Rumination and valued living in women with chronic pain: How they relate to the link between mindfulness and depressive symptoms

AbstractObjectivesStudies have shown that self-compassion plays a protective role against depression in women with chronic pain (CP). However, the majority of studies in CP have used the total score of the self-compassion scale (SCS), which have raised concerns due to potential overlap, not only between the uncompassionate self-responding factors and psychopathology, but also between self-compassion as a whole and other well-known psychological processes (e.g., mindfulness, acceptance, psychological flexibility). This calls for a more nuanced understanding of which components of (un)compassionate self-responding adds to better mental health in CP.MethodsThis study explores the unique contribution of compassionate and uncompassionate self-responding to depressive symptoms in women with CP undergoing pain consultation (n = 49).ResultsCorrelation analyses suggest that compassionate self-responding only significantly correlates with progress in valued living, while the uncompassionate self-responding significantly correlates with pain fusion, pain avoidance, obstructions to valued living and depression. Multiple regression analysis showed that self-compassion contributes to depressive symptoms (R2 = 8%) above and beyond pain intensity and disability (R2 = 12%) and psychological (in) flexibility processes (R2 = 31%), and uncompassionate (but not compassionate) self-responding uniquely contributes to depressive symptoms (sr2 = 18%).ConclusionsFindings suggest that uncompassionate self-responding is a stronger contributor to depression in CP than compassionate self-responding. Clinical implications are further discussed.

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Faculty Opinions recommendation of A neural circuit for comorbid depressive symptoms in chronic pain.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.736492007.793564607 ◽

2019 ◽

Author(s):

Ru-Rong Ji

Keyword(s):

Chronic Pain ◽

Depressive Symptoms ◽

Neural Circuit

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Transdiagnostic Cognitive Processes in Chronic Pain and Comorbid PTSD and Depression in Veterans

Annals of Behavioral Medicine ◽

10.1093/abm/kaab033 ◽

2021 ◽

Author(s):

Melissa A Day ◽

Rhonda M Williams ◽

Aaron P Turner ◽

Dawn M Ehde ◽

Mark P Jensen

Keyword(s):

Chronic Pain ◽

Depressive Symptoms ◽

Pain Intensity ◽

Cognitive Processes ◽

Cognitive Process ◽

Stress Disorder ◽

Secondary Analysis ◽

Lower Pain ◽

Depression Scales ◽

Ptsd Group

Abstract Background Chronic pain in Veterans is a major problem compounded by comorbid posttraumatic stress disorder (PTSD) and depression. Adopting a transdiagnostic framework to understanding “shared territory” among these diagnoses has the potential to inform our understanding of the underlying cognitive processes and mechanisms that transverse diagnostic boundaries. Purpose To examine the associations between pain-related cognitive processes (diversion, distancing, absorption, and openness), pain intensity, PTSD and depressive symptoms, and the extent to which Veterans with chronic pain with and without comorbid PTSD and depression engage in different/similar pain-related cognitive processes. Methods Secondary analysis of pretreatment data with a subsample (n = 147) of Veterans with chronic pain from a larger clinical trial. Pretreatment PCL-5 and PROMIS Depression scales were used to categorize participants into three groups: (a) Pain-only; (b) Pain-PTSD; and (c) Pain-PTSD-DEP. Results Compared to the Pain-only group, the Pain-PTSD and Pain-PTSD-DEP groups reported significantly greater pain intensity, PTSD and depressive symptoms, and ruminative pain absorption. The Pain-PTSD-DEP group had significantly lower pain diversion and pain openness scores. When diversion and openness were used within the Pain-PTSD-DEP group, however, they were both associated with lower pain intensity and openness was additionally associated with lower PTSD scores. However, in the Pain-PTSD group, pain openness was associated with higher depression scores. Conclusions Across increasing complexity of comorbidity profiles (i.e., one vs. two comorbid conditions), ruminative absorption with pain emerged as a cognitive process that transverses diagnoses and contributes to worse outcomes. Nonjudgmental acceptance may not be universally beneficial, potentially depending upon the nature of comorbidity profiles.

