faculty of Science and Technology, Bournemouth University
| | - Vanessa Bartholomew
- Clinical Academic Doctoral Student, Department of Midwifery & Health Sciences, Faculty of Health & Social Sciences, Bournemouth University
| | - Helen Cheyne
- RCM (Scotland) Professor of Midwifery Research, NMAHP Research Unit, University of Stirling
| | - Vanora A Hundley
- Professor of Midwifery, Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University
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Verster JC, Severeijns NR, Sips ASM, Saeed HM, Benson S, Scholey A, Bruce G. Alcohol Hangover Across the Lifespan: Impact Of Sex and Age. Alcohol Alcohol 2021; 56:589-598. [PMID: 33822860 PMCID: PMC8406052 DOI: 10.1093/alcalc/agab027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/10/2021] [Accepted: 03/16/2021] [Indexed: 11/17/2022] Open
Abstract
AIM To investigate the relationship between age and hangover frequency and severity. METHOD An online survey, generated through Facebook, collected self-report data relating to alcohol consumption from 761 Dutch alcohol consumers aged 18-94 years (61.6% female). RESULTS Overall, young individuals consumed more alcohol than older drinkers, and men more than women. Significant interactions between age group and sex were found for both subjective intoxication and hangover severity, indicating that the sex differences in these variables were greatest in the younger age groups but became significantly smaller or absent in the older age groups. Partial correlations, correcting for estimated blood alcohol concentration (eBAC), revealed significant and negative partial correlations between age and subjective intoxication (r = -0.444, P < 0.0001), age and hangover severity (r = -0.327, P < 0.0001) and between age and hangover frequency (r = -0.195, P < 0.0001), i.e. subjective intoxication, hangover severity and hangover frequency decline with age. With regard to sex differences, the observed correlations with age for the past month heaviest drinking occasion were stronger in men for subjective intoxication, (z = -2.25, P = 0.024), hangover severity (z = -3.36, P = 0.0008) and hangover frequency (z = -3.63, P = 0.0003). CONCLUSIONS Hangover severity declines with age, even after controlling for eBAC or the amount of alcohol consumed. Sex differences were greatest in the younger age groups but became significantly smaller or absent in the older age groups. The relationship between age and hangover severity is strongly mediated by subjective intoxication. Pain sensitivity, lower with aging, might be a mediator.
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Affiliation(s)
- Joris C Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3584 CG, The Netherlands
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne VIC 3122, Australia
| | - Noortje R Severeijns
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3584 CG, The Netherlands
| | - Annabel S M Sips
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3584 CG, The Netherlands
| | - Hama M Saeed
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht 3584 CG, The Netherlands
| | - Sarah Benson
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne VIC 3122, Australia
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne VIC 3122, Australia
| | - Gillian Bruce
- Division of Psychology and Social Work, School of Education and Social Sciences, University of the West of Scotland, Paisley PA1 2BE, UK
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Klonowski T, Kropp P, Straube A, Ruscheweyh R. Psychological factors associated with headache frequency, intensity, and headache-related disability in migraine patients. Neurol Sci 2021; 43:1255-1266. [PMID: 34304327 PMCID: PMC8789634 DOI: 10.1007/s10072-021-05453-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/29/2021] [Indexed: 12/04/2022]
Abstract
Background Several psychological cofactors of migraine have been identified, but relationships to different headache parameters (e.g., headache frequency vs. headache-related disability) are only incompletely understood. Methods We cross-sectionally assessed 279 migraine patients at their first presentation at our tertiary headache center. We obtained headache and acute medication frequency, pain intensity, the Migraine Disability Assessment Scale (MIDAS), and the Pain Disability Index (PDI) as headache-related outcomes as well as scores of the Hospital Anxiety and Depression Scale (HADS), the Pain Catastrophizing Scale (PCS), Pain-Related Control Scale (PRCS), and Avoidance Endurance Questionnaire (AEQ) as psychological factors. Results Linear regression models revealed the highest associations of the psychological factors with the PDI (adjusted R2 = 0.296, p < 0.001, independent predictors: PCS, AEQ social avoidance, depression) followed by the MIDAS (adjusted R2 = 0.137, p < 0.001, predictors: depression, AEQ social avoidance) and headache frequency (adjusted R2 = 0.083, p < 0.001, predictors: depression, AEQ humor/distraction). Principal component analysis corroborated that psychological factors were preferentially associated with the PDI, while the MIDAS loaded together with headache frequency. Conclusion Our results suggest that psychological factors are more strongly associated with the subjective degree of headache-related disability measured by the PDI than with the days with disability (MIDAS) or the more objective parameter of headache frequency. This once again highlights the need for comprehensive assessment of migraine patients with different headache parameters and the need for considering psychological treatment, especially in patients with high disability. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05453-2.
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Affiliation(s)
- Theresa Klonowski
- Department of Neurology, Ludwig-Maximilians-Universität, Klinikum Grosshadern, Munich, Germany.
| | - Peter Kropp
- Institute of Medical Psychology and Medical Sociology, University Medical Center Rostock, Rostock, Germany
| | - Andreas Straube
- Department of Neurology, Ludwig-Maximilians-Universität, Klinikum Grosshadern, Munich, Germany
| | - Ruth Ruscheweyh
- Department of Neurology, Ludwig-Maximilians-Universität, Klinikum Grosshadern, Munich, Germany
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12
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Auckley ED, Bentov N, Zelber-Sagi S, Jeong L, Reed MJ, Bentov I. Frailty status as a potential factor in increased postoperative opioid use in older adults. BMC Geriatr 2021; 21:189. [PMID: 33736611 PMCID: PMC7977609 DOI: 10.1186/s12877-021-02101-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/22/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Prescription opioids are commonly used for postoperative pain relief in older adults, but have the potential for misuse. Both opioid side effects and uncontrolled pain have detrimental impacts. Frailty syndrome (reduced reserve in response to stressors), pain, and chronic opioid consumption are all complex phenomena that impair function, nutrition, psychologic well-being, and increase mortality, but links among these conditions in the acute postoperative setting have not been described. This study seeks to understand the relationship between frailty and patterns of postoperative opioid consumption in older adults. METHODS Patients ≥ 65 years undergoing elective surgery with a planned hospital stay of at least one postoperative day were recruited for this cohort study at pre-anesthesia clinic visits. Preoperatively, frailty was assessed by Edmonton Frailty and Clinical Frailty Scales, pain was assessed by Visual Analog and Pain Catastrophizing Scales, and opioid consumption was recorded. On the day of surgery and subsequent hospitalization days, average pain ratings and total opioid consumption were recorded daily. Seven days after hospital discharge, patients were interviewed using uniform questionnaires to measure opioid prescription use and pain rating. RESULTS One hundred seventeen patients (age 73.0 (IQR 67.0, 77.0), 64 % male), were evaluated preoperatively and 90 completed one-week post discharge follow-up. Preoperatively, patients with frailty were more likely than patients without frailty to use opioids (46.2 % vs. 20.9 %, p = 0.01). Doses of opioids prescribed at hospital discharge and the prescribed morphine milligram equivalents (MME) at discharge did not differ between groups. Seven days after discharge, the cumulative MME used were similar between cohorts. However, patients with frailty used a larger fraction of opioids prescribed to them (96.7 % (31.3, 100.0) vs. 25.0 % (0.0, 83.3), p = 0.007) and were more likely (OR 3.7, 95 % CI 1.13-12.13) to use 50 % and greater of opioids prescribed to them. Patients with frailty had higher pain scores before surgery and seven days after discharge compared to patients without frailty. CONCLUSIONS Patterns of postoperative opioid use after discharge were different between patients with and without frailty. Patients with frailty tended to use almost all the opioids prescribed while patients without frailty tended to use almost none of the opioids prescribed.
