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Fonseca das Neves J, Kornacka M, Serra E, Rollin N, Kosinski T, Maréchal V, Jehel L, Rusinek S. The impact of rumination on fibromyalgia pain after physical activity: an experimental study. Sci Rep 2023; 13:20523. [PMID: 37993555 PMCID: PMC10665397 DOI: 10.1038/s41598-023-47414-z] [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: 05/03/2023] [Accepted: 11/03/2023] [Indexed: 11/24/2023] Open
Abstract
Some fibromyalgia (FM) patients engage in rumination (i.e. a chain of repetitive, passive and relatively uncontrollable thoughts focused on negative content) to cope with the pain and discomfort of daily activities. The partial model of rumination in chronic pain suggests that rumination processes may play a causal role in maintaining pain. Rumination might also be one of the key factors interfering with the reestablishment of adapted physical activity. The objective of this study was to test how rumination vs. distraction induction influence FM patients' pain intensity, discomfort linked to pain, and affect after physical activity. Forty-seven participants with a diagnosis of FM were randomly assigned to undergo distraction induction vs. rumination induction after performing a physical activity in ecological setting. Their pain intensity, pain-related discomfort, and affect were measured at the baseline, after physical activity, and after rumination versus distraction induction. A series of mixed-design ANOVAs showed that rumination induction after physical activity impairs patients' recovery in terms of pain intensity and discomfort, but not affect, as compared to the distraction condition. In conclusion, participants with fibromyalgia who engage in rumination following a physical activity recover less from their pain experience as compared to distraction induction. These results are consistent with the partial model of rumination in chronic pain and support the idea that rumination may play a causal role in the development and maintenance of pain.
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Affiliation(s)
| | - Monika Kornacka
- Emotion Cognition Lab, SWPS University, Technikow 9, 40-326, Katowice, Poland.
| | - Eric Serra
- Centre d'étude et de Traitement de la Douleur, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
- Univ. Lille, ULR 4072 - PSITEC - Psychologie: Interactions Temps Émotions Cognition, F-59000, Lille, France
- UFR Santé, Université de Picardie Jules Verne, Amiens, France
| | - Noémie Rollin
- Univ. Lille, ULR 4072 - PSITEC - Psychologie: Interactions Temps Émotions Cognition, F-59000, Lille, France
- Consultation de la Douleur, Centre Hospitalier de Soissons, Soissons, France
| | - Thierry Kosinski
- Univ. Lille, ULR 4072 - PSITEC - Psychologie: Interactions Temps Émotions Cognition, F-59000, Lille, France
| | - Virginie Maréchal
- Psychiatrie de Liaison, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
| | - Louis Jehel
- Psychiatrie de Liaison, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France
- UFR Santé, Université de Picardie Jules Verne, Amiens, France
- Equipe MOODS-IPSOM, U1018, CESP/INSERM, 94807, Villejuif Cedex, France
| | - Stéphane Rusinek
- Univ. Lille, ULR 4072 - PSITEC - Psychologie: Interactions Temps Émotions Cognition, F-59000, Lille, France
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Tunç H, Morris PG, Kyranides MN, McArdle A, McConachie D, Williams J. The relationships between valued living and depression and anxiety: A systematic review, meta-analysis, and meta-regression. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
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Guiomar R, Trindade IA, Carvalho SA, Menezes P, Patrão B, Nogueira MR, Lapa T, Duarte J, Pinto-Gouveia J, Castilho P. Usability Study of the iACTwithPain Platform: An Online Acceptance and Commitment Therapy and Compassion-Based Intervention for Chronic Pain. Front Psychol 2022; 13:848590. [PMID: 35936338 PMCID: PMC9355698 DOI: 10.3389/fpsyg.2022.848590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background This pilot study aims to test the usability of the iACTwithPain platform, an online ACT-based intervention for people with chronic pain, to obtain information on which intervention and usability aspects need improvement and on expected retention rates. Methods Seventy-three Portuguese women with chronic pain were invited to complete the first three sessions of the iACTwithPain intervention assess their quality, usefulness and the platform’s usability. Twenty-one accepted the invitation. Additionally, eight healthcare professionals working with chronic medical conditions assessed the platform and the intervention from a practitioner’s point of view. Results This study presented a considerable attrition rate (71.43%) among chronic pain participants, with six completers. There were no significant differences in demographic or clinical variables between dropouts and completers except for completed education (participants who dropped out presented less education than completers). Reasons for dropout were related to difficult personal events occurring during the time of the intervention, lack of time, or having forgotten. There seemed to be an overall satisfaction with both the intervention, its contents and form of presentation of information, and the platform, concerning its design, appearance, and usability. Real image videos were preferred over animations or audio by chronic pain participants. Healthcare professionals emphasized the appealing and dynamic aspects of the animation format. Conclusion This study informs the ongoing improvement of the iACTwithPain platform and provides valuable information on aspects researchers should consider while developing online psychological interventions for chronic pain. Further implications are discussed.
