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Le LHL, Brown VAV, Mol S, Azijli K, Kuijper MM, Becker L, Koopman SSHA. Sex differences in pain catastrophizing and its relation to the transition from acute pain to chronic pain. BMC Anesthesiol 2024; 24:127. [PMID: 38566044 PMCID: PMC10985981 DOI: 10.1186/s12871-024-02496-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND AND IMPORTANCE Differences exist between sexes in pain and pain-related outcomes, such as development of chronic pain. Previous studies suggested a higher risk for pain chronification in female patients. Furthermore, pain catastrophizing is an important risk factor for chronification of pain. However, it is unclear whether sex differences in catastrophic thinking could explain the sex differences in pain chronification. OBJECTIVES The aim of this study was to examine sex differences in pain catastrophizing. Additionally, we investigated pain catastrophizing as a potential mediator of sex differences in the transition of acute to chronic pain. DESIGN, SETTINGS AND PARTICIPANTS Adults visiting one of the 15 participating emergency departments in the Netherlands with acute pain-related complaints. Subjects had to meet inclusion criteria and complete questionnaires about their health and pain. OUTCOMES MEASURE AND ANALYSIS The outcomes in this prospective cohort study were pain catastrophizing (short form pain catastrophizing) and pain chronification at 90 days (Numeric Rating Scale ≥ 1). Data was analysed using univariate and multivariable logistic regression models. Finally, stratified regression analyses were conducted to assess whether differences in pain catastrophizing accounted for observed differences in pain chronification between sexes. MAIN RESULTS In total 1,906 patients were included. Females catastrophized pain significantly more than males (p < 0.001). Multiple regression analyses suggested that pain catastrophizing is associated with pain chronification in both sexes. CONCLUSIONS This study reported differences between sexes in catastrophic cognitions in the development of chronic pain. This is possibly of clinical importance to identify high-risk patients and ensure an early intervention to prevent the transition from acute to chronic pain.
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Affiliation(s)
- Linh H L Le
- Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Vanessa A V Brown
- Department of Emergency Medicine, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands
| | - Sander Mol
- Department of Emergency Medicine, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands
| | - Kaoutar Azijli
- Department of Emergency Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | | | - Leonie Becker
- Department of Cardiology, Maasstad Hospital, Rotterdam, The Netherlands
| | - Seppe S H A Koopman
- Department of Anaesthesiology, Maasstad Hospital, Maasstadweg 21 3079 DZ Rotterdam, Rotterdam, The Netherlands.
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Stragapede E, Huber JD, Corsini-Munt S. My Catastrophizing and Your Catastrophizing: Dyadic Associations of Pain Catastrophizing and the Physical, Psychological, and Relational Well-being of Persons With Endometriosis and Their Partners. Clin J Pain 2024; 40:221-229. [PMID: 38229502 DOI: 10.1097/ajp.0000000000001193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024]
Abstract
OBJECTIVES Endometriosis, a painful chronic gynecologic condition, contributes to disruptions in multiple areas of life for both those affected and their partner. Pain catastrophizing has been associated with worse pain outcomes and quality of life for women with endometriosis and with more cognitive load for partners. Examining both partners' pain catastrophizing dyadically with our variables of interest will enhance understanding of its associations with the distressing nature of experiencing and responding to pain during sex for couples with endometriosis. METHODS Persons with endometriosis experiencing pain during sex and their partners (n=52 couples; 104 individuals) completed online self-report measures of pain catastrophizing, depressive symptoms, sexual satisfaction, and partner responses to pain. Persons with endometriosis reported on pain during sexual activity. Analyses were guided by the Actor-Partner Interdependence Model. RESULTS Persons with endometriosis' pain catastrophizing was associated with their higher pain intensity and unpleasantness during sex. When persons with endometriosis reported more pain catastrophizing, they were less sexually satisfied and reported their partners responded more negatively to their pain. When partners reported higher catastrophizing, they were more depressed and responded more negatively to the pain. DISCUSSION Consistent with the Communal Coping Model of pain catastrophizing, although meant to elicit support from the environment, the often-deleterious cognitive process of magnifying, ruminating, and feeling helpless about one's pain (or one's partner's pain) is associated with poorer outcomes for the individual with pain and their romantic partner. Implications for pain management include the relevance of involving the partner and attending to the pain cognitions of both members of the couple.
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Affiliation(s)
| | - Jonathan D Huber
- Huber Medicine Professional Corporation, Private Practice Ottawa, ON, Canada
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Ogawa M, Saito A, Karukivi M, Lahti S. Associations of sensory sensitivity, pain catastrophizing, and alexithymia with dental anxiety. Eur J Oral Sci 2024; 132:e12973. [PMID: 38311805 DOI: 10.1111/eos.12973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 12/27/2023] [Indexed: 02/06/2024]
Abstract
We aimed to reveal interrelationships between alexithymia, catastrophic thinking, sensory processing patterns, and dental anxiety among 460 participants who were registrants of a Japanese research company. Measures used were the Modified Dental Anxiety Scale, the Adult Sensory Profile, the Pain Catastrophizing Scale, and the 20-item Toronto Alexithymia Scale. The interrelationships among the constructs were analyzed using structural equation modeling, adjusting for age, gender, and negative dental treatment experience. Data from 428 participants were used in the analyses. Sensory sensitivity and pain catastrophizing were independently associated with anticipatory and treatment-related dental anxiety, while difficulty identifying feelings was not. In the mediation model, sensory sensitivity and pain catastrophizing served as full mediators between difficulty identifying feelings and the dimensions of dental anxiety (indirect effects were between 0.13 and 0.15). The strength of the associations was 0.55 from difficulty identifying feelings to both pain catastrophizing and sensory sensitivity, and between 0.24 and 0.26 to anticipatory and treatment-related dental anxiety. The association between trait-like phenomena, such as alexithymia, and dental anxiety may be mediated by neurophysiological and cognitive factors such as sensory sensitivity and pain catastrophizing. These findings could be crucial for new and innovative interventions for managing dental anxiety.
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Affiliation(s)
- Mika Ogawa
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Akihiro Saito
- Department of Business Administration, The University of Kitakyushu, Kitakyushu, Japan
| | - Max Karukivi
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland
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Fonseca Das Neves J, Serra E, Kosinski T, Maréchal V, Rollin N, Richard O, Jehel L, Rusinek S. Catastrophizing and rumination mediate the link between functional disabilities and anxiety/depression in fibromyalgia. A double-mediation model. Encephale 2024; 50:162-169. [PMID: 37137739 DOI: 10.1016/j.encep.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/23/2023] [Accepted: 04/04/2023] [Indexed: 05/05/2023]
Abstract
Fibromyalgia can be considered to be a model of chronic pain resulting from dysregulation of pain processing. From a psychological point of view, it is possible to consider transdiagnostic processes that would participate in both the dysregulation of pain and associated emotions. OBJECTIVE The aim of this study was to test the links that exist between the tendency to Repetitive Negative Thinking (RNT) and the anxious-depressive manifestations in fibromyalgia. More specifically, we wanted to test a double mediation model where RNT would mediate the link between pain and depression/anxiety via catastrophizing. METHOD Eighty-two patients with fibromyalgia completed a series of questionnaires evaluating their level of depression, anxiety, disability related to pain, catastrophizing as well as various measures of Repetitive Thoughts. RESULTS The results showed strong correlations between RNT levels, pain, and anxious-depressive manifestations in this population. Moreover, the links between pain and depression/anxiety were mediated by catastrophizing and RNT in serial. CONCLUSION Results support the interest of studying RNT as a transdiagnostic process in fibromyalgia pain. Considering RNT in fibromyalgia allows a better understanding of tthe links that exist between pain and emotional disorders in this population and thus to better understand the psychopathological comorbidity of fibromyalgia.
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Affiliation(s)
| | - Eric Serra
- Centre d'étude et de traitement de la douleur, Centre hospitalier universitaire Amiens-Picardie, Amiens, France; Laboratoire PSITEC ULR 4072 , université de Lille, Lille, France
| | - Thierry Kosinski
- Laboratoire PSITEC ULR 4072 , université de Lille, Lille, France
| | - Virginie Maréchal
- Psychiatrie de Liaison, Centre hospitalier universitaire Amiens-Picardie, 80000 Amiens, France
| | - Noémie Rollin
- Laboratoire PSITEC ULR 4072 , université de Lille, Lille, France; Consultation douleur, Centre hospitalier de Soissons, Soissons, France
| | - Olivier Richard
- Centre d'étude et de traitement de la douleur, Centre hospitalier universitaire Amiens-Picardie, Amiens, France
| | - Louis Jehel
- Psychiatrie de Liaison, Centre hospitalier universitaire Amiens-Picardie, 80000 Amiens, France; Equipe MOODS-IPSOM, U1018, CESP/INSERM, 94807 Villejuif Cedex, France
| | - Stéphane Rusinek
- Laboratoire PSITEC ULR 4072 , université de Lille, Lille, France
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Wang L, Qin F, Liu H, Lu XH, Zhen L, Li GX. Pain Sensitivity and Acute Postoperative Pain in Patients Undergoing Abdominal Surgery: The Mediating Roles of Pain Self-Efficacy and Pain Catastrophizing. Pain Manag Nurs 2024; 25:e108-e114. [PMID: 38184383 DOI: 10.1016/j.pmn.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/25/2023] [Accepted: 12/02/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Inadequately managed postoperative pain remains a common issue. Examining factors like pain sensitivity, pain catastrophizing, and pain self-efficacy can help improve postoperative pain management. While these factors have been identified as potential predictors of acute postoperative pain, their effects have been inconsistent. Few studies have explored the interactions between these factors. AIM To investigate the influence of preoperative pain sensitivity, pain catastrophizing, and pain self-efficacy on acute postoperative pain in abdominal surgery patients and to determine the mediating roles of pain catastrophizing and pain self-efficacy in the relationship between pain sensitivity and acute postoperative pain, as per the gate control theory. METHODS A total of 246 patients were enrolled in this study. General information was collected before surgery, and the Pain Sensitivity Questionnaire (PSQ), Pain Catastrophizing Scale (PCS), and Pain Self-Efficacy Questionnaire (PSEQ) were administered. After surgery, patients' average pain scores over the 24 hours were reported using the Numerical Rating Scale (NRS). Correlation analyses and a structural equation model were used to examine the relationships among these variables. RESULTS NRS scores over 3 during the 24 hours post-surgery were reported by 21.54% of patients. Postoperative acute pain was found to be associated with pain sensitivity (rs = 0.463, p < .001), pain catastrophizing (rs = 0.328, p < .001), and pain self-efficacy (rs = -0.558, p < .001). A direct effect on postoperative acute pain was exerted by pain sensitivity (effect = 0.250, p = .001), along with indirect effects through: (A) pain catastrophizing (effect = 0.028, p = .001); (B) pain self-efficacy (effect = 0.132, p = .001); and (C) the chain mediation of pain self-efficacy and pain catastrophizing (effect = 0.021, p = .008). CONCLUSIONS The severity of postoperative acute pain can be predicted by pain self-efficacy and pain catastrophizing, and the connection between moderate pain sensitivity and postoperative acute pain severity is mediated by them. Therefore, intervention programs aimed at boosting pain self-efficacy and reducing pain catastrophizing can enhance postoperative pain outcomes for abdominal surgery patients.
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Affiliation(s)
- Ling Wang
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Fang Qin
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
| | - Hao Liu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao-Hua Lu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Li Zhen
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Guo-Xin Li
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Tieppo Francio V, Alm J, Leavitt L, Mok D, Yoon BV, Nazir N, Lam C, Latif U, Sowder T, Braun E, Sack A, Khan T, Sayed D. Variables associated with nonresponders to high-frequency (10 kHz) spinal cord stimulation. Pain Pract 2024; 24:584-599. [PMID: 38078593 DOI: 10.1111/papr.13328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
INTRODUCTION The use of spinal cord stimulation (SCS) therapy to treat chronic pain continues to rise. Optimal patient selection remains one of the most important factors for SCS success. However, despite increased utilization and the existence of general indications, predicting which patients will benefit from neuromodulation remains one of the main challenges for this therapy. Therefore, this study aims to identify the variables that may correlate with nonresponders to high-frequency (10 kHz) SCS to distinguish the subset of patients less likely to benefit from this intervention. MATERIALS AND METHODS This was a retrospective single-center observational study of patients who underwent 10 kHz SCS implant. Patients were divided into nonresponders and responders groups. Demographic data and clinical outcomes were collected at baseline and statistical analysis was performed for all continuous and categorical variables between the two groups to calculate statistically significant differences. RESULTS The study population comprised of 237 patients, of which 67.51% were responders and 32.49% were nonresponders. There was a statistically significant difference of high levels of kinesiophobia, high self-perceived disability, greater pain intensity, and clinically relevant pain catastrophizing at baseline in the nonresponders compared to the responders. A few variables deemed potentially relevant, such as age, gender, history of spinal surgery, diabetes, alcohol use, tobacco use, psychiatric illness, and opioid utilization at baseline were not statistically significant. CONCLUSION Our study is the first in the neuromodulation literature to raise awareness to the association of high levels of kinesiophobia preoperatively in nonresponders to 10 kHz SCS therapy. We also found statistically significant differences with greater pain intensity, higher self-perceived disability, and clinically relevant pain catastrophizing at baseline in the nonresponders relative to responders. It may be appropriate to screen for these factors preoperatively to identify patients who are less likely to respond to SCS. If these modifiable risk factors are present, it might be prudent to consider a pre-rehabilitation program with pain neuroscience education to address these factors prior to SCS therapy, to enhance successful outcomes in neuromodulation.