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Affiliation(s)
| | - Nathalie Bentov
- Department of Family Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA
| | - Shira Zelber-Sagi
- School of Public Health, University of Haifa, 3498838, Haifa, Israel
| | - Lily Jeong
- University of Washington School of Medicine, Seattle, WA, USA
| | - May J Reed
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, WA, Seattle, USA
| | - Itay Bentov
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
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13
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Smith CR, Baharloo R, Nickerson P, Wallace M, Zou B, Fillingim RB, Crispen P, Parvataneni H, Gray C, Prieto H, Machuca T, Hughes S, Murad G, Rashidi P, Tighe PJ. Predicting long-term postsurgical pain by examining the evolution of acute pain. Eur J Pain 2021; 25:624-636. [PMID: 33171546 PMCID: PMC8628519 DOI: 10.1002/ejp.1698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/08/2020] [Indexed: 09/13/2023]
Abstract
BACKGROUND Increased acute postoperative pain intensity has been associated with the development of persistent postsurgical pain (PPP) in mechanistic and clinical investigations, but it remains unclear which aspects of acute pain explain this linkage. METHODS We analysed clinical postoperative pain intensity assessments using symbolic aggregate approximations (SAX), a graphical way of representing changes between pain states from one patient evaluation to the next, to visualize and understand how pain intensity changes across sequential assessments are associated with the intensity of postoperative pain at 1 (M1) and 6 (M6) months after surgery. SAX-based acute pain transition patterns were compared using cosine similarity, which indicates the degree to which patterns mirror each other. RESULTS This single-centre prospective cohort study included 364 subjects. Patterns of acute postoperative pain sequential transitions differed between the 'None' and 'Severe' outcomes at M1 (cosine similarity 0.44) and M6 (cosine similarity 0.49). Stratifications of M6 outcomes by preoperative pain intensity, sex, age group, surgery type and catastrophising showed significant heterogeneity of pain transition patterns within and across strata. Severe-to-severe acute pain transitions were common, but not exclusive, in patients with moderate or severe pain intensity at M6. CONCLUSIONS Clinically, these results suggest that individual pain-state transitions, even within patient or procedural strata associated with PPP, may not alone offer good predictive information regarding PPP. Longitudinal observation in the immediate postoperative period and consideration of patient- and surgery-specific factors may help indicate which patients are at increased risk of PPP. SIGNIFICANCE Symbolic aggregate approximations of clinically obtained, acute postoperative pain intraday time series identify different motifs in patients suffering moderate to severe pain 6 months after surgery.
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Affiliation(s)
- Cameron R Smith
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Raheleh Baharloo
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, USA
| | - Paul Nickerson
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Margaret Wallace
- Center for NeuroGenetics, University of Florida, Gainesville, FL, USA
| | - Baiming Zou
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Roger B Fillingim
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Paul Crispen
- Department of Urology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Hari Parvataneni
- Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine, Gainesville, FL, USA
| | - Chancellor Gray
- Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine, Gainesville, FL, USA
| | - Hernan Prieto
- Department of Orthopaedics and Rehabilitation, University of Florida College of Medicine, Gainesville, FL, USA
| | - Tiago Machuca
- Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Steven Hughes
- Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Gregory Murad
- Lillian S. Wells Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Parisa Rashidi
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, USA
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Patrick J Tighe
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA
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Ghandehari O, Gallant NL, Hadjistavropoulos T, Williams J, Clark DA. The Relationship Between the Pain Experience and Emotion Regulation in Older Adults. PAIN MEDICINE 2020; 21:3366-3376. [PMID: 32488250 DOI: 10.1093/pm/pnaa135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate the relationship of emotion regulation strategies (i.e., emotional suppression and reappraisal) with pain catastrophizing, fear of pain, pain intensity, worry, and depression as function of age in samples of older and younger adults. DESIGN Cross-sectional design using validated questionnaires. SETTING Participants resided in the community. They completed validated measures using online questionnaires. SUBJECTS Two-hundred fifty-seven older adults and 254 younger adults with chronic pain participated. METHODS Participants completed validated questionnaires of emotion regulation strategies, pain-related functioning and mental health. RESULTS Emotion regulation varied as a function of age and gender. Among our chronic pain sample, older adult males reported lower use of reappraisal and suppression than younger adult males, while older adult females reported higher use of reappraisal than younger adult females. Emotional suppression was positively related to pain catastrophizing, pain intensity, worry, and depression. Reappraisal was negatively related to depression and worry. Interestingly, age showed a positive relationship with fear of pain, pain catastrophizing, worry, depression, and pain intensity, while gender was related to fear of pain and worry. Finally, emotional reappraisal partially mediated the relationship between the affective dimensions of pain intensity and pain catastrophizing among older adults. CONCLUSIONS Our results indicate that reappraisal strategies are important for older and younger adults with chronic pain, pointing to the necessity of considering these strategies when working clinically with such populations. However, given our findings as well as those in the literature, gender should also be considered.
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Affiliation(s)
- Omeed Ghandehari
- Department of Psychology, University of Regina, Regina, SK, Canada.,Centre on Aging and Health, University of Regina, Regina, SK, Canada
| | - Natasha L Gallant
- Department of Psychology, University of Regina, Regina, SK, Canada.,Centre on Aging and Health, University of Regina, Regina, SK, Canada
| | - Thomas Hadjistavropoulos
- Department of Psychology, University of Regina, Regina, SK, Canada.,Centre on Aging and Health, University of Regina, Regina, SK, Canada
| | - Jaime Williams
- Department of Psychology, University of Regina, Regina, SK, Canada.,Centre on Aging and Health, University of Regina, Regina, SK, Canada
| | - David A Clark
- Department of Psychology, University of New Brunswick, Fredericton, NB, Canada
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15
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Körfer K, Schemer L, Kube T, Glombiewski JA. An Experimental Analogue Study on the "Dose-Response Relationship" of Different Therapeutic Instructions for Pain Exposures: The More, The Better? J Pain Res 2020; 13:3181-3193. [PMID: 33293855 PMCID: PMC7719044 DOI: 10.2147/jpr.s265709] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/20/2020] [Indexed: 01/05/2023] Open
Abstract
Objective Novel suggestions derived from the inhibitory learning model on how to optimize exposure therapy have been debated with enthusiasm in the last few years, particularly with respect to the focus on expectancy violations. However, little is known about how this new approach directly compares to the traditional habituation rationale of exposure therapy. In the present study, we examined these two competing therapeutic instructions among healthy female participants in an experimental heat pain paradigm. Design and Methods Participants (N= 116) received a therapeutic instruction derived from either a habituation-based approach or the inhibitory learning model (expectation violation). Participants were repeatedly exposed to painful thermal stimulations until a predefined exposure goal was reached. Results The expectation violation instruction led to faster goal attainment and higher response rates than the habituation instruction. Both instructions led to increased pain tolerance in the short and long term (one-week follow-up). Conclusion Our results suggest that exposure treatments using an expectation violation instruction are especially time-effective. Although the findings from this analogue design cannot be directly generalized to populations with clinically relevant levels of chronic pain, they do point to some important theoretical and clinical implications for the treatment of pain.
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Affiliation(s)
- Karoline Körfer
- Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Lea Schemer
- Department of Clinical Psychology and Psychotherapy, University of Koblenz - Landau, Landau, Germany
| | - Tobias Kube
- Department of Clinical Psychology and Psychotherapy, University of Koblenz - Landau, Landau, Germany
| | - Julia A Glombiewski
- Department of Clinical Psychology and Psychotherapy, University of Koblenz - Landau, Landau, Germany
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16
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Majumder MSM, Ahmed S, Shazzad N, Hasan ATMT, Haq SA, Rasker JJ. Translation, cross-cultural adaptation and validation of the Pain Catastrophizing Scale (PCS) into Bengali in patients with chronic non-malignant musculoskeletal pain. Int J Rheum Dis 2020; 23:1481-1487. [PMID: 32862495 PMCID: PMC7754436 DOI: 10.1111/1756-185x.13954] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/03/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022]
Abstract
Aim To develop a culturally adapted and validated Bengali Pain Catastrophizing Scale (BePCS). Methods The English PCS was translated, adapted and back‐translated into and from Bengali, pre‐tested by 30 adult patients with chronic non‐malignant musculoskeletal pain. The BePCS was administered twice with 14 days interval to 90 patients. Convergent validity was measured by comparing the BePCS score with scores of the domains physical functioning and mental health of the Bengali Short Form 36, through Spearman's correlation coefficient. Test‐retest reliability was assessed by intraclass correlation coefficient (ICC) and Spearman's rank correlation coefficient and internal consistency by Cronbach's alpha. Content validity was assessed by index for content validity (ICV) and floor and ceiling effects. Results The BePCS was well accepted by the patients in the pre‐test. The content validity was excellent, both item ICV and scale ICV were 1. Construct validity: the convergent validity was −0.424 for physical functioning and −0.413 for mental health, indicating a moderate negative correlation. Total BePCS score showed excellent internal consistency with a mean Cronbach's α = 0.92. Internal consistency for subscales rumination, magnification and helplessness, were Cronbach's α 0.903, 0.72 and 0.872 respectively. The test‐retest reliability of total BePCS was 0.78 (P < .001) and for the subscales rumination 0.872 (P < .001), magnification 797 (P < .001) and helplessness 0.927 (P < .001), showing excellent test‐retest reliability. Conclusions The interviewer‐administered BePCS appears to be an acceptable, reliable and valid instrument for measuring health‐related quality of life in Bengali speaking patients with chronic non‐malignant musculoskeletal pain. Further evaluation in the general population and in different medical conditions should be done.