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Affiliation(s)
- Raquel Guiomar
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
- *Correspondence: Raquel Guiomar,
| | - Inês A. Trindade
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Sérgio A. Carvalho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
- Digital Human-Environment Interaction Lab, School of Psychology and Life Sciences, Lusófona University, Lisbon, Portugal
| | - Paulo Menezes
- University of Coimbra, Institute of Systems and Robotics, Coimbra, Portugal
- University of Coimbra, Department of Electrical and Computer Engineering, Coimbra, Portugal
| | - Bruno Patrão
- University of Coimbra, Institute of Systems and Robotics, Coimbra, Portugal
| | | | - Teresa Lapa
- Pain Unit, Coimbra Hospital and University Centre, Coimbra, Portugal
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Joana Duarte
- Department of Psychology, Lund University, Lund, Sweden
| | - José Pinto-Gouveia
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Paula Castilho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
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Braunwalder C, Müller R, Glisic M, Fekete C. Are positive psychology interventions efficacious in chronic pain treatment? A systematic review and meta-analysis of randomized controlled trials. PAIN MEDICINE 2021; 23:122-136. [PMID: 34347095 DOI: 10.1093/pm/pnab247] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/25/2021] [Accepted: 08/03/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Although positive psychology interventions are increasingly popular in chronic pain treatment their efficacy is still unclear. The objective is to summarize evidence on the effect of positive psychology interventions (PPIs) on pain, physical functioning, and emotional functioning in adults with chronic pain. METHODS Four electronic databases and additional references were searched for randomized controlled trials published between 1990 and 2020. Findings from included studies were qualitatively and quantitatively synthesized, and study quality was assessed for risk of bias. A random effects meta-analysis model was applied for outcomes with more than four findings. RESULTS Of 16 included randomized controlled trials, almost half delivered positive psychology interventions as self-help online interventions, and half conducted guided face-to-face interventions which lasted mostly eight weeks. Results from meta-analysis showed beneficial effects of positive psychology interventions compared to the control group on pain intensity and emotional functioning (i.e., less depressive symptoms, pain catastrophizing, negative affect; more positive affect) post-intervention. At 3-month follow-up, beneficial effects were maintained for depressive symptoms and positive and negative affect, but not for pain catastrophizing. However, the evidence on the long-term efficacy of PPIs and the efficacy of PPIs on physical functioning remains limited. CONCLUSION This review supports the notion that positive psychology interventions are beneficial to chronic pain treatment, although further, high quality research is needed to support this conclusion.
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Affiliation(s)
- Céline Braunwalder
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Rachel Müller
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Marija Glisic
- Swiss Paraplegic Research, Nottwil, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Christine Fekete
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Carvalho SA, Trindade IA, Duarte J, Menezes P, Patrão B, Nogueira MR, Guiomar R, Lapa T, Pinto-Gouveia J, Castilho P. Efficacy of an ACT and Compassion-Based eHealth Program for Self-Management of Chronic Pain (iACTwithPain): Study Protocol for a Randomized Controlled Trial. Front Psychol 2021; 12:630766. [PMID: 33767648 PMCID: PMC7985342 DOI: 10.3389/fpsyg.2021.630766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/11/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Chronic pain (CP) has serious medical and social consequences and leads to economic burden that threatens the sustainability of healthcare services. Thus, optimized management of pain tools to support CP patients in adjusting to their condition and improving their quality of life is timely. Although acceptance and commitment therapy (ACT) is considered an evidence-based psychological approach for CP, evidence for the efficacy of online-delivered ACT for CP is still scarce. At the same time, studies suggest that self-compassion mediates the change in disability and psychopathological symptoms in ACT interventions for CP, although self-compassion is not a specific target in ACT. Thus, an explicit focus on self-compassion might increase the efficacy of ACT interventions for CP, although this hypothesis has not been tested. This study aims to develop an eHealth ACT and compassion-based self-management intervention for CP, the iACTwithPain, and to compare its efficacy in improving health outcomes to a similar ACT-only intervention and a medical TAU group. METHODS The eHealth platform that will host the interventions will be developed using a flat design identity and will be interactive. The iACTwithPain intervention will comprise eight weekly self-management sessions and will be developed taking into consideration the psychological flexibility model applied to CP, with the addition of explicit compassion-based components. To analyze whether the iACTwithPain intervention will present superiority in improving CP's impact and related health markers over the two other conditions, this study will follow an RCT design with three arms. CP patients will be recruited through direct contact with patient associations and healthcare services and a national press release in Portugal. Outcome measurement will be conducted at baseline, post-intervention and at 3- and 6-month follow-ups. The interventions' acceptability will also be assessed. DISCUSSION The iACTwithPain intervention is expected to improve CP patients' psychosocial functioning, quality of life, and empowerment, by promoting adaptive disease management and regulation of pain-related internal experiences. Results will contribute to a better understanding on the pertinence of adding compassion elements to ACT for CP and to reach an optimized intervention for CP. CLINICAL TRIAL REGISTRATION This trial has been registered at ClinicalTrials.Gov (NCT04200183; 16 December 2019; https://clinicaltrials.gov/ct2/show/NCT04200183). The current manuscript comprises the first version of this clinical trial's protocol.
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Affiliation(s)
- Sérgio A. Carvalho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Coimbra, Portugal
| | - Inês A. Trindade
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Coimbra, Portugal
| | - Joana Duarte
- Lund University, Department of Psychology, Lund, Sweden
| | - Paulo Menezes
- University of Coimbra, Department of Electrical and Computer Engineering, Coimbra, Portugal
- Institute of Systems and Robotics, Coimbra, Portugal
| | - Bruno Patrão
- University of Coimbra, Department of Electrical and Computer Engineering, Coimbra, Portugal
- Institute of Systems and Robotics, Coimbra, Portugal
| | - Maria Rita Nogueira
- Institute of Systems and Robotics, Coimbra, Portugal
- University of Coimbra, College of Arts, Coimbra, Portugal
| | - Raquel Guiomar
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Coimbra, Portugal
| | - Teresa Lapa
- Coimbra Hospital and University Center, Pain Unit, Coimbra, Portugal
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - José Pinto-Gouveia
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Coimbra, Portugal
| | - Paula Castilho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Coimbra, Portugal
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