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Haspert V, Wieser MJ, Pauli P, Reicherts P. Acceptance-Based Emotion Regulation Reduces Subjective and Physiological Pain Responses. Front Psychol 2020; 11:1514. [PMID: 32695054 PMCID: PMC7338768 DOI: 10.3389/fpsyg.2020.01514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/08/2020] [Indexed: 11/23/2022] Open
Abstract
Acceptance-based regulation of pain, which focuses on the allowing of pain and pain related thoughts and emotions, was found to modulate pain. However, results so far are inconsistent regarding different pain modalities and indices. Moreover, studies so far often lack a suitable control condition, focus on behavioral pain measures rather than physiological correlates, and often use between-subject designs, which potentially impede the evaluation of the effectiveness of the strategies. Therefore, we investigated whether acceptance-based strategies can reduce subjective and physiological markers of acute pain in comparison to a control condition in a within-subject design. To this end, participants (N = 30) completed 24 trials comprising 10 s of heat pain stimulation. Each trial started with a cue instructing participants to welcome and experience pain (acceptance trials) or to react to the pain as it is without employing any regulation strategies (control trials). In addition to pain intensity and unpleasantness ratings, heart rate (HR) and skin conductance (SC) were recorded. Results showed significantly decreased pain intensity and unpleasantness ratings for acceptance compared to control trials. Additionally, HR was significantly lower during acceptance compared to control trials, whereas SC revealed no significant differences. These results demonstrate the effectiveness of acceptance-based strategies in reducing subjective and physiological pain responses relative to a control condition, even after short training. Therefore, the systematic investigation of acceptance in different pain modalities in healthy and chronic pain patients is warranted.
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Affiliation(s)
- Valentina Haspert
- Department of Biological Psychology, Clinical Psychology, and Psychotherapy, Institute of Psychology, University of Würzburg, Würzburg, Germany
| | - Matthias J Wieser
- Department of Biological Psychology, Clinical Psychology, and Psychotherapy, Institute of Psychology, University of Würzburg, Würzburg, Germany.,Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Paul Pauli
- Department of Biological Psychology, Clinical Psychology, and Psychotherapy, Institute of Psychology, University of Würzburg, Würzburg, Germany.,Center of Mental Health (ZEP), University Hospital of Würzburg, Würzburg, Germany
| | - Philipp Reicherts
- Department of Biological Psychology, Clinical Psychology, and Psychotherapy, Institute of Psychology, University of Würzburg, Würzburg, Germany.,Department of Medical Psychology and Sociology, Medical Faculty, University of Augsburg, Augsburg, Germany
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Bento S, Gaultney W, Dahlquist L. An exploratory factor analysis of the procedural coping questionnaire. CHILDRENS HEALTH CARE 2020. [DOI: 10.1080/02739615.2018.1558058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Samantha Bento
- Department of Psychology, University of Maryland, Baltimore County (UMBC), Baltimore, MD, USA
| | - Wendy Gaultney
- Department of Psychology, University of Maryland, Baltimore County (UMBC), Baltimore, MD, USA
| | - Lynnda Dahlquist
- Department of Psychology, University of Maryland, Baltimore County (UMBC), Baltimore, MD, USA
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3
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Chayadi E, McConnell BL. Gaining insights on the influence of attention, anxiety, and anticipation on pain perception. J Pain Res 2019; 12:851-864. [PMID: 30881096 PMCID: PMC6402711 DOI: 10.2147/jpr.s176889] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose This article highlights the influence of attention and pain anticipation on pain attenuation. Pain-related trait anxiety was found to moderate the effect that attention strategies impose on pain perception. This article may contribute to clinical treatments quality, where pain attenuation effect is desired. Participants and methods One hundred seven participants, comprising of 72 (67%) females and 35 (33%) males between the age of 17 and 48 (M=22.6, SD =4.36), were used in the analysis. The current study measured the effect of pain anticipation and attention on three aspects of pain perception: threshold, tolerance, and perceived pain intensity. Pain anticipation was manipulated by varying the amount of information given to participants about a future pain stimulus. Attention was manipulated through a sensory focusing task and a distraction task. Participants were randomized into 1) InfoControl group with distraction task trial (n=30), 2) InfoControl group with attention to pain trial (n=26), 3) InfoExtra group with distraction task trial (n=26), or 4) InfoExtra group with attention to pain trial (n=25). The pain stimulus was delivered in a form of heat. The moderating effects of pain-related trait anxiety on these variables were also investigated using Pain Anxiety Symptom Scale Short Form. Results Two structural equation models revealed that anticipation is not a predictor of pain perception and neither did it interact with pain-related trait anxiety. However, attention strategies do significantly relate to pain perception. Furthermore, pain-related anxiety was a significant moderator of attention and pain attenuation. These findings imply that the effectiveness of attention strategies in attenuating pain is affected by individuals’ pain-related trait anxiety. Conclusion The results suggest the importance of appointing the appropriate attention strategy to different individuals with varying level of trait anxiety. Future explorations are necessary to develop a more specific understanding on the nature of information and distractions on pain perception.
