A-76 Coping Style Moderates the Effect of Pain on Depression in Multiple Sclerosis

2021 ◽  
Vol 36 (6) ◽  
pp. 1118-1118
Author(s):  
Megan L Bradson ◽  
Margaret H Cadden ◽  
Erin T Guty ◽  
Kaitlin E Riegler ◽  
Garrett A Thomas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Coping Style ◽  
Neuropsychological Test ◽  
Brief Pain Inventory ◽  
Active Coping ◽  
Avoidant Coping ◽  
Pain Severity ◽  
Pain Interference ◽  
Affective Outcomes ◽  
The Relationship

Abstract Objective The present study examined coping style as a possible moderator in the relationship between pain and depression in persons with multiple sclerosis (PwMS). Method Fifty-four PwMS (38 female) completed a comprehensive neuropsychological test battery and psychosocial questionnaires. Pain was measured using the Brief Pain Inventory (BPI), and indices of pain severity and pain interference were derived. Active coping and avoidant coping scores were derived from the COPE Questionnaire. The Beck Depression Inventory-Fast Screen (BDI-FS) was used to measure depression. Results Regression analyses revealed that the interactions between pain severity and both avoidant (p = 0.005) and active (p = 0.004) coping composites significantly predicted depression. Simple effects tests revealed that pain severity predicted depression in PwMS with low active coping (p < 0.001) and high avoidant coping (p < 0.001), but not high active coping or low avoidant coping. The interactions between pain interference and both avoidant (p = 0.02) and active (p = 0.008) coping composites also significantly predicted depression. Simple effects tests revealed that pain interference predicted depression in PwMS with low active coping (p < 0.001), high active coping, (p = 0.048), and high avoidant coping (p < 0.001), but not low avoidant coping. Conclusions We found that coping style moderated the relationship between pain and depression in MS. Pain severity and pain interference predicted depression in PwMS who exhibited less active and more avoidant coping. Interventions that aim to reduce avoidant coping and increase active coping skills may be useful in improving affective outcomes in PwMS.

Evaluating the Role of Coping Style as a Moderator of Fatigue and Risk for Future Cognitive Impairment in Multiple Sclerosis

2014 ◽  
Vol 20 (7) ◽  
pp. 751-755 ◽  
Author(s):  
Dede M. Ukueberuwa ◽  
Peter A. Arnett
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Coping Style ◽  
Empirical Studies ◽  
Avoidant Coping ◽  
Cognitive Tests ◽  
Impact Scale ◽  
High Fatigue ◽  
The Relationship

AbstractApproximately 50% of persons with multiple sclerosis experience cognitive impairment, which adversely affects daily functioning. Although patients report that fatigue contributes to cognitive difficulties, previous empirical studies do not show a clear association. This study assessed coping style as a moderator of the relationship between fatigue and cognition in a 3-year longitudinal sample. Scores on the Fatigue Impact Scale and the Coping Orientation to Problems Experienced (COPE) at baseline were modeled to predict later performance on a composite of cognitive tests to investigate the hypothesis that coping would have a significant moderating effect on fatigue in predicting cognitive performance. Findings partially supported hypotheses by showing that avoidant coping moderated the relationship between fatigue and cognitive performance. Patients who experienced relatively high fatigue performed better on cognitive tests if they used less avoidant coping. Those who reported lower fatigue had relatively good cognitive performance regardless of their coping style. This study provides evidence that coping style is associated with the ability to deal with stress, like fatigue, and their interaction can impact functional outcomes of disease. These results could benefit understanding of prognosis and improve treatment for patients with MS. (JINS, 2014, 20, 1–5.)

