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Reply to Manhapra. Pain 2023; 164:e175. [PMID: 36779561 DOI: 10.1097/j.pain.0000000000002833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Reed DE, Cobos B, Nagpal AS, Eckmann M, McGeary DD. The role of identity in chronic pain cognitions and pain-related disability within a clinical chronic pain population. Int J Psychiatry Med 2022; 57:35-52. [PMID: 33487093 DOI: 10.1177/0091217421989141] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Chronic pain has a significant impact on functioning and results in the disruption of one's assumed life trajectory, potentially altering their self-perceived identity. The present research is designed to determine whether identity-related issues are associated with common chronic pain cognitions and pain-related disability, which may help inform understanding of clinical chronic pain populations. METHOD Ninety-eight adult chronic pain patients were assessed at a local pain clinic during a regularly scheduled appointment focusing on pain management. Multivariate hierarchal regression was used to determine whether issues related to identity and death anxiety were associated with pain catastrophizing, pain acceptance, and pain-related disability, above and beyond pain severity, fear-avoidance, and age. RESULTS Self-concept clarity was significantly related to pain catastrophizing and pain acceptance, above and beyond death anxiety, pain severity, fear-avoidance, and age. Death anxiety was associated with pain catastrophizing, pain acceptance, and pain-related disability above and beyond pain severity, fear-avoidance, and age. CONCLUSIONS To the best of our knowledge, the present study is the first examination of self-concept clarity and death anxiety as they relate to pain catastrophizing, pain acceptance, and pain-related disability. These descriptive results support the inclusion of identity and death anxiety within the pain experience and could serve as a foundation for future directions relevant to clinical applications.
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Affiliation(s)
- David E Reed
- Department of Psychiatry, University of Texas - Health Science Center at San Antonio, San Antonio, TX, USA
| | - Briana Cobos
- Department of Psychiatry, University of Texas - Health Science Center at San Antonio, San Antonio, TX, USA.,University of Texas at San Antonio, San Antonio, TX, USA
| | - Ameet S Nagpal
- Department of Anesthesiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Max Eckmann
- Department of Anesthesiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Donald D McGeary
- Department of Psychiatry, University of Texas - Health Science Center at San Antonio, San Antonio, TX, USA.,Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Costanza A, Chytas V, Piguet V, Luthy C, Mazzola V, Bondolfi G, Cedraschi C. Meaning in Life Among Patients With Chronic Pain and Suicidal Ideation: Mixed Methods Study. JMIR Form Res 2021; 5:e29365. [PMID: 34003136 PMCID: PMC8214181 DOI: 10.2196/29365] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/06/2021] [Accepted: 05/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients with chronic pain have elevated risk of suicidal ideation and behavior, including suicide attempts and completed suicides. In most studies, associations between chronic pain and suicidal ideation/suicidal behavior are robust even after adjusting for the effect of sociodemographics and psychiatric comorbidity. However, to refine the risk profile of these patients, further exploration of other possible risk and protective factors is necessary. OBJECTIVE There is a common clinical observation that experiencing chronic pain often requires a revision of life goals and expectations, and hence, it impacts the existential domain including one's perception of the meaning in life (MiL). This study aimed to characterize the main domains that constitute the personal MiL, including the "presence of" and "search for" constructs, in a group of patients with chronic pain and suicidal ideation. METHODS Seventy participants were enlisted by ongoing recruitment through a larger project anchored in daily clinical practice at the Multidisciplinary Pain Center of the Geneva University Hospitals. It was an observational mixed method study. Data were recorded through both validated quantitative questionnaires and qualitative open-ended questions. RESULTS The total sample consisted of 70 patients. Responses to questionnaires showed a depressive episode in 68 (97%) patients and anxious disorders in 25 (36%) patients. With a score threshold for positive MiL of 24, the mean score for the "presence of" construct was 20.13 (SD 8.23), and 63% (44/70) of respondents had a score <24. The mean score for the "search for" construct was lower at 18.14 (SD 8.64), and 70% (49/70) of respondents had a score <24. The "presence of" and "search for" constructs were significantly positively correlated (R=0.402; P=.001). An open question addressed the "presence of" construct by inviting the respondents to cite domains they consider as providing meaning in their life at the present time. All patients responded to this question, citing one or more domains. The three main dimensions that emerged from content analysis of this qualitative