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Van Ryckeghem DM, Van Damme S, Eccleston C, Crombez G. The efficacy of attentional distraction and sensory monitoring in chronic pain patients: A meta-analysis. Clin Psychol Rev 2017; 59:16-29. [PMID: 29126746 DOI: 10.1016/j.cpr.2017.10.008] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/02/2017] [Accepted: 10/24/2017] [Indexed: 01/06/2023]
Abstract
Attentional strategies, such as distraction and sensory monitoring, are often offered to reduce pain and pain-related distress. However, evidence for their efficacy in chronic pain patients is equivocal. We report a meta-analysis on the efficacy of distraction and sensory monitoring in chronic pain patients, and explore possible methodological and theoretical moderators. The scientific literature was searched for relevant articles, which were coded for methodological quality and several theoretical and methodological moderator variables. Only 10 articles fulfilled the search criteria. Eight studies allowed us to compare distraction with a control condition, two studies to compare sensory monitoring with a control condition, and four studies to compare the effect of distraction with the effect of sensory monitoring. Overall, results indicate that distraction did not differ from control in altering pain experience (k=8; Hedges' g=0.10, ns) and distress (k=2; Hedges' g=0.549). Sensory monitoring did also not alter pain experience (k=2; Hedges' g=-0.21, ns) and distress (k=1; Hedges' g=-0.191, ns). We found no evidence to support the superiority of distraction or sensory monitoring in altering pain compared to control conditions. We offer guidance for future theory-driven research to investigate distraction and sensory monitoring in this largely unexplored field, albeit one replete with methodological difficulties.
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Affiliation(s)
- Dimitri Ml Van Ryckeghem
- Institute for Health and Behaviour, INSIDE, University of Luxembourg, Luxembourg; Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.
| | - Stefaan Van Damme
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Christopher Eccleston
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium; Centre for Pain Research, University of Bath, UK
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium; Centre for Pain Research, University of Bath, UK
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Dodd H, Fletchall S, Starnes C, Jacobson K. Current Concepts Burn Rehabilitation, Part II: Long-Term Recovery. Clin Plast Surg 2017; 44:713-728. [PMID: 28888297 DOI: 10.1016/j.cps.2017.05.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This article summarizes current interventions for several of the most common challenges faced by patients during their rehabilitation from burn injury. These challenges include range of motion preservation through scar contracture management, achieving maximal independence through exercise and activities of daily living training, and psychological recovery through nonpharmacologic approaches pain and anxiety.
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Affiliation(s)
- Heather Dodd
- Rehabilitation Therapy Services, NC Jaycee Burn Center, 101 Manning Drive, CB #7600, Chapel Hill, NC 27599, USA
| | - Sandra Fletchall
- Burn Rehabilitation, Firefighters Burn Center, 890 Madison Avenue, TG 043, Memphis, TN 380103, USA
| | - Carrie Starnes
- Rehabilitation Therapy Services, NC Jaycee Burn Center, 101 Manning Drive, CB #7600, Chapel Hill, NC 27599, USA
| | - Keith Jacobson
- Rehabilitation Therapy Services, NC Jaycee Burn Center, 101 Manning Drive, CB #7600, Chapel Hill, NC 27599, USA.
