An exploratory investigation into the effects of mental defeat on pain threshold, pain rating, pain anticipation, and mood

AbstractIn chronic pain, mental defeat is considered as a disabling type of self-evaluation triggered by repeated episodes of debilitating pain. This exploratory study experimentally tested the effect of an activated sense of defeat, as well as its interaction with pain catastrophizing, on pain and mood. Participants (N = 71) were allocated to either high or low pain catastrophizing groups and then randomly assigned to receive either defeat or neutral manipulations. A cold pressor task administered before and after the thought manipulation measured pain threshold, alongside visual analogue scales for mental defeat, attention, pain intensity, pain anticipation as well as mood. Thought manipulation checks supported successful defeat activation. Defeat activation was associated with increased negative mood and attentional disengagement from the nociceptive stimuli, irrespective of pain catastrophizing tendency. There were no changes in pain threshold, pain or pain anticipation ratings. The results suggest that mental defeat can be experimentally activated using an autobiographical memory task and that an activated sense of defeat appears to operate independently from pain catastrophizing in influencing mood and attentional disengagement from the nociceptive stimuli. Future research can utilize our experimental approach to evaluate the effect of an activated sense of mental defeat in people with chronic pain, for whom the magnitude of pain, mood and attentional responses may be stronger and broader.

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Can pain catastrophizing be changed in surgical patients? A scoping review

Canadian Journal of Surgery ◽

10.1503/cjs.015417 ◽

2018 ◽

pp. 311-318

Author(s):

Eric Gibson ◽

Marlis T. Sabo

Keyword(s):

Surgical Outcomes ◽

Pain Catastrophizing ◽

Behavioural Therapy ◽

Surgical Patients ◽

Future Research ◽

Surgical Patient ◽

Original Research ◽

Surgery Patient ◽

Cognitive Behavioural ◽

Before And After

Background: Catastrophizing, a coping style characterized by an exaggerated negative affect when experiencing or anticipating pain, is an important factor that adversely affects surgical outcomes. Various interventions have been attempted with the goal of reducing catastrophizing and, by extension, improving treatment outcomes. We performed a systematic review to determine whether catastrophizing can be altered in surgical patients and to present evidence for interventions aimed at reducing catastrophizing in this population. Methods: Using a scoping design, we performed a systematic search of MEDLINE and Embase. Studies reporting original research measuring catastrophizing, before and after an intervention, on the Pain Catastrophizing Scale (PCS) or Coping Strategies Questionnaire (CSQ) were selected. Studies were assessed for quality, the nature of the intervention and the magnitude of the effect observed. Results: We identified 47 studies that measured the change in catastrophizing score following a broad range of interventions in surgical patients, including surgery, patient education, physiotherapy, cognitive behavioural therapy, psychologist-directed therapy, nursing-directed therapy and pharmacological treatments. The mean change in catastrophizing score as assessed with the PCS ranged from 0 to –19, and that with the CSQ, from +0.07 to –13. Clinically important changes in catastrophizing were observed in 7 studies (15%). Conclusion: Catastrophizing was observed to be modifiable with an intervention in a variety of surgical patient populations. Some interventions produced greater reductions than others, which will help direct future research in the improvement of surgical outcomes.

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(382) The influence of negative mood and pain catastrophizing on outcomes from a chronic pain rehabilitation program

Journal of Pain ◽

10.1016/j.jpain.2008.01.306 ◽

2008 ◽

Vol 9 (4) ◽

pp. 71

Author(s):

S. George ◽

V. Wittmer ◽

J. Beneciuk ◽

R. Fillingim ◽

M. Robinson

Keyword(s):

Chronic Pain ◽

Pain Catastrophizing ◽

Negative Mood ◽

Rehabilitation Program

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Applied Relaxation (Coping) in Control of Laboratory Pain: Effects of Signalled Pain and Instructions of When to Relax

Psychological Reports ◽

10.2466/pr0.1983.53.2.467 ◽

1983 ◽

Vol 53 (2) ◽

pp. 467-476 ◽

Cited By ~ 1

Author(s):

Steven J. Linton ◽

K. Gunnar Götestam

Keyword(s):

Pain Threshold ◽

Relaxation Training ◽

Cold Pressor ◽

Warning Signal ◽

Control Measures ◽

Control Group ◽

Subjective Evaluations ◽

Before And After ◽

Applied Relaxation ◽

Experimental Group

This experiment was designed to test the idea that using a warning signal and relaxing before a pain stimulus was applied (a common coping strategy) would lead to significantly greater improvements in pain threshold and tolerance than relaxing after pain was first experienced. Three groups of 10 subjects participated in cold-pressor pain tests before and after relaxation training. The relaxation training was exactly the same for all three groups, but the experimental group was provided a warning signal 1 min. before the posttest began, and they relaxed at the signal. One control group was given the same signal, but they relaxed when they first felt pain. A second control group had no signal, and they also relaxed when they felt the pain. The results did not support the hypothesis. Both control groups improved significantly more in pain threshold and tolerance than the experimental group. There were no significant differences between the groups on subjective evaluations of the pain or on control measures of expectancy level, compliance, or ability to relax. These results point to the need for research concerning the use of warning signals and early relaxation in coping programs.