Early Treatment Improvements in Depression Are Associated With Overall Improvements in Fatigue Impact and Pain Interference in Adults With Multiple Sclerosis

2020 ◽  
Author(s):  
Lindsey M Knowles ◽  
Anne Arewasikporn ◽  
Anna L Kratz ◽  
Aaron P Turner ◽  
Kevin N Alschuler ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Depressive Symptoms ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Brief Pain Inventory ◽  
Chronic Fatigue ◽  
The Other ◽  
Pain Interference ◽  
Or Education ◽  
Impact Scale

Abstract Background Depression, fatigue, and pain commonly co-occur in multiple sclerosis (MS) and are positively associated with one another. However, it is unclear whether treatment-related improvement in one of these symptoms is associated with improvements in the other two symptoms. Purpose This study examined whether early improvements in depressive symptoms, fatigue impact, and pain interference during a multisymptom intervention in persons with MS were associated with overall improvements in the other two symptoms. Methods Secondary analysis of a randomized controlled trial in which both treatments improved depressive symptoms, fatigue, and pain interference. Adults with MS experiencing chronic pain, chronic fatigue, and/or moderate depressive symptoms (N = 154, 86% women) participated in an 8-week, telephone-delivered intervention: self-management (n = 69) or education (n = 85); intervention groups were combined for the current study. Outcome measures were depressive symptoms (PHQ-9), fatigue impact (Modified Fatigue Impact Scale), and pain interference (Brief Pain Inventory). Path analysis examined associations between pre-to-mid intervention improvement in one symptom (i.e., depression, fatigue, pain interference) and pre-to-post (overall) improvement in the other two symptoms. Results Early reduction in depressive symptoms was associated with an overall reduction in pain interference and fatigue impact (p’s < .01). Early reduction in fatigue impact was associated with an overall reduction in depressive symptom severity (p = .04) but not pain interference. Early reduction in pain interference was not associated with reductions in fatigue impact or depressive symptoms. Conclusions These findings suggest the potential importance of reducing depressive symptoms to overall improvement in fatigue and pain interference in persons with MS. Clinical Trial Registrations NCT00944190.

scholarly journals Good Sleep Quality Improves the Relationship Between Pain and Depression Among Individuals With Chronic Pain

2021 ◽  
Vol 12 ◽  
Author(s):  
Zoe Zambelli ◽  
Elizabeth J. Halstead ◽  
Antonio R. Fidalgo ◽  
Dagmara Dimitriou
Keyword(s):  
Chronic Pain ◽  
Sleep Quality ◽  
Sleep Problems ◽  
Pain Severity ◽  
Pain Interference ◽  
Poor Sleep ◽  
Regression Analyses ◽  
Cross Sectional Survey ◽  
The Relationship ◽  
Good Sleep

Individuals with chronic pain often experience co-existing sleep problems and depression-related states. Chronic pain, sleep problems, and depression interrelate, and have been shown to exacerbate one another, which negatively impacts quality of life. This study explored the relationships between pain severity, pain interference, sleep quality, and depression among individuals with chronic pain. Secondly, we tested whether sleep quality may moderate the relationship between pain and depression. A cross-sectional survey was completed by 1,059 adults with non-malignant chronic pain conditions (Mage 43 years, 88% identified as women) and collected measures related to pain severity, pain interference, sleep quality, and depression. Multiple regression analyses found that pain severity, pain interference, and sleep quality are all significantly associated with depression. Secondly, moderated regression analyses revealed that sleep quality moderates the relationship between pain interference and depression among individuals with chronic pain such that good sleep quality attenuates the effect of pain interference on depression, and poor sleep quality amplifies the effect of pain interference on depression. These findings suggest that sleep quality may be a relevant therapeutic target for individuals with chronic pain and co-existing depression.