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Affiliation(s)
| | - Shamim Ahmed
- Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Nahiduzzamane Shazzad
- Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | | | - Syed Atiqul Haq
- Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Johannes J Rasker
- Faculty of Behavioral, Management and Social sciences, Department Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
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17
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Dong HJ, Gerdle B, Bernfort L, Levin LÅ, Dragioti E. Pain Catastrophizing in Older Adults with Chronic Pain: The Mediator Effect of Mood Using a Path Analysis Approach. J Clin Med 2020; 9:jcm9072073. [PMID: 32630330 PMCID: PMC7408783 DOI: 10.3390/jcm9072073] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 12/20/2022] Open
Abstract
Cognitive models of pain propose that catastrophic thinking is negatively associated with chronic pain. However, pain catastrophizing is a complex phenomenon requiring a multivariate examination. This study estimates the effects of mood variables (anxiety and depression) on pain catastrophizing in older adults with chronic pain. A postal survey addressing pain aspects was sent to 6611 people ≥ 65 years old living in south-eastern Sweden. Pain catastrophizing was measured using the pain catastrophizing scale. Anxiety and depression were assessed using two subscales of the general well-being schedule. Data were analysed using a path analysis approach. A total of 2790 respondents (76.2 ± 7.4 years old) reported chronic pain (≥three months). The mediation model accounted for 16.3% of anxiety, 17.1% of depression, and 30.9% of pain catastrophizing variances. Pain intensity, insomnia, number of comorbidities, and lifestyle factors (smoking, alcohol consumption, and weight) significantly affected both pain catastrophizing and mood. Anxiety (standardized path coefficient (bstd) = 0.324, p < 0.001) in comparison to depression (bstd = 0.125, p < 0.001) had a greater effect on pain catastrophizing. Mood mediated the relationship between pain catastrophizing and pain-related factors accounting for lifestyle and sociodemographic factors.
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Affiliation(s)
- Huan-Ji Dong
- Pain and Rehabilitation Centre, and, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden; (H.-J.D.); (B.G.)
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden; (H.-J.D.); (B.G.)
| | - Lars Bernfort
- Division of Health Care Analysis, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden; (L.B.); (L.-Å.L.)
| | - Lars-Åke Levin
- Division of Health Care Analysis, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden; (L.B.); (L.-Å.L.)
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden; (H.-J.D.); (B.G.)
- Correspondence:
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18
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Altan A, Akkoç S, Erdil A, Çolak S, Demir O, Altan H. Effects of pain catastrophizing and anxiety on analgesic use after surgical removal of impacted mandibular third molars. J Dent Anesth Pain Med 2019; 19:379-388. [PMID: 31942453 PMCID: PMC6946835 DOI: 10.17245/jdapm.2019.19.6.379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/19/2019] [Accepted: 12/25/2019] [Indexed: 11/15/2022] Open
Abstract
Background In dentistry, pain is a factor that negatively affects treatments and drug use. The aim of this study was to evaluate the correlations of the postoperative analgesic use with pain catastrophizing and anxiety in patients who underwent removal of an impacted mandibular third molar. Methods We recruited 92 patients who underwent the extraction of impacted mandibular third molar. In this study, the Pederson index was used to preoperatively determine the difficulty of surgical extraction. Patients were asked to note the number of analgesics used for 7 postoperative days. Patients were divided into two groups based on the Pain Catastrophizing Scale: low and high score groups. State-Trait Anxiety Inventory-trait and State-Trait Anxiety Inventory-state questionnaires were used to determine the anxiety levels of the patients. The obtained data were examined to evaluate the correlations of pain catastrophizing and anxiety with the postoperative analgesic use. Results In this study, 92 patients, including 60 women and 32 men, were recruited. The analgesic use was higher in women than in men but with no significant difference (P > 0.05). Pain Catastrophizing Scale scores were higher in women than in men but with no significant difference (P > 0.05). The analgesic use was higher in patients with high pain catastrophizing than in those with low pain catastrophizing but with no significant difference (P > 0.05). State-Trait Anxiety Inventory-trait scores were higher in women than in men but with no significant difference. However, state-Trait Anxiety Inventory-state scores were significantly higher in women than in men (P < 0.05). Conclusion The postoperative analgesic use may be higher in patients who catastrophize pain than in others. Knowing the patient's catastrophic characteristics preoperatively would contribute to successful pain management and appropriate drug selection.
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Affiliation(s)
- Ahmet Altan
- Department of Oral and Maxillofacial Surgery, Tokat Gaziosmanpasa University Faculty of Dentistry, Tokat, Turkey
| | - Sümeyra Akkoç
- Department of Pediatric Dentistry, Tokat Gaziosmanpasa University Faculty of Dentistry, Tokat, Turkey
| | - Aras Erdil
- Department of Oral and Maxillofacial Surgery, Tokat Gaziosmanpasa University Faculty of Dentistry, Tokat, Turkey
| | - Sefa Çolak
- Department of Oral and Maxillofacial Surgery, Tokat Gaziosmanpasa University Faculty of Dentistry, Tokat, Turkey
| | - Osman Demir
- Department of Biostatistics, Tokat Gaziosmanpasa University Faculty of Medicine, Tokat, Turkey
| | - Halenur Altan
- Department of Pediatric Dentistry, Tokat Gaziosmanpasa University Faculty of Dentistry, Tokat, Turkey
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Patient-defined outcomes for pain, fatigue, emotional distress, and interference with activities did not differ by age for individuals with musculoskeletal pain. Pain Rep 2019; 4:e798. [PMID: 31984302 PMCID: PMC6903348 DOI: 10.1097/pr9.0000000000000798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 01/21/2023] Open
Abstract
Introduction: Age impacts the prevalence and experience of musculoskeletal pain; however, it is unknown whether this factor impacts patient's anticipated outcomes after treatment. Objective: Using the Patient-Centered Outcomes Questionnaire (PCOQ), the primary purpose was to determine whether there are age-related differences in desired, successful, expected levels, and importance of improvement in pain, fatigue, emotional distress, and interference with daily activities. As a secondary purpose, anatomical location and sex were then included in the model to examine for interaction effects. Methods: A secondary analysis of the Optimal Screening for Prediction of Referral and Outcome cross-sectional and longitudinal cohorts was conducted. Included in this analysis were 572 individuals seeking physical therapy for nonsurgical neck, low back, shoulder, and knee pain who completed the PCOQ at the initial evaluation. A three-way analysis of variance examined PCOQ domains by age categories, sex, and anatomical location. Results: Interaction effects were not observed for any of the domains of interest (P > 0.01). Significant main effects were also not observed for age, sex, and anatomical location (P > 0.01). Conclusion: Musculoskeletal pain prevalence may differ across age categories but, in this cohort, neither age, nor sex, nor anatomical location impacted patient-defined outcomes for intensity, fatigue, emotional distress, and interference with daily activities.
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The Pain Catastrophizing Scale-short form: psychometric properties and threshold for identifying high-risk individuals. Int Psychogeriatr 2019; 31:1665-1674. [PMID: 30782232 DOI: 10.1017/s1041610219000024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The Pain Catastrophizing Scale (PCS) measures three aspects of catastrophic cognitions about pain-rumination, magnification, and helplessness. To facilitate assessment and clinical application, we aimed to (a) develop a short version on the basis of its factorial structure and the items' correlations with key pain-related outcomes, and (b) identify the threshold on the short form indicative of risk for depression. DESIGN Cross-sectional survey. SETTING Social centers for older people. PARTICIPANTS 664 Chinese older adults with chronic pain. MEASUREMENTS Besides the PCS, pain intensity, pain disability, and depressive symptoms were assessed. RESULTS For the full scale, confirmatory factor analysis showed that the hypothesized 3-factor model fit the data moderately well. On the basis of the factor loadings, two items were selected from each of the three dimensions. An additional item significantly associated with pain disability and depressive symptoms, over and above these six items, was identified through regression analyses. A short-PCS composed of seven items was formed, which correlated at r=0.97 with the full scale. Subsequently, receiver operating characteristic (ROC) curves were plotted against clinically significant depressive symptoms, defined as a score of ≥12 on a 10-item version of the Center for Epidemiologic Studies-Depression Scale. This analysis showed a score of ≥7 to be the optimal cutoff for the short-PCS, with sensitivity = 81.6% and specificity = 78.3% when predicting clinically significant depressive symptoms. CONCLUSIONS The short-PCS may be used in lieu of the full scale and as a brief screen to identify individuals with serious catastrophizing.
