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Sullivan MJL, Tripp DA. Pain Catastrophizing: Controversies, Misconceptions and Future Directions. THE JOURNAL OF PAIN 2024; 25:575-587. [PMID: 37442401 DOI: 10.1016/j.jpain.2023.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023]
Abstract
Recent reports have pointed to problems with the term "pain catastrophizing." Critiques of the term pain catastrophizing have come from several sources including individuals with chronic pain, advocates for individuals with chronic pain, and pain scholars. Reports indicate that the term has been used to dismiss the medical basis of pain complaints, to question the authenticity of pain complaints, and to blame individuals with pain for their pain condition. In this paper, we advance the position that the problems prompting calls to rename the construct of pain catastrophizing have little to do with the term, and as such, changing the term will do little to solve these problems. We argue that continued calls for changing or deleting the term pain catastrophizing will only divert attention away from some fundamental flaws in how individuals with pain conditions are assessed and treated. Some of these fundamental flaws have their roots in the inadequate training of health and allied health professionals in evidence-based models of pain, in the use of psychological assessment and intervention tools for the clinical management of pain, and in gender equity and antiracism. Critiques that pain scholars have leveled against the defining, operational, and conceptual bases of pain catastrophizing are also addressed. Arguments for reconceptualizing pain catastrophizing as a worry-related construct are discussed. Recommendations are made for remediation of the problems that have contributed to calls to rename the term pain catastrophizing. PERSPECTIVE: The issues prompting calls to rename the construct of pain catastrophizing have their roots in fundamental flaws in how individuals with pain are assessed and treated. Efforts to address these problems will require more than a simple change in terminology.
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Affiliation(s)
| | - Dean A Tripp
- Departments of Psychology, Anesthesiology and Urology, Queen's University, Kingston, Ontario, Canada
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Salemi MDM, Gomes VMDSA, Bezerra LMR, Melo TMDS, Alencar GGD, Montenegro IHPDM, Calado APDM, Montenegro EJN, Siqueira GRD. Effect of Dry Cupping Therapy on Pain and Functional Disability in Persistent Non-Specific Low Back Pain: A Randomized Controlled Clinical Trial. J Acupunct Meridian Stud 2021; 14:219-230. [DOI: 10.51507/j.jams.2021.14.6.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/10/2021] [Accepted: 09/07/2021] [Indexed: 11/03/2022] Open
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Darnall BD, Roy A, Chen AL, Ziadni MS, Keane RT, You DS, Slater K, Poupore-King H, Mackey I, Kao MC, Cook KF, Lorig K, Zhang D, Hong J, Tian L, Mackey SC. Comparison of a Single-Session Pain Management Skills Intervention With a Single-Session Health Education Intervention and 8 Sessions of Cognitive Behavioral Therapy in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2113401. [PMID: 34398206 PMCID: PMC8369357 DOI: 10.1001/jamanetworkopen.2021.13401] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Chronic low back pain (CLBP), the most prevalent chronic pain condition, imparts substantial disability and discomfort. Cognitive behavioral therapy (CBT) reduces the effect of CLBP, but access is limited. OBJECTIVE To determine whether a single class in evidence-based pain management skills (empowered relief) is noninferior to 8-session CBT and superior to health education at 3 months after treatment for improving pain catastrophizing, pain intensity, pain interference, and other secondary outcomes. DESIGN, SETTING, AND PARTICIPANTS This 3-arm randomized clinical trial collected data from May 24, 2017, to March 3, 2020. Participants included individuals in the community with self-reported CLBP for 6 months or more and an average pain intensity of at least 4 (range, 0-10, with 10 indicating worst pain imaginable). Data were analyzed using intention-to-treat and per-protocol approaches. INTERVENTIONS Participants were randomized to (1) empowered relief, (2) health education (matched to empowered relief for duration and format), or (3) 8-session CBT. Self-reported data were collected at baseline, before treatment, and at posttreatment months 1, 2, and 3. MAIN OUTCOMES AND MEASURES Group differences in Pain Catastrophizing Scale scores and secondary outcomes at month 3 after treatment. Pain intensity and pain interference were priority secondary outcomes. RESULTS A total of 263 participants were included in the analysis (131 women [49.8%], 130 men [49.4%], and 2 other [0.8%]; mean [SD] age, 47.9 [13.8] years) and were randomized into 3 groups: empowered relief (n = 87), CBT (n = 88), and health education (n = 88). Empowered relief was noninferior to CBT for pain catastrophizing scores