scholarly journals A Network Analysis of Potential Antecedents and Consequences of Pain-Related Activity Avoidance and Activity Engagement in Adolescents

Pain Medicine ◽  
2019 ◽  
Author(s):  
Melanie Beeckman ◽  
Laura E Simons ◽  
Sean Hughes ◽  
Tom Loeys ◽  
Liesbet Goubert
Keyword(s):  
Pain Intensity ◽  
Pain Catastrophizing ◽  
Psychological Flexibility ◽  
Pediatric Pain ◽  
Related Activity ◽  
Activity Engagement ◽  
Activity Avoidance ◽  
Engagement Behavior ◽  
Antecedents And Consequences

Abstract Objective This study sets out to identify potential daily antecedents and consequences of pain-related activity avoidance and engagement behavior in adolescents with chronic pain. Methods Adolescents (N = 65, Mage = 14.41) completed baseline self-reports and a diary for 14 days. Afternoon and evening reports were used to infer a network structure of within-day associations between pain intensity, pain-related fear, pain catastrophizing, affect, and pain-related activity avoidance and engagement behavior. Baseline psychological flexibility was examined as a potential resilience factor. Results Activity avoidance in the evening was predicted by pain-related fear and avoidance earlier that afternoon. Activity engagement was predicted by positive affect and activity engagement in the afternoon. Pain-related behavior in the afternoon was not related to subsequent changes in pain intensity, pain-related fear, pain catastrophizing, or affect. Pain-related fear in the afternoon was predictive of increased levels of pain and pain catastrophizing in the evening. Both pain-related fear and pain catastrophizing in the evening were predicted by negative affect in the afternoon. Psychological flexibility was associated with lower levels of daily activity avoidance and buffered the negative association between pain intensity and subsequent activity engagement. Conclusions This study provides insight into unique factors that trigger and maintain activity avoidance and engagement and into the role of psychological flexibility in pediatric pain. Future work should focus on both risk and resilience factors and examine the role of psychological flexibility in chronic pediatric pain in greater detail.

scholarly journals Activity Patterns and Functioning. A Contextual–Functional Approach to Pain Catastrophizing in Women with Fibromyalgia

2021 ◽  
Vol 18 (10) ◽  
pp. 5394
Author(s):  
Cecilia Peñacoba ◽  
Maria Ángeles Pastor-Mira ◽  
Carlos Suso-Ribera ◽  
Patricia Catalá ◽  
Ainara Nardi-Rodríguez ◽  
...  
Keyword(s):  
Pain Catastrophizing ◽  
Activity Patterns ◽  
Fibromyalgia Impact Questionnaire ◽  
Psychological Flexibility ◽  
Relevant Variable ◽  
Activity Avoidance ◽  
Disease Impact ◽  
Motivational Approaches ◽  
Moderating Role

Background: The psychological flexibility model states that activity patterns are not deemed to be intrinsically functional or dysfunctional; it is considered that underlying factors, such as personal goals and contextual factors, are what will determine their effects on disability. Pain catastrophizing has frequently been associated with several important pain-related outcomes. Despite its recent conceptualization within affective–motivational approaches, its moderating role between activity patterns and dysfunction has not been analyzed. Methods: This study analyzes the moderating role of pain catastrophizing and its dimensions (Pain Catastrophizing Scale) between activity patterns (Activity Patterns Scale) and disease impact (Fibromyalgia Impact Questionnaire—Revised) in 491 women with fibromyalgia. Results: Activity avoidance (p < 0.001), excessive persistence (p < 0.001) and pacing (p < 0.01) patterns were positively associated with fibromyalgia impact. Helplessness shows a moderating role between pain avoidance (B = 0.100, t =2.30, p = 0.021, [0.01, 0.18]), excessive persistence (B = −0.09, t = −2.24, p = 0.02, [−0.18, −0.01]), pain persistence (B = −0.10, t = −2.04, p = 0.04, [−0.19, −0.004]) and functioning. Conclusion: Helplessness (within pain catastrophizing) is a relevant variable within psychological flexibility models applied to activity patterns. Specifically, pain avoidance is especially dysfunctional in patients with high helplessness. To improve excessive persistence and pain persistence, it is necessary to reduce helplessness before regulating activity patterns.

scholarly journals Menstrual Pain Intensity, Coping, and Disability: The Role of Pain Catastrophizing

Pain Medicine ◽  
2003 ◽  
Vol 4 (4) ◽  
pp. 352-361 ◽  
Author(s):  
Trudi M. Walsh ◽  
Leeanne LeBlanc ◽  
Patrick J. McGrath
Keyword(s):  
Pain Intensity ◽  
Pain Catastrophizing ◽  
Menstrual Pain

scholarly journals Adult Attachment and Approaches to Activity Engagement in Chronic Pain