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Affiliation(s)
- Vinicius Tieppo Francio
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - John Alm
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Logan Leavitt
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Daniel Mok
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - B Victor Yoon
- Department of Physical Medicine and Rehabilitation, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Niaman Nazir
- Department of Population Health, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Christopher Lam
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Usman Latif
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Timothy Sowder
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Edward Braun
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Andrew Sack
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Talal Khan
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Dawood Sayed
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA
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Ochandorena-Acha M, Escribà-Salvans A, Hernández-Hermoso JA, Terradas-Monllor M. Perioperative experiences of patients with high pain catastrophizing and knee arthroplasty after receiving or not preoperative physiotherapy: Qualitative study. Musculoskelet Sci Pract 2024; 70:102918. [PMID: 38330866 DOI: 10.1016/j.msksp.2024.102918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Among the risk factors studied for persistent pain after total knee arthroplasty (TKA), pain catastrophizing stands out above the others. In this regard, preoperative interventions based on pain neuroscience education or multimodal physiotherapy have been shown to be effective in reducing pain catastrophizing. OBJECTIVES The present qualitative study aims to explore the perioperative experiences of high pain catastrophizing participants undergoing total knee arthroplasty surgery. Comparisons will be made between those who received, and those who did not receive a preoperative physiotherapy intervention. METHODS Based on the purposive sampling approach, participants from a randomized controlled trial were selected. In total, 14 persons participated in face-to-face semi-structured interviews. RESULTS Following a thematic analysis, the results were divided into two themes: 1) The preoperative experiences of patients with symptomatic knee arthroplasty, covering aspects related to health, functioning, cognition, and behaviour; and 2) The perioperative TKA rehabilitation process, illustrating differing experiences between individuals who received the preoperative physiotherapy interventions and those who did not. CONCLUSIONS While participants who received no preoperative physiotherapy intervention showed limited coping strategies during post-surgery rehabilitation and the same cognitions as before (hypervigilance, rumination, or avoidance of activities), those participants who received the preoperative physiotherapy showed abilities to cope with their pain, felt empowered and were involved in their rehabilitation.
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Affiliation(s)
- Mirari Ochandorena-Acha
- Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia, Vic, Spain; Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Anna Escribà-Salvans
- Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia, Vic, Spain; Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Jose Antonio Hernández-Hermoso
- Orthopedic Surgery Department, Germans Trias i Pujol University Hospital, Badalona, Spain; Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Marc Terradas-Monllor
- Faculty of Health Sciences and Welfare, University of Vic - Central University of Catalonia, Vic, Spain; Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain; Pain Medicine Section, Anaesthesiology Dept., Hospital Clinic de Barcelona, Spain.
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Lavefjord A, Sundström FTA, Buhrman M, McCracken LM. The role of stigma in health and functioning in chronic pain: Not just catastrophizing. Eur J Pain 2024; 28:620-632. [PMID: 37985939 DOI: 10.1002/ejp.2207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 10/16/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND People with chronic pain are frequently exposed to stigma, which is typically distressing and may lead to internal stigmatizing thoughts. The thought content associated with stigma has similarities to pain catastrophizing, although these concepts differ in that stigma is arguably more social in origin. Stigma can be measured by the Stigma Scale for Chronic Illness - 8-item version (SSCI-8). In this study, we first demonstrate the validity of this measure in Swedish. We then examine the role of stigma in the health and functioning of people with chronic pain, particularly beyond the role played by pain catastrophizing. METHODS Adult participants (N = 404) with chronic pain recruited online completed measures of pain, stigma, catastrophizing, pain interference, work and social adjustment and depression on two occasions. RESULTS A one-factor solution had an overall good model fit as long as residuals were allowed to covary, indicating some redundancy in the items. The SSCI-8 demonstrated good internal consistency and moderate temporal stability, and SSCI-8 scores demonstrated medium-to-large correlations with the measures of health and functioning. Furthermore, stigma was found to significantly contribute to explained variance in pain interference, work and social adjustment and depression, uniquely adding to the explained variance in these outcomes even after accounting for pain catastrophizing. CONCLUSIONS The SSCI-8 provides an adequate measure to capture stigma experiences. Stigma is uniquely associated with pain-related outcomes and should be further considered in pain research and clinical practice in the future. SIGNIFICANCE This study points to the importance of a social perspective on pain-related outcomes. We may need to more fully appreciate the way that people with chronic pain are treated by both health care providers and others can have an impact on their well-being. Potential negative impacts of stigmatizing responses to people with chronic pain are highlighted by the current results.
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Affiliation(s)
- Amani Lavefjord
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - F T A Sundström
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - M Buhrman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - L M McCracken
- Department of Psychology, Uppsala University, Uppsala, Sweden
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Alves SM, Puentedura EJ, Silva AG. Pain neuroscience education and graded exposure versus Pilates and postural education: A pilot study in an occupational context. Physiother Theory Pract 2024; 40:456-467. [PMID: 36111620 DOI: 10.1080/09593985.2022.2122914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Pain neuroscience education (PNE) and graded exposure have not been explored in occupational settings for low back pain (LBP). AIM To pilot feasibility and assess preliminary effectiveness of PNE and graded exposure for LBP. METHODS A pilot study where workers were randomized to either PNE and graded exposure or Pilates and postural education. Both interventions consisted of weekly individual face-to-face sessions for 8 weeks (a total of 8 sessions). The primary outcome was pain intensity. Secondary outcomes were disability, catastrophizing, fear-avoidance, sleep, endurance of back extensor muscles, and patient's perceived impression of change. RESULTS Seventeen participants entered the PNE and graded exposure group and 20 the Pilates and postural education group. PNE and graded exposure were feasible to implement. Between-group comparisons suggest higher improvements in the PNE group for extensor muscle endurance (p < .001, η2p = .29), pain catastrophizing (p < .001; η2p = .56) and fear-avoidance related to physical activity (p < .001; η2p = .48) and work (p < .001; η2p = .47). In the PNE group, at least 13 (76.5%) participants reported being at least "moderately better" against 6 (30%) participants in the Pilates group. CONCLUSION PNE and graded exposure can be successfully implemented in an occupational context and is potentially more beneficial than Pilates and postural education for extensor muscle endurance, catastrophizing, and fear avoidance and similarly as beneficial for pain intensity and disability. Further studies are needed to confirm these results.
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Affiliation(s)
- Sara M Alves
- Department of Physical Medicine and Rehabilitation, Hospital Center of Vila Nova de Gaia - Espinho, R. Dr. Francisco Sá Carneiro 4400-129, 4430-999, Vila Nova de Gaia, Portugal
| | - Emilio J Puentedura
- Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Anabela G Silva
- School of Health Sciences and CINTESIS.UA@RISE, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
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Yamin JB, Meints SM, Edwards RR. Beyond pain catastrophizing: rationale and recommendations for targeting trauma in the assessment and treatment of chronic pain. Expert Rev Neurother 2024; 24:231-234. [PMID: 38277202 PMCID: PMC10923018 DOI: 10.1080/14737175.2024.2311275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/24/2024] [Indexed: 01/27/2024]
Affiliation(s)
- Jolin B. Yamin
- Department of Anesthesiology and Pain Medicine, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Samantha M. Meints
- Department of Anesthesiology and Pain Medicine, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert R. Edwards
- Department of Anesthesiology and Pain Medicine, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Carlson KJ, Dashtizad BI, Larson MO, Dougherty WM, Dobratz EJ. Assessment of opioid use following septorhinoplasty and its association with pain catastrophizing. Am J Otolaryngol 2024; 45:104123. [PMID: 38043298 DOI: 10.1016/j.amjoto.2023.104123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/19/2023] [Indexed: 12/05/2023]
Abstract
PURPOSE Anxiety towards pain is correlated with increased post-surgical pain and assessed with the "Pain Catastrophizing Scale" (PCS). We assess patient reported pain and opioid usage following septorhinoplasty and their association with the PCS. METHODS This prospective cohort study enrolled patients over 18 years of age undergoing open septorhinoplasty on an outpatient basis at a single academic institution. Participants completed the PCS preoperatively and recorded post-operative pain and analgesic use with a daily online based survey through post-operative day 5. Total opioid use and highest pain rating are assessed. RESULTS Postoperative pain was assessed in 34 patients with a median age of 37 years (Range: 22-62y). The average highest pain rating was 6.2/10 (σ = 2.03) and occurred on post-operative day 2. A median of 20 5-mg narcotic tablets (Range: 10-25) was prescribed to study participants though only an average of 7.25 (Range: 0-15) were reported as used. Medical comorbidities and surgical characteristics, including history of anxiety, cosmetic indication, surgical revision, use of osteotomies, Doyle splints, costal or conchal cartilage grafts, or inferior turbinate reduction, were not associated with increased pain or narcotic use. Those using >10 tablets scored higher on the PCS ([10.6] v. [4.8], p = 0.025). CONCLUSION Most patients require <10, 5 mg opioid tablets following septorhinoplasty. Surgeons should attempt to decrease opioid prescriptions while considering that patients with significant anxiety towards pain may report higher narcotic needs.
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Affiliation(s)
- Kevin J Carlson
- Department of Otolaryngology - Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA, USA; Department of Surgery, Division of Otolaryngology, University of Wisconsin, Madison, WI, USA
| | | | - Michael O Larson
- Department of Otolaryngology - Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA, USA; Department of Otolaryngology, University of Arkansas; Little Rock, AR, USA
| | - William M Dougherty
- Department of Otolaryngology - Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Eric J Dobratz
- Department of Otolaryngology - Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
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12
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Crombez G, Scott W, De Paepe AL. Knowing What We Are Talking About: The Case of Pain Catastrophizing. J Pain 2024; 25:591-594. [PMID: 38211846 DOI: 10.1016/j.jpain.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 01/13/2024]
Affiliation(s)
- Geert Crombez
- Department of Experimental - Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Whitney Scott
- Health Psychology Section, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, United Kingdom; INPUT Pain Management Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Annick L De Paepe
- Department of Experimental - Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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13
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Fang Y, Liu M, Wu M, Liu M, Niu T, Zhang X. Pain intensity and self-perceived burden mediate the relationship between family functioning and pain catastrophizing in patients with neuropathic pain. Nurs Health Sci 2024; 26:e13097. [PMID: 38369318 DOI: 10.1111/nhs.13097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/18/2023] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
This cross-sectional study aimed to investigate the relationship between family functioning, pain intensity, self-perceived burden, and pain catastrophizing. Moreover, we also wanted to explore the multiple mediating roles of pain intensity and self-perceived burden. From October 2022 to March 2023, 252 Chinese people with neuropathic pain completed face-to-face questionnaires to assess family functioning, pain intensity, self-perceived burden, and pain catastrophizing. Data analysis was done using descriptive statistics and a structural equation model. The results showed better family functioning was significantly associated with more intense pain, less self-perceived burden, and less pain catastrophizing. Mediation analysis showed that family functioning could indirectly affect pain catastrophizing through pain intensity and self-perceived burden in addition to a direct effect on pain catastrophizing. Moreover, the mediating variable of pain intensity played a masking role. These findings suggest that good family functioning can effectively reduce the self-perceived burden and pain catastrophizing in patients with neuropathic pain. However, family functioning cannot show its maximum effectiveness, and it may be necessary to construct a model of family functioning suitable for patients with neuropathic pain in the future.
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Affiliation(s)
- Yu Fang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Mengjie Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Min Wu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Mengshi Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Tianchen Niu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Xiaoman Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
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14
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Connoy L, Webster F. Why Language Matters in Chronic Pain: The Example of Pain Catastrophizing. J Pain 2024; 25:588-590. [PMID: 38159787 DOI: 10.1016/j.jpain.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Laura Connoy
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Fiona Webster
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
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15
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Licciardone JC, Ibrahim M, Baker J, Thornton T, Vu S. Pain catastrophizing and risk of progression to widespread pain among patients with chronic low back pain: A retrospective cohort study. Musculoskelet Sci Pract 2024; 69:102886. [PMID: 38096594 DOI: 10.1016/j.msksp.2023.102886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND Chronic low back pain often progresses to widespread pain. Although many factors are associated with progression, their roles in contributing to chronic widespread pain (CWP) are often unclear. OBJECTIVE To determine if pain catastrophizing is an independent risk factor for CWP. DESIGN Retrospective cohort study within a national pain research registry from April 2016 through August 2022. METHODS A total of 1111 participants with chronic low back pain, but without CWP, were included. Participants were followed at quarterly intervals for up to 48 months to measure CWP risk. Survival analyses involved Kaplan-Meier plots and the Cox proportional hazards model to measure CWP risk according to pain catastrophizing and subscale scores for rumination, magnification, and helplessness. RESULTS Crude CWP risks for moderate pain catastrophizing (HR, 2.13; 95% CI, 1.54-2.95; P < 0.001) and high pain catastrophizing (HR, 3.98; 95% CI, 2.95-5.35; P < 0.001) were each elevated in comparison with low pain catastrophizing. Adjusted CWP risks for moderate pain catastrophizing (HR, 1.80; 95% CI, 1.27-2.53; P < 0.001) and high pain catastrophizing (HR, 2.82; 95% CI, 1.98-4.02; P < 0.001) remained elevated in analyses that controlled for potential confounders. Corresponding results were observed in the survival analyses involving rumination, magnification, and helplessness. CONCLUSIONS Pain catastrophizing appears to be an independent risk factor for progression to CWP among patients with chronic low back pain. These findings provide a rationale for interventions aimed at reducing pain catastrophizing, including rumination, magnification, and helplessness, among patients with chronic low back pain.