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School Functioning in Adolescents With Chronic Pain: The Role of Depressive Symptoms in School Impairment

Journal of Pediatric Psychology ◽

10.1093/jpepsy/jsn143 ◽

2009 ◽

Vol 34 (8) ◽

pp. 882-892 ◽

Cited By ~ 48

Author(s):

D. E. Logan ◽

L. E. Simons ◽

K. J. Kaczynski

Keyword(s):

Chronic Pain ◽

Depressive Symptoms ◽

School Functioning

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Effect of Psychological Inflexibility on Depressive Symptoms and Sleep Disturbance among Japanese Young Women with Chronic Pain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207426 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7426

Author(s):

Tsukasa Kato

Keyword(s):

Chronic Pain ◽

Depressive Symptoms ◽

Sleep Disturbance ◽

Sleep Disturbances ◽

Female College Students ◽

Psychological Inflexibility ◽

Management Interventions ◽

Pain Status ◽

Acceptance And Commitment ◽

Acceptance And Action Questionnaire

Background: Psychological inflexibility based on an acceptance and commitment therapy model is theoretically well-established as a process to exacerbate psychological distress, such as depressive symptoms and sleep disturbance. This study aimed to examine the associations of psychological inflexibility with depressive symptoms and sleep distribution. We hypothesized that psychological inflexibility would be associated with higher levels of depressive symptoms and sleep disturbance in women with chronic pain. Methods: Female college students in Japan answered a questionnaire on pain status, treatment, and psychological inflexibility as measured by the Acceptance and Action Questionnaire-Ⅱ before answering questionnaires on depressive symptoms and sleep disturbance eight months after. Results: Women with chronic pain (n = 320) reported more severe depressive symptoms and sleep disturbances compared to women without chronic pain (n = 90). Hierarchical multiple regressions revealed that psychological inflexibility predicted higher levels of depressive symptoms and sleep disturbance, independent of the pain intensity, whether they consulted a doctor or used pain medication. Conclusion: Based on our findings self-management interventions aimed at reducing psychological inflexibility should be developed for individuals who are experiencing chronic pain.

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Transition to chronic pain in men with low back pain: Predictive relationships among pain intensity, disability, and depressive symptoms.

Health Psychology ◽

10.1037/0278-6133.17.5.421 ◽

1998 ◽

Vol 17 (5) ◽

pp. 421-427 ◽

Cited By ~ 52

Author(s):

JoAnne E. Epping-Jordan ◽

Dennis R. Wahlgren ◽

Rebecca A. Williams ◽

Sheri D. Pruitt ◽

Mark A. Slater ◽

...

Keyword(s):

Chronic Pain ◽

Low Back Pain ◽

Back Pain ◽

Depressive Symptoms ◽

Pain Intensity ◽

Low Back ◽

Predictive Relationships

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Depressive symptoms and pain evaluations among persons with chronic pain: Catastrophizing, but not pain acceptance, shows significant effects

Pain ◽

10.1016/j.pain.2009.08.030 ◽

2009 ◽

Vol 147 (1) ◽

pp. 147-152 ◽

Cited By ~ 36

Author(s):

Elizabeth J. Richardson ◽

Timothy J. Ness ◽

Daniel M. Doleys ◽

James H. Baños ◽

Leanne Cianfrini ◽

...

Keyword(s):

Chronic Pain ◽

Depressive Symptoms ◽

Pain Catastrophizing ◽

Pain Acceptance

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The Role of Anxiety Sensitivity in the Relation Between Pain Intensity with Substance Use and Anxiety and Depressive Symptoms Among Smokers with Chronic Pain

International Journal of Behavioral Medicine ◽

10.1007/s12529-020-09914-4 ◽

2020 ◽

Vol 27 (6) ◽

pp. 668-676

Author(s):

Michael J. Zvolensky ◽

Andrew H. Rogers ◽

Lorra Garey ◽

Joseph W. Ditre ◽

Justin M. Shepherd ◽

...