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The mechanisms of pain tolerance and pain-related anxiety in acute pain

Health Psychology Open ◽

10.1177/2055102919865161 ◽

2019 ◽

Vol 6 (2) ◽

pp. 205510291986516 ◽

Cited By ~ 2

Author(s):

Alina Cimpean ◽

Daniel David

Keyword(s):

Pain Catastrophizing ◽

Cold Pressor ◽

Pain Tolerance ◽

Path Model ◽

Cold Pressor Task ◽

Psychological Measures ◽

Before And After ◽

Healthy Sample ◽

Anxiety Response ◽

Response Expectancies

This study emphasizes the role of pain catastrophizing and state anxiety on pain tolerance and pain-related anxiety. Response expectancies for pain tolerance and pain intensity were tested as potential mediators. A cold-pressor task was used on a healthy sample. Measures were taken before and after cold-pressor procedure, while aversive versus neutral information regarding the cold-pressor task was given prior to the pain induction. An exploratory path model was conducted. Similar paths for pain tolerance and for pain-related anxiety were shown in aversive condition. Also, psychological measures may explain pain experience in aversive context.

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Does validation and alliance during the multimodal investigation affect patients’ acceptance of chronic pain? An experimental single case study

Scandinavian Journal of Pain ◽

10.1515/sjpain-2018-0051 ◽

2019 ◽

Vol 19 (1) ◽

pp. 73-82 ◽

Cited By ~ 1

Author(s):

Mikael Svanberg ◽

Ann-Christin Johansson ◽

Katja Boersma

Keyword(s):

Chronic Pain ◽

Therapeutic Effect ◽

Pain Catastrophizing ◽

Single Case ◽

Rehabilitation Program ◽

Self Report ◽

Pain Coping ◽

Chronic Pain Patients ◽

Before And After ◽

Pain Patients

Abstract Background and aims Among chronic pain patients who are referred to participation in a multimodal rehabilitation program (MMRP), pain catastrophizing and dysfunctional pain coping is common. In many cases it may have driven the patient to a range of unsuccessful searches for biomedical explanations and pain relief. Often these efforts have left patients feeling disappointed, hopeless and misunderstood. The MMRP process can be preceded by a multimodal investigation (MMI) where an important effort is to validate the patient to create a good alliance and begin a process of change towards acceptance of the pain. However, whether the MMI has such therapeutic effect is unclear. Using a repeated single case experimental design, the purpose of this study was to investigate the therapeutic effect of MMI by studying changes in patients’ experience of validation, alliance, acceptance of pain, coping, catastrophizing, and depression before and during the MMI process. Methods Participants were six chronic pain patients with high levels of pain catastrophizing (>25 on the Pain Catastrophizing Scale) and risk for long term disability (>105 on the Örebro Musculoskeletal Pain Screening Questionnaire) who were subjected to MMI before planned MMRP. For each patient, weekly self-report measures of validation, alliance and acceptance of pain were obtained during a 5–10-weeks baseline, before the MMI started. Subsequently, these measures were also obtained during a 6–8 weeks MMI process in order to enable comparative analyses. Additionally, pain coping, depression and pain catastrophizing were measured using standardized questionnaires before and after the MMI. Results Irrespective of experiences of validation and alliance before MMI, all six patients felt validated and experienced a good alliance during MMI. Acceptance of pain improved only in one patient during MMI. None of the patients showed clinically relevant improvement in pain coping, depression or catastrophizing after the MMI. Conclusions The patients did not change their acceptance and pain coping strategies despite of good alliance and experience of validation during the MMI process. Even if the design of this study precludes generalization to chronic pain patients in general, the results suggest that MMI may not have a therapeutic effect.

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Embodiment in Virtual Reality for Treatment of Chronic Pain: A Feasibility Study (Preprint)

10.2196/preprints.34162 ◽

2021 ◽

Author(s):

Adam Saby ◽

Anthony Alvarez ◽

David Smolins ◽

James Petros ◽

Lincoln Nguyen ◽

...

Keyword(s):