section were as follows: the domain of relationships, the domain of personal activities, and pain and its consequences on MiL. CONCLUSIONS The study results provide insights into patients with chronic pain and suicidal ideation, including the domains that provide them with meaning in their lives and the impact of pain on these domains with regard to suicidal ideation. The main clinical implications concern both prevention and supportive/psychotherapeutic interventions. They are based on a narrative approach aiming to explore with the patients the content of their suffering and the MiL domains that they could identify to mitigate it, in order to restructure/reinforce these domains and thus possibly reduce suicidal ideation. Specifically, a focus on maintaining the domains of interpersonal relationships and personal activities can allow patients to ultimately escape the biopsychosocial vicious cycle of chronic pain-induced deep moral suffering.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Vasileios Chytas
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Valérie Piguet
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Luthy
- Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva, Switzerland.,Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Viridiana Mazzola
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Christine Cedraschi
- Division of Clinical Pharmacology & Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of General Medical Rehabilitation, Geneva University Hospitals, Geneva, Switzerland.,Department of Geriatrics and Rehabilitation, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Abstract
Pain is considered a hardwired signal of bodily disturbance belonging to a basic motivational system that urges the individual to act and to restore the body's integrity, rather than just a sensory and emotional experience. Given its eminent survival value, pain is a strong motivator for learning. Response to repeated pain increases when harm risks are high (sensitization) and decreases in the absence of such risks (habituation). Discovering relations between pain and other events provides the possibility to predict (Pavlovian conditioning) and control (operant conditioning) harmful events. Avoidance is adaptive in the short term but paradoxically may have detrimental long-term effects. Pain and pain-related responses compete with other demands in the environment. Exposure-based treatments share the aim of facilitating or restoring the pursuit of individual valued life goals in the face of persistent pain, and further improvements in pain treatment may require a paradigm shift toward more personalized approaches.
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Affiliation(s)
- Johan W S Vlaeyen
- Research Group on Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, 3000 Leuven, Belgium; .,Experimental Health Psychology, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, 9000 Ghent, Belgium.,Centre for Pain Research, University of Bath, Bath BA2 7AY, United Kingdom
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Pilch I. As cold as a fish? Relationships between the Dark Triad personality traits and affective experience during the day: A day reconstruction study. PLoS One 2020; 15:e0229625. [PMID: 32097954 PMCID: PMC7041966 DOI: 10.1371/journal.pone.0229625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/10/2020] [Indexed: 11/24/2022] Open
Abstract
The Dark Triad of personality is a cluster of three socially aversive personality traits: Machiavellianism, narcissism and psychopathy. These traits are associated with a selfish, aggressive and exploitative interpersonal strategy. The objective of the current study was to establish relationships between the Dark Triad traits (and their dimensions) and momentary affect. Machiavellianism, grandiose narcissism, vulnerable narcissism and the dimensions of the Triarchic model of psychopathy (namely, boldness, meanness and disinhibition) were examined. We used the Day Reconstruction Method, which is based on reconstructing affective states experienced during the previous day. The final sample consisted of 270 university students providing affective ratings of 3047 diary episodes. Analyses using multilevel modelling showed that only boldness had a positive association with positive affective states and affect balance, and a negative association with negative affective states. Grandiose narcissism and its sub-dimensions had no relationship with momentary affect. The other dark traits were related to negative momentary affect and/or inversely related to positive momentary affect and affect balance. As a whole, our results empirically demonstrated distinctiveness of the Dark Triad traits in their relationship to everyday affective states. These findings are not congruent with the notion that people with the Dark Triad traits, who have a dispositional tendency to manipulate and exploit others, are generally cold and invulnerable to negative feelings. The associations between the Dark Triad and momentary affect were discussed in the contexts of evolutionary and positive psychology, in relation to the role and adaptive value of positive and negative emotions experienced by individuals higher in Machiavellianism, narcissism and psychopathy.