The scope and nature of pain in persons with multiple sclerosis

2006 ◽  
Vol 12 (5) ◽  
pp. 629-638 ◽  
Author(s):  
D M Ehde ◽  
T L Osborne ◽  
M A Hanley ◽  
M P Jensen ◽  
G H Kraft
Keyword(s):  
Multiple Sclerosis ◽  
Pain Intensity ◽  
Psychosocial Functioning ◽  
Psychological Functioning ◽  
Severe Pain ◽  
Brief Pain Inventory ◽  
Postal Survey ◽  
Community Dwelling ◽  
Pain Interference ◽  
Standardized Measures

Much remains unknown about the scope, nature, and impact of pain on the lives of persons with multiple sclerosis (MS). In the present study, 180 community dwelling adults with MS completed a postal survey that included demographic measures, MS disease measures, and several standardized measures of pain, including pain intensity, variability, location, and pain-related interference. Some 66% of the sample reported pain, 25% of whom reported severe pain. Persons with pain reported an average of 6.6 distinct pain sites. Using the Brief Pain Inventory Interference Scale, the average level of overall pain interference was 3.33 (0- 10 scale) in the group reporting pain. The highest levels of pain interference were reported for sleep, recreational activities, and work in and outside the home. Persons with pain were more likely to report greater MS disease severity, poorer psychological functioning, and poorer health than persons with MS but not pain. Persons with pain were also less likely to be employed. These findings are consistent with previous research that shows that pain is common in MS, that it is severe in a substantial subset of these individuals and has the potential to negatively impact physical and psychosocial functioning over and above the effects of MS itself.

scholarly journals Association Between Pain and Mindfulness in Multiple Sclerosis

2018 ◽  
Vol 20 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Angela Senders ◽  
Alena Borgatti ◽  
Douglas Hanes ◽  
Lynne Shinto
Keyword(s):  
Multiple Sclerosis ◽  
Pain Interference ◽  
Measurement Information ◽  
Common Symptom ◽  
Five Facet Mindfulness Questionnaire ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Reported ◽  
Clinically Significant ◽  
The Relationship

Abstract Background: Chronic pain is a common symptom in people with multiple sclerosis (MS) and often requires a multimodal approach to care. The practice of mindfulness has been shown to decrease the experience of pain in other conditions, yet little is known about the relationship between mindfulness and pain in people with MS. The objective of this study was to evaluate the association between pain interference and trait mindfulness in people with MS. Methods: In this cross-sectional survey, 132 people with any type of MS completed the Patient-Reported Outcomes Measurement Information System Pain Interference scale and the Five Facet Mindfulness Questionnaire. Linear regression was used to test the association between pain and mindfulness while adjusting for demographic and MS-related characteristics. Results: The relationship between pain and mindfulness was clinically meaningful and highly significant (t = −5.52, P < .0001). For every 18-point increase in mindfulness scores, pain interference scores are expected to decrease by 3.96 (95% CI, −2.52 to −5.40) points (β = −0.22, P < .0001). The adjusted model, including age, type of MS, the interaction between mindfulness and age, and the interaction between mindfulness and MS type, explains 26% of the variability in pain interference scores (R2 = 0.26). Conclusions: These results suggest a clinically significant association between mindfulness and pain interference in MS and support further exploration of mindfulness-based interventions in the management of MS-related pain.

scholarly journals Depressive symptoms and health-related quality of life in a heterogeneous psychiatric sample: conditional indirect effects of pain severity and interference

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen Lin Teh ◽  
Jianlin Liu ◽  
Pratika Satghare ◽  
Ellaisha Samari ◽  
Yee Ming Mok ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Pain Severity ◽  
Pain Interference ◽  
Depression Severity ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Relationship

Abstract Background Few studies have examined clinically relevant mechanisms that underlie the association between two important indices of recovery— depression severity and health-related quality of life (HRQOL) in psychiatric outpatients. This study aimed to explicate the roles of pain interference and pain severity as mediating and moderating mechanisms in the relationship between depressive symptoms and HRQOL. Methods Data from 290 outpatients diagnosed with schizophrenia (n = 102), depressive (n = 98), and anxiety (n = 90) disorders were examined. Participants completed a set of questionnaires that queried their sociodemographic statuses, current pain severity and interference levels, depression severity levels, and HRQOL. Subsequently, mediation and moderation analyses were conducted. Results Analyses revealed that pain interference fully mediated the relationship between depressive symptoms and physical (34% of the total effect) but not mental HRQOL. At high pain levels (+ 1 SD from mean), depressive symptoms may interfere with physical quality of life through pain interference, but this was not present at low pain levels (− 1 SD from mean). Conclusions Prolonged pain symptoms could negatively influence psychiatric recovery beyond the physical aspect of HRQOL. These results thus imply a need to detect and manage severe physical pain complaints at the acute stage in psychiatric outpatients.