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Affiliation(s)
- John C Licciardone
- Department of Family Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA.
| | - Mira Ibrahim
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Joshua Baker
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Tyler Thornton
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Stephanie Vu
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
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16
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Rivel M, Achiron A, Stern Y, Zeilig G, Defrin R. Emotional burden among MS patients: associations between specific chronic pain diagnoses and psychological features. J Neurol 2024; 271:688-698. [PMID: 37875677 DOI: 10.1007/s00415-023-12048-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023]
Abstract
Central neuropathic pain (CNP) and musculoskeletal pain (MSP) are often comorbid with multiple sclerosis (MS), yet data on the emotional burden entailed by this comorbidity are very limited. We studied whether MS patients with CNP exhibited greater emotional burden and pain severity than those with MSP and whether this emotional burden was attributed to the MS, the chronic pain, or both. Participants were 125 MS patients (55 with CNP; 30 with MSP; 40 MS pain-free) and 30 healthy controls (HCs). Participants completed questionnaires assessing pain interference, pain catastrophizing, depression, anxiety, stress, hypervigilance, and chronic pain. Group comparisons and a two-step cluster analysis were performed, and the association between cluster membership and clinical group membership was evaluated. Chronic pain was stronger and more widespread in the CNP group than in the MSP group. Both pain groups had higher pain interference, pain catastrophizing, and stress compared to MS pain-free and HC groups. All MS groups had greater depression levels compared to HCs, and the CNP group had the highest anxiety level. The "high psychological distress" cluster comprised mainly participants with CNP (57%), and the "minimal psychological distress" cluster comprised mainly the MS pain-free and HC groups. In conclusion, CNP seems to induce greater emotional burden and pain severity than does MSP. Whereas depression may be attributed to MS, and anxiety to CNP, enhanced pain interference, catastrophizing, and stress may be attributed to the comorbidity of MS and chronic pain. Identifying these traits among MS patients and targeting them in management programs may contribute to more effective, individually based care.
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Affiliation(s)
- Michal Rivel
- Department of Physical Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Anat Achiron
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Stern
- Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Gabi Zeilig
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Ruth Defrin
- Department of Physical Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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17
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Takano Y, Ubara A, Machida N, Ibata R, Okajima I. Psychometric properties of the Japanese version of the Insomnia Catastrophizing Scale and relationship of insomnia severity with catastrophic thoughts, safety behaviors, and dysfunctional beliefs. Sleep Med 2024; 114:64-72. [PMID: 38157622 DOI: 10.1016/j.sleep.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND This study aimed to clarify the reliability and validity of the Japanese version of the Insomnia Catastrophizing Scale (ICS) and to examine the relationship between insomnia severity and insomnia-related cognitive factors. METHODS A total of 786 participants were recruited via an online survey and classified into the insomnia group (n = 342) and healthy group (n = 444). The insomnia group comprised individuals who self-reported meeting the diagnostic criteria for chronic insomnia disorder in the third edition of the International Classification of Sleep Disorders. RESULTS The ICS is used to independently assess nighttime (ICS-N) and daytime (ICS-D) catastrophic thoughts, and item response theory revealed that each ICS-N and ICS-D item can adequately assess catastrophic thoughts during the night and day, respectively. The internal consistency and test-retest reliability of the ICS-N and ICS-D were good. Further, the ICS-N and ICS-D had a significant positive correlation with insomnia severity, hyperarousal, sleep-related safety behaviors, dysfunctional beliefs about sleep, and anxiety symptoms. Multiple regression analyses with insomnia severity as the dependent variable in the insomnia group demonstrated that catastrophic thoughts were more strongly associated with insomnia severity than sleep-related safety behaviors and dysfunctional beliefs about sleep. The interaction between nighttime catastrophic thoughts and sleep-related safety behaviors increased insomnia severity. CONCLUSIONS The Japanese versions of ICS-N and ICS-D were found to be superior in measuring insomnia-related catastrophic thoughts and to have high reliability and validity. Furthermore, these findings more clearly demonstrate that the catastrophic thoughts may be an important associated factor of insomnia.
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Affiliation(s)
- Yuta Takano
- Department of Somnology, Tokyo Medical University, Tokyo, Japan; Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | | | - Naho Machida
- Osaka Counseling Center Bellflower, Osaka, Japan
| | - Rui Ibata
- Graduate School of Psychological Science, Health Sciences University of Hokkaido, Hokkaido, Japan; Sapporo Mental and Physical Health Clinic, Hokkaido, Japan
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan.
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18
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Oliveira I, Vaz Garrido M, Carvalho H, Figueira Bernardes S. Sensing the body matters: profiles of interoceptive sensibility in chronic pain adjustment. Pain 2024; 165:412-422. [PMID: 37768722 DOI: 10.1097/j.pain.0000000000003032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/04/2023] [Indexed: 09/29/2023]
Abstract
ABSTRACT Interoception is critical to health regulation and is often disrupted in individuals with chronic pain (ICPs). Interoceptive sensibility (IS)-the self-reported experience and relationship toward internal states-includes skills such as sensing, interpreting, and using bodily information for self-regulation. Current studies on IS and chronic pain (CP) adjustment are scarce, and how the interplay between different IS skills shapes CP adjustment remains unclear. This cross-sectional study aimed to identify profiles of IS skills among ICPs and examined their associations with pain outcomes and psychological and behavioral risk or protective processes. Individuals with chronic musculoskeletal pain (n = 173; 84.4% women) completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), measures of CP adjustment (depression, anxiety, vitality, pain severity, interference, and physical function), psychological (self-efficacy, catastrophizing, and kinesiophobia), and behavioral processes (activity patterns). A cluster analysis identified 3 IS skills profiles: (1) high IS skills (n = 68), with the highest levels of attention regulation toward bodily sensations, body trust, listening for insight, and self-regulation; (2) low IS skills (n = 29), who distracted less and worried more about bodily sensations, and presented lower-body trust; and (3) mixed IS skills (n = 71), despite good body trust, attention regulation, and low worrying, showed lower awareness of body-mind connections. Interoceptive sensibility skills profiles differed in depression, vitality (fatigue), and psychological or behavioral processes, such as pain-related self-efficacy, catastrophizing, kinesiophobia, and activity pacing. These findings contribute to integrating body-mind connections more explicitly into current theoretical CP models and developing tailored interventions targeting specific IS skills to improve CP adjustment.
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Affiliation(s)
- Inês Oliveira
- Department of Social and Organizational Psychology, Centre for Psychological Research and Social Intervention (CIS-Iscte), Iscte-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Margarida Vaz Garrido
- Department of Social and Organizational Psychology, Centre for Psychological Research and Social Intervention (CIS-Iscte), Iscte-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Helena Carvalho
- Department of Social Research Methods, Centre for Research and Studies in Sociology (CIES-Iscte), Iscte-Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Sónia Figueira Bernardes
- Department of Social and Organizational Psychology, Centre for Psychological Research and Social Intervention (CIS-Iscte), Iscte-Instituto Universitário de Lisboa, Lisbon, Portugal
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19
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Fang Y, Shi L, Qin F, Li T, Zhang X, Li M. Influence of Family-Learned Fear-of-Pain on Patients. Pain Manag Nurs 2024; 25:11-18. [PMID: 37183071 DOI: 10.1016/j.pmn.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 04/01/2023] [Accepted: 04/07/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Fear-of-pain is a common feeling of patients and their family who experience or witness severe or chronic pain. Fear-of-pain may disturb patient's recovery, and also influence family support to assist patients' recovery. AIM This study is to measure the level of family support for each patient; evaluate the extent of the supporting families' fear-of-pain; and identify possible interventions in family support and family fear-of-pain. METHODS This cross-sectional descriptive research involved 77 participants in the orthopedics department of a tertiary hospital by convenience sampling. The online questionnaire includes general information, and scales of fear-of-pain, pain anxiety, pain vigilance and awareness, pain catastrophizing, and family support. T-test, Pearson correlation analysis and Spearman correlation analysis were used to analyze data. RESULTS Most participants reported that they experienced a moderate-to-high level of fear-of-pain, pain anxiety, pain vigilance and awareness. A total of 15.6% of participants are at risk of pain catastrophizing. The family's pain vigilance and awareness, and fear-of-pain were often similar to those of the patient, and their levels of pain anxiety and catastrophizing were often higher than the patient's. Family support and families' fear-of-pain affect patients' feelings of pain and families' behavior in decision-making for patient recovery, necessitating the development of interventions for patients' families. CONCLUSIONS Family members can develop the fear-of-pain from witnessing painful experiences and may exhibit fear-avoidance behaviors in deciding on patients' rehabilitation plan. Family support, including the type of relationship with families, and length of time family spent with the patient, had an effect on patients' pain and fear-of-pain.
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Affiliation(s)
- Yaxuan Fang
- School of Nursing, Southern Medical University, Guangdong, China; Faculty of Nursing, Chiang Mai University, Chiangmai, Thiland
| | - Lei Shi
- School of Nursing, Southern Medical University, Guangdong, China.
| | - Fang Qin
- School of Nursing, Southern Medical University, Guangdong, China
| | - Ting Li
- School of Nursing, Southern Medical University, Guangdong, China
| | - Xishun Zhang
- Department of Orthopedics, Foshan First People's Hospital, Foshan, Guangdong, China
| | - Manman Li
- People's Hospital of Nanhai District, Foshan, Guangdong, China
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20
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Brody DL. New Findings in Long-Neglected Areas of Traumatic Brain Injury Research: Intimate Partner Violence, Effects of Neighborhood Disadvantage, and Racial Differences in Pain Catastrophizing. J Neurotrauma 2024; 41:303-304. [PMID: 38301248 DOI: 10.1089/neu.2024.29142.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
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21
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Peralta FM, Condon LP, Torrez D, Neumann KE, Pollet AL, McCarthy RJ. Association of pain catastrophizing with labor pain and analgesia consumption in obstetrical patients. Int J Obstet Anesth 2024; 57:103954. [PMID: 38087766 DOI: 10.1016/j.ijoa.2023.103954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/26/2023] [Accepted: 11/05/2023] [Indexed: 02/04/2024]
Abstract
INTRODUCTION Pain catastrophizing is an exaggerated negative orientation to painful stimuli which in obstetric patients is associated with fear of overwhelming labor pain and negative pain-related outcomes. This study aimed to quantitatively examine the association of pain catastrophizing with maternal labor pain outcomes. METHODS We conducted a prospective observational study of women admitted for a vaginal trial of labor. Subjects completed the 13-item Pain Catastrophizing scale (PCS) questionnaire (scored 0 to 52, higher scores representing greater catastrophizing). Pain was assessed at baseline and at request for neuraxial labor analgesia. Labor and postpartum pain intensity was assessed as the average area under the pain intensity by time curve. Pain at request for analgesia, labor pain, postpartum pain, analgesic consumption, and quality of recovery was compared between high (PCS ≥ 17) and low catastrophizing groups. RESULTS Data from 138/157 (88%) subjects were included in the analysis. Median (IQR) pain scores at request for analgesia were 9 (8,10) and 8 (6,9), a difference of 1 (95% CI 0 to 2.5, P = 0.008) in high-catastrophizing and in low-catastrophizing groups, respectively. Adjusted pain during labor, postpartum pain and opioid analgesic use were not significantly different. High-catastrophizers reported less comfort, ability to mobilize and less control during hospitalization. Post-discharge there were no differences in pain or analgesic use. CONCLUSION We did not observe greater labor or post-delivery pain or increased analgesic use in high-catastrophizing parturients. High catastrophizers reported greater pain when requesting analgesia, which is consistent with the role of catastrophizing in intensifying the experience of pain.
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Affiliation(s)
- F M Peralta
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - L P Condon
- Department of Anesthesiology, Rush University, Chicago, IL, USA
| | - D Torrez
- Department of Anesthesiology, Rush University, Chicago, IL, USA
| | - K E Neumann
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - A L Pollet
- Department of Anesthesiology, Rush University, Chicago, IL, USA
| | - R J McCarthy
- Department of Anesthesiology, Rush University, Chicago, IL, USA
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22
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Liu S, Zhang X, You B, Jiang G, Chen H, Jackson T. Pain Catastrophizing Dimensions Mediate the Relationship between Chronic Pain Severity and Depression. Pain Manag Nurs 2024; 25:4-10. [PMID: 37059665 DOI: 10.1016/j.pmn.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/04/2023] [Accepted: 03/19/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Although past studies have found significant positive correlations of both pain severity and overall pain catastrophizing (PC) levels with depression in chronic pain samples, less is known about the extent to which specific PC dimensions (i.e., helplessness, magnification, rumination) explain links between pain severity and depression. AIM This study assessed the relative importance of PC dimensions as mediators of relations between chronic pain severity and depression. DESIGN A cross sectional study design was employed. METHOD Mainland Chinese adults with chronic pain (n = 983) completed validated questionnaire measures of PC, depression, and chronic pain severity within a cross-sectional research design. RESULTS Analyses indicated helplessness mediated the association between pain severity and depression while magnification partially mediated the association of helplessness with depression. Conversely, rumination did not make a significant contribution in the mediation model. CONCLUSIONS The helplessness dimension of PC, in particular, may help to explain why people with more severe chronic pain are prone to co-occurring depression.