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Fox L, Walsh JC, Morrison TG, O’ Gorman D, Ruane N, Mitchell C, Carey JJ, Coughlan R, McGuire BE. Cognitive Coping Style and the Effectiveness of Distraction or Sensation-Focused Instructions in Chronic Pain Patients. PLoS One 2016; 11:e0142285. [PMID: 27071028 PMCID: PMC4829147 DOI: 10.1371/journal.pone.0142285] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 10/20/2015] [Indexed: 11/19/2022] Open
Abstract
AIM This study set out to investigate whether cognitive coping strategies that match participants' preferred coping style effectively reduce pain intensity and situational anxiety in a population of people with chronic pain. METHOD Chronic pain patients (N = 43) completed questionnaires on coping style, pain intensity, self-efficacy, and situational/trait anxiety. Participants were classified as Monitors (n = 16) or Blunters (n = 19) based on their Miller Behavioural Style Scale score. Participants were then provided with an audiotaped intervention in which they were instructed to focus on pain sensations or to engage in a distraction task and then to rate the pain intensity and their anxiety during and after the attentional focus and distraction conditions. The two interventions were each completed by all participants, having been presented in counterbalanced order. RESULTS Findings revealed that Monitors' level of anxiety decreased following a congruent (i.e., sensation-focused) intervention. No effects were obtained in terms of perceived pain. For blunters, however, their perceived levels of anxiety and pain did not attenuate following a congruent, distraction-focused intervention. CONCLUSION Among persons experiencing chronic pain, tailoring coping strategies to match an individual's preferred coping style--in particular, those with a high level of monitoring--may enhance the benefit of psychological approaches to management of anxiety.
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Affiliation(s)
- Lisa Fox
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Jane C. Walsh
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Todd G. Morrison
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | - David O’ Gorman
- Centre for Pain Research, National University of Ireland, Galway, Ireland
- Division of Pain Medicine, Galway University Hospitals, Galway, Ireland
| | - Nancy Ruane
- Centre for Pain Research, National University of Ireland, Galway, Ireland
- Division of Pain Medicine, Galway University Hospitals, Galway, Ireland
| | - Caroline Mitchell
- Centre for Pain Research, National University of Ireland, Galway, Ireland
- Division of Pain Medicine, Galway University Hospitals, Galway, Ireland
| | - John J. Carey
- Rheumatology Department, Galway University Hospitals, Galway, Ireland
- School of Medicine, National University of Ireland, Galway, Ireland
| | - Robert Coughlan
- Rheumatology Department, Galway University Hospitals, Galway, Ireland
- School of Medicine, National University of Ireland, Galway, Ireland
| | - Brian E. McGuire
- School of Psychology, National University of Ireland, Galway, Ireland
- Centre for Pain Research, National University of Ireland, Galway, Ireland
- * E-mail:
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Moore H, Stewart I, Barnes-Holmes D, Barnes-Holmes Y, McGuire BE. Comparison of acceptance and distraction strategies in coping with experimentally induced pain. J Pain Res 2015; 8:139-51. [PMID: 25834464 PMCID: PMC4370922 DOI: 10.2147/jpr.s58559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study compared an acceptance-based strategy with a control-based strategy (distraction) in terms of the ability of participants to tolerate a painful stimulus, across two experiments. In addition, participants were either actively encouraged, or not, to link pain tolerance with pursuit of valued goals to examine the impact of pursuing a personally meaningful goal or value on the extent to which pain will be tolerated. METHODS Participants in experiment 1 (n=41) and experiment 2 (n=52) were equally assigned to acceptance or distraction protocols. Further, half the participants in each group generated examples from their own lives in which they had pursued a valued objective, while the other half did not. In experiment 2, the values focus was enhanced to examine the impact on pain tolerance. RESULTS There were no significant differences overall between the acceptance and distraction groups on pain tolerance in either experiment. However, in experiment 2, individuals classified as accepting in terms of general coping style and who were assigned to the acceptance strategy showed significantly better pain tolerance than accepting individuals who were in the distraction condition. Across both experiments, those with strong goal-driven values in both protocols were more tolerant of pain. Participants appeared to have more difficulty adhering to acceptance than to distraction as a strategy. CONCLUSION Acceptance may be associated with better tolerance of pain, but may also be more difficult to operationalize than distraction in experimental studies. Matching coping style and coping strategy may be most effective, and enhancement of goal-driven values may assist in pain coping.
