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Fazia G, Carbone EA, Rania M, Quirino D, Aloi M, de Filippis R, De Fazio P, Colloca L, Segura-García C. Pain experience in eating disorders: The mediating role of depression, alexithymia and interoceptive awareness. EUROPEAN EATING DISORDERS REVIEW 2024; 32:148-160. [PMID: 37676995 DOI: 10.1002/erv.3020] [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: 02/20/2023] [Revised: 07/02/2023] [Accepted: 08/03/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Evidence suggests reduced sensitivity to pain due to high pain threshold in anorexia and bulimia nervosa and a possible role of depression, alexithymia and interoceptive awareness on pain experience. This study examined whether self-report and real-time evoked pain experience were mediated by depression, alexithymia and interoceptive awareness in a comprehensive sample of patients with eating disorders (ED). METHOD 145 participants (90 ED, 55 healthy controls (HC)) underwent a real-time evoked examination of pain and completed self-report questionnaires for pain (Pain Detect Questionnaire (PD-Q), PD-Q VAS, Leeds Assessment of Neuropathic Symptoms and Signs), depression (BDI-II), interoceptive awareness Multidimensional Assessment of Interoceptive Awareness (MAIA), and alexithymia (TAS-20). Three mediation models, with ED diagnosis as independent variable, and BDI, MAIA and TAS-20 as mediators, were tested. RESULTS Participants with ED and HC exhibited similar pain type and intensity (self-report and real-time). Eating disorders diagnosis was associated with lower self-report pain intensity and non-neuropathic like pain experience (model 1-2). Depressive symptoms partially (model 1-2) or fully (model 3) mediated the association between ED diagnosis and pain experience, alone (model 1) or via alexithymia (model 3). Interoceptive awareness did not influence pain symptomatology. DISCUSSION ED diagnosis is associated with non-neuropathic and lower pain experience. However, concurrent depression and alexithymia are associated with higher pain symptoms and neuropathic features. These results could inform clinicians about the influence of psychopathology on pain experience in ED.
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Affiliation(s)
- Gilda Fazia
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Elvira Anna Carbone
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatry Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Marianna Rania
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Daria Quirino
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Matteo Aloi
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Renato de Filippis
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Luana Colloca
- Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland, USA
- Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, USA
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland, USA
| | - Cristina Segura-García
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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Adhikari N, Uddin S. Health Inequalities in Older Norwegians and the Mediating Role of Social Networks. Int J Aging Hum Dev 2022:914150221112281. [PMID: 35837689 DOI: 10.1177/00914150221112281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to contribute to understanding how social networks serve as an intervening pathway leading to socioeconomic health inequality among older adults in Norway. Longitudinal survey data from the second and the third waves of the Norwegian Life Course, Ageing, and Generation Study were used in this paper. Hayes PROCESS was used to estimate the mediating effect of the contact frequency and the support potential of friends on the impact of social-economic position (SEP) at wave 2 on health outcomes at wave 3. The total indirect effect of the income on physical health observed was 0.04. The total indirect effect of the highest level of education attained on physical health observed was 0.12. The result showed a social-economic gradient in health among older adults in Norway where the social network is a crucial pathway via which SEP influences peoples' health.
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Affiliation(s)
- Nabaraj Adhikari
- International Social Welfare and Health Policy Scholar, 418298Oslo Metropolitan University, Oslo, Norway.,Master of Public Health, The Royal Tropical Institute (KIT), Amsterdam, the Netherlands
| | - Shahad Uddin
- International Social Welfare and Health Policy Scholar, 418298Oslo Metropolitan University, Oslo, Norway
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Wongprommate D, Wongpakaran T, Pinyopornpanish M, Lerttrakarnnon P, Jiraniramai S, Satthapisit S, Saisavoey N, Wannarit K, Nakawiro D, Tantrarungroj T, Wongpakaran N. Predictors for quality of life among older adults with depressive disorders: A prospective 3-month follow-up cohort study. Perspect Psychiatr Care 2022; 58:1029-1036. [PMID: 34159608 DOI: 10.1111/ppc.12895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/15/2021] [Accepted: 06/05/2021] [Indexed: 02/02/2023] Open
Abstract
PURPOSE The study aimed to investigate the predictive factors for quality of life among subjects with late-life depression. DESIGN AND METHODS Data including depressive symptoms assessed by the Hamilton Rating Scale of Depression (HAMD), geriatric depression scale (GDS), perceived stress scale (PSS), multidimensional scale for perceived social support, and the EQ-5D scale were collected at baseline and at 3-month follow-up from 264 participants. FINDINGS After controlling for covariates, time, GDS, PSS, HAMD, and living alone were confirmed predictors for change of EQ-5D scores. PRACTICE IMPLICATIONS Perceived stress is important, and intervention to reduce stress especially in early treatment of depressive disorder should be encouraged.