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Affiliation(s)
- Shuyang Liu
- From the Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China
| | - Xin Zhang
- From the Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China
| | - Beibei You
- School of Nursing, Guizhou Medical University, Guiyang City, Guizhou, China
| | - Guifang Jiang
- Department of Nursing, Zhouning County Chinese Medical Hospital, Shicheng, Fujian, China
| | - Hong Chen
- From the Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa, Macau, SAR China.
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23
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Alshehri MA, Alzahrani H, van den Hoorn W, Klyne DM, Vette AH, Hendershot BD, Roberts BWR, Larivière C, Barbado D, Vera-Garcia FJ, van Dieen JH, Cholewicki J, Nussbaum MA, Madigan ML, Reeves NP, Silfies SP, Brown SHM, Hodges PW. Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis. PLoS One 2024; 19:e0296968. [PMID: 38265999 PMCID: PMC10807788 DOI: 10.1371/journal.pone.0296968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Sitting on an unstable surface is a common paradigm to investigate trunk postural control among individuals with low back pain (LBP), by minimizing the influence lower extremities on balance control. Outcomes of many small studies are inconsistent (e.g., some find differences between groups while others do not), potentially due to confounding factors such as age, sex, body mass index [BMI], or clinical presentations. We conducted a systematic review with an individual participant data (IPD) meta-analysis to investigate whether trunk postural control differs between those with and without LBP, and whether the difference between groups is impacted by vision and potential confounding factors. METHODS We completed this review according to PRISMA-IPD guidelines. The literature was screened (up to 7th September 2023) from five electronic databases: MEDLINE, CINAHL, Embase, Scopus, and Web of Science Core Collection. Outcome measures were extracted that describe unstable seat movements, specifically centre of pressure or seat angle. Our main analyses included: 1) a two-stage IPD meta-analysis to assess the difference between groups and their interaction with age, sex, BMI, and vision on trunk postural control; 2) and a two-stage IPD meta-regression to determine the effects of LBP clinical features (pain intensity, disability, pain catastrophizing, and fear-avoidance beliefs) on trunk postural control. RESULTS Forty studies (1,821 participants) were included for the descriptive analysis and 24 studies (1,050 participants) were included for the IPD analysis. IPD meta-analyses revealed three main findings: (a) trunk postural control was worse (higher root mean square displacement [RMSdispl], range, and long-term diffusion; lower mean power frequency) among individuals with than without LBP; (b) trunk postural control deteriorated more (higher RMSdispl, short- and long-term diffusion) among individuals with than without LBP when vision was removed; and (c) older age and higher BMI had greater adverse impacts on trunk postural control (higher short-term diffusion; longer time and distance coordinates of the critical point) among individuals with than without LBP. IPD meta-regressions indicated no associations between the limited LBP clinical features that could be considered and trunk postural control. CONCLUSION Trunk postural control appears to be inferior among individuals with LBP, which was indicated by increased seat movements and some evidence of trunk stiffening. These findings are likely explained by delayed or less accurate corrective responses. SYSTEMATIC REVIEW REGISTRATION This review has been registered in PROSPERO (registration number: CRD42021124658).
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Affiliation(s)
- Mansour Abdullah Alshehri
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Hosam Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Wolbert van den Hoorn
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Albert H. Vette
- Department of Mechanical Engineering, Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, Canada
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Canada
| | - Brad D. Hendershot
- Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, United States of America
| | - Brad W. R. Roberts
- Department of Mechanical Engineering, Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, Canada
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada
| | - David Barbado
- Sport Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernández University of Elche, Alicante, Spain
| | - Francisco J. Vera-Garcia
- Sport Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernández University of Elche, Alicante, Spain
| | - Jaap H. van Dieen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Jacek Cholewicki
- Center for Neuromusculoskeletal Clinical Research, Michigan State University, Lansing, Michigan, United States of America
- Department of Osteopathic Manipulative Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Maury A. Nussbaum
- Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia, United States of America
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, United States of America
| | - Michael L. Madigan
- Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia, United States of America
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, United States of America
| | | | - Sheri P. Silfies
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States of America
| | - Stephen H. M. Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Vinkel MN, Rackauskaite G, Østergaard JR, Finnerup NB, Jensen MP. Pain coping and catastrophizing in youth with and without cerebral palsy. Scand J Pain 2024; 24:sjpain-2023-0062. [PMID: 38451484 DOI: 10.1515/sjpain-2023-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 12/08/2023] [Indexed: 03/08/2024]
Abstract
OBJECTIVES The aim of this study is to compare the use of pain coping strategies and pain catastrophizing in youth with and without cerebral palsy (CP), and to examine how these two groups differ with respect to the associations between pain coping, catastrophizing, and measures of psychological function and sleep disturbance. METHODS Twenty-seven individuals with CP and 49 healthy controls aged 15-22 were included in this cross-sectional observational study. Pain was assessed using a semi-structured interviews and participants completed measures of pain coping, pain catastrophizing, psychological function, and sleep. RESULTS Youth with CP used information seeking and problem solving (p = 0.003, Cohen's d (d) = -0.80) and sought social support (p = 0.044, d = -0.51) less often, and used internalizing as a coping strategy more often (p = 0.045, d = 0.59) than healthy controls. The use of information seeking and problem solving correlated more strongly with measures of depression (p = 0.023, Cohen's f (f) = 0.08) and sleep disturbance (p = 0.022, f = 0.08), while behavioral distraction correlated more strongly with measures of anxiety (p = 0.006, f = 0.11) and sleep disturbance (p = 0.017, f = 0.09) in youth with CP, compared to healthy controls. CONCLUSIONS The study findings raise the possibility that youth with CP may benefit more in terms of psychological function and sleep quality from coping training interventions that focus on behavioral distraction, information seeking, and problem solving. Research to test these ideas in additional samples of youth with CP is warranted.
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Affiliation(s)
- Michael N Vinkel
- Danish Pain Research Center, Department of Clinical Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, DK-8200, Aarhus, Denmark
| | - Gija Rackauskaite
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - John R Østergaard
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Nanna B Finnerup
- Danish Pain Research Center, Department of Clinical Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, DK-8200, Aarhus, Denmark
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, USA
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Petrini L, Arendt-Nielsen L. Pain catastrophizing in the elderly: An experimental pain study. Scand J Pain 2024; 24:sjpain-2023-0035. [PMID: 38452201 DOI: 10.1515/sjpain-2023-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/29/2023] [Indexed: 03/09/2024]
Abstract
OBJECTIVES Pain catastrophizing in the aging population has not been studied in great detail. Existing investigations have reported conflicting results on the effects of age on pain catastrophizing in relation to pain responses. This study investigated the relationship between pain catastrophizing, and its individual components (rumination, magnification, and helplessness), and the responses to standardized experimental pain stimuli in old and young, healthy adults. METHODS Sixty-six volunteers (32 old: 65-87, 18 females; 34 young: 20-35, 17 females) participated in the study. Pain catastrophizing including the components of rumination, magnification, and helplessness was assessed with the pain catastrophizing scale (PCS). Experimental pain was induced by applying predefined pressure stimulations to the trapezius muscle. Pain intensity and unpleasantness were assessed using numerical rating scales. Pain catastrophizing levels and pain responses were statistically compared between the two age groups. RESULTS Elderly individuals reported significantly (p = 0.028) lower scores of pain catastrophizing (Med = 5; interquartile range [IQR] = 14) than younger individuals; this difference was driven by the significantly lower components of rumination (Med = 2; IQR = 4; p = 0.017) and helplessness (Med = 2; IQR = 7; p = 0.049). A larger proportion of young (57.8%) rated pain catastrophizing at high levels, with scores above the 75th percentile (Med = 20). Additionally, elderly reported the lowest pain intensity (Med = 5; p = 0.034) and pain unpleasantness (Med = 4.5; p = 0.011) responses to the experimental pressure stimuli. In the elderly group, pain unpleasantness was positively and significantly associated with pain catastrophizing (r s = 0.416, p = 0.021), rumination (r s = 0.42, p = 0.019), and helplessness (r s = 0.434, p = 0.015), respectively. No associations were found in the young group. CONCLUSIONS Elderly reported lower PCSs than young adults. Rumination and helplessness were reduced in the elderly group. The elderly population showed positive correlations between catastrophizing levels and pain unpleasantness to standardized pressure pain stimuli. Results supported the view that elderly possess resilience over specific domains of pain catastrophizing that could counteract pain perception due to physiological decline.
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Affiliation(s)
- Laura Petrini
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
- Department of Gastroenterology & Hepatology, Mech-Sense, Clinical Institute, Aalborg University Hospital, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
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Bemani S, Sarrafzadeh J, Dehkordi SN, Talebian S, Salehi R, Zarei J. Effect of multidimensional physiotherapy on non-specific chronic low back pain: a randomized controlled trial. Adv Rheumatol 2023; 63:57. [PMID: 38049905 DOI: 10.1186/s42358-023-00329-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/27/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Many people with non-specific chronic low back pain (NSCLBP) do not recover with current conventional management. Systematic reviews show multidimensional treatment improves pain better than usual active interventions. It is unclear whether multidimensional physiotherapy improves pain better than usual physiotherapy. This study determines the effectiveness of this treatment to reduce pain and disability and improve quality of life, pain cognitions, and electroencephalographic pattern in individuals with NSCLBP. METHODS 70 eligible participants aged 18 to 50 years with NSCLBP were randomized into either the experimental group (multidimensional physiotherapy) or the active control group (usual physiotherapy). Pain intensity was measured as the primary outcome. Disability, quality of life, pain Catastrophizing, kinesiophobia, fear Avoidance Beliefs, active lumbar range of motion, and brain function were measured as secondary outcomes. The outcomes were measured at pre-treatment, post-treatment, 10, and 22 weeks. Data were analyzed using intention-to-treat approaches. RESULTS There were 17 men and 18 women in the experimental group (mean [SD] age, 34.57 [6.98] years) and 18 men and 17 women in the active control group (mean [SD] age, 35.94 [7.51] years). Multidimensional physiotherapy was not more effective than usual physiotherapy at reducing pain intensity at the end of treatment. At the 10 weeks and 22 weeks follow-up, there were statistically significant differences between multidimensional physiotherapy and usual physiotherapy (mean difference at 10 weeks, -1.54; 95% CI, -2.59 to -0.49 and mean difference at 22 weeks, -2.20; 95% CI, - 3.25 to - 1.15). The standardized mean difference and their 95% confidence intervals (Cohen's d) revealed a large effect of pain at 22 weeks: (Cohen's d, -0.89; 95% CI (-1.38 to-0.39)). There were no statistically significant differences in secondary outcomes. CONCLUSIONS In this randomized controlled trial, multidimensional physiotherapy resulted in statistically and clinically significant improvements in pain compared to usual physiotherapy in individuals with NSCLBP at 10 and 22 weeks. TRIAL REGISTRATION ClinicalTrials.gov NCT04270422; IRCT IRCT20140810018754N11.
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Affiliation(s)
- Sanaz Bemani
- Department of Physiotherapy, Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blvd., Tehran, Iran
| | - Javad Sarrafzadeh
- Department of Physiotherapy, Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blvd., Tehran, Iran.
| | - Shohreh Noorizadeh Dehkordi
- Department of Physiotherapy, Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blvd., Tehran, Iran
| | - Saeed Talebian
- Department of Physiotherapy, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Salehi
- Department of Physiotherapy, Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St, Shahnazari St, Madar Sq. Mirdamad Blvd., Tehran, Iran
- Department of Rehabilitation Management, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
- Geriatric Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jamileh Zarei
- Department of Health Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
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You DS, Cook KF, Lannon EW, Ziadni MS, Darnall BD, Mackey SC. Establishing the interpretability and utility of the 4-item BriefPCS. Sci Rep 2023; 13:21272. [PMID: 38042937 PMCID: PMC10693612 DOI: 10.1038/s41598-023-48433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/27/2023] [Indexed: 12/04/2023] Open
Abstract
To reduce the patient burden associated with completing the 13-item Pain Catastrophizing Scale (PCS), the 4-item "BriefPCS" was developed. To date, no crosswalk has been developed that associates scores on the BriefPCS with PCS scores. Further, no study has compared the use of BriefPCS and PCS scores in a randomized clinical trial (RCT). We aimed to: (1) establish the interpretability of BriefPCS scores in reference to PCS scores, (2) compare the concurrent validity between the BriefPCS and PCS, and (3) asssess the use of BriefPCS in an RCT. First, we conducted equipercentile linking, created a crosswalk that associated scores of BriefPCS with PCS, and calculated differences between PCS and crosswalked PCS scores. Secondly, we compared Bootstrap correlation coefficients between PCS and self-reported measures of other domains. Lastly, we compared results from an RCT using BriefPCS scores versus PCS scores. Findings indicated that the correlation coefficient estimates with the BriefPCS and PCS scores were not significantly different. BriefPCS and PCS scores had similar ability to detect treatment-related changes. The BriefPCS scores validly, reliably, and accurately distinguish levels of pain catastrophizing. Additionally, the BriefPCS scores are sensitive to changes after behavioral interventions, with less respondent burden compared to the PCS scores.