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Affiliation(s)
- Hazel Moore
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Ian Stewart
- School of Psychology, National University of Ireland, Galway, Ireland
| | | | | | - Brian E McGuire
- School of Psychology, National University of Ireland, Galway, Ireland ; Centre for Pain Research, National University of Ireland, Galway, Ireland
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Distraction of attention with the use of virtual reality. Influence of the level of game complexity on the level of experienced pain. ACTA ACUST UNITED AC 2014. [DOI: 10.2478/ppb-2014-0058] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
: Research done in recent years shows that Virtual Reality (VR) can be an effective tool for distracting attention from pain. The purpose of this study was to test how the complexity of Virtual Environment (VE) influences the experienced intensity of thermal pain stimuli.
A within-subjects design experiment was conducted, using cold pressor test for pain stimulation. Research was done on 31 students of Wroclaw Universities. Participants played games created for the purpose of the study, using head mounted displays and movement sensors. Two Virtual Environments differing in the level of complexity and non-VR control condition were used. The order of all conditions was counterbalanced.
Participants reported significantly lower pain intensity (Visual Analogue Scale) after playing the high complexity game, compared to the low complexity game. There were also significant differences between non-VR control condition and high complexity game, but not between non-VR and low complexity game. The pain tolerance (measured by time of keeping the hand in cold water) was significantly higher in both VR conditions comparing to non-VR conditions. However, no significant differences between VE’s were found in pain tolerance ratings. Results of this study provide preliminary evidence that game complexity can be related to pain experience during VR interventions.
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Rance M, Ruttorf M, Nees F, Schad LR, Flor H. Neurofeedback of the difference in activation of the anterior cingulate cortex and posterior insular cortex: two functionally connected areas in the processing of pain. Front Behav Neurosci 2014; 8:357. [PMID: 25360092 PMCID: PMC4197653 DOI: 10.3389/fnbeh.2014.00357] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 09/26/2014] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was the analysis of the effect of a learned increase in the dissociation between the rostral anterior cingulate cortex (rACC) and the left posterior insula (pInsL) on pain intensity and unpleasantness and the contribution of each region to the effect, exploring the possibility to influence the perception of pain with neurofeedback methods. We trained ten healthy subjects to increase the difference in the blood oxygenation level-dependent response between the rACC and pInsL to painful electric stimuli. Subjects learned to increase the dissociation with either the rACC (state 1) or the pInsL (state 2) being higher. For feedback we subtracted the signal of one region from the other and provided feedback in four conditions with six trials each yielding two different states: [rACC-pInsL increase (state 1), rACC-pInsL decrease (state 2), pInsL-rACC increase (state 2), pInsL-rACC decrease (state 1)]. Significant changes in the dissociation from trial one to six were seen in all conditions. There were significant changes from trial one to six in the pInsL in three of the four conditions, the rACC showed no significant change. Pain intensity or unpleasantness ratings were unrelated to the dissociation between the regions and the activation in each region. Learning success in the conditions did not significantly correlate and there was no significant correlation between the two respective conditions of one state, i.e., learning to achieve a specific state is not a stable ability. The pInsL seems to be the driving force behind changes in the learned dissociation between the regions. Despite successful differential modulation of activation in areas responsive to the painful stimulus, no corresponding changes in the perception of pain intensity or unpleasantness emerged. Learning to induce different states of dissociation between the areas is not a stable ability since success did not correlate overall or between two conditions of the the same state.