Keyword(s):

Chronic Pain ◽

Substance Use ◽

Depressive Symptoms ◽

Pain Intensity ◽

Anxiety Sensitivity

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Dialectical Pain Management: Feasibility of a Hybrid Third-Wave Cognitive Behavioral Therapy Approach for Adults Receiving Opioids for Chronic Pain

Pain Medicine ◽

10.1093/pm/pnaa361 ◽

2020 ◽

Author(s):

Deborah Barrett ◽

Carrie E Brintz ◽

Amanda M Zaski ◽

Mark J Edlund

Keyword(s):

Chronic Pain ◽

Depressive Symptoms ◽

Pain Management ◽

Dialectical Behavior Therapy ◽

Emotion Dysregulation ◽

Qualitative Interviews ◽

Self Report ◽

Control Group ◽

Global Rating ◽

Pain Acceptance

Abstract Objectives This study evaluated the feasibility, acceptability, and potential effectiveness of a hybrid skills-based group intervention, dialectical pain management (DPM), for adults with chronic pain who are receiving long-term opioid therapy. DPM adapts dialectical behavior therapy, a rigorous psychotherapeutic approach to emotion dysregulation, to treat disorders of physiological dysregulation. Methods Individuals with chronic pain (N = 17) participated in one of two 8-week DPM intervention cohorts. At pre-test and post-test, participants completed quantitative self-report assessments measuring pain intensity and interference, depressive symptoms, pain acceptance, beliefs about pain medications, and global rating of change. Within 2 weeks after the intervention, participants completed qualitative interviews to assess participant satisfaction and obtain feedback about specific intervention components. Results Of the 17 enrolled, 15 participants completed the group with 12 (70%) attending six or more sessions. Participants reported high satisfaction with the intervention. Preliminary findings suggested a significant increase in pain acceptance and a significant reduction in depressive symptoms. Participants also reported an improved relationship with their pain conditions and increased flexibility in responding to pain and applying coping skills. Several participants showed a reduction in opioid dosage over the course of the intervention. Discussion Findings support that DPM is a feasible and well-received intervention for individuals with chronic pain. Additional research with a control group is needed to further determine the intervention’s efficacy and impact.

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The buffering role of positive affect on the association between pain intensity and pain related outcomes

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2016.09.008 ◽

2017 ◽

Vol 14 (1) ◽

pp. 91-97 ◽

Cited By ~ 8

Author(s):

Ivan S.K. Thong ◽

Gabriel Tan ◽

Mark P. Jensen

Keyword(s):

Chronic Pain ◽

Depressive Symptoms ◽

Negative Affect ◽

Positive Affect ◽

Pain Intensity ◽

Sleep Problems ◽

Cross Sectional Study ◽

Pain Interference ◽

Cross Sectional ◽

The Impact

AbstractObjectivesChronic pain is a significant problem worldwide and is associated with significant elevations in negative affect, depressive symptoms, sleep problems, and physical dysfunction. Positive affect could potentially buffer the impact of pain on patient functioning. If it does, then positive affect could be directly targeted in treatment to benefit individuals with chronic pain. The purpose of this study was to test for such moderating effects.MethodsThis was a cross-sectional study, we administered measures of pain intensity, depressive symptoms, sleep problems, pain interference, and positive and negative affect to 100 individuals with chronic back or knee pain in a single face-to-face assessment session.ResultsThe associations between pain intensity and negative affect, and between pain intensity and depressive symptoms were moderated by positive affect. This moderation effect was explained by the fact that participants with low positive affect evidenced strong associations between pain intensity and both depression and negative affect; participants with high positive affect, on the other hand, evidenced weak and non-significant associations between pain intensity and both depression and negative affect. Positive affect did not moderate the associations between pain intensity and either sleep problems or pain interference.ConclusionThe findings are consistent with the possibility that positive affect may buffer the impact of pain intensity on negative affect and depressive symptoms. Longitudinal and experimental research is needed to determine the potential benefits of treatments that increase positive affect on negative affect and depressive symptoms in chronic pain populations.ImplicationsThe study findings suggest the possibility that “positive psychology” interventions which increase positive affect could benefit individuals with chronic pain by reducing the impact of pain on negative outcomes. Research to test this possibility is warranted.

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