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21
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Transcultural adaptation and French validation of the Pain Sensitivity Questionnaire. Can J Anaesth 2019; 66:1202-1212. [PMID: 31020630 DOI: 10.1007/s12630-019-01377-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To validate a French translation of the Pain Sensitivity Questionnaire (PSQ), which is a valuable tool to predict an individual's natural disposition to feel pain that could be used after surgery. METHODS We studied content validity, internal consistency, convergent validity (anxiety, depression and catastrophism) and test-retest reliability of the French version of the PSQ (PSQ-F) in 146 patients either before scheduled surgery or during pregnancy; then, convergent and concurrent validity in 85 healthy volunteers submitted to nociceptive tests. RESULTS Internal consistency of the PSQ-F was found to be excellent, with Cronbach's α at 0.866, 0.886, and 0.927, respectively for its "minor", "moderate" and "total" scores. Test-retest reliability was significant, with intraclass correlation coefficients at 0.629, 0.629, and 0.635, respectively for the above- mentioned scores. These three scores correlated with anxiety, depression and catastrophizing scores in patients, but not in healthy volunteers, possibly because of low and few variant psychometric scores in this group. They were inversely correlated to the temperature needed to evoke heat pain rated 6 out of 10, but not to the mechanical pain threshold (electronic von Frey), nor to the heat pain threshold. Finally, they directly correlated to the pain induced by the cold pressor test (minor and total scores only). DISCUSSION This validated version can now be used by French-speaking researchers and physicians. TRIAL REGISTRATION www.ClinicalTrials.gov (NCT03113903); 14 April, 2017.
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Miró J, Sánchez-Rodríguez E, Brijaldo S, Jensen MP. The Silhouettes Fatigue Scale: comprehensibility and validity in older individuals. Disabil Rehabil 2019; 42:1906-1911. [PMID: 30672341 DOI: 10.1080/09638288.2018.1539129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Fatigue has been shown to be one of the key factors that interfere in the quality of life of elderly individuals. In order to understand its impact and evaluate the efficacy of treatments that target fatigue, researchers and clinicians need psychometrically sound and easy to use assessment instruments. The aim of this work was to address this need by evaluating the comprehensibility and validity of the Silhouettes Fatigue Scale (SFS) in a sample of older individuals.Methods: A total of 70 older individuals participated in the study. Participants were interviewed individually and asked to rate their level of fatigue during the week before the interview using the SFS and the FACIT-Fatigue Scale (to help evaluate convergent validity), and respond to the Pain Catastrophizing Scale (to help evaluate discriminant validity).Results: The results indicate that the SFS is understandable and that the scores have an adequate convergent validity and discriminant validity when used with older adults.Conclusions: The SFS is a valid measure of fatigue that can be used with older adults. It fills the need for a brief and easy to administer and score measure, which can be used in situations where assessment burden is a significant issue.Implications for rehabilitationFatigue is a significant problem among the elderly resulting in significant disability, and psychometrically sound and easy to use questionnaires are needed.The Silhouettes Fatigue Scale (SFS) is a new single-item self-report fatigue rating scale.Results show that the SFS is understandable, and that the scores have discriminant and convergent validity when used with older adults.As it does not use written items, it may be more easily understood by people who have basic or even no literacy level, thus making it easier to use for a wider audience.
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Affiliation(s)
- Jordi Miró
- Department of Psychology, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment, Universitat Rovira i Virgili, Tarragona, Spain
| | - Elisabet Sánchez-Rodríguez
- Department of Psychology, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment, Universitat Rovira i Virgili, Tarragona, Spain
| | - Solángel Brijaldo
- Department of Psychology, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment, Universitat Rovira i Virgili, Tarragona, Spain
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Comparison of the Pain Sensitivity Questionnaire and the Pain Catastrophizing Scale in Predicting Postoperative Pain and Pain Chronicization After Spine Surgery. Clin Spine Surg 2018; 31:E432-E440. [PMID: 30036209 DOI: 10.1097/bsd.0000000000000694] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
STUDY DESIGN This was a prospective study evaluating the Pain Sensitivity Questionnaire (PSQ) in 110 patients undergoing spine surgery. OBJECTIVE The purpose of this study was to compare the ability of the PSQ-total and PSQ-minor scores with the Pain Catastrophizing Scale (PCS) in predicting the immediate postoperative pain of patients after spinal surgery and their risk of developing a chronically painful state. SUMMARY OF BACKGROUND DATA Studies evaluating the PSQ as a preoperative determinant for the development of chronic pain are lacking. Therefore, we undertook the following study. MATERIALS AND METHODS Patients undergoing lumbar or cervical spine surgery were prospectively included in the study. The PSQ-total and PSQ-minor, the PCS and its subscores, the Oswestry Disability Index (ODI) and the Neck Disability Index were used preoperatively. Preoperative and postoperative Visual Analog Scale scores for pain at rest and movement and analgesics were recorded. At 12 months postoperatively, the Neck Disability Index and the ODI were once more assessed to evaluate pain chronicization. RESULTS A total of 110 patients scheduled to undergo surgery at our spine center participated in the study. Our results highlighted that Visual Analog Scale scores were increased for high catastrophizers at rest on the first postoperative day when compared with low catastrophizers. Preoperative use of opioids and a high score on the rumination subscale of the PCS were linked to greater postoperative morphine consumption. At 12 months, the PCS, the PSQ-total, and PSQ-minor showed correlations with the development of a chronically painful state for ODI scores >21, indicating a marked persistent disability. CONCLUSIONS Both PSQ and PCS showed an ability to predict a chronically painful state as defined by the persistence of disability after lumbar surgery.
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Mitrirattanakul S, Jariyasakulroj S. Dental treatment as perceived etiology of temporomandibular disorders. Cranio 2018; 38:109-114. [DOI: 10.1080/08869634.2018.1495304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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25
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Keskindag B, Karaaziz M. Influence of Depressive Symptoms on Pain Catastrophizing in Healthy Young Adults: The Role of Sadness, Self-criticalness and Pessimism. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2018. [DOI: 10.1007/s10942-018-0294-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Simon CB, Hicks GE. Paradigm Shift in Geriatric Low Back Pain Management: Integrating Influences, Experiences, and Consequences. Phys Ther 2018; 98:434-446. [PMID: 29669088 PMCID: PMC6692842 DOI: 10.1093/ptj/pzy028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 01/09/2018] [Indexed: 12/19/2022]
Abstract
Geriatric low back pain (LBP) can have a profound impact on physical activity and can cause a decline in physical function, which is a major health risk for older adults. Within the last decade, physical therapist management of LBP has shifted from an emphasis on pathoanatomical mechanisms, such as spine degeneration, to addressing psychological distress factors. Although this approach is promising, the complexity of LBP in older adults (including biological, psychological, cognitive, and social influences), which may differ from that in younger adults, must be considered. Further, outcome assessment should represent not only the LBP experience (eg, pain intensity, pain with movement) but also LBP consequences, such as physical activity decline and physical function decline. This perspective discusses influences on geriatric LBP, experiences, and consequences with the goal of facilitating standardized and comprehensive physical therapist management.
