Evaluation of a Humor Training for Patients with Chronic Pain: A Randomized Clinical Trial

Positive psychology interventions can improve mental health for chronic pain patients: a systematic review and meta-analysis

OBJECTIVE

This study examines the efficacy of positive psychology interventions (PPIs) for patients with chronic pain through a systematic review and meta-analysis. PPIs are defined as strategies that involve focusing on positive emotions, thoughts, and behaviors that improve mental health by increasing mental well-being and reducing psychological distress.

DESIGN

The search was conducted using the PubMed, Scopus, PsycINFO, and Cochrane Library databases.

MAIN OUTCOME MEASURES

Subjective, psychological, and social well-being were used as indicators of mental well-being, and depression, anxiety, and stress symptoms were used as indicators of psychological distress. Results: Nine studies were included. Eight studies evaluated subjective well-being, seven evaluated depression, and three evaluated anxiety symptoms. No studies examined psychological well-being, social well-being, or stress. PPIs were found to be effective in promoting subjective well-being post-treatment (Hedges' g = 0.40; 95% CI [0.06, 0.73]) and reducing anxiety (Hedges' g = -0.32, 95% CI [-0.59, -0.06]), but no significant results were found for depression (Hedges' g = -0.23, 95% CI [-0.50, 0.04]).

CONCLUSION

The included investigations, while limited, suggest the utility of PPIs in mitigating the psychological consequences of chronic pain. Researchers and practitioners are encouraged to implement PPI practices.

Understanding Patient Experiences of Vulvodynia Through Reddit: Qualitative Analysis

Background

Vulvodynia is a chronic vulvar pain condition affecting up to 25% of the US population. However, diagnosis and effective treatment remain elusive. Many individuals with vulvodynia face stigma and medical uncertainty, leading them to seek information and web-based support. Reddit is a popular social media platform where patients share health concerns and experiences. The anonymity and accessibility of this platform make it a valuable source of real-world patient perspectives that are often overlooked in clinical settings.

Objective

This study evaluated Reddit content related to vulvodynia to explore how individuals with vulvodynia describe their symptoms, treatments, and personal experiences.

Methods

The subreddits "r/vulvodynia" and "r/vestibulodynia" were selected for analysis in May 2023. Threads were sorted from the most popular to least popular, with "popularity" measured by upvotes. Opening threads from the top 70 posts in each subreddit were extracted and analyzed using inductive qualitative analysis to identify themes and sentiment analysis to evaluate attitudes.

Results

In May 2023, the "r/vulvodynia" and "r/vestibulodynia" subreddits had a total of 7930 members (7245 and 685 members, respectively). Out of 140 analyzed threads, 77 (55%) contained negative attitudes. A total of 50 (35.7%) threads were seeking information or advice and 90 (64.3%) included some form of peer support. Inductive thematic analysis identified 6 core themes: symptoms (n=86, 61.4%), treatments (n=83, 59.3%), sexuality (n=47, 33.6%), erasure or disbelief (n=38, 27.1%), representation or media (n=17, 12.1%), and humor (n=15, 10.7%). Threads that discussed treatments (48/83, 57.8%), sexual experiences (25/47, 53.2%), and representation (14/17, 82.4%) had the highest proportions of positive attitudes, while threads that touched on erasure (21/38, 55.3%), symptoms (51/86, 59.3%), and humor (12/15, 80%), had the highest proportion of negative attitudes. A multivariable logistic regression of valence on the themes revealed that posts referring to treatments (odds ratio 12.5, 95% CI 3.7-42.2; P<.001) or representation (odds ratio 21.2, 95% CI 4.2-106.0; P<.001) were associated with significantly increased odds of positive valence. Furthermore, it was noted that 3 of the 5 most frequently discussed treatments aligned with clinical guidelines from the American College of Obstetricians and Gynecologists, American Urological Association, and International Society for the Study of Vulvovaginal Disease. Despite this alignment, threads frequently mentioned alternative remedies and frustration with medical professionals related to diagnostic delays and perceived lack of understanding.

Conclusions

This is the first study of Reddit discussions about vulvodynia. Findings suggest a gap between patient experiences and provider understanding, underscoring the need for improved patient education and greater clinician awareness of psychosocial factors in vulvodynia care. While limited by its sample size and lack of demographic data, this study highlights how web-based communities can help identify ways health care providers can better meet patient needs and how patients mutually support each other.

Positive Psychology Interventions in Medical Populations: Critical Issues in Intervention Development, Testing, and Implementation

Positive psychological well-being is prospectively associated with superior health outcomes. Positive psychology interventions have promise as a potentially feasible and effective means of increasing well-being and health in those with medical illness, and several initial studies have shown the potential of such programs in medical populations. At the same time, numerous key issues in the existing positive psychology literature must be addressed to ensure that these interventions are optimally effective. These include (1) assessing the nature and scope of PPWB as part of intervention development and application; (2) identifying and utilizing theoretical models that can clearly outline potential mechanisms by which positive psychology interventions may affect health outcomes; (3) determining consistent, realistic targets for positive psychology interventions; (4) developing consistent approaches to the promotion of positive psychological well-being; (5) emphasizing the inclusion of diverse samples in treatment development and testing; and (6) considering implementation and scalability from the start of intervention development to ensure effective real-world application. Attention to these six domains could greatly facilitate the generation of effective, replicable, and easily adopted positive psychology programs for medical populations with the potential to have an important impact on public health.

"A laugh a day keeps the failure away": The role of self-enhancing humor and host country community embeddedness in career satisfaction of dual-earner expatriate couples

For dual-earner expatriate couples (DEECs), it is particularly challenging to achieve career satisfaction after relocating to another country and the associated career transitions. While studies have addressed the strenuous career pathways of individuals in DEECs, the identification and empirical analysis of resources that may contribute to the attainment of career satisfaction remains a desideratum. This research investigates the impact of self-enhancing humor and community embeddedness on individual career satisfaction and the crossover effects of humor on that of the partners in DEECs. Using data from 109 DEECs in Europe and Actor-Partner Interdependent Model (APIM), the results show that embeddedness in one's community mediated the relationship between humor and career satisfaction. The study also unfolded the crossover effects of humor within couples: Men's humor promoted their female partner's community embeddedness, which, in turn, promoted women's career satisfaction. This study entails fruitful implications for future research on DEECs and practical recommendations for relevant stakeholders to facilitate the careers of DEECs.