scholarly journals The Role of Pain-Related Cognitions in the Relationship Between Pain Severity, Depression, and Pain Interference in a Sample of Primary Care Patients with Both Chronic Pain and Depression

Pain Medicine ◽  
2020 ◽  
Vol 21 (10) ◽  
pp. 2200-2211
Author(s):  
Elisabet Sánchez-Rodríguez ◽  
Enric Aragonès ◽  
Mark P Jensen ◽  
Catarina Tomé-Pires ◽  
Concepció Rambla ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Catastrophizing ◽  
Positive Association ◽  
Pain Severity ◽  
Pain Interference ◽  
Regression Analyses ◽  
Depression Severity ◽  
Cross Sectional ◽  
The Relationship

Abstract Objective The aims of this study were twofold: 1) to better understand the associations between pain-related cognitions and pain severity, and psychological and physical function, and 2) to determine the extent to which these cognitions function as mediators in the association between pain severity and depression in a sample of primary care adult patients with chronic pain and depression. Design Cross-sectional design. Methods Three hundred twenty-eight patients with both depression and chronic pain from primary care centers responded to measures of pain severity, pain interference, depression severity, and pain-related cognitions (including measures of catastrophizing and other pain-related beliefs). We performed three hierarchical regression analyses and two multiple regression analyses. Results The helplessness domain of pain catastrophizing was positively associated with pain severity, depression severity, and pain interference and mediated the relationship between depression and pain severity and vice versa. Beliefs about disability showed a positive association with pain severity, pain interference, and depression severity, and also mediated the relationship between pain severity and depression. Believing in a medical cure was positively associated with pain interference and negatively associated with depression; emotion beliefs were positively associated with pain severity. Conclusions These findings provide important new information about the associations between several pain-related cognitions and pain severity, depression, and pain interference and the potential mediating roles that these cognitions play in the associations between pain severity and depression in patients with both chronic pain and depression in the primary care setting.

scholarly journals Cognitive Behavioral Therapy for the Management of Multiple Sclerosis–Related Pain

2020 ◽  
Vol 22 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Elizabeth S. Gromisch ◽  
Robert D. Kerns ◽  
Rebecca Czlapinski ◽  
Beth Beenken ◽  
John Otis ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Depressive Symptom ◽  
Cognitive Behavioral Therapy ◽  
Symptom Severity ◽  
Standard Care ◽  
Behavioral Therapy ◽  
Pain Severity ◽  
Cognitive Behavioral ◽  
Pain Interference ◽  
Depressive Symptom Severity

Abstract Background: Pain is a common and often debilitating symptom in persons with multiple sclerosis (MS). Besides interfering with daily functioning, pain in MS is associated with higher levels of depression and anxiety. Although cognitive behavioral therapy (CBT) for pain has been found to be an effective treatment in other populations, there has been a dearth of research in persons with MS. Methods: Persons with MS with at least moderate pain severity (N = 20) were randomly assigned to one of two groups: CBT plus standard care or MS-related education plus standard care, each of which met for 12 sessions. Changes in pain severity, pain interference, and depressive symptom severity from baseline to 15-week follow-up were assessed using a 2×2 factorial design. Participants also rated their satisfaction with their treatment and accomplishment of personally meaningful behavioral goals. Results: Both treatment groups rated their treatment satisfaction as very high and their behavioral goals as largely met, although only the CBT plus standard care group's mean goal accomplishment ratings represented significant improvement. Although there were no significant differences between groups after treatment on the three primary outcomes, there was an overall improvement over time for pain severity, pain interference, and depressive symptom severity. Conclusions: Cognitive behavioral therapy or education-based programs may be helpful adjunctive treatments for persons with MS experiencing pain.

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