2014 ◽  
Vol 19 (6) ◽  
pp. 317-327 ◽  
Author(s):  
Nicole E Andrews ◽  
Pamela J Meredith ◽  
Jenny Strong ◽  
Genevieve F Donohue
Keyword(s):  
Chronic Pain ◽  
Psychological Functioning ◽  
Pain Catastrophizing ◽  
Activity Patterns ◽  
Activity Engagement ◽  
Mediation Analyses ◽  
Mediating Role ◽  
Activity Avoidance ◽  
Pain Cognitions ◽  
Preoccupied Attachment

BACKGROUND: The way in which individuals with chronic pain habitually approach activity engagement has been shown to impact daily functioning, with both avoidance of one’s daily activities and overactivity (activity engagement that significantly exacerbates pain) associated with more pain, higher levels of physical disability and poorer psychological functioning.OBJECTIVE: To provide insight into the development of maladaptive habitual approaches to activity engagement in chronic pain by applying an attachment theory framework.METHODS: A sample of 164 adults with chronic pain completed selfreport measures of attachment, approach to activity and pain cognitions. Mediation analyses were undertaken to examine the direct association between attachment variables and maladaptive approaches to activity, and to test for the mediating role of pain cognitions (catastrophizing and thought suppression).RESULTS: Results demonstrated that higher levels of secure attachment were associated with lower levels of activity avoidance, which was fully mediated by lower levels of pain catastrophizing; higher levels of preoccupied or fearful attachment were directly associated with higher levels overactivity; higher levels of preoccupied attachment were associated with higher levels of activity avoidance, which was partially mediated by higher levels of pain catastrophizing; and higher levels of fearful attachment were indirectly associated with higher levels of activity avoidance through higher levels of catastrophizing.CONCLUSIONS: These results provide preliminary support for the suggestion that insecure attachment may be a source of vulnerability to the development of disabling activity patterns in chronic pain.

scholarly journals The Relationship between Pain Catastrophizing and Headache-Related Disability: The Mediating Role of Pain Intensity

2017 ◽  
Vol 59 (4) ◽  
pp. 266-274 ◽  
Author(s):  
Fereshte Sadat Mortazavi Nasiri ◽  
Shahla Pakdaman ◽  
Mohsen Dehghani ◽  
Mansoureh Togha
Keyword(s):  
Pain Intensity ◽  
Pain Catastrophizing ◽  
Mediating Role ◽  
The Relationship

scholarly journals The Role of Perfectionistic Self-Presentation in Pediatric Pain

2021 ◽  
Vol 18 (2) ◽  
pp. 591
Author(s):  
Elisabet Sánchez-Rodríguez ◽  
Alexandra Ferreira-Valente ◽  
Anupa Pathak ◽  
Ester Solé ◽  
Saurab Sharma ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Children And Adolescents ◽  
Pain Treatment ◽  
Pain Catastrophizing ◽  
Pain Interference ◽  
Hierarchical Regression ◽  
Self Presentation ◽  
Mediation Analyses ◽  
New Information

This study sought to better understand the associations between perfectionistic self-presentation and measures of pain intensity, pain catastrophizing, pain interference, and fatigue in children and adolescents with pain. In the study, 218 adolescents responded to measures of perfectionistic self-presentation (i.e., perfectionistic self-promotion, nondisplay of imperfection and nondisclosure of imperfection), pain intensity, pain catastrophizing, pain interference, and fatigue. Four hierarchical regression analyses and three mediation analyses were conducted. Our results showed that perfectionistic self-promotion was significantly and independently associated with pain intensity and that nondisplay of imperfection was significantly and independently associated with pain catastrophizing, pain interference, and fatigue. Nondisclosure of imperfection was not significantly associated with any criterion variable. Pain catastrophizing mediated the association between both perfectionistic self-presentation and nondisplay imperfection and pain interference but not between nondisclosure of imperfection and pain interference. The findings provide new information about the role of perfectionistic self-presentation in children and adolescents’ experience of pain. These findings, if replicated, support perfectionism as a potential target of pain treatment in young people.