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Affiliation(s)
- Dokyoung S You
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, 1070 Arastradero Road, Suite 200, MC 5596, Palo Alto, CA, 94304, USA.
| | - Karon F Cook
- Feral Scholars, 257 County Road 4754, Broaddus, TX, 75929, USA
| | - Edward W Lannon
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, 1070 Arastradero Road, Suite 200, MC 5596, Palo Alto, CA, 94304, USA
| | - Maisa S Ziadni
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, 1070 Arastradero Road, Suite 200, MC 5596, Palo Alto, CA, 94304, USA
| | - Beth D Darnall
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, 1070 Arastradero Road, Suite 200, MC 5596, Palo Alto, CA, 94304, USA
| | - Sean C Mackey
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, 1070 Arastradero Road, Suite 200, MC 5596, Palo Alto, CA, 94304, USA
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Wauters A, Van Ryckeghem DML, Noel M, Rheel E, Vervoort T. The Influence of Children's Pain-Related Attention Shifting Ability and Pain Catastrophizing Upon Negatively Biased Pain Memories in Healthy School Children. J Pain 2023; 24:2140-2152. [PMID: 37385420 DOI: 10.1016/j.jpain.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/23/2023] [Accepted: 06/08/2023] [Indexed: 07/01/2023]
Abstract
The current study investigated the influence of children's ability to flexibly shift attention toward and away from pain information on the development of negatively biased pain memories, thereby employing a direct measure of attention control reliant on behavioral responses in the context of pain (ie, an attention switching task). The direct influence of children's attention-shifting ability and pain catastrophizing as well as the moderating role of this shifting ability in the relationship between pain catastrophizing and the development of negatively biased pain memories was examined. Healthy school children (N = 41; 9-15 years old) received painful heat stimuli and completed measures of state and trait pain catastrophizing. They then performed an attention-switching task wherein they had to shift attention between personally relevant pain-related and neutral cues. Two weeks after the painful task, children's pain-related memories were elicited via telephone. Findings indicated that children's reduced ability to disengage attention away from pain information predicted more fear memory bias 2 weeks later. Children's pain-related attention-shifting ability did not moderate the relationship between children's pain catastrophizing and negatively biased pain memories. Findings highlight the contribution of children's attention control skills in the development of negatively biased pain memories. PERSPECTIVE: Results of the current study indicate that children with a reduced ability to shift attention away from pain information are at risk for developing negatively biased pain memories. Findings can inform interventions to minimize the development of these maladaptive negatively biased pain memories by targeting pain-relevant attention control skills in children.
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Affiliation(s)
- Aline Wauters
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Dimitri M L Van Ryckeghem
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium; Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands
| | - Melanie Noel
- Department of Psychology, Hotchkiss Brain Institute, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Emma Rheel
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium; Pain in Motion research group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tine Vervoort
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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29
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Nasir M, Scott EJ, Westermann RC. Pain Catastrophizing, Kinesiophobia, Stress, Depression, and Poor Resiliency Are Associated With Pain and Dysfunction in the Hip Preservation Population. Iowa Orthop J 2023; 43:125-132. [PMID: 38213857 PMCID: PMC10777701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Background Psychiatric disorders are known to have a negative impact on outcomes attained from hip-preservation surgery. Psychosocial traits such as resiliency and pain avoidance likely also affect treatment outcomes, however these characteristics are less easily identified, and data is lacking supporting their presence and impact on related outcomes within the hip preservation population. We therefore evaluated hip preservation patients for a variety of maladaptive psychosocial traits and assessed patient-reported outcomes (PROs) in order to ascertain which specific traits were most associated with hip pain and dysfunction. Methods 62 subjects aged 15-49 years presenting for evaluation of a nonarthritic hip condition completed psychosocial questionnaires and patient reported outcome measures via electronic survey as listed in table one. Participants were tested again eight weeks later to evaluate the relationship between changes in physical function, pain, and mental health behaviors. Pearson correlation coefficients assessed association between hip PROs and psychosocial tests and analyses were corrected for multiple comparisons. Results Pain Catastrophizing (PCS), Kinesiophobia (TSK), Stress, and PROMIS-Global Mental Health (GMH) scores correlated with poor physical function and high pain scores at zero and eight weeks. Low resiliency (BRS) and depression were also associated with elevated pain on PRO tests as well as HOOS-Physical Function. There was a moderately strong correlation between improvement in PROMIS-Physical Function (PF) from zero to eight weeks and subjects initial scores for kinesiophobia, anxiety, and stress (r= -0.45, -0.41, -0.44, all p<0.05). Conclusion PCS, TSK, Stress, Depression, and low BRS are associated with pain and disability in hip preservation subjects. Elevated TSK, Anxiety and Stress may be predictors of failure to improve with nonoperative treatment. These psychosocial characteristics should be investigated further as predictors of clinical outcomes in the hip preservation population. Level of Evidence: II.
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Affiliation(s)
- Momin Nasir
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Elizabeth J. Scott
- Department of Orthopaedics and Rehabilitation, Duke University, Durham, North Carolina, USA
| | - Robert C. Westermann
- Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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30
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van Roozendaal AS, Schellekens MPJ, van Woezik RAM, van der Lee ML. Exploring the dynamic interconnectedness of protective and perpetuating factors of cancer-related fatigue. Psychooncology 2023; 32:1876-1884. [PMID: 37902175 DOI: 10.1002/pon.6235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/29/2023] [Accepted: 10/18/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVE Approximately 25% of cancer patients suffer from cancer-related fatigue (CRF) after cancer treatment. CRF is a multi-factorial condition affected by several interrelated protective and perpetuating factors. As most studies merely assessed bivariate associations, more insight into the complex relationships among these constructs is needed. We applied the multivariate network approach to gain a better understanding of how patients' fatigue, perpetuating and protective factors are dynamically interconnected. METHOD Between February and August 2022, 30 cancer patients filled out a carefully developed ecological momentary assessment questionnaire (EnergyInSight) five times a day for at least 21 days while being on the waitlist for psychological care for CRF. We performed a multi-level vector autoregression analysis to examine the interconnectedness among fatigue, protective factors (allowing rest, acceptance, and self-efficacy) and perpetuating factors (worrying, catastrophizing, and feeling guilty). RESULTS In the contemporaneous network (concurrent associations), higher acceptance and self-efficacy were associated with lower fatigue, whereas all other factors were associated with higher fatigue. The strongest relationships were between worrying and feeling guilty and between acceptance and allowing rest. In the temporal network (lagged associations), fatigue was related to two factors: higher self-efficacy preceded lower fatigue, and higher fatigue preceded increased allowing rest. CONCLUSIONS Taking all included factors into account, the networks identified self-efficacy and allowing rest as key protective factors of CRF. Patients may benefit from psychological interventions that cultivate self-efficacy, as it seems to pave the way to reduced fatigue.
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Affiliation(s)
- Anne S van Roozendaal
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands
| | - Melanie P J Schellekens
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands
- Tilburg University School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology, Tilburg, The Netherlands
| | - Rosalie A M van Woezik
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands
| | - Marije L van der Lee
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Bilthoven, The Netherlands
- Tilburg University School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology, Tilburg, The Netherlands
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Kayacik Günday Ö, Harmanci H, Şenol Y. The Effect of Affective Temperament, Pain Catastrophizing, and Anxiety Sensitivity on Pain Severity in Patients With Chronic Pelvic Pain: A Pilot Study. J Psychiatr Pract 2023; 29:447-455. [PMID: 37801636 DOI: 10.1097/pra.0000000000000742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
OBJECTIVE The goals of this study were to investigate whether there was a dominant temperament type, and to assess the effect of temperament, pain catastrophizing, and anxiety sensitivity on pain severity, in female patients diagnosed with chronic pelvic pain (CPP) compared with healthy controls. METHODS This cross-sectional study involved 51 patients 18 to 65 years of age who were diagnosed with CPP without a history of psychiatric treatment and 97 healthy volunteer women with sociodemographic characteristics similar to those of the study group. A sociodemographic form prepared by the researchers, the Anxiety Sensitivity Index, the Pain Catastrophizing Scale, a temperament scale (Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire), and a visual analog pain scale (VAS) were completed. The results were compared between the patient and control groups. Multiple regression analyses were performed to examine the predictive effects of temperament characteristics, pain catastrophizing, and anxiety sensitivity on pain severity. RESULTS Scores on the Pain Catastrophizing Scale and the VAS were statistically significantly higher in the CPP group ( P <0.001). The frequency of depressive, cyclothymic, and irritable temperaments was found to be significantly higher in the CPP group (CPP: 7.78±3.32 vs. controls: 6.54±3.19; P =0.027; CPP:10.61±4.41 vs. controls: 8.82±4.21; P =0.017; CPP: 5.22±4.29 vs. controls: 3.75±3.41; P =0.025). According to the model established by temperament traits, anxiety sensitivity, and pain catastrophizing level, pain catastrophizing level explained 11.6% of the variance in pain severity. A 1-unit change in the score for pain catastrophizing level caused a 0.278-point change in the VAS total score ( P <0.01). CONCLUSIONS Cyclothymic, depressive, and irritable temperament types that increase the risk of affective disease are more common in patients with CPP. The level of pain catastrophizing in patients with CPP affects their perception of the severity of the pain.
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Zachariades F, Maras D, Mervitz D, Martelli B, Prayal-Brown A, Hayawi L, Barrowman N, Lamontagne C. Virtual psychoeducation for improvement of pain catastrophizing in pediatric presurgical patients and caregivers: a proof-of-concept study. Can J Anaesth 2023; 70:1753-1764. [PMID: 37789219 DOI: 10.1007/s12630-023-02583-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 10/05/2023] Open
Abstract
PURPOSE Pain catastrophizing (PC) is the tendency to magnify the threat value of pain sensations and is associated with greater postsurgical pain intensity, functional disability, and pain chronicity. Higher parental PC predicts higher chronic postsurgical pain in youth. Treating PC in caregivers and youth prior to surgery may improve recovery and surgical outcomes. We developed and evaluated a psychoeducational workshop addressing PC for presurgical youth and their parents/caregivers. We hypothesized that parent/caregiver and youth PC scores would decrease over time. We also explored preintervention levels of youth anxiety and depression as moderators of outcome. METHODS Youth (n = 43) and caregivers (n = 41) attended a virtual, group-based single-session intervention (SSI). Single-session intervention content addressed pain neuroscience, PC, and adaptive coping strategies for managing pain and PC drawn from cognitive-behavioural, acceptance and commitment, and dialectical behaviour therapy approaches. Participants completed questionnaires assessing PC at preintervention, postintervention, and two weeks postsurgery. Youth mood and anxiety were assessed at preintervention. RESULTS Caregiver PC scores decreased from pre- to postintervention (P = 0.006), and this was maintained at postsurgery (P = 0.002). Youth PC scores decreased from preintervention to postsurgery, but only for those with higher preintervention anxiety (P = 0.01). CONCLUSION Our results provide proof-of-concept support for a virtual SSI targeting caregivers and youth PC during the perioperative period. The present findings highlight the possible need to screen presurgical candidates for symptoms of anxiety. Replication with larger and more diverse samples, and a more robust design are warranted.
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Affiliation(s)
| | - Danijela Maras
- Mental Health Service, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Deborah Mervitz
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
- Acute Pain Service, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Brenda Martelli
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
- Acute Pain Service, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Audrey Prayal-Brown
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Lamia Hayawi
- Clinical Research Unit, Research Institute, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Nick Barrowman
- Clinical Research Unit, Research Institute, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Christine Lamontagne
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
- Chronic Pain Services at the Children's Hospital of Eastern Ottawa, Ottawa, ON, Canada.
- Children's Hospital of Eastern Ontario, 401 Symth Rd., Ottawa, ON, K1H 8L1, Canada.