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Affiliation(s)
- Darawan Wongprommate
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Manee Pinyopornpanish
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Peerasak Lerttrakarnnon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Surin Jiraniramai
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Nattha Saisavoey
- Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kamonporn Wannarit
- Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Daochompu Nakawiro
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thanita Tantrarungroj
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Grunberg VA, Mace RA, Bannon S, Greenberg J, Bakhshaie J, Vranceanu AM. Mechanisms of change in depression and anxiety within a mind-body activity intervention for chronic pain. J Affect Disord 2021; 292:534-541. [PMID: 34147965 PMCID: PMC8282750 DOI: 10.1016/j.jad.2021.05.069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/21/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Chronic pain is challenging and costly to treat. Depression and anxiety co-occur with chronic pain. Identifying psychosocial mechanisms contributing to emotional outcomes among chronic pain patients can inform future iterations of this intervention. METHODS We examined explanatory mechanisms of change in emotional distress following a mind-body and activity intervention among 82 participants (21 - 79 years old, 65.85% female, 80.48% White). With depression and anxiety as outcomes, we hypothesized that potential mediators would include pain catastrophizing, mindfulness, and pain resilience. We used mixed-effects modeling to assess the indirect effects of time on each outcome variable through hypothesized mediators simultaneously. RESULTS Improvements in depression from baseline to post-treatment were most explained by pain catastrophizing (b = -2.53, CI = [-3.82, -1.43]), followed by mindfulness (b = -1.21, CI = [-2.15, -0.46]), and pain resilience (b = -0.76, CI = [-1.54, -1.66]). Improvements in anxiety from baseline to post-treatment were most explained by pain catastrophizing(b = -2.16, CI = [-3.45, -1.08]) and mindfulness (b = -1.51, CI = [-2.60, -0.65]), but not by pain resilience, (b = -0.47, CI = [-1.26, 0.17]). LIMITATIONS Findings are limited by the lack of a control group, relatively small sample, and two timepoints. However, findings can guide future mind-body intervention efficacy testing trials. CONCLUSIONS Pain catastrophizing and mindfulness appear to be important intervention targets to enhance emotional functioning for chronic pain patients, and should be considered simultaneously in interventions for chronic pain.
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Affiliation(s)
- Victoria A. Grunberg
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Ryan A. Mace
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Sarah Bannon
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Jafar Bakhshaie
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA USA; Harvard Medical School, Boston, MA USA.
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Banjongrewadee M, Wongpakaran N, Wongpakaran T, Pipanmekaporn T, Punjasawadwong Y, Mueankwan S. Role of perceived stress in postoperative delirium: an investigation among elderly patients. Aging Ment Health 2020; 24:148-154. [PMID: 30518247 DOI: 10.1080/13607863.2018.1523881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives: This study examined levels of perceived stress (PS), postoperative delirium (POD) and associated factors among Thai elderly patients undergoing elective noncardiac surgery.Background and aims: Preoperative PS and change after operation have not been widely studied. Moreover, psychological factors associated with PS and POD has been poorly investigated.Materials and Methods: In total, 429 elderly patients were recruited at a university hospital. The preoperative evaluation included sociodemographic data, health behaviors at risk, Perceived Stress Scale (PSS-10), Neuroticism Inventory (NI), Mental State Examination T10 (MSET10), Montreal Cognitive Assessment (MoCA) and Geriatric Depression Scale (GDS-15). Three-day postoperative evaluation included PSS-10 and Confusion Assessment Method Algorithm (CAM) or CAM-ICU for Delirium. Multiple regression and logistic regression analysis were performed to determine potential predictors.Results: Females were 58.97%, and the mean age was 69.93 ± 6.87 years. Mean pre- and postoperative PS were 12.77 ± 5.41 and 13.39 ± 5.26, respectively (P < 0.05). Multiple regression revealed that neuroticism, depression, and BMI predicted PS significantly. None of the independent variables was found to predict postoperative PS except for preoperative PS (p <.001). POD at the recovery room was predicted by preoperative PS (odds ratio = 1.181, 95% CI = 1.019-1.369), whereas overall POD was predicted by MoCA (odds ratio = .864, 95% CI = .771 -.968).Conclusion: Preoperative PS was significant in that it was associated with postoperative PS and POD. A careful assessment of preoperative PS as well as providing brief interventions for patients with high levels of this condition may reduce the risk of POD.