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Affiliation(s)
- Corey B Simon
- Doctor of Physical Therapy Division, Department of Orthopaedic Surgery, Duke University School of Medicine, PO Box 104002 DUMC, Durham, NC 27708 (USA); and Musculoskeletal Research Team, Duke Clinical Research Institute, Durham, NC,Address all correspondence to Dr Simon at:
| | - Gregory E Hicks
- Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark, Delaware
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Paquet A, Plansont B, Labrunie A, Malauzat D, Girard M. Past Pain Experience and Experimentally induced Pain Perception. Issues Ment Health Nurs 2017; 38:1013-1021. [PMID: 28766994 DOI: 10.1080/01612840.2017.1354103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
UNLABELLED Many intercurrent factors may be involved in the modulation of the pain message and its expression, such as the previous experience of pain built along the life. In this study, we aimed to determine whether susceptibility to experimentally induced pain is differentially influenced by the individual previous painful experience in subjects with schizophrenia (SC) major depression (MD), and controls (C). METHODS The SC (30), MD (32) and C (30) groups participated in experimental pain tests (application of pressure and induction of ischemia) after a semi-structured interview to make an inventory of the previous painful experiences, and the evaluation of anxiety either with autonomic (heart rate, blood pressure) or psychological (Hospital Anxiety Depression scale HAD) measures, and catastrophism. RESULTS The reported pain intensities, severities, duration, of the previous pain events, and the number of previous painful events were equivalent in the three groups, except for the number of painful events experimented before the last six months which was lower in the MD group. Experimental pain sensitivity was influenced by the diagnosis, the HAD scores or the number and intensities of previous lived painful events. CONCLUSION The lack of a past experience of pain was comparable for the different groups, suggesting that psychiatric disorders do not affect the experience of pain associated with daily life or past events. For each subject, the reported previous experience of pain influences the present feeling of pain.
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Affiliation(s)
- Aude Paquet
- a Unité de recherche et de neurostimulation , Centre Hospitalier Esquirol , Limoges , France
| | - Brigitte Plansont
- a Unité de recherche et de neurostimulation , Centre Hospitalier Esquirol , Limoges , France
| | - Anaïs Labrunie
- b INSERM, U1094 , Neuroépidémiologie Tropicale , Limoges , France ; CHU Limoges , Centre d'Epidémiologie, de Biostatistique et de Méthodologie de la Recherche , Limoges , France
| | - Dominique Malauzat
- a Unité de recherche et de neurostimulation , Centre Hospitalier Esquirol , Limoges , France
| | - Murielle Girard
- a Unité de recherche et de neurostimulation , Centre Hospitalier Esquirol , Limoges , France
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Do Correlates of Pain-Related Stoicism and Cautiousness Differ in Younger and Older People With Advanced Cancer? THE JOURNAL OF PAIN 2017; 19:301-316. [PMID: 29155166 DOI: 10.1016/j.jpain.2017.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/31/2017] [Accepted: 11/06/2017] [Indexed: 11/20/2022]
Abstract
Age differences are not evident in pain-related stoicism and cautiousness in people with cancer pain. Little is known about the factors associated with these pain-related attitudes or age-related patterns in these associations. The present cross-sectional study investigated the biopsychosocial correlates of the attitudes in younger and older patients with advanced cancer. Pain-related stoicism (fortitude, concealment, superiority) and cautiousness (self-doubt, reluctance) were assessed using the Pain Attitudes Questionnaire-Revised (PAQ-R). Participants, 155 younger (younger than 60 years old) and 114 older (60 years old or older) patients with advanced cancer completed the PAQ-R and measures of sociodemographic and medical characteristics, pain intensity, cognitive-affective pain-related responses, physical functioning, psychological distress and well-being, and psychosocial functioning. Backwards regression analyses identified correlates for each PAQ-R factor separately for younger and older patients. Activity engagement was a frequent correlate, but its relationship with concealment was the only association common to both age groups. Younger and older patients exhibited different avoidance-related constructs suggesting relational challenges in the former group (avoidant attachment) and intrapersonal fear in the latter (cognitive avoidance). Medical correlates also showed age differences: younger patients showed symptom-focused correlates, whereas older patients showed aging-related correlates. Findings support a biopsychosocial framework of cancer-pain adaptation incorporating a lifespan-developmental perspective. PERSPECTIVE To our knowledge, this article is the first to identify biopsychosocial correlates of stoic and cautious attitudes toward cancer pain in younger and older patients with advanced cancer. Findings highlight possible age-related motivations for greater pain-related stoicism or cautiousness and can potentially inform interventions addressing challenges in cancer-pain adaptation in advanced cancer.
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Dunn LK, Durieux ME, Fernández LG, Tsang S, Smith-Straesser EE, Jhaveri HF, Spanos SP, Thames MR, Spencer CD, Lloyd A, Stuart R, Ye F, Bray JP, Nemergut EC, Naik BI. Influence of catastrophizing, anxiety, and depression on in-hospital opioid consumption, pain, and quality of recovery after adult spine surgery. J Neurosurg Spine 2017; 28:119-126. [PMID: 29125426 DOI: 10.3171/2017.5.spine1734] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Perception of perioperative pain is influenced by various psychological factors. The aim of this study was to determine the impact of catastrophizing, anxiety, and depression on in-hospital opioid consumption, pain scores, and quality of recovery in adults who underwent spine surgery. METHODS Patients undergoing spine surgery were enrolled in this study, and the preoperatively completed questionnaires included the verbal rating scale (VRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), and Oswestry Disability Index (ODI). Quality of recovery was assessed using the 40-item Quality of Recovery questionnaire (QoR40). Opioid consumption and pain scores according to the VRS were recorded daily until discharge. RESULTS One hundred thirty-nine patients were recruited for the study, and 101 completed the QoR40 assessment postoperatively. Patients with higher catastrophizing scores were more likely to have higher maximum pain scores postoperatively (estimate: 0.03, SE: 0.01, p = 0.02), without increased opioid use (estimate: 0.44, SE: 0.27, p = 0.11). Preoperative anxiety (estimate: 1.18, SE: 0.65, p = 0.07) and depression scores (estimate: 1.06, SE: 0.71, p = 0.14) did not correlate with increased postoperative opioid use; however, patients with higher preoperative depression scores had lower quality of recovery after surgery (estimate: -1.9, SE: 0.56, p < 0.001). CONCLUSIONS Catastrophizing, anxiety, and depression play important roles in modulating postoperative pain. Preoperative evaluation of these factors, utilizing a validated tool, helps to identify patients at risk. This might allow for earlier psychological intervention that could reduce pain severity and improve the quality of recovery.
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Affiliation(s)
| | - Marcel E Durieux
- Departments of1Anesthesiology and.,2Neurosurgery, University of Virginia, Charlottesville, Virginia; and
| | | | - Siny Tsang
- 3Department of Epidemiology, Columbia University, New York, New York
| | | | | | | | | | | | | | | | - Fan Ye
- Departments of1Anesthesiology and
| | | | - Edward C Nemergut
- Departments of1Anesthesiology and.,2Neurosurgery, University of Virginia, Charlottesville, Virginia; and
| | - Bhiken I Naik
- Departments of1Anesthesiology and.,2Neurosurgery, University of Virginia, Charlottesville, Virginia; and
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Kröner-Herwig B, Gorbunova A, Maas J. Predicting the occurrence of headache and back pain in young adults by biopsychological characteristics assessed at childhood or adolescence. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2017; 8:31-39. [PMID: 28405174 PMCID: PMC5378444 DOI: 10.2147/ahmt.s127501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the current study was to identify predictors of recurrent headache and back pain in young adults (aged 18–27 years) from data assessed in childhood or adolescence, i.e., 9 years before the final survey. Our interest was whether psychological characteristics contribute to the risk of pain prevalence in adult age when controlling for already empirically supported risk factors such as parental pain, pediatric pain and sex. The study was part of a five-wave epidemiological investigation of >5000 families with children aged between 7 and 14 years when addressed first. In a multiple hierarchical regression analysis, the abovementioned three variables (Block-I variables) were entered first followed by five psychological trait variables (Block-II variables: internalizing, anxiety sensitivity, somatosensory amplification, catastrophizing and dysfunctional stress coping) to find out the extent of model improvement. The multivariable hierarchical regression analysis confirmed the hypothesis that the Block-I variables significantly enhance the risk of future pain at young adult age. None of the psychological variables did so. Thus, the hypothesis of a significant surplus predictive effect was not confirmed. The amount of total explained variance differed strongly between headache and back pain. In particular, a valid prediction of back pain was not possible. When analyzed separately in simple regression analysis, psychological variables turned out to be significant predictors, however, of very low effect size. The inclusion of Block-I variables in the model clearly reduced the impact of the psychological variables. This risk profile is discussed in the context of the different trajectories of headache and back pain from childhood to adult age, which were proposed by various studies. We propose that a biopsychological characteristic denoted as emotional negativity, especially regarding self-reference, might be a common factor behind all selected variables. Risk research in recurrent pain is a field where much more multidisciplinary research is needed before progress can be expected.