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Rasmussen AH, Petersen LK, Kaasgaard Sperling M, Bertelsen MM, Rathleff MS, Petersen KKS. The potential effect of walking on quantitative sensory testing, pain catastrophizing, and perceived stress: an exploratory study. Scand J Pain 2023; 23:751-758. [PMID: 37694875 DOI: 10.1515/sjpain-2023-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES Studies suggest that a range of pain mechanisms, such as poor quality of sleep, perceived stress, pain catastrophizing or pain sensitivity, are likely to enhance clinical pain. Animal studies suggest that these pain mechanisms can be modulated by increasing physical activity, but human data are needed to support this hypothesis. This exploratory study aimed to investigate the changes in pain mechanisms after a simple self-directed walking program of 8-weeks. Additionally, this exploratory study investigated the interaction between changes over time in assessments of poor quality of sleep, perceived stress, pain catastrophizing or pain sensitivity and how these changes interacted with each other. METHODS This prospective cohort study included 30 healthy subjects who were assessed at baseline and 4- and 8-weeks after initiating the walking program (30 min walking/day for 8 weeks). Self-report outcomes included: Pain Catastrophizing Scale (PCS), the Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index. Pressure pain thresholds, temporal summation of pain and conditioned pain modulation (CPM) were assessed using cuff algometry. RESULTS Twenty-four subjects completed all the visits (age: 42.2, SD: 14.9, 16 females). PCS and PSS significantly decreased at the 8-week's visit compared to baseline (p<0.05). No significant differences were seen for an improvement in quality of sleep (p=0.071) and pain sensitivity (p>0.075) when comparing the 8-week's visit to the baseline visit. Changes in pain mechanisms comparing baseline and 8-weeks data were calculated and regression analyses found that an improvement in PCS was associated with an improvement in CPM (R2=0.197, p=0.017) and that a higher adherence to the walking program was associated with a larger improvement in PCS (R2=0.216, p=0.013). CONCLUSIONS The current exploratory study indicates that a simple self-directed walking program of 8-weeks can improve pain catastrophizing thoughts, perceived stress. Higher adherence to the walking program were associated with an improvement in pain catastrophizing and an improvement in pain catastrophizing was associated with an increase in conditioned pain modulation.
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Affiliation(s)
- Anna Houmøller Rasmussen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Lærke Kjeldgaard Petersen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Mette Kaasgaard Sperling
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Maria Møller Bertelsen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Michael Skovdal Rathleff
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Clinical Medicine, Center for General Practice, Aalborg University, Aalborg, Denmark
| | - Kristian Kjær-Staal Petersen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Center for Neuroplasticity and Pain, Aalborg University, Aalborg, Denmark
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Aalborg University, Aalborg, Denmark
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Mooney KM, Mulroy M, Poirier É, Pukall CF. Interpersonal Experiences with Persistent Genital Arousal: Connections between Symptom Disclosure, Partner Responses, and Catastrophizing on Relationship Adjustment and Symptom Severity. J Sex Marital Ther 2023; 50:182-196. [PMID: 37878759 DOI: 10.1080/0092623x.2023.2269931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Increased research attention to interpersonal factors in genitopelvic pain conditions, such as vulvodynia, have led to more comprehensive understanding of couple dynamics in pain, sexual, and relationship outcomes. There has been very little examination of interpersonal factors in Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia (PGAD/GPD), a distressing condition involving persistent sensations of arousal and often pain. The aims of the present study were to examine whether individuals disclose their symptoms to intimate partners and whether interpersonal variables (e.g., partner responses, symptom disclosure, and catastrophizing) are related to relationship adjustment and symptom severity. Seventy-six individuals with symptoms of PGAD/GPD participated in a one-time anonymous online survey. Over three-quarters (85.5%) of the sample disclosed their symptoms to their partners in some way. Greater supportive partner responses and lower symptom catastrophizing were related to better relationship adjustment among participants with PGAD/GPD symptoms. Greater symptom catastrophizing also predicted greater PGAD/GPD symptom severity. Partner responses were not related to PGAD/GPD symptom severity. Although interpersonal factors have been linked to symptom severity in chronic pain and genitopelvic pain conditions, the results of the current study suggest that interpersonal factors may play a slightly different role in PGAD/GPD symptom experiences and in the conceptualization of PGAD/GPD more broadly.
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Affiliation(s)
- Kayla M Mooney
- Department of Psychology, Queen's University, Kingston, Canada
| | - Maeve Mulroy
- Department of Psychology, Queen's University, Kingston, Canada
| | - Évéline Poirier
- Department of Psychology, Queen's University, Kingston, Canada
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Jee HJ, Zhu E, Sun M, Liu W, Zhang Q, Wang J. Anterior cingulate cortex regulates pain catastrophizing-like behaviors in rats. Mol Brain 2023; 16:71. [PMID: 37833814 PMCID: PMC10576271 DOI: 10.1186/s13041-023-01060-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023] Open
Abstract
Negative pain expectation including pain catastrophizing is a well-known clinical phenomenon whereby patients amplify the aversive value of a painful or oftentimes even a similar, non-painful stimulus. Mechanisms of pain catastrophizing, however, remain elusive. Here, we modeled pain catastrophizing behavior in rats, and found that rats subjected to repeated noxious pin pricks on one paw demonstrated an aversive response to similar but non-noxious mechanical stimuli delivered to the contralateral paw. Optogenetic inhibition of pyramidal neuron activity in the anterior cingulate cortex (ACC) during the application of repetitive noxious pin pricks eliminated this catastrophizing behavior. Time-lapse calcium (Ca2+) imaging in the ACC further revealed an increase in spontaneous neural activity after the delivery of noxious stimuli. Together these results suggest that the experience of repeated noxious stimuli may drive hyperactivity in the ACC, causing increased avoidance of subthreshold stimuli, and that reducing this hyperactivity may play a role in treating pain catastrophizing.
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Affiliation(s)
- Hyun Jung Jee
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA
- Interdisciplinary Pain Research Program, New York University Langone Health, New York, NY, 10016, USA
| | - Elaine Zhu
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Mengqi Sun
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Weizhuo Liu
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Qiaosheng Zhang
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA.
- Interdisciplinary Pain Research Program, New York University Langone Health, New York, NY, 10016, USA.
| | - Jing Wang
- Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, NY, 10016, USA.
- Interdisciplinary Pain Research Program, New York University Langone Health, New York, NY, 10016, USA.
- Department of Neuroscience and Physiology, New York University Grossman School of Medicine, New York, NY, 10016, USA.
- Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, 10016, USA.
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Hassan S, Nesovic K, Babineau J, Furlan AD, Kumbhare D, Carlesso LC. Identifying chronic low back pain phenotypic domains and characteristics accounting for individual variation: a systematic review. Pain 2023; 164:2148-2190. [PMID: 37027149 DOI: 10.1097/j.pain.0000000000002911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/27/2023] [Indexed: 04/08/2023]
Abstract
ABSTRACT Interpatient variability is frequently observed among individuals with chronic low back pain (cLBP). This review aimed at identifying phenotypic domains and characteristics that account for interpatient variability in cLBP. We searched MEDLINE ALL (through Ovid), Embase Classic and EMBASE (through Ovid), Scopus, and CINAHL Complete (through EBSCOhost) databases. Studies that aimed to identify or predict cLBP different phenotypes were included. We excluded studies that focused on specific treatments. The methodological quality was assessed using an adaptation of the Downs and Black tool. Forty-three studies were included. Although the patient and pain-related characteristics used to identify phenotypes varied considerably across studies, the following were among the most identified phenotypic domains and characteristics that account for interpatient variability in cLBP: pain-related characteristics (including location, severity, qualities, and duration) and pain impact (including disability, sleep, and fatigue), psychological domains (including anxiety and depression), behavioral domains (including coping, somatization, fear avoidance, and catastrophizing), social domains (including employment and social support), and sensory profiling (including pain sensitivity and sensitization). Despite these findings, our review showed that the evidence on pain phenotyping still requires further investigation. The assessment of the methodological quality revealed several limitations. We recommend adopting a standard methodology to enhance the generalizability of the results and the implementation of a comprehensive and feasible assessment framework to facilitate personalized treatments in clinical settings.
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Affiliation(s)
- Samah Hassan
- Institute of Education Research (TIER), University Health Network, Toronto, ON, Canada
| | - Karlo Nesovic
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Jessica Babineau
- Institute of Education Research (TIER), University Health Network, Toronto, ON, Canada
- Library and Information Services, University Health Network, Toronto, ON, Canada
| | - Andrea D Furlan
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Dinesh Kumbhare
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lisa C Carlesso
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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Wang Y, Li X, Zhang Y, Ma Y, Xu S, Shuai Z, Pan F, Cai G. Association of Sleep Disturbance With Catastrophizing and Knee Pain: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2023; 75:2134-2141. [PMID: 37038964 PMCID: PMC10524285 DOI: 10.1002/acr.25127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 02/15/2023] [Accepted: 04/04/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE To investigate the relationship between sleep disturbance, catastrophizing, and knee pain in middle-aged and older individuals. METHODS Data from the Osteoarthritis Initiative cohort from months 48 to 96 were used, where month 48 was treated as baseline. Knee pain (Western Ontario and McMaster Universities Osteoarthritis Index pain scale score ≥5 [range 0-20]), catastrophizing (extracted from Coping Strategies Questionnaire score ≥3 [range 0-6]), and sleep quality (extracted from Center for Epidemiologic Studies Depression Scale [range 1-4]) were assessed annually. We described the association of sleep disturbance with the presence and risk of knee pain and catastrophizing. The mediation effect of knee pain and catastrophizing on the sleep-catastrophizing and sleep-pain association was evaluated, respectively. RESULTS Catastrophizing and knee pain were reported in 346 (10%) and 917 (24%) of the 3,813 participants (mean 64.9 years, 58% female) at baseline. Participants with worse sleep disturbance were more likely to have knee pain (prevalence ratio [PR] 1.4-2.0, P for trend <0.001) and catastrophizing (PR 1.4-3.1, P for trend <0.001). Sleep disturbance at baseline predicted the risk of knee pain (risk ratio [RR] 1.1, P for trend <0.001) and catastrophizing (RR 1.2-1.7, P for trend <0.001) during follow-up. No statistically significant interactions between sleep disturbance and knee pain or catastrophizing were observed. Knee pain and catastrophizing mediated the sleep-catastrophizing and sleep-pain association, respectively, at baseline, and knee pain negatively mediated the sleep-catastrophizing association longitudinally. CONCLUSION Sleep disturbance was associated with the presence and risk of catastrophizing and knee pain. Sleep interventions may have a universal and independent effect in preventing incident knee pain.
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Affiliation(s)
- Yining Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Xiaoxi Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Youyou Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Shengqian Xu
- Department of Rheumatism and Immunity, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Zongwen Shuai
- Department of Rheumatism and Immunity, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
| | - Guoqi Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, Anhui, China
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Blanch A, Solé S. Classification of pain intensity with the pain beliefs and perceptions inventory (PBPI) and the pain catastrophizing scales (PCS). Qual Life Res 2023; 32:2853-2859. [PMID: 37233965 PMCID: PMC10214345 DOI: 10.1007/s11136-023-03444-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE The pain beliefs and perceptions inventory (PBPI) and the pain catastrophizing scales (PCS) characterize beliefs or distress dimensions of the pain experience. It is relatively unknown, however, to what degree the PBPI and the PCS are well suited to classifying pain intensity. METHODS This study applied a receiver operating characteristic (ROC) approach to these instruments against the criterion of a visual analogue scale (VAS) of pain intensity with fibromyalgia and chronic back pain patients (n = 419). RESULTS The largest areas under the curve (AUC) were moderate and limited to the constancy subscale (71%) and total score (70%) of the PBPI and to the helplessness subscale (75%) and total score (72%) of the PCS. The best cut-off scores for the PBPI and PCS were better off at detecting true negatives than true positives, with larger specificity than sensitivity values. CONCLUSION Whereas, the PBPI and PCS are certainly useful instruments to evaluate diverse pain experiences, they may be inappropriate to classify intensity. The PCS performs marginally better than the PBPI for classifying pain intensity.
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Affiliation(s)
- Angel Blanch
- Department of Psychology, University of Lleida, Lleida, Spain
| | - Sílvia Solé
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Department of Physiotherapy, Andalucia TECH, University of Malaga, Málaga, Spain
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Imperiale MN, Lieb R, Meinlschmidt G. Treatment-associated network dynamics in patients with globus sensations: a proof-of-concept study. Sci Rep 2023; 13:15615. [PMID: 37730963 PMCID: PMC10511470 DOI: 10.1038/s41598-023-42186-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 09/06/2023] [Indexed: 09/22/2023] Open
Abstract
In this proof-of-concept study, we used a systems perspective to conceptualize and investigate treatment-related dynamics (temporal and cross-sectional associations) of symptoms and elements related to the manifestation of a common functional somatic syndrome (FSS), Globus Sensations (GS). We analyzed data from 100 patients (M = 47.1 years, SD = 14.4 years; 64% female) with GS who received eight sessions of group psychotherapy in the context of a randomized controlled trial (RCT). Symptoms and elements were assessed after each treatment session. We applied a multilevel graphical vector-autoregression (ml GVAR) model approach resulting in three separate, complementary networks (temporal, contemporaneous, and between-subject) for an affective, cognitive, and behavioral dimension, respectively. GS were not temporally associated with any affective, cognitive, and behavioral elements. Temporally, catastrophizing cognitions predicted bodily weakness (r = 0.14, p < 0.01, 95% confidence interval (CI) [0.04-0.23]) and GS predicted somatic distress (r = 0.18, p < 0.05, 95% CI [0.04-0.33]). Potential causal pathways between catastrophizing cognitions and bodily weakness as well as GS and somatic distress may reflect treatment-related temporal change processes in patients with GS. Our study illustrates how dynamic NA can be used in the context of outcome research.
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Affiliation(s)
- Marina N Imperiale
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstrasse 62a, 4055, Basel, Switzerland
| | - Roselind Lieb
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstrasse 62a, 4055, Basel, Switzerland
| | - Gunther Meinlschmidt
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstrasse 62a, 4055, Basel, Switzerland.