Behavioral Activation and Inhibition Systems: Further Evaluation of a BIS-BAS Model of Chronic Pain

Pain Medicine ◽  
2020 ◽  
Author(s):  
Elisabet Sánchez-Rodríguez ◽  
Mélanie Racine ◽  
Elena Castarlenas ◽  
Catarina Tomé-Pires ◽  
Santiago Galán ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Self Efficacy ◽  
Behavioral Inhibition ◽  
Online Survey ◽  
Behavioral Activation ◽  
Pain Catastrophizing ◽  
Pain Interference ◽  
Activity Engagement ◽  
Wide Range

Abstract Objectives The role of the behavioral inhibition system (BIS) and behavioral activation system (BAS) in function has been evaluated in a wide range of populations. However, research on the role of the BIS and BAS in pain is in its early stages. This study sought to evaluate the utility of a BIS-BAS model of chronic pain. Methods Participants were 164 individuals with chronic pain who responded to an online survey. Participants provided information about pain location, intensity, and frequency and completed questionnaires assessing behavioral inhibition and activation sensitivity, pain catastrophizing, pain interference, activity engagement, pain willingness, hope, and pain self-efficacy. Seven hierarchical regression analyses were conducted to test hypothesized associations between BIS and BAS sensitivity and measures of participant function. Results BIS scores were significantly and positively associated with pain catastrophizing, anxiety, depression, and pain interference and were negatively associated with activity engagement, hope, and pain self-efficacy (P&lt;0.01). BAS scores showed significant and positive associations with activity engagement and hope and showed significant negative associations with pain catastrophizing and anxiety (P&lt;0.05). Furthermore, BIS sensitivity evidenced stronger associations with all the other study measures than did BAS sensitivity. Conclusions The findings provide important new information regarding the utility of the BIS-BAS model of chronic pain. Our results support the idea that BIS activation is more important than BAS activation in explaining a variety of pain-related outcomes, including positive and negative responses to pain, and suggest that modification of the model may be indicated. These results have several theoretical and clinical implications.

scholarly journals Pain Catastrophizing and Its Relationship with Health Outcomes: Does Pain Intensity Matter?

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Carlos Suso-Ribera ◽  
Azucena García-Palacios ◽  
Cristina Botella ◽  
Maria Victoria Ribera-Canudas
Keyword(s):  
Mental Health ◽  
Pain Intensity ◽  
Pain Catastrophizing ◽  
Pain Interference ◽  
Health Study ◽  
Physical And Mental Health ◽  
Mental Health Study ◽  
The Relationship ◽  
Pain Patients

Pain catastrophizing is known to contribute to physical and mental functioning, even when controlling for the effect of pain intensity. However, research has yet to explore whether the strength of the relationship between pain catastrophizing and pain-related outcomes varies across pain intensity levels (i.e., moderation). If this was the case, it would have important implications for existing models of pain and current interventions. The present investigation explored whether pain intensity moderates the relationship between pain catastrophizing and pain-related outcomes. Participants were 254 patients (62% women) with heterogeneous chronic pain. Patients completed a measure of pain intensity, pain interference, pain catastrophizing, and physical and mental health. Pain intensity moderated the relationship between pain catastrophizing and pain interference and between pain catastrophizing and physical health status. Specifically, the strength of the correlation between pain catastrophizing and these outcomes decreased considerably as pain intensity increased. In contrast, pain intensity did not moderate the relationship between pain catastrophizing and mental health. Study findings provide a new insight into the role of pain intensity (i.e., moderator) in the relationship between pain catastrophizing and various pain-related outcomes, which might help develop existent models of pain. Clinical implications are discussed in the context of personalized therapy.

scholarly journals The Role of Pain Catastrophizing in the Prediction of Acute and Chronic Postoperative Pain

2013 ◽  
Vol 6 (1) ◽  
pp. 176-182 ◽  
Author(s):  
Ran Kremer ◽  
Michal Granot ◽  
David Yarnitsky ◽  
Yonathan Crispel ◽  
Shiri Fadel ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Prospective Observational Study ◽  
Pain Catastrophizing ◽  
Pain Catastrophizing Scale ◽  
Chronic Postoperative Pain ◽  
Unique Role ◽  
Relative Contribution ◽  
Postthoracotomy Pain

Background and Objectives: Despite the established association between greater pain catastrophizing and enhanced postoperative pain, it is still unclear: (i) what is the relative contribution of each of the pain catastrophizing scale (PCS) dimensions in the prediction of acute and chronic postoperative pain; and (ii) whether PCS scores mediate the association between acute and chronic postoperative pain intensity. Methods: The current prospective, observational study was conducted at Rambam Health Care Campus, Haifa, Israel. PCS was obtained in 48 pain-free patients a day before an elective thoracotomy in response to tonic heat pain. Acute postthoracotomy pain (APTP) was assessed during rest, including general pain (Restgeneral), and incision-related pain (Restincision), and in response to provoked physical activity, including hand elevation (Provokedhand) and cough (Provokedcough). Chronic postthoracotomy pain (CPTP) was assessed after 4.5±2.3 months. Results: Of the PCS subscales, only rumination: (i) was correlated with Restgeneral scores (r=0.337, P=0.027); and (ii) predicted chronic postthoracotomy pain in a