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Affiliation(s)
- Mukda Banjongrewadee
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tanyong Pipanmekaporn
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Yodying Punjasawadwong
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirirat Mueankwan
- Division of Surgical Critical Care and Trauma, Department of Surgery, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand
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Venta A, Harmon J, Abate A, Marshall K, Mouton-Odum S. Pilot data supporting an attachment-based theory of adolescent social media use. Child Adolesc Ment Health 2019; 24:274-282. [PMID: 32677210 DOI: 10.1111/camh.12329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adolescents have virtually universal access to social media. Despite ample research linking attachment to social functioning in youth, neither this empirical research nor related theory has been extended to the virtual social context. The broad aim of this study was to test an attachment-based model of social media use in adolescents in order to address a gap in the literature during this developmental stage and examine attachment and the related process of mentalizing as correlates of online behavior. METHOD Online social comparison/feedback-seeking was selected as an outcome variable due to its known negative effects on adolescents. Analyses were conducted in a sample of 68 adolescents ranging in age from 15 to 18. RESULTS No evidence of a main effect of parent-child attachment on social comparison/feedback-seeking was found, but a significant mediational effect indicated that more insecure parent-child attachment is linked with hypermentalizing errors (i.e., overinterpretation of others' mental states) and that such errors explain increased social comparison/feedback-seeking. CONCLUSIONS The current study confirmed previously documented relations between parent-child attachment and hypermentalization as well as research demonstrating that parent-child attachment acts on an adolescent's social world - in this case their virtual social world - through anomalous mentalization.
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Affiliation(s)
- Amanda Venta
- Psychiatry and Behavioral Sciences, Sam Houston State University, Huntsville, TX, USA
| | - Jennifer Harmon
- Psychiatry and Behavioral Sciences, Sam Houston State University, Huntsville, TX, USA
| | - Anna Abate
- Psychiatry and Behavioral Sciences, Sam Houston State University, Huntsville, TX, USA
| | - Kaisa Marshall
- Psychiatry and Behavioral Sciences, Sam Houston State University, Huntsville, TX, USA
| | - Suzanne Mouton-Odum
- Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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7
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Cha DS, Carmona NE, Mansur RB, Lee Y, Park HJ, Rodrigues NB, Subramaniapillai M, Rosenblat JD, Pan Z, Lee JH, Lee J, Almatham F, Alageel A, Shekotikhina M, Zhou AJ, Rong C, Harrison J, McIntyre RS. Pain and major depressive disorder: Associations with cognitive impairment as measured by the THINC-integrated tool (THINC-it). Scand J Pain 2017; 15:62-67. [PMID: 28850348 DOI: 10.1016/j.sjpain.2016.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 12/17/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To examine the role of pain on cognitive function in adults with major depressive disorder (MDD). METHODS Adults (18-65) with a Diagnostic and Statistical Manual - Fifth Edition (DSM-5)-defined diagnosis of MDD experiencing a current major depressive episode (MDE) were enrolled (nMDD=100). All subjects with MDD were matched in age, sex, and years of education to healthy controls (HC) (nHC=100) for comparison. Cognitive function was assessed using the recently validated THINC-integrated tool (THINC-it), which comprises variants of the choice reaction time (i.e., THINC-it: Spotter), One-Back (i.e., THINC-it: Symbol Check), Digit Symbol Substitution Test (i.e., THINC-it: Codebreaker), Trail Making Test - Part B (i.e., THINC-it: Trails), as well as the Perceived Deficits Questionnaire for Depression - 5-item (i.e., THINC-it: PDQ-5-D). A global index of objective cognitive function was computed using objective measures from the THINC-it, while self-rated cognitive deficits were measured using the PDQ-5-D. Pain was measured using a Visual Analogue Scale (VAS). Regression analyses evaluated the role of pain in predicting objective and subjective cognitive function. RESULTS A significant between-group differences on the VAS was observed (p<0.001), with individuals with MDD reporting higher pain severity as evidenced by higher scores on the VAS than HC. Significant interaction effects were observed between self -rated cognitive deficits and pain ratings (p<0.001) on objective cognitive performance (after adjusting for MADRS total score), suggesting that pain moderates the association between self-rated and objective cognitive function. CONCLUSIONS Results indicated that pain is associated with increased self-rated and objective cognitive deficits in adults with MDD. IMPLICATIONS The study herein provides preliminary evidence demonstrating that adults with MDD reporting pain symptomatology and poorer subjective cognitive function is predictive of poorer objective cognitive performance. THINC-it is capable of detecting cognitive dysfunction amongst adults with MDD and pain.
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Affiliation(s)
- Danielle S Cha
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Nicole E Carmona
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Hyun Jung Park
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Nelson B Rodrigues
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | | | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Zihang Pan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Jae Hon Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, Samsung Seoul Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - JungGoo Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Paik Institute for Clinical Research, Inje University, Busan, Republic of Korea
| | - Fahad Almatham
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Asem Alageel
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, College of Medicine, Imam University, Riyadh, Saudi Arabia
| | | | - Aileen J Zhou
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Carola Rong
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,American University of Integrative Sciences School of Medicine, Sint Maarten, The Netherlands
| | - John Harrison
- Alzheimer Center, VU Medical Center, Amsterdam, The Netherlands.,Metis Cognition Ltd, Warminster, UK
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
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