- Department of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University (IPU) Berlin, Stromstrasse 1, 10555, Berlin, Germany.
- Department of Digital and Blended Psychosomatics and Psychotherapy, Psychosomatic Medicine, University Hospital Basel and University of Basel, Hebelstrasse 2, 4031, Basel, Switzerland.
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Nyitrai E, Takács S. [Psychological factors influencing the experience of menstrual pain - the role of pain catastrophizing]. Orv Hetil 2023; 164:1469-1475. [PMID: 37717237 DOI: 10.1556/650.2023.32857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/26/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Research on menstrual pain is lacking in the literature in terms of the number of people affected, the amount of time spent suffering, and the consequences. OBJECTIVE We examined the role of pain catastrophizing in experiencing the subjective extent and frequency of menstrual pain and its perception as a limitation to daily activities. METHOD In our study, during personal tests between 2015 and 2018, we collected data from around 1000 healthy women aged 18 to 51 years, predominantly with secondary and higher education, already and still menstruating, mostly living in a large city, mainly in a relationship, perceiving themselves to be in excellent or good health, predominantly not using hormonal contraceptives, mostly having a regular menstrual cycle. We used an open-ended question to measure the extent, frequency, and impact on daily activities of menstrual pain, and used the Pain Catastrophizing Questionnaire. RESULTS In our own sample, we found that the more the subject "tends" to report pain catastrophizing, the stronger is the menstrual pain she reports, the more often she experiences menstrual pain and says that the pain limits her daily activities. CONCLUSION The results showed that it is worth examining the personality characteristics among the factors influencing the extent of menstrual pain; the results can be incorporated into diagnostic and therapeutic work. Orv Hetil. 2023; 164(37): 1469-1475.
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Affiliation(s)
- Erika Nyitrai
- 1 Károli Gáspár Református Egyetem, Személyiség- és Egészségpszichológia Tanszék Budapest, Bécsi út 321., 1032 Magyarország
| | - Szabolcs Takács
- 2 Károli Gáspár Református Egyetem, Általános Lélektani és Módszertani Tanszék Budapest Magyarország
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Alcon C, Bergman E, Humphrey J, Patel RM, Wang-Price S. The Relationship between Pain Catastrophizing and Cognitive Function in Chronic Musculoskeletal Pain: A Scoping Review. Pain Res Manag 2023; 2023:5851450. [PMID: 37719894 PMCID: PMC10505081 DOI: 10.1155/2023/5851450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/16/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
Objective Chronic musculoskeletal pain (CMP) poses a considerable threat to physical, mental, and financial health worldwide. Beyond physical difficulties, CMP has a pronounced impact on pain behaviors and cognitive function. The purpose of this scoping review was to examine the relationship between pain catastrophizing (PC) and cognitive function in CMP, identify gaps in the literature, and provide future directions for research on the topic. Methods Search strings were entered in the following databases: PubMed, CINAHL, Nursing and Allied Health, Ovid Emcare, PsycInfo, and Scopus. Data from the included articles were extracted thematically based on diagnostic classification and included author(s), year of publication, country, aim, sample, methods, intervention (if applicable), and key findings. Results 30 articles were included after screening. The studied populations included patients with fibromyalgia, chronic low back pain, and CMP. Two studies were designed to assess the relationship between PC and cognition as the primary aim. The included studies demonstrated variable evidence regarding the relationship between PC and cognition. Only four studies included clinically relevant PC populations (i.e., Pain Catastrophizing Scale score >30), and all found significant correlations. Conclusion Although evidence exists for the relationship between cognitive function and PC, there is a lack of rigorous research to indicate the strength of this relationship and the specific cognitive functions affected. The literature lacks appropriate populations needed to investigate clinically relevant PC and is limited by heterogeneous neuropsychological test batteries. Future research should include populations demonstrating the behaviors being studied, intentional analysis of outcomes, and appropriate cognitive tests.
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Affiliation(s)
- Cory Alcon
- High Point University, Department of Physical Therapy, High Point, NC, USA
- Texas Woman's University, School of Physical Therapy, Dallas, TX, USA
| | - Elizabeth Bergman
- Texas Woman's University, School of Physical Therapy, Houston, TX, USA
| | - John Humphrey
- Texas Woman's University, School of Physical Therapy, Dallas, TX, USA
| | - Rupal M. Patel
- Texas Woman's University, School of Physical Therapy, Houston, TX, USA
| | - Sharon Wang-Price
- Texas Woman's University, School of Physical Therapy, Dallas, TX, USA
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Chen J, Caluori C, Alberton L, Zhang J, Shashoua D, Calva V, Gauthier N, Edger-Lacoursière Z, de Oliveira A, Marois-Pagé E, Nedelec B. Validation of the Burn Survivor Fear-Avoidance Questionnaire and Its Association With Pain Intensity, Catastrophizing, and Disability. J Burn Care Res 2023; 44:1189-1199. [PMID: 36812056 DOI: 10.1093/jbcr/irad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Indexed: 02/24/2023]
Abstract
According to the Fear-avoidance (FA) model, FA beliefs can lead to disability due to avoidance of activities expected to result in pain or further injury. Extensive research on the relationship of FA, pain, catastrophizing, and disability has been generated with patients suffering from chronic neck and back pain, but little research has been conducted with burn survivors. To address this need, the Burn Survivor FA Questionnaire (BSFAQ) was developed (Langlois J, Vincent-Toskin, S, Duchesne, P et al. Fear-avoidance beliefs and behaviors of burn survivors: A mixed-methods approach. Burns 2021;47:175-89.) but has not been validated. Thus, the primary objective of this study was to investigate the construct validity of the BSFAQ among burn survivors. The secondary objective was to examine the relationship between FA and 1) pain intensity and 2) catastrophizing at baseline, 3 months and 6 months postburn, and 3) disability among burn survivors at 6 months postburn. A prospective mixed-methods approach was used to examine the construct validity by comparing the quantitative scores of the BSFAQ to independently performed qualitative interviews of burn survivors (n = 31) that explored their lived experiences, to determine if the BSFAQ discriminated those who had, from those who did not have FA beliefs. Data for the secondary objective, scores of burn survivors (n = 51) pain intensity (numeric rating scale), catastrophizing (pain catastrophizing scale), and disability (Burn Specific Health Scale-brief), were collected through a retrospective chart review. For the primary objective, Wilcoxon rank sum test results showed a statistically significant difference (P = .015) between the BSFAQ scores of participants who were identified from the qualitative interviews as fear avoidant compared to those who were identified as non fear avoidant, with a receiver operating characteristic curve indicating that the BSFAQ correctly predicted FA 82.4% of the time. For the secondary objective, Spearman correlation test results showed a moderate correlation between FA and 1) pain at baseline (r = .466, P = .002), 2) catastrophizing thoughts over time (r = .557, P = .000; r = .470, P = .00; r = .559, P = .002 respectively at each time point), and 3) disability at 6 months postburn (r = -.643, P = .000). These results support that the BSFAQ is able to discriminate which burn survivors are experiencing FA beliefs. It is also consistent with the FA model since burn survivors who express FA are more likely to report higher levels of pain early during their recovery that correlates with persistently elevated catastrophizing thoughts and ultimately results in higher self-reported disability. The BSFAQ demonstrates construct validity and is able to correctly predict fear-avoidant burn survivors; however, additional research is required to further examine the BSFAQ's clinimetric properties.
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Affiliation(s)
- Jocelyn Chen
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Cassandra Caluori
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Laura Alberton
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Jinny Zhang
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | | | - Valérie Calva
- Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada
| | | | - Zoë Edger-Lacoursière
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Ana de Oliveira
- Centre de recherche, Center hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | | | - Bernadette Nedelec
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- Hôpital de réadaptation Villa Medica, Montréal, Québec, Canada
- Centre de recherche, Center hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
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Abe T, Tamura M, Azuma N, Matsui K. The role of pain catastrophizing in pain perception among patients with rheumatoid arthritis without clinical signs of inflammation. Musculoskeletal Care 2023; 21:694-701. [PMID: 36748978 DOI: 10.1002/msc.1740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Pain in rheumatoid arthritis (RA) is considered to be associated with non-inflammatory factors, including physical disabilities, psychiatric disorders, and pain catastrophizing (PC). PC is reportedly a key driver in the development of pain in patients with RA without clinical signs of inflammation; however, previous studies enroled patients with RA who were potentially in an inflammatory state. Hence, our aim was to investigate the role of PC as the possible link between pain, physical disabilities, and psychiatric disorders in patients with RA without clinical signs of inflammation. MATERIALS AND METHODS In this cross-sectional study, 81 patients with RA without clinical signs of inflammation were included; all patients had serum C-reactive protein levels <0.5 mg/dL, without any inflammatory joints. We examined the demographic and clinical data and administered the pain visual analogue scale (VAS), pain catastrophizing scale (PCS), Health Assessment Questionnaire Disability Index (HAQ-DI), and patient version of the Brief Scale for Psychiatric Problems in Orthopaedic Patients (pBS-POP). A series of multivariate-adjusted multiple regression analyses were performed to examine the associations between PC and pain intensity, physical disabilities, and psychiatric disorders. RESULTS We found associations between all the above-mentioned variables in separate models with HAQ-DI, pBS-POP, and PCS scores. However, in the model associated with pain VAS, the PCS score (β = 0.34, p = 0.0073) emerged as the only variable showing a statistically significant association. CONCLUSIONS PC is associated with pain in patients with RA without clinical signs of inflammation, and this association may be mediated through pathways involving physical disabilities and psychiatric disorders.
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Affiliation(s)
- Takeo Abe
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
- Department of Rheumatology Medicine, Kobe City Medical Center West Hospital, Kobe-shi, Hyogo, Japan
| | - Masao Tamura
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
- Department of Rheumatology Medicine, Kobe City Medical Center West Hospital, Kobe-shi, Hyogo, Japan
| | - Naoto Azuma
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Kiyoshi Matsui
- Division of Diabetes, Endocrinology and Clinical Immunology, Department of Internal Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
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Neves Antonio GL, Almeida MQ, Avila MA, de Noronha MA, Approbato Selistre LF. Efficacy of telerehabilitation exercise in patients with chronic neck pain: a protocol for a non-inferiority randomized controlled trial. Pain Manag 2023; 13:497-507. [PMID: 37850374 DOI: 10.2217/pmt-2023-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
The aim of this study is to investigate if telerehabilitation is just as effective as the same face-to-face exercise program in patients with chronic neck pain (NP). 140 participants will participate in this non-inferiority randomized controlled trial. Primary outcomes will be pain intensity and disability, and secondary outcomes will be kinesiophobia, catastrophizing, fear avoidance beliefs, anxiety and depression symptoms, self-efficacy for pain and global perceived effect. It will be collected at baseline, 6 weeks and 6 months after intervention. The analysis of non-inferiority will be calculated by mixed linear models considering the non-inferiority margin. The results of this clinical trial will be able to overcome the barriers that physiotherapists face for the success of their therapies. In addition, it may reduce the high demands and public health costs with NP. Brazilian Clinical Trials Registry (RBR-6VBSMB). Clinical Trial Registration: REBEC (Brazilian Registry of Clinical Trials) RBR-6VBSMB (ClinicalTrials.gov).
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Affiliation(s)
| | | | - Mariana Arias Avila
- Department of Physical Therapy, Federal University of São Carlos (UFSCar) São Carlos, São Paulo, Brazil
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Delgado-López PD, Fernández Carballal C, Paredes I, Roldan Delgado H, Suárez Fernández D, Vázquez Míguez A. Catastrophising in spinal surgery and the impact of radiology reports. Neurocirugia (Astur : Engl Ed) 2023; 34:217-220. [PMID: 37516278 DOI: 10.1016/j.neucie.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Affiliation(s)
- Pedro David Delgado-López
- Servicio de Neurocirugía, Hospital Universitario de Burgos, Burgos, Spain; Sociedad Española de Cirugía Vertebral y Medular - Neurorraquis, Spain.