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Affiliation(s)
- Birgit Kröner-Herwig
- Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller-Institute of Psychology, University of Göttingen, Göttingen, Germany
| | - Anastasia Gorbunova
- Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller-Institute of Psychology, University of Göttingen, Göttingen, Germany
| | - Jennifer Maas
- Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller-Institute of Psychology, University of Göttingen, Göttingen, Germany
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Situational but Not Dispositional Pain Catastrophizing Correlates With Early Postoperative Pain in Pain-Free Patients Before Surgery. THE JOURNAL OF PAIN 2016; 17:549-60. [DOI: 10.1016/j.jpain.2015.12.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 11/05/2015] [Accepted: 12/28/2015] [Indexed: 12/12/2022]
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Cabak A, Dąbrowska-Zimakowska A, Truszczyńska A, Rogala P, Laprus K, Tomaszewski W. Strategies for Coping with Chronic Lower Back Pain in Patients with Long Physiotherapy Wait Time. Med Sci Monit 2015; 21:3913-20. [PMID: 26670743 PMCID: PMC4734674 DOI: 10.12659/msm.894743] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Treatment efficacy for the increasing prevalence of back pain is a great challenge for both health care providers and individuals coping with this problem. This study aimed to evaluate pain coping strategies used by primary care patients with chronic lower back pain (CLBP) as a supplementation of medical diagnosis before a physiotherapy programme. MATERIAL AND METHODS A total of 88 people were divided into 3 age groups: young adults (21-40 years old), middle-aged adults (41-60 years old), and the elderly (over 60 years old). Data was gathered from rehabilitation centers and primary medical care facilities. A cross-sectional design was used. The Coping Strategies Questionnaire (CSQ) was completed before the physiotherapy course. RESULTS Patients complained of CLBP for 11.32±6.81 years on average. The most common strategies to cope with back pain included declaring that the pain is manageable, praying and hoping, as well as increased behavioral activity. Statistically significant differences in coping strategies were found between age groups. The elderly patients were more likely to "declare coping with pain" in comparison to the younger age groups (p<0.01). People over 60 years of age were more likely to declare active coping with pain, while young people reported catastrophizing. CONCLUSIONS Patients in different age groups had various difficulties in pain coping. Most of them required support in self-management of pain in addition to physiotherapy. The basic assessment of pain coping strategies should be consistently taken into account and included in rehabilitation protocols in chronic pain treatment.
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Affiliation(s)
- Anna Cabak
- Department of Physiotherapy, Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland
| | - Anna Dąbrowska-Zimakowska
- Department of Psychosocial Foundations of Rehabilitation and Bioethics, Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland
| | - Aleksandra Truszczyńska
- Department of Physiotherapy, Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland
| | | | - Katarzyna Laprus
- Department of Psychosocial Foundations of Rehabilitation and Bioethics, Józef Piłsudski University of Physical Education in Warsaw, Warsaw, Poland
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Koenig J, De Kooning M, Bernardi A, Williams DP, Nijs J, Thayer JF, Daenen L. Lower Resting State Heart Rate Variability Relates to High Pain Catastrophizing in Patients with Chronic Whiplash-Associated Disorders and Healthy Controls. Pain Pract 2015; 16:1048-1053. [PMID: 26614574 DOI: 10.1111/papr.12399] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 07/20/2015] [Indexed: 11/28/2022]
Abstract
Vagally mediated heart rate variability (vmHRV) is widely respected as a psychophysiological measure of emotion regulation capacity and serves as a readily available index of executive brain areas that exert an inhibitory influence on subcortical structures. Pain catastrophizing (PC) is conceptualized as the tendency to misinterpret and exaggerate pain-related situations that may be threatening. Chronic pain patients show lower vmHRV and higher PC. Previously, no study has investigated the association of PC and vmHRV. We examined the association of PC and vmHRV in a sample of patients with chronic whiplash-associated disorders (WAD, n = 30) and healthy controls (n = 31). Patients with WAD showed lower vmHRV, indexed by high-frequency HRV (effect size, Cohen's d = 0.442), and greater PC (d = 0.815). Zero-order and partial correlations controlling for age and sex revealed that vmHRV and PC are inversely related. The results provide evidence for a psychophysiological mechanism underlying PC, in particular in chronic pain patients.
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Affiliation(s)
- Julian Koenig
- Department of Psychology, The Ohio State University, Columbus, Ohio, U.S.A
| | - Margot De Kooning
- Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel (VUB), Brussel, Belgium.,Born Bunge Institute, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Anthony Bernardi
- Department of Psychology, The Ohio State University, Columbus, Ohio, U.S.A
| | - DeWayne P Williams
- Department of Psychology, The Ohio State University, Columbus, Ohio, U.S.A
| | - Jo Nijs
- Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Julian F Thayer
- Department of Psychology, The Ohio State University, Columbus, Ohio, U.S.A
| | - Liesbeth Daenen
- Pain in Motion Research Group, Departments of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel (VUB), Brussel, Belgium
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Fischin J, Chehab G, Richter JG, Fischer-Betz R, Winkler-Rohlfing B, Willers R, Schneider M. Factors associated with pain coping and catastrophising in patients with systemic lupus erythematosus: a cross-sectional study of the LuLa-cohort. Lupus Sci Med 2015; 2:e000113. [PMID: 26629351 PMCID: PMC4654099 DOI: 10.1136/lupus-2015-000113] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 10/12/2015] [Accepted: 10/17/2015] [Indexed: 11/25/2022]
Abstract
Objective The aim of this study was to identify factors associated with pain coping and catastrophising in patients with systemic lupus erythematosus. Methods All patients were participants of the lupus erythematosus long-term study, which is based on patient-reported data assessed among members of the German Lupus Erythematosus Self-Help Organization. Assessments were performed by means of a questionnaire. Among self-reported clinical data the Pain-Related Self Statements Scale (PRSS) was included. To depict significant differences univariable analyses were carried out using non-parametrical rank tests. To examine factors influencing our outcome variables, we performed a multivariable stepwise regression model including variables that presented significantly in the univariable analysis. Results 447 cases (94.9% female) were analysed showing a mean catastrophising score of 1.1 (SD 0.8) and a mean coping score of 2.8 (SD 0.9) in the PRSS subscales. Higher catastrophising quartiles went along with higher experienced pain, lupus activity, fatigue, damage and decreased health related quality of life, whereas they presented inversely for coping. In our multivariable model, factors associated with catastrophising were: number of lupus-specific drugs (p value 0.004), pain in the last 7 days (p value 0.034), the Short Form 12 Health Survey Mental Component Summary (p value <0.001) and disease activity measured by the Systemic Lupus Activity Questionnaire (p value 0.042). Social participation reflected by performed leisure activities such as dancing or bowling had a positive association with coping (p value 0.006). In contrast, other health related physical activities and their extent had no impact on coping. A direct association between the amount of pain coping and catastrophising, as well as a great impact of the catastrophising, respectively, coping level on physical and mental functioning could be shown. Conclusions Reduction or increase of detected factors might lead to a modification of pain coping and catastrophising and offer an approach to more effective care in patients with SLE.
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Affiliation(s)
- Julia Fischin
- Policlinic of Rheumatology and Hiller Research Unit Rheumatology , Heinrich-Heine-University , Düsseldorf , Germany
| | - Gamal Chehab
- Policlinic of Rheumatology and Hiller Research Unit Rheumatology , Heinrich-Heine-University , Düsseldorf , Germany
| | - Jutta G Richter
- Policlinic of Rheumatology and Hiller Research Unit Rheumatology , Heinrich-Heine-University , Düsseldorf , Germany
| | - Rebecca Fischer-Betz
- Policlinic of Rheumatology and Hiller Research Unit Rheumatology , Heinrich-Heine-University , Düsseldorf , Germany
| | | | - Reinhart Willers
- Policlinic of Rheumatology and Hiller Research Unit Rheumatology , Heinrich-Heine-University , Düsseldorf , Germany
| | - Matthias Schneider
- Policlinic of Rheumatology and Hiller Research Unit Rheumatology , Heinrich-Heine-University , Düsseldorf , Germany
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Kim HJ, Park JW, Chang BS, Lee CK, Yeom JS. The influence of catastrophising on treatment outcomes after surgery for lumbar spinal stenosis. Bone Joint J 2015; 97-B:1546-54. [DOI: 10.1302/0301-620x.97b11.36016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pain catastrophising is an adverse coping mechanism, involving an exaggerated response to anticipated or actual pain. The purpose of this study was to investigate the influence of pain ‘catastrophising’, as measured using the pain catastrophising scale (PCS), on treatment outcomes after surgery for lumbar spinal stenosis (LSS). A total of 138 patients (47 men and 91 women, mean age 65.9; 45 to 78) were assigned to low (PCS score < 25, n = 68) and high (PCS score ≥ 25, n = 70) PCS groups. The primary outcome measure was the Oswestry Disability Index (ODI) 12 months after surgery. Secondary outcome measures included the ODI and visual analogue scale (VAS) for back and leg pain, which were recorded at each assessment conducted during the 12-month follow-up period The overall changes in the ODI and VAS for back and leg pain over a 12-month period were significantly different between the groups (ODI, p < 0.001; VAS for back pain, p < 0.001; VAS for leg pain, p = 0.040). The ODI and VAS for back and leg pain significantly decreased over time after surgery in both groups (p < 0.001 for all three variables). The patterns of change in the ODI and VAS for back pain during the follow-up period significantly differed between the two groups, suggesting that the PCS group is a potential treatment moderator. However, there was no difference in the ODI and VAS for back and leg pain between the low and high PCS groups 12 months after surgery. In terms of minimum clinically important differences in ODI scores (12.8), 22 patients (40.7%) had an unsatisfactory surgical outcome in the low PCS group and 16 (32.6%) in the high PCS group. There was no statistically significant difference between the two groups (p = 0.539). Pre-operative catastrophising did not always result in a poor outcome 12 months after surgery, which indicates that this could moderate the efficacy of surgery for LSS. Cite this article: Bone Joint J 2015;97-B:1546–54.