at 3 months (difference from CBT, 1.39 [97.5% CI, -∞ to 4.24]). Empowered relief and CBT were superior to health education for pain catastrophizing scores (empowered relief difference from health education, -5.90 [95% CI, -8.78 to -3.01; P < .001]; CBT difference from health education, -7.29 [95% CI, -10.20 to -4.38; P < .001]). Pain catastrophizing score reductions for empowered relief and CBT at 3 months after treatment were clinically meaningful (empowered relief, -9.12 [95% CI, -11.6 to -6.67; P < .001]; CBT, -10.94 [95% CI, -13.6 to -8.32; P < .001]; health education, -4.60 [95% CI, -7.18 to -2.01; P = .001]). Between-group comparisons for pain catastrophizing at months 1 to 3 were adjusted for baseline pain catastrophizing scores and used intention-to-treat analysis. Empowered relief was noninferior to CBT for pain intensity and pain interference (priority secondary outcomes), sleep disturbance, pain bothersomeness, pain behavior, depression, and anxiety. Empowered relief was inferior to CBT for physical function. CONCLUSIONS AND RELEVANCE Among adults with CLBP, a single-session pain management class resulted in clinically significant improvements in pain catastrophizing, pain intensity, pain interference, and other secondary outcomes that were noninferior to 8-session CBT at 3 months. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03167086.
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Affiliation(s)
- Beth D. Darnall
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Anuradha Roy
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Abby L. Chen
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Maisa S. Ziadni
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Ryan T. Keane
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Dokyoung S. You
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Kristen Slater
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Heather Poupore-King
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Ian Mackey
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Ming-Chih Kao
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | | | - Kate Lorig
- Department of Rheumatology, Stanford University School of Medicine, Palo Alto, California
| | - Dongxue Zhang
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Juliette Hong
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Lu Tian
- Department of Biomedical Data Science, Stanford University School of Medicine, Palo Alto, California
| | - Sean C. Mackey
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
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Kooner S, Kubik J, Mahdavi S, Piroozfar SG, Khong H, Mohan K, Batuyong E, Sharma R. Do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty? SAGE Open Med 2021; 9:20503121211012254. [PMID: 33996082 PMCID: PMC8107666 DOI: 10.1177/20503121211012254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 03/31/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: The purpose of this study is to evaluate the role of major psychiatric illness on patient outcomes after total joint arthroplasty. Methods: Patients with a diagnosis of a major psychiatric disorder undergoing total joint arthroplasty were retrospectively matched one-to-one with a cohort without such a diagnosis. Major psychiatric disorder in the registry was identified by diagnosis of anxiety, mood, or a psychotic disorder. Primary outcome of interest included perioperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included EuroQol-5D, adverse events, length of stay, 30-day readmission, and discharge destination. Results: Total number of patients were 1828. The total hip arthroplasty (37.80 ± 17.91, p = 0.023) and the total knee arthroplasty psychiatric group (43.38 ± 18.41, p = 0.050) had significantly lower pre-operative WOMAC scores. At 3 months, the total hip arthroplasty (76.74 ± 16.94, p = 0.036) and total knee arthroplasty psychiatric group (71.09 ± 18.64, p < 0.01) again had significantly lower 3-month post-operative WOMAC score compared to the control groups. However, outcomes at 1 year were difficult to interpret, as patients with major psychiatric conditions had an extremely high loss to follow-up. Compared to the control groups, the total hip arthroplasty and total knee arthroplasty psychiatric group had an increased length of stay by 1.43 days (p < 0.01) and 0.77 days, respectively (p = 0.05). Similarly, the psychiatric groups were discharged directly home less often (total hip arthroplasty 86.9%, p = 0.024 and total knee arthroplasty 87.6%, p = 0.022) than the control groups. Conclusion: Patients with the diagnosis of a major psychiatric illness have an increased length of stay and are more likely to require a rehabilitation facility, compared to the control groups. Arguably, of utmost importance, there is a very high rate of loss to follow-up within the psychiatric groups. As such, we recommend these patients should be treated for their diagnosis prior to total joint arthroplasty. Furthermore, importance of clinical follow-up should be emphasized carefully.
