Self-Compassion Demonstrating a Dual Relationship with Pain Dependent on High-Frequency Heart Rate Variability

Investigating the effects and efficacy of self-compassion intervention on generalized anxiety disorders

BACKGROUND

Generalized anxiety disorder (GAD) is the least successfully treated anxiety disorder. This clinical trial investigated the effects and efficacy of a novel self-compassion intervention in GAD.

METHODS

A total of 75 GAD patients were assigned to a self-compassion intervention group (n = 25), a mindfulness intervention group (n = 25), or a treat-as-usual group (n = 25). Patients in the two active groups received eight intervention sessions in two weeks in addition to usual treatment i.e., pharmacotherapy. Primary outcomes were anxiety and worry, assessed at pre-intervention, post-intervention, and three-month follow-up. Secondary outcomes included depression, sleep, as well as self-compassion and mindfulness.

RESULTS

Both the self-compassion and mindfulness intervention induced a more rapid decrease in anxiety and depression than pharmacological treatment alone with excellent response and remission rate. Self-compassion intervention also induced a more rapid improvement in sleep quality compared to mindfulness intervention and pharmacological treatment alone. We also presented a mechanism for the self-compassion intervention in which decreased anxiety led to improvement in sleep quality. There was also a higher pleasure, acceptance, and willingness to re-attend in the self-compassion compared to the mindfulness intervention.

LIMITATIONS

This study was single blinded and nonrandomized which may bring risks of bias.

CONCLUSIONS

Overall, we provided novel evidence that self-compassion intervention is an alternative psychotherapy for GAD with excellent response and acceptability.

The effect on back pain, anxiety, and comfort levels of an elevated supine position and back support applied to patients undergoing coronary angiography: A randomized controlled experimental study

OBJECTIVES

To determine the effect of elevated supine position with back support on back pain, anxiety and comfort in patients undergoing coronary angiography.

METHODS

This randomized-controlled, experimental study was conducted in the Coronary Intensive Care Unit between September 2021 and January 2022, with an intervention group of 51 patients and a control group of 53 patients. Data were collected using a patient information form, a visual analog scale, the anxiety state inventory and the immobilization comfort questionnaire. Following angiography, the intervention group received pillow support to the back and the bedhead was elevated to 30 degrees. Routine nursing care was applied to the control group. In both groups, the severity of back pain was measured at 0, 2, and 4 hours, and anxiety and comfort at 0 and 4 hours.

RESULTS

The pain severity at 2 and 4 hours after the procedure was determined to be significantly lower in the intervention group than in the control group (p<0.001, p<0.001). At 4 hours, the anxiety levels were similar in both groups (p<0.05), and the comfort level was higher in the intervention group (p<0.001). The mean pain value was 6.003 points lower and the comfort level was 20.499 points higher in the intervention group than in the control group.

CONCLUSION

The elevated supine position with back support was seen to reduce back pain, increase comfort, and did not change anxiety levels.Clinical Trials No: NCT05546216.

Distinct Emotional and Cardiac Responses to Audio Erotica between Genders

Emotional and cardiac responses to audio erotica and their gender differences are relatively unclear in the study of the human sexual response. The current study was designed to investigate gender differences regarding positive and negative emotional responses to erotica, as well as its association with cardiac response. A total of 40 healthy participants (20 women) were exposed to erotic, neutral, and happy audio segments during which emotions and heart rate changes were evaluated. Our data showed distinct emotional responses to erotica between genders, in which women reported a higher level of shame than men and rated erotic audios as less pleasant than happy audios. Meanwhile, men reported erotic and happy audios as equally pleasant. These results were independent of cardiac changes, as both sexes demonstrated comparable heart rate deceleration when exposed to erotica relative to neutral and happy stimuli. Our results highlight the role of sociocultural modulation in the emotional response to erotica.

Compassion-based interventions in Asian communities: A meta-analysis of randomised controlled trials

PURPOSE

Practising compassion increases well-being and reduces depression, anxiety, and psychological distress among clinical and non-clinical populations. There is a rapid increase in compassion-based interventions within the past two decades. However, the reviews are limited to predominantly Western cultures. Therefore, this meta-analysis aimed to evaluate the literature attempting to promote and increase compassion in Asian communities.

METHOD

Eight randomised controlled trials (RCTs) conducted between 2016 to 2021 were included in the meta-analysis with data from 1012 participants across Thailand, Japan, China and Hong Kong. Effect sizes were calculated to test the efficacy of the compassion-based interventions on the self-compassion outcome. Intervention efficacy was tested by comparing the intervention groups against control groups (wait-list control and active control groups) at pre- and post-interventions.

RESULTS

Significant between-group differences in change scores were found on self-report measures of self-compassion with large effect sizes in interventions with wait-list control groups (d = .86) and small effect sizes in interventions with active-control groups (d = .19).

CONCLUSIONS

Although compassion-based interventions are heterogeneous in nature and limited in scope, there is promising evidence of improving self-compassion in Asian communities. This supports for the cross-cultural applicability of compassion-based interventions. However, research within the Asian context is limited and at an infancy stage, signifying the importance of conducting further compassion-based interventions in clinical and non-clinical groups living in the Asian communities.