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Affiliation(s)
- H. J. Kim
- Seoul National University College of Medicine, and
Seoul National University Bundang Hospital, 166
Gumiro, Bundang-gu, Sungnam, 463-707, Republic
of Korea
| | - J. W. Park
- Seoul National University College of Medicine, and
Seoul National University Bundang Hospital, 166
Gumiro, Bundang-gu, Sungnam, 463-707, Republic
of Korea
| | - B. S. Chang
- Seoul National University College of Medicine,
Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic
of Korea
| | - C. K. Lee
- Seoul National University College of Medicine,
Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic
of Korea
| | - J. S. Yeom
- Seoul National University College of Medicine, and
Seoul National University Bundang Hospital, 166
Gumiro, Bundang-gu, Sungnam, 463-707, Republic
of Korea
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Gopinath B, Harris IA, Nicholas M, Casey P, Blyth F, Maher CG, Cameron ID. A comparison of health outcomes in older versus younger adults following a road traffic crash injury: a cohort study. PLoS One 2015; 10:e0122732. [PMID: 25830702 PMCID: PMC4382341 DOI: 10.1371/journal.pone.0122732] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 02/12/2015] [Indexed: 11/19/2022] Open
Abstract
Background Given the aging demographics of most developed countries, understanding the public health impact of mild/moderate road traffic crash injuries in older adults is important. We aimed to determine whether health outcomes (pain severity and quality of life measures) over 24 months differ significantly between older (65+) and younger adults (18–64). Methods Prospective cohort study of 364, 284 and 252 participants with mild/moderate injury following a vehicle collision at baseline, 12 and 24 months, respectively. A telephone-administered questionnaire obtained information on socio-economic, pre- and post-injury psychological and heath characteristics. Results At baseline, there were 55 (15.1%) and 309 (84.9%) participants aged ≥65 and 18–64 years, respectively. At 12- and 24-month follow-up, older compared to younger participants who had sustained a mild/moderate musculoskeletal injury had lower physical functioning (3.9-units lower Short Form-12 Physical Composite Score, multivariable-adjusted p = 0.03 at both examinations). After multivariable adjustment, older (n = 45) versus younger (n = 207) participants had lower self-perceived health status (8.1-units lower European Quality of Life-5 Dimensions Visual Acuity Scale scores at 24 months, p = 0.03), 24 months later. Conclusions Older compared to younger participants who sustained a mild/moderate injury following a road-traffic crash demonstrated poorer physical functioning and general health at 24 months.
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Affiliation(s)
- Bamini Gopinath
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, University of Sydney, Sydney, Australia
- * E-mail:
| | - Ian A. Harris
- Ingham Institute for Applied Medical Research and South Western Sydney Clinical School, University of New South Wales, Kensington, Australia
| | - Michael Nicholas
- Pain Management Research Institute, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Petrina Casey
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Fiona Blyth
- Pain Management Research Institute, Sydney Medical School, University of Sydney, Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
| | - Christopher G. Maher
- George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Ian D. Cameron
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, University of Sydney, Sydney, Australia
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Kapoor S, Thorn B, Bandy O, Clements K. Pain referents used to respond to the
P
ain
C
atastrophizing
S
cale. Eur J Pain 2015; 19:400-7. [DOI: 10.1002/ejp.561] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2014] [Indexed: 11/06/2022]
Affiliation(s)
- S. Kapoor
- Psychology Department The University of Alabama Tuscaloosa USA
| | - B.E. Thorn
- Psychology Department The University of Alabama Tuscaloosa USA
| | - O. Bandy
- Psychology Department The University of Alabama Tuscaloosa USA
| | - K.L. Clements
- Department of Behavior and Mental Health Birmingham Veterans Affairs Medical Center Birmingham USA
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Goli Z, Asghari A, Moradi A. Effects of Mood Induction on the Pain Responses in Patients with Migraine and the Role of Pain Catastrophizing. Clin Psychol Psychother 2014; 23:66-76. [PMID: 25523303 DOI: 10.1002/cpp.1939] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/25/2014] [Accepted: 11/27/2014] [Indexed: 11/09/2022]
Abstract
UNLABELLED Migraine has close associations with depression and anxiety. Catastrophizing, an alarmist reaction to pain, has been proposed as one of the mediators in the relationship between headache and emotional distress. However, much experimental evidence is needed to make such a view more validated. The aims of this study are to examine the effects of mood induction on the pain responses and to investigate the role of pain catastrophizing in the relationship between pain and mood amongst a sample of patients with migraine. For this purpose, 60 patients with migraine were recruited from a headache clinic in Tehran-Iran and were randomly assigned into one of three groups: negative mood induced group, positive mood induced group and control group. The following instruments and measures were used in this study: mood induction by presenting different types of films (positive, negative), a computerized cognitive task to elicit pain, Beck Depression Inventory and Pain Catastrophizing Scale. The results showed that while the induction of depressed mood increased the pain intensity, the induction of positive mood reduced it significantly (p < 0.05). Further analyses revealed that catastrophizing is as a confounding factor in the relationship between pain and mood. Once catastrophizing scores were entered into the analyses as a covariate, the significant effect of mood on the pain intensity reduced. In conclusion, both mood and catastrophizing are important factors in understanding the migraine pain. Clinical implications of these findings are discussed in the paper. Copyright © 2014 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE Pain-related catastrophizing and mood induction are important factors in understanding pain intensity amongst patients with migraine pain. Catastrophizing as a confounding factor in the relationship between pain and mood may partially mediate the relationship between mood and pain. Therapeutic interventions should focus on the reduction of depression and catastrophizing.
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Affiliation(s)
- Zahra Goli
- Kharazmi University, Psychology Department, Tehran, Islamic Republic of Iran
| | - Ali Asghari
- Shahed University, Department of Psychology, Tehran, Islamic Republic of Iran
| | - Alireza Moradi
- Shahed University, Department of Psychology, Tehran, Islamic Republic of Iran
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Ozone (O3) elicits neurotoxicity in spinal cord neurons (SCNs) by inducing ER Ca2+ release and activating the CaMKII/MAPK signaling pathway. Toxicol Appl Pharmacol 2014; 280:493-501. [DOI: 10.1016/j.taap.2014.08.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 08/21/2014] [Accepted: 08/24/2014] [Indexed: 01/19/2023]
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Toth C, Brady S, Hatfield M. The importance of catastrophizing for successful pharmacological treatment of peripheral neuropathic pain. J Pain Res 2014; 7:327-38. [PMID: 25028563 PMCID: PMC4077695 DOI: 10.2147/jpr.s56883] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Objective Catastrophizing may be a negative predictor of pain-related outcomes. We evaluated the impact of catastrophizing upon success of first-line pharmacotherapy in the management of neuropathic pain (NeP) due to peripheral polyneuropathy. Methods Patients with confirmed NeP with NeP Visual Analog Scale (VAS) pain severity score ≥4 (0–10 scale) completed the Coping Strategies Questionnaire (CSQ) catastrophizing subscale at baseline. Pharmacological therapy consisting of first-line agents gabapentin, pregabalin, or a tricyclic antidepressant was initiated. Other measures examined included the Karnofsky Performance Scale, Beck Depression Inventory, EuroQol Quality of Life Health Questionnaire, and Modified Brief Pain Inventory. At 3 and 6 months, questionnaires were repeated and adverse effect reporting was completed. Outcome measures assessed were pharmacotherapy success (≥30% relief of NeP) and tolerability over 6 months of follow-up. Bivariate relationships using Pearson product-moment correlations were examined for baseline CSQ catastrophizing subscale score and the change in the NeP VAS scores and medication discontinuation. Results Sixty-six patients were screened, 62 subjects participated, and 58 subjects (94%) completed the final follow-up visit. Greater catastrophizing was associated with poor pain relief response and greater likelihood of discontinuation of pharmacotherapy, reports of greater disability, and impaired quality of life. Duration of pain was negatively associated with likelihood of pharmacotherapy success. Conclusion Catastrophizing exerts maladaptive effects on outcomes with pharmacotherapy in NeP patients. Detection of catastrophizing during clinical visits when pharmacological therapy is being considered can be a predictive factor for patient outcomes.