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Affiliation(s)
- Sahil Kooner
- Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Jeremy Kubik
- Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Saboura Mahdavi
- Department of Surgery, University of Calgary, Calgary, AB, Canada.,Alberta Hip and Knee Clinic, Calgary, AB, Canada
| | - Sophie Ghashang Piroozfar
- Alberta Hip and Knee Clinic, Calgary, AB, Canada.,Alberta Bone and Joint Health Institute, Calgary, AB, Canada
| | - Hoa Khong
- Alberta Bone and Joint Health Institute, Calgary, AB, Canada
| | - Kanwal Mohan
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | | | - Rajrishi Sharma
- Department of Surgery, University of Calgary, Calgary, AB, Canada.,McCaig Institute for Bone and Joint Health, Alberta Hip and Knee Clinic, Calgary, AB, Canada
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De Wit M, Horreh B, Daams JG, Hulshof CTJ, Wind H, de Boer AGEM. Interventions on cognitions and perceptions that influence work participation of employees with chronic health problems: a scoping review. BMC Public Health 2020; 20:1610. [PMID: 33109123 PMCID: PMC7590449 DOI: 10.1186/s12889-020-09621-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cognitions and perceptions, such as motivation and return to work (RTW) expectations, can influence work participation of employees with chronic health problems. This makes these cognitions and perceptions important factors for occupational health professionals to intervene upon in order to increase work participation. There is, however, no overview of interventions that influence these factors and are aimed at increasing work participation. Therefore, the purpose of this scoping review is to explore available interventions that are focused on cognitions and perceptions of employees with chronic health problems and aimed at increasing work participation. METHODS A scoping review was carried out following the framework of Arksey and O'Malley. Ovid MEDLINE and PsycINFO were searched for original papers published between January 2013 and June 2020. We included studies that describe interventions that focus on at least one of ten cognitions and perceptions and on work participation. The risk of bias of the studies included was assessed using quality assessment tools from the Joanna Briggs Institute. RESULTS In total, 29 studies were identified that studied interventions aimed at changing at least one of ten cognitions and perceptions in order to change work participation. The interventions that were included mainly focused on changing recovery and RTW expectations, self-efficacy, feelings of control, perceived health, fear-avoidance beliefs, perceived work-relatedness of the health problem, coping strategies and catastrophizing. No interventions were found that focused on changing motivation or on optimism/pessimism. Four interventions were judged as effective in changing coping, self-efficacy, fear-avoidance beliefs, or perceived work-relatedness and work participation according to results of randomized controlled trials. CONCLUSIONS This review provides an overview of interventions that focus on changing cognitions and perceptions and work participation. Evidence was found for four effective interventions focused on changing these factors and increasing work participation. Occupational health professionals may use the overview of interventions to help employees with chronic health problems to increase their work participation.
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Affiliation(s)
- Mariska De Wit
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands.