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Affiliation(s)
- Mariela Rance
- Department of Cognitive and Clinical Neuroscience, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University Mannheim, Germany
| | - Michaela Ruttorf
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University Mannheim, Germany
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University Mannheim, Germany
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University Mannheim, Germany
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Rutchick AM, Slepian ML. Handling Ibuprofen increases pain tolerance and decreases perceived pain intensity in a cold pressor test. PLoS One 2013; 8:e56175. [PMID: 23469170 PMCID: PMC3587636 DOI: 10.1371/journal.pone.0056175] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 01/10/2013] [Indexed: 12/30/2022] Open
Abstract
Pain contributes to health care costs, missed work and school, and lower quality of life. Extant research on psychological interventions for pain has focused primarily on developing skills that individuals can apply to manage their pain. Rather than examining internal factors that influence pain tolerance (e.g., pain management skills), the current work examines factors external to an individual that can increase pain tolerance. Specifically, the current study examined the nonconscious influence of exposure to meaningful objects on the perception of pain. Participants (N = 54) completed a cold pressor test, examined either ibuprofen or a control object, then completed another cold pressor test. In the second test, participants who previously examined ibuprofen reported experiencing less intense pain and tolerated immersion longer (relative to baseline) than those who examined the control object. Theoretical and applied implications of these findings are discussed.
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Affiliation(s)
- Abraham M Rutchick
- Department of Psychology, California State University, Northridge, Northridge, California, United States of America.
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Kola S, Walsh JC, Hughes BM, Howard S. Matching intra-procedural information with coping style reduces psychophysiological arousal in women undergoing colposcopy. J Behav Med 2012; 36:401-12. [DOI: 10.1007/s10865-012-9435-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 06/05/2012] [Indexed: 10/28/2022]
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Chapin H, Bagarinao E, Mackey S. Real-time fMRI applied to pain management. Neurosci Lett 2012; 520:174-81. [PMID: 22414861 DOI: 10.1016/j.neulet.2012.02.076] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 02/21/2012] [Accepted: 02/23/2012] [Indexed: 11/16/2022]
Abstract
Current views recognize the brain as playing a pivotal role in the arising and maintenance of pain experience. Real-time fMRI (rtfMRI) feedback is a potential tool for pain modulation that directly targets the brain with the goal of restoring regulatory function. Though still relatively new, rtfMRI is a rapidly developing technology that has evolved in the last 15 years from simple proof of concept experiments to demonstrations of learned control of single and multiple brain areas. Numerous studies indicate rtfMRI feedback assisted control over specific brain areas may have applications including mood regulation, language processing, neurorehabilitation in stroke, enhancement of perception and learning, and pain management. We discuss in detail earlier work from our lab in which rtfMRI feedback was used to train both healthy controls and chronic pain patients to modulate anterior cingulate cortex (ACC) activation for the purposes of altering pain experience. Both groups improved in their ability to control ACC activation and modulate their pain with rtfMRI feedback training. Furthermore, the degree to which participants were able to modulate their pain correlated with the degree of control over ACC activation. We additionally review current advances in rtfMRI feedback, such as real-time pattern classification, that bring the technology closer to more comprehensive control over neural function. Finally, remaining methodological questions concerning the further development of rtfMRI feedback and its implications for the future of pain research are also discussed.
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Affiliation(s)
- Heather Chapin
- Department of Anesthesia, Stanford University, Palo Alto, CA, United States.