| | - Carlos Fernández Carballal
- Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Sociedad Española de Cirugía Vertebral y Medular - Neurorraquis, Spain
| | - Igor Paredes
- Servicio de Neurocirugía, Hospital Universitario 12 de Octubre, Madrid, Spain; Sociedad Española de Cirugía Vertebral y Medular - Neurorraquis, Spain
| | - Héctor Roldan Delgado
- Servicio de Neurocirugía, Complejo Hospitalario universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain; Sociedad Española de Cirugía Vertebral y Medular - Neurorraquis, Spain
| | - David Suárez Fernández
- Servicio de Neurocirugía, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain; Sociedad Española de Cirugía Vertebral y Medular - Neurorraquis, Spain
| | - Alfonso Vázquez Míguez
- Servicio de Neurocirugía, Hospital Universitario de Pamplona, Pamplona, Navarra, Spain; Sociedad Española de Cirugía Vertebral y Medular - Neurorraquis, Spain
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Priol R, Pasquier G, Putman S, Migaud H, Dartus J, Wattier JM. Trajectory of chronic and neuropathic pain, anxiety and depressive symptoms and pain catastrophizing after total knee replacement. Results of a prospective, single-center study at a mean follow-up of 7.5 years. Orthop Traumatol Surg Res 2023; 109:103543. [PMID: 36608901 DOI: 10.1016/j.otsr.2022.103543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/30/2022] [Accepted: 09/22/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION A considerable number of patients are not satisfied after total knee replacement (TKR) because of persistent pain. This pain can also be neuropathic in origin. Both types of pain have a large impact on function and quality of life. Furthermore, the trajectory of anxiety and depressive symptoms and pain catastrophizing has rarely been studied after TKR surgery. The primary objective of this study was to define the trajectory of knee pain after primary TKR. The secondary objectives were to evaluate how neuropathic pain, anxiety and depressive symptoms and pain catastrophizing change over time. METHODS This prospective, single-center study included patients who underwent primary TKR for primary osteoarthritis between July 2011 and December 2012. Personal data (age, sex, body mass index, knee history, operated side, surgical approach, type of implant, operative time, and rehabilitation course) and the responses to seven questionnaires (Numerical pain rating scale, DN4-interview for neuropathic pain, Oxford Knee Scale, Hospital and Anxiety Depression Scale, Beck Depression Inventory, Patient Catastrophizing Scale and Brief Pain Inventory) were determined preoperatively, at 6 months postoperative and at a mean follow-up of 7.5 years. RESULTS Preoperatively, 129 patients (35 men, 94 women) filled out all the questionnaires. Subsequently, 32 patients were excluded because of incomplete responses at 6 months postoperative, 6 were excluded because they had undergone revision surgery, 11 patients were lost to follow-up and 5 patients had died. In the end, 65 patients were available for analysis (50% of the initial cohort) who were 74 years old on average at inclusion. Between the preoperative period and 6 months postoperative, pain (p<0.001), function (p<0.001), anxiety symptoms (p<0.001) and catastrophizing (p<0.001) had improved. Depressive symptoms did not change (p=0.63). Between 6 months postoperative and the latest follow-up, none of the parameters changed further (p>0.05). Of the 65 patients analyzed, 21% had chronic pain of undefined origin at 6 months postoperative and 26% had chronic pain at the end of follow-up, with 50% also having neuropathic pain. Preoperatively, 40% of the 65 patients had neuropathic pain, 30% at 6 months (p=0.27) and 18% at 7.5 years after TKR (p=0.01). CONCLUSION The number of patients who have chronic pain after TKR is considerable, especially since knee pain stabilized at 6 months postoperative. Early detection is vital to prevent the pain from becoming chronic, which makes it more difficult to treat. Half the patients with persistent pain also had neuropathic pain, which should be detected before surgery so the patients can be referred to a specialized pain management center. The presence of anxiety and depressive symptoms and pain catastrophizing is not a contraindication to TKR, but these patients should be referred to specialists for treatment before surgery. LEVEL OF EVIDENCE IV, prospective cohort study.
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Affiliation(s)
- Romain Priol
- Service d'orthopédie, hôpital Roger-Salengro, centre hospitalier régional universitaire de Lille (CHRU de Lille), rue Emile-Laine, 59037 Lille, France.
| | - Gilles Pasquier
- Service d'orthopédie, hôpital Roger-Salengro, centre hospitalier régional universitaire de Lille (CHRU de Lille), rue Emile-Laine, 59037 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France
| | - Sophie Putman
- Service d'orthopédie, hôpital Roger-Salengro, centre hospitalier régional universitaire de Lille (CHRU de Lille), rue Emile-Laine, 59037 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France
| | - Henri Migaud
- Service d'orthopédie, hôpital Roger-Salengro, centre hospitalier régional universitaire de Lille (CHRU de Lille), rue Emile-Laine, 59037 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France
| | - Julien Dartus
- Service d'orthopédie, hôpital Roger-Salengro, centre hospitalier régional universitaire de Lille (CHRU de Lille), rue Emile-Laine, 59037 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France
| | - Jean-Michel Wattier
- Centre d'évaluation et de traitement de la douleur, hôpital Claude-Huriez, centre hospitalier régional universitaire de Lille (CHRU de Lille), rue Michel-Polonowski, 59000 Lille, France
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Junghaenel DU, Schneider S, Lucas G, Boberg J, Weinstein FM, Richeimer SH, Stone AA, Lumley MA. Virtual Human-Delivered Interviews for Patients With Chronic Pain: Feasibility, Acceptability, and a Pilot Randomized Trial of Standard Medical, Psychosocial, and Educational Interviews. Psychosom Med 2023; 85:627-638. [PMID: 37363989 PMCID: PMC10527278 DOI: 10.1097/psy.0000000000001228] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Seminal advances in virtual human (VH) technology have introduced highly interactive, computer-animated VH interviewers. Their utility for aiding in chronic pain care is unknown. We developed three interactive telehealth VH interviews-a standard pain-focused, a psychosocial risk factor, and a pain psychology and neuroscience educational interview. We then conducted a preliminary investigation of their feasibility, acceptability, and efficacy. We also experimentally compared a human and a computer-generated VH voice. METHODS Patients ( N = 94, age = 22-78 years) with chronic musculoskeletal pain were randomly assigned to the standard ( n = 31), psychosocial ( n = 34), or educational ( n = 29) VH interview and one of the two VH voices. Acceptability ratings included patient satisfaction and expectations/evaluations of the VH interview. Outcomes assessed at baseline and about 1-month postinterview were pain intensity, interference, emotional distress, pain catastrophizing, and readiness for pain self-management. Linear mixed-effects models were used to test between- and within-condition effects. RESULTS Acceptability ratings showed that satisfaction with the VH and telehealth format was generally high, with no condition differences. Study attrition was low ( n = 5). Intent-to-treat-analyses showed that, compared with the standard interview, the psychosocial interview yielded a significantly greater reduction in pain interference ( p = .049, d = 0.43) and a marginally greater reduction in pain intensity ( p = .054, d = 0.36), whereas the educational interview led to a marginally greater yet nonsignificant increase in readiness for change ( p = .095, d = 0.24), as well as several significant improvements within-condition. Results did not differ by VH voice. CONCLUSIONS Interactive VH interviewers hold promise for improving chronic pain care, including probing for psychosocial risk factors and providing pain-related education.
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Affiliation(s)
- Doerte U. Junghaenel
- Dornsife Center for Self-Report Science and Center for Economic & Social Research, University of Southern California, CA, USA
- Department of Psychology, University of Southern California, CA, USA
- Leonard Davis School of Gerontology, University of Southern California, CA, USA
| | - Stefan Schneider
- Dornsife Center for Self-Report Science and Center for Economic & Social Research, University of Southern California, CA, USA
- Department of Psychology, University of Southern California, CA, USA
- Leonard Davis School of Gerontology, University of Southern California, CA, USA
| | - Gale Lucas
- Institute for Creative Technologies, University of Southern California, CA, USA
- Viterbi School of Engineering, University of Southern California, CA, USA
| | - Jill Boberg
- Institute for Creative Technologies, University of Southern California, CA, USA
| | - Faye M. Weinstein
- Department of Anesthesiology, Keck School of Medicine, University of Southern California, CA, USA
| | - Steven H. Richeimer
- Department of Anesthesiology, Keck School of Medicine, University of Southern California, CA, USA
| | - Arthur A. Stone
- Dornsife Center for Self-Report Science and Center for Economic & Social Research, University of Southern California, CA, USA
- Department of Psychology, University of Southern California, CA, USA
| | - Mark A. Lumley
- Department of Psychology, Wayne State University, MI, USA
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Fujiwara A, Watanabe K, Yoshimura K, Yamamura Y, Ida M, Kawaguchi M. Correlation between pain catastrophizing in acute herpes zoster and postherpetic neuralgia: a retrospective analysis. J Anesth 2023; 37:589-595. [PMID: 37285023 DOI: 10.1007/s00540-023-03208-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/26/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE The objective of this study was to examine the association between pain catastrophizing in acute phase herpes zoster and the development of postherpetic neuralgia. METHODS The medical records of all patients diagnosed with herpes zoster between February 2016 and December 2021 were retrieved. Inclusion criteria were patients aged > 50 years who visited our pain center within 60 days after rash onset and reported a pain intensity of ≥ 3 in a numerical rating scale. Patients with a score of 30 or more in the pain catastrophizing scale at baseline were assigned to the catastrophizer group, and those with a score < 30 were assigned to the non-catastrophizer group. We defined patients with "postherpetic neuralgia" and "severe postherpetic neuralgia" as those with a numerical rating scale score of 3 or more and 7 or more at 3 months after baseline, respectively. RESULTS Data of 189 patients were available for complete analysis. Age, baseline numerical rating scale, and prevalence of anxiety and depression were significantly higher in the catastrophizer than those in the non-catastrophizer group. Incidence of postherpetic neuralgia did not differ significantly between the groups (p = 0.26). Multiple logistic regression analysis showed that age, severe pain at baseline, and immunosuppressive state were the factors which were independently associated with developing postherpetic neuralgia. Severe pain at baseline was the only factor related to developing severe postherpetic neuralgia. CONCLUSION Pain catastrophizing in the acute phase of herpes zoster may not be related to the development of postherpetic neuralgia.
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Affiliation(s)
- Aki Fujiwara
- Department of Anesthesiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8522, Japan.
| | - Keisuke Watanabe
- Department of Anesthesiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8522, Japan
| | - Kie Yoshimura
- Department of Anesthesiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8522, Japan
| | - Yuji Yamamura
- Department of Anesthesiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8522, Japan
| | - Mitsuru Ida
- Department of Anesthesiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8522, Japan
| | - Masahiko Kawaguchi
- Department of Anesthesiology, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8522, Japan
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Dugas MJ, Giguère Marchal K, Cormier S, Bouchard S, Gouin JP, Shafran R. Pain catastrophizing and worry about health in generalized anxiety disorder. Clin Psychol Psychother 2023; 30:852-861. [PMID: 36807639 DOI: 10.1002/cpp.2843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
Because the diagnostic criteria of generalized anxiety disorder (GAD) are not tied to specific worry domains (worry is 'generalized'), research on the content of worry in GAD is lacking. To our knowledge, no study has addressed vulnerability for specific worry topics in GAD. The goal of the current study, a secondary analysis of data from a clinical trial, is to explore the relationship between pain catastrophizing and worry about health in a sample of 60 adults with primary GAD. All data for this study were collected at pretest, prior to randomization to experimental condition in the larger trial. The hypotheses were that (1) pain catastrophizing would be positively related to the severity of GAD, (2) the relationship between pain catastrophizing and the severity of GAD would not be explained by intolerance of uncertainty and psychological rigidity, and (3) pain catastrophizing would be greater in participants reporting worry about health compared to those not reporting worry about health. All hypotheses were confirmed, suggesting that pain catastrophizing may be a threat-specific vulnerability for health-related worry in GAD. The implications of the current findings include a better understanding of the ideographic content of worry, which could help focus treatment interventions for individuals with GAD.
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Affiliation(s)
- Michel J Dugas
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, Quebec, Canada
| | - Katia Giguère Marchal
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, Quebec, Canada
| | - Stéphanie Cormier
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, Quebec, Canada
| | - Stéphane Bouchard
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, Quebec, Canada
| | | | - Roz Shafran
- Great Ormond Street Institute of Child Health, University College London, London, UK
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Shih S, Donati MR, Cohen LL, Shneider C, Sil S. A dyadic analysis of parent and child pain catastrophizing and health-related quality of life in pediatric sickle cell disease. Pain 2023; 164:1537-1544. [PMID: 36645172 DOI: 10.1097/j.pain.0000000000002848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/05/2022] [Indexed: 01/17/2023]
Abstract
ABSTRACT The purpose of this study was to examine the dyadic and individual level effects of parent and child pain catastrophizing on child health-related quality of life (HRQOL) in pediatric sickle cell disease. Questionnaires assessing child pain frequency, child and parent pain catastrophizing, and child HRQOL were completed by youth and their primary caregiver. A Common Fate Model was estimated to test the dyadic level relationship between parent and child pain catastrophizing and child HRQOL. An Actor-Partner-Common Fate Model hybrid was estimated to test the relationship between child HRQOL and individual-level child pain catastrophizing and parent pain catastrophizing, respectively. In each model, child HRQOL was modelled as a dyadic variable by factoring parent and child ratings. Patients (N = 100, M age = 13.5 years, 61% female) and their caregivers (M age = 41.8 years, 86% mothers) participated. Dyad-level pain catastrophizing was negatively associated with child HRQOL, demonstrating a large effect (β = -0.809). Individual-level parent and child pain catastrophizing were each uniquely negatively associated with child HRQOL, demonstrating small to medium effects (β = -0.309, β = -0.270). Individual level effects were net of same-rater bias, which was significant for both parents and children. Both the unique and the overlapping aspects of parent and child pain catastrophizing are significant contributors to associations with child HRQOL, such that higher levels of pain catastrophizing are associated with worse child HRQOL. Findings suggest the need for multipronged intervention targeting factors common to parent-child dyads and factors unique to parents and children, respectively.
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Affiliation(s)
- Sharon Shih
- Georgia State University, Atlanta, GA, United States
| | | | - Lindsey L Cohen
- Georgia State University, Atlanta, GA, United States
- Children's Healthcare of Atlanta, Atlanta, GA, United States
| | | | - Soumitri Sil
- Children's Healthcare of Atlanta, Atlanta, GA, United States
- Emory University School of Medicine, Atlanta, GA, United States
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