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Affiliation(s)
- Cory Toth
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Shauna Brady
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Melinda Hatfield
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
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Psychological Reactions and Persistent Facial Pain following Enucleation. PAIN RESEARCH AND TREATMENT 2014; 2014:232989. [PMID: 24864208 PMCID: PMC4017877 DOI: 10.1155/2014/232989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 03/12/2014] [Accepted: 03/30/2014] [Indexed: 11/17/2022]
Abstract
Background. Enucleation is a psychologically and physically traumatic event associated with chronic pain. It would be desirable to better predict which patients will have pain after surgery. Methods. A cross-sectional postal questionnaire study of adults undergoing enucleation captured the demographic details, Pain Quality Assessment Scale (PQAS), Pain Catastrophizing Scale (PCS), and the Facial Pain Assessment questionnaire. Patients were classified as suffering from chronic pain if they reported a pain score of >1 out of 10 on the numerical pain score (NRS). Results. Seventeen of 60 adults participated in the study. 47% of patients reported chronic pain (mean pain score = 1.4 ± 0.7, n = 17); 25% experienced pain daily. No difference in age, surgical side, reason for surgery, or the duration of time since the surgery was noted. All patients had low PQAS scores and 50% of individuals with persistent pain were concerned about their facial appearance. There was no significant difference in the level of catastrophization noted in patients with or without pain or between the subgroups (rumination, magnification, or helplessness). Conclusions. Although persistent pain following enucleation affected a significant number of patients, the pain intensity was mild. Enucleation influenced the physical perception some individuals had of themselves.
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Abstract
BACKGROUND "Pain catastrophizing" refers to an exaggerated negative mental set brought to bear during an actual or anticipated painful experience. A patient's perception of a dental care experience as catastrophic can result not only in poor satisfaction with the therapy but also in avoidance of necessary treatments, resulting in the deterioration of oral health. METHODS The author reviewed literature regarding pain catastrophizing regarding dental treatment as well as behavioral models related to catastrophizing. RESULTS People who catastrophize show excessive attention to pain (rumination), exaggerate the threat value of pain (magnification) and feel unable to cope with their suffering (helplessness). During dental treatments, greater pain catastrophizing is associated with increased pain, dental anxiety and negative thoughts regarding pain and dental procedures. CONCLUSIONS It is important that clinicians identify dental patients who catastrophize so as to plan and provide the best treatment for their needs. PRACTICAL IMPLICATIONS To manage the care of patients who catastrophize, the clinician can actively probe patients' pain experience, help them reappraise threat, manipulate their attention to pain and improve dentist-patient communication.
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Pulvers K, Hood A. The role of positive traits and pain catastrophizing in pain perception. Curr Pain Headache Rep 2013; 17:330. [PMID: 23512722 DOI: 10.1007/s11916-013-0330-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A variety of biological, psychological, and social factors interact to influence pain. This article focuses on two distinct, but connected, psychological factors--positive personality traits and pain catastrophizing--and their link with pain perception in healthy and clinical populations. First, we review the protective link between positive personality traits, such as optimism, hope, and self-efficacy, and pain perception. Second, we provide evidence of the well-established relationship between pain catastrophizing and pain perception and other related outcomes. Third, we outline the inverse relationship between positive traits and pain catastrophizing, and offer a model that explains the inverse link between positive traits and pain perception through lower pain catastrophizing. Finally, we discuss clinical practice recommendations based on the aforementioned relationships.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, 333 S. Twin Oaks Valley Rd., San Marcos, CA 92096, USA.
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Keefe FJ, Porter L, Somers T, Shelby R, Wren AV. Psychosocial interventions for managing pain in older adults: outcomes and clinical implications. Br J Anaesth 2013; 111:89-94. [PMID: 23794650 DOI: 10.1093/bja/aet129] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Interest in the use of psychosocial interventions to help older adults manage pain is growing. In this article, we review this approach. The first section reviews the conceptual background for psychosocial interventions with a special emphasis on the biopsychosocial model of pain. The second section highlights three psychosocial interventions used with older adults: cognitive behavioural therapy, emotional disclosure, and mind-body interventions (specifically mindfulness-based stress reduction and yoga). The final section of the paper highlights important future directions for work in this area.
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Affiliation(s)
- F J Keefe
- Department of Psychiatry, Duke University Medical Center, Durham, NC 27705, USA.
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Suren M, Kaya Z, Gokbakan M, Okan I, Arici S, Karaman S, Comlekci M, Balta MG, Dogru S. The Role of Pain Catastrophizing Score in the Prediction of Venipuncture Pain Severity. Pain Pract 2013; 14:245-51. [DOI: 10.1111/papr.12060] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 03/04/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Mustafa Suren
- Department of Anesthesiology and Reanimation; Medical Faculty; Gaziosmanpasa University; Tokat Turkey
| | - Ziya Kaya
- Department of Anesthesiology and Reanimation; Medical Faculty; Gaziosmanpasa University; Tokat Turkey
| | - Mehmet Gokbakan
- Department of General Surgery; Medical Faculty; Gaziosmanpasa University; Tokat Turkey
| | - Ismail Okan
- Department of Psychiatry; Medical Faculty; Gaziosmanpasa University; Tokat Turkey
| | - Semih Arici
- Department of Anesthesiology and Reanimation; Medical Faculty; Gaziosmanpasa University; Tokat Turkey
| | - Serkan Karaman
- Department of Anesthesiology and Reanimation; Medical Faculty; Gaziosmanpasa University; Tokat Turkey
| | - Mevlut Comlekci
- Department of Anesthesiology and Reanimation; Bagcilar Education and Research Hospital; Istanbul Turkey
| | - Mehtap G. Balta
- Department of Anesthesiology and Reanimation; Medical Faculty; Gaziosmanpasa University; Tokat Turkey
| | - Serkan Dogru
- Department of Anesthesiology and Reanimation; Medical Faculty; Gaziosmanpasa University; Tokat Turkey
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Abstract
Pain catastrophizing has been described for more than half a century which adversely affects the pain coping behavior and overall prognosis in susceptible individuals when challenged by painful conditions. It is a distinct phenomenon which is characterized by feelings of helplessness, active rumination and excessive magnification of cognitions and feelings toward the painful situation. Susceptible subjects may have certain demographic or psychological predisposition. Various models of pain catastrophizing have been proposed which include attention-bias, schema-activation, communal-coping and appraisal models. Nevertheless, consensus is still lacking as to the true nature and mechanisms for pain catastrophizing. Recent advances in population genomics and noninvasive neuroimaging have helped elucidate the known determinants and neurophysiological correlates behind this potentially disabling behavior.
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Affiliation(s)
- Lawrence Leung
- Department of Family Medicine, Centre of Neurosciences Study, Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada
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Kelemen L, Lee AL, Button BM, Presnell S, Wilson JW, Holland AE. Pain Impacts on Quality of Life and Interferes with Treatment in Adults with Cystic Fibrosis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2011; 17:132-41. [DOI: 10.1002/pri.524] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 08/09/2011] [Accepted: 09/11/2011] [Indexed: 11/10/2022]
Affiliation(s)
- Lee Kelemen
- Physiotherapy; La Trobe University; Bundoora; Victoria; Australia
| | | | | | - Scott Presnell
- Physiotherapy; La Trobe University; Bundoora; Victoria; Australia
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