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Kola S, Walsh J, Hughes B, Howard S. Attention focus, trait anxiety and pain perception in patients undergoing colposcopy. Eur J Pain 2011; 16:890-900. [DOI: 10.1002/j.1532-2149.2011.00068.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2011] [Indexed: 11/10/2022]
Affiliation(s)
- S. Kola
- School of Psychology; National University of Ireland; Galway; Ireland
| | - J.C. Walsh
- School of Psychology; National University of Ireland; Galway; Ireland
| | - B.M. Hughes
- School of Psychology; National University of Ireland; Galway; Ireland
| | - S. Howard
- School of Psychology; National University of Ireland; Galway; Ireland
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Abstract
BACKGROUND Cognitive strategies are a set of psychologic behaviors used to modulate one's perception or interpretation of a sensation or situation. Although the effectiveness of each cognitive strategy seems to differ between individuals, they are commonly used clinically to help patients with chronic pain cope with their condition. The neural basis of commonly used cognitive strategies is not well understood. Understanding the neural correlates that underlie these strategies will enhance understanding of the analgesic network of the brain and the cognitive modulation of pain. METHODS The current study examines patterns of brain activation during two common cognitive strategies, external focus of attention and reappraisal, in patients with chronic pain using functional magnetic resonance imaging. RESULTS Behavioral results revealed interindividual variability in the effectiveness of one strategy versus another in the patients. Functional magnetic resonance imaging revealed distinct patterns of activity when the two strategies were used. During external focus of attention, activity was observed mainly in cortical areas including the postcentral gyrus, inferior parietal lobule, middle occipital gyrus, and precentral gyrus. The use of reappraisal evoked activity in the thalamus and amygdala in addition to cortical regions. Only one area, the postcentral gyrus, was observed to be active during both strategies. CONCLUSIONS The results of this study suggest that different cognitive behavioral strategies recruit different brain regions to perform the same task: pain modulation.
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Zschaler S. [Increased pain through psychological therapy? : combination of PCA morphine therapy with virtual reality by awake dressing change: paradoxical effects]. Schmerz 2010; 24:629-30. [PMID: 20882299 DOI: 10.1007/s00482-010-0981-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Zschaler
- Pädagogische und Rehabilitationspsychologie, Institut für Psychologie II, Universität Leipzig, Seeburgstr. 14-20, 04103 Leipzig, Deutschland.
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Jokic-Begic N, Ivanec D, Markanovic D. Effects of cognitive pain coping strategies and locus of control on perception of cold pressor pain in healthy individuals: Experimental study. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.acpain.2009.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wiechman Askay S, Patterson DR, Sharar SR, Mason S, Faber B. Pain management in patients with burn injuries. Int Rev Psychiatry 2009; 21:522-30. [PMID: 19919205 DOI: 10.3109/09540260903343844] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Shelley Wiechman Askay
- University of Washington School of Medicine, Harborview Medical Center, Department of Rehabilitation Medicine, Seattle, Washington 98104, USA.
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Rutter CE, Dahlquist LM, Weiss KE. Sustained efficacy of virtual reality distraction. THE JOURNAL OF PAIN 2009; 10:391-7. [PMID: 19231295 DOI: 10.1016/j.jpain.2008.09.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Revised: 09/10/2008] [Accepted: 09/23/2008] [Indexed: 11/30/2022]
Abstract
UNLABELLED The current study tested whether the effectiveness of distraction using virtual reality (VR) technology in reducing cold pressor pain would maintain over the course of 8 weekly exposures. Twenty-eight adults, 18 to 23 years of age, underwent 1 baseline cold pressor trial and 1 VR distraction trial in randomized order each week. VR distraction led to significant increases in pain threshold and pain tolerance and significant decreases in pain intensity, time spent thinking about pain, and self-reported anxiety, relative to baseline. Repeated exposure did not appear to affect the benefits of VR. Implications for the long-term use of VR distraction as a nonpharmacological analgesic are discussed. PERSPECTIVE This article addresses the concern that the efficacy of virtual reality-assisted distraction from pain could potentially decrease with repeated exposure. The current finding that efficacy did not diminish over several repeated exposures provides support for the use of virtual reality as an adjuvant treatment of pain.
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Affiliation(s)
- Charles E Rutter
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD 21250, USA
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19
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Felix E, Cardena D. Future Directions for Evidence-Based Pain Management. Top Spinal Cord Inj Rehabil 2007. [DOI: 10.1310/sci1302-94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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