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Affiliation(s)
- Irena Pilch
- Institute of Psychology, Faculty of Social Sciences, University of Silesia in Katowice, Katowice, Poland
- * E-mail:
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Leon-Llamas JL, Villafaina S, Murillo-Garcia A, Collado-Mateo D, Domínguez-Muñoz FJ, Sánchez-Gómez J, Gusi N. Strength Assessment Under Dual Task Conditions in Women with Fibromyalgia: A Test-Retest Reliability Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244971. [PMID: 31817817 PMCID: PMC6950610 DOI: 10.3390/ijerph16244971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 12/03/2019] [Indexed: 12/31/2022]
Abstract
The present study aimed to: (1) analyze the test-retest reliability of the 30 s chair stand test and the 30 s arm curl test under dual-task conditions; (2) analyze the test-retest reliability of a new variable which assesses the total performance (cognitive + physical) in both tests. A total of 37 women with fibromyalgia participated in the study. Participants completed the 30 s arm curl test and 30 s chair stand test in both simple and dual-task conditions. These tests were repeated after seven days. In the 30 s chair stand dual-task test the reliability was low to good whereas that of the total performance variable was low to moderate. The reliability in both the 30 s arm curl dual-task test and the total performance variable were good to moderate. Both the 30 s chair stand test and 30 s arm curl test under dual-task conditions and the total performance variables had good test-retest reliability. However, it is necessary to consider the fluctuations of the intraclass correlation coefficient (ICC).
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Affiliation(s)
- Juan Luis Leon-Llamas
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.L.L.-L.); (J.S.-G.); (N.G.)
| | - Santos Villafaina
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.L.L.-L.); (J.S.-G.); (N.G.)
- Correspondence: (S.V.); (A.M.-G.)
| | - Alvaro Murillo-Garcia
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.L.L.-L.); (J.S.-G.); (N.G.)
- Correspondence: (S.V.); (A.M.-G.)
| | | | | | - Jesús Sánchez-Gómez
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.L.L.-L.); (J.S.-G.); (N.G.)
| | - Narcis Gusi
- Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (J.L.L.-L.); (J.S.-G.); (N.G.)
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Reward Processing under Chronic Pain from the Perspective of "Liking" and "Wanting": A Narrative Review. Pain Res Manag 2019; 2019:6760121. [PMID: 31149319 PMCID: PMC6501242 DOI: 10.1155/2019/6760121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/06/2019] [Accepted: 04/04/2019] [Indexed: 11/29/2022]
Abstract
The therapeutic goals of patients with chronic pain are not only to relieve pain but also to improve the quality of life. Chronic pain negatively affects various aspects of daily life, such as by decreasing the motivation to work and reward sensitivity, which may lead to difficulties in daily life or even unemployment. Human and animal studies have shown that chronic pain damages reward processing; the exploration of associated internal mechanisms may aid the development of treatments to repair this damage. Incentive salience theory, used widely to describe reward processing, divides this processing into “liking” (reward-induced hedonic sensory impact) and “wanting” (reward-induced motivation) components. It has been employed to explain pathological changes in reward processing induced by psychiatric disorders. In this review, we summarize the findings of studies of reward processing under chronic pain and examine the effects of chronic pain on “liking” and “wanting.” Evidence indicates that chronic pain compromises the “wanting” component of reward processing; we also discuss the neural mechanisms that may mediate this effect. We hope that this review aids the development of therapies to improve the quality of life of patients with chronic pain.
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Blouin JE, Gyurcsik NC. Adults with conflicting or facilitating goals differ in adherence‐related self‐regulatory factors and exercise over time. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2019. [DOI: 10.1111/jasp.12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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