Heart rate variability is not suitable as surrogate marker for pain intensity in patients with chronic pain

ABSTRACT

The search towards more objective outcome measurements and consequently surrogate markers for pain started decades ago; however, no generally accepted biomarker for pain has qualified yet. The goal is to explore the value of heart rate variability (HRV) as surrogate marker for pain intensity chronic pain setting. Pain intensity scores and HRV were collected in 366 patients with chronic pain, through a cross-sectional multicenter study. Pain intensity was measured with both the Visual Analogue Scale and Numeric Rating Scale, while 16 statistical HRV parameters were derived. Canonical correlation analysis was performed to evaluate the correlation between the dependent pain variables and the HRV parameters. Surrogacy was determined for each HRV parameter with point estimates between 0 and 1 whereby values close to 1 indicate a strong association between the surrogate and the true endpoint at the patient level. Weak correlations were revealed between HRV parameters and pain intensity scores. The highest surrogacy point estimate was found for mean heart rate as marker for average pain intensity on the Numeric Rating Scale with point estimates of 0.0961 (95% CI from 0.0384 to 0.1537) and 0.0209 (95% CI from 0 to 0.05) for patients without medication use, and medication use respectively. This study indicated that HRV parameters as separate entities are no suitable surrogacy candidates for pain intensity, in a population of chronic pain patients. Further potential surrogate candidates and clinical robust true endpoints should be explored, in order to find a surrogate measure for the highly individual pain experience.

Concurrent TMS-EEG and EEG reveal neuroplastic and oscillatory changes associated with self-compassion and negative emotions

Background/Objective

Self-compassion has a consensual relevance for overall mental health, but its mechanisms remain unknown. Using intermittent theta burst stimulation (iTBS) and concurrent transcranial magnetic stimulation-electroencephalography (TMS-EEG), this study investigated the causal relationship of the dorsolateral prefrontal cortex (DLPFC) with self-compassion and explored the changes in neuroplasticity and neural dynamics.

Method

Thirty-two healthy participants received iTBS or sham stimulation over the DLPFC, before and after which they were instructed to either use self-compassionate strategies or to be rejected in the context of social rejection and to report the level of self-compassion or negative affect. TMS-evoked potentials were evaluated as novel neuroplastic techniques with N45, P60, N100, and P180.

Results

iTBS uniquely decreased P180 amplitude measured with TMS-EEG whereby sham stimulation had no effect on neuroplasticity. In line with neuroplasticity changes, iTBS enhanced a widespread gamma band power and coherence, which correlated consistently with increased engagement in self-compassion. Meanwhile, iTBS demonstrated opposite effects on theta activity dependent on the social contexts whereby self-compassion decreased and social rejection enhanced it respectively. This unique effect of iTBS on theta activity was also supplemented by the enhancement of theta band coherence following iTBS.

Conclusions

We found a causal relationship between DLPFC and self-compassion. We also provide evidence to indicate widespread gamma activity and connectivity to correlate with self-compassion as well as the critical role of the DLPFC in modulating theta activity and negative emotions.

Role of Occupational Therapy in Pain Management

This new position statement from the American Occupational Therapy Association (AOTA) describes occupational therapy's role in pain management. AOTA asserts that occupational therapy practitioners are distinctly prepared to work independently and to contribute to interprofessional teams in the treatment of pain. Practitioners strive to ensure active engagement in meaningful occupations for clients at risk for and affected by pain.

Role of Occupational Therapy in Pain Management

The American Occupational Therapy Association (AOTA) asserts that occupational therapists and occupational therapy assistants, collectively referred to as occupational therapy practitioners (AOTA, 2020b), are distinctly prepared to work independently and to contribute to interprofessional teams in the treatment of pain. Occupational therapy practitioners work to ensure active engagement in meaningful occupations for "persons, groups, or populations (i.e., the client)" (AOTA, 2020b, p. 1) at risk for and affected by pain.

Heart Rate Variability and Pain: A Systematic Review

Background and Objective: Heart rate variability (HRV) as an index of the autonomic nervous system appears to be related to reactivity to experimental pain stimuli. HRV could better explain the contributions of sympathetic and parasympathetic activity response to nociceptive stimulation. The aim of this study was to systematically review and synthesize the current evidence on HRV in relation to the experience of pain in experimental tasks. Databases and Data Treatment: Studies indexed in the PubMed, PsycINFO, MEDLINE, WebOfScience, and Scopus databases were reviewed for eligibility. Studies on the autonomic response (i.e., HRV) to experimentally induced pain in healthy adults were included. Different methods of pain induction were considered (e.g., thermal, pressure, and electrical). Data were synthesized considering the association between HRV and both pain induction and subjective measures of pain. Results: Seventy-one studies were included. The results underline significant change in both the sympathetic and parasympathetic autonomic nervous systems during the painful stimulation independent of the pain induction method. The autonomic reaction to pain could be affected by several factors, such as sex, age, body mass index, breathing patterns, the intensity of the stimulation, and the affective state. Moreover, an association between the autonomic nervous system and the subjective experience of pain was found. Higher parasympathetic activity was associated with better self-regulation capacities and, accordingly, a higher pain inhibition capacity. Conclusions: HRV appears to be a helpful marker to evaluate nociceptive response in experimentally induced pain. Future studies are also needed in clinical samples to understand better the interindividual changes of autonomic response due to pain stimuli.

Corrigendum to "Self-Compassion Demonstrating a Dual Relationship with Pain Dependent on High-Frequency Heart Rate Variability"

[This corrects the article DOI: 10.1155/2020/3126036.].