Chronic Pain ◽

Virtual Reality ◽

Pain Catastrophizing ◽

Controlled Trial ◽

Pain Catastrophizing Scale ◽

Analog Scale ◽

Functional Rehabilitation ◽

Randomized Controlled ◽

Before And After ◽

Rehabilitation Exercises

BACKGROUND Chronic pain has long been a major health burden that has been addressed through numerous forms of pharmacological and non-pharmacological treatment. One of the tenets of modern medicine is to minimize risk while providing efficacy. Because of its non-invasive nature, Virtual Reality provides an attractive platform for potentially developing novel therapeutic modalities. OBJECTIVE We describe a feasibility study that use embodiment in virtual reality as a treatment for chronic pain. The purpose of this study was to determine the feasibility of a novel virtual reality-based digital therapeutic for the treatment of chronic pain. METHODS An open label study assessed the feasibility of using virtual embodiment in virtual reality to treat chronic pain (Clinicaltrials.gov Identifier: NCT04060875). Twenty-four chronic pain patients were recruited from local pain clinics and completed eight session of a novel digital therapeutic that combines virtual embodiment with graded motor imagery to deliver functional rehabilitation exercises over the course of four weeks. Pain intensity as measured by a visual analog scale before and after each virtual embodiment training session was used as a primary outcome measure. Additionally, a battery of patient reported pain questionnaires (Fear and Avoidance Beliefs Questionnaire, OSWESTRY, Pain Catastrophizing Scale, and Patient Health Questionnaire) were administered before and after eight sessions of virtual embodiment training as exploratory outcome measures to get an indication if the measures are appropriate and warrant a larger randomized controlled trial. RESULTS A two-way ANOVA on session x pre vs. post Virtual embodiment training revealed that individual virtual embodiment training sessions significantly reduced the intensity of pain as measured by visual analog scale. Perceived disability due to lower back pain as measured by OSWESTRY significantly improved over the four-week course of virtual embodiment regimen. Improvement was also observed on the helplessness subscale of the Pain Catastrophizing Scale. CONCLUSIONS This study provide evidence that functional rehabilitation exercises delivered in virtual reality are safe and may have positive effects on alleviating the symptoms of chronic pain. These results support the justification for a larger randomized controlled trial to assess the extent to which virtual embodiment training can exert an effect on symptoms associated with chronic pain. CLINICALTRIAL Clinicaltrials.gov Identifier: NCT04060875

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The Relationship Between Interoception and Metacognition

Journal of Psychophysiology ◽

10.1027/0269-8803/a000157 ◽

2016 ◽

Vol 30 (2) ◽

pp. 76-86 ◽

Cited By ~ 10

Author(s):

Judith Meessen ◽

Verena Mainz ◽

Siegfried Gauggel ◽

Eftychia Volz-Sidiropoulou ◽

Stefan Sütterlin ◽

...

Keyword(s):

Memory Performance ◽

Memory Task ◽

Demographic Characteristics ◽

Metacognitive Awareness ◽

Interoceptive Awareness ◽

Future Research ◽

Heartbeat Perception ◽

Interoceptive Accuracy ◽

The Relationship

Abstract. Recently, Garfinkel and Critchley (2013) proposed to distinguish between three facets of interoception: interoceptive sensibility, interoceptive accuracy, and interoceptive awareness. This pilot study investigated how these facets interrelate to each other and whether interoceptive awareness is related to the metacognitive awareness of memory performance. A sample of 24 healthy students completed a heartbeat perception task (HPT) and a memory task. Judgments of confidence were requested for each task. Participants filled in questionnaires assessing interoceptive sensibility, depression, anxiety, and socio-demographic characteristics. The three facets of interoception were found to be uncorrelated and interoceptive awareness was not related to metacognitive awareness of memory performance. Whereas memory performance was significantly related to metamemory awareness, interoceptive accuracy (HPT) and interoceptive awareness were not correlated. Results suggest that future research on interoception should assess all facets of interoception in order to capture the multifaceted quality of the construct.

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Weekly Exercise Consistently Reinstates Positive Mood

European Psychologist ◽

10.1027/1016-9040.3.4.271 ◽

1998 ◽

Vol 3 (4) ◽

pp. 271-280 ◽

Cited By ~ 12

Author(s):

Hannah Steinberg ◽

Briony R. Nicholls ◽

Elizabeth A. Sykes ◽

N. LeBoutillier ◽

Nerina Ramlakhan ◽

...

Keyword(s):

Physical Exercise ◽

Negative Mood ◽

Real Life ◽

Positive Mood ◽

Field Investigation ◽

Single Bout ◽

Before And After ◽

Exercise Class ◽

Negative Feelings ◽

Over Time

Mood improvement immediately after a single bout of exercise is well documented, but less is known about successive and longer term effects. In a “real-life” field investigation, four kinds of exercise class (Beginners, Advanced, Body Funk and Callanetics) met once a week for up to 7 weeks. Before and after each class the members assessed how they felt by completing a questionnaire listing equal numbers of “positive” and “negative” mood words. Subjects who had attended at least five times were included in the analysis, which led to groups consisting of 18, 20, 16, and 16 subjects, respectively. All four kinds of exercise significantly increased positive and decreased negative feelings, and this result was surprisingly consistent in successive weeks. However, exercise seemed to have a much greater effect on positive than on negative moods. The favorable moods induced by each class seemed to have worn off by the following week, to be reinstated by the class itself. In the Callanetics class, positive mood also improved significantly over time. The Callanetics class involved “slower,” more demanding exercises, not always done to music. The Callanetics and Advanced classes also showed significantly greater preexercise negative moods in the first three sessions. However, these differences disappeared following exercise. Possibly, these two groups had become more “tolerant” to the mood-enhancing effects of physical exercise; this may be in part have been due to “exercise addiction.”

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