| | - Bedra Horreh
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
| | - Joost G Daams
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
| | - Haije Wind
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, 1100, DE, Amsterdam, The Netherlands
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Verna JL, Matheson LN, Scherer S, Mayer JM. Validity of the Multidimensional Task Ability Profile. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:822-831. [PMID: 31201594 DOI: 10.1007/s10926-019-09842-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background The Multidimensional Task Ability Profile (MTAP) is a patient-reported outcome (PRO) measure that provides a global score linked to the physical demand characteristics of work, but needs to be validated against established measures. Purpose To assess the concurrent validity of the MTAP compared with the Oswestry Disability Index (ODI), Neck Disability Index (NDI), Disabilities of the Arm, Shoulder, and Hand (DASH), Lower Extremity Functional Scale (LEFS), and Short Form 12 Health-Related Quality of Life (SF-12) questionnaires. Methods An observational study was conducted in 157 patients undergoing musculoskeletal rehabilitation. At baseline and after 30 days of treatment, patients completed the MTAP, ODI, NDI, DASH, LEFS, and SF-12 and provided self-reported work status. Results At baseline and after 30 days, convergent validity between the MTAP and DASH, LEFS, NDI, and ODI was good to excellent. Concurrent validity between the MTAP and SF-12 physical component score (PCS) and mental component score (MCS) was moderate or fair, respectively. Sensitivity to change over the 30-day treatment interval was established for the MTAP, SF-12 PCS, SF-12 MCS, and LEFS. Fair to moderate predictive validity for work status was found for the MTAP, ODI, NDI, DASH, and SF-12 PCS. Conclusions The MTAP demonstrated adequate concurrent validity, predictive validity, and sensitivity to change compared to other PROs. For patients with various impairment types, the MTAP may be a useful omnibus measure to supplement specialty instruments such as the DASH, NDI, ODI, or LEFS.
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Affiliation(s)
- Joe L Verna
- Vert Mooney Research Foundation, San Diego, CA, USA
- Spine & Sport, Inc, San Diego, CA, USA
| | - Leonard N Matheson
- Vert Mooney Research Foundation, San Diego, CA, USA
- Epic Neurorehabilitation & Psychological Services, Inc, Chico, CA, USA
| | | | - John M Mayer
- Vert Mooney Research Foundation, San Diego, CA, USA.
- Excellcior, LLC, Tampa, FL, USA.
- Vert Mooney Research Foundation, 3760 Convoy Street, Suite 101, San Diego, CA, 92123, USA.
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de Wit M, Wind H, Hulshof CTJ, Frings-Dresen MHW. Person-related factors associated with work participation in employees with health problems: a systematic review. Int Arch Occup Environ Health 2018; 91:497-512. [PMID: 29700608 PMCID: PMC6002456 DOI: 10.1007/s00420-018-1308-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/18/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The objective of this systematic review was to explore and provide systematically assessed information about the association between person-related factors and work participation of people with health problems. The research question was: what is the association between selected person-related factors and work participation of workers with health problems? METHODS A systematic review was carried out in PubMed and PsycINFO to search for original papers published between January 2007 and February 2017. The risk of bias of the studies included was assessed using quality assessment tools from the Joanna Briggs Institute. The quality of evidence was assessed using the GRADE framework for prognostic studies. RESULTS In total, 113 studies were included, all of which addressed the association between person-related factors and work participation. The factors positively associated with work participation were positive expectations regarding recovery or return to work, optimism, self-efficacy, motivation, feelings of control, and perceived health. The factors negatively associated with work participation were fear-avoidance beliefs, perceived work-relatedness of the health problem, and catastrophizing. Different coping strategies had a negative or a positive relationship with work participation. CONCLUSIONS The results of this review provide more insight into the associations between different cognitions and perceptions and work participation. The results of this study suggest that person-related factors should be considered by occupational- and insurance physicians when they diagnose, evaluate or provide treatment to employees. Further research is required to determine how these physicians could obtain and apply such information and whether its application leads to a better quality of care.
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Affiliation(s)
- Mariska de Wit
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
| | - Haije Wind
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Carel T J Hulshof
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
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Sullivan M, Adams H, Ellis T, Clark R, Sully C, Thibault P. Treatment-related reductions in catastrophizing predict return to work in individuals with post-traumatic stress disorder. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/jabr.12087] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Michael Sullivan
- Faculty of Health and Behavioural Sciences; The University of Queensland; Herston Qld Australia
- Department of Psychology; McGill University; Montreal QC Canada
| | - Heather Adams
- Recover, Injury Research Centre; The University of Queensland; Herston Qld Australia
| | - Tamra Ellis
- Centre for Rehabilitation and Health; Toronto ON Canada
| | | | | | - Pascal Thibault
- Department of Psychology; McGill University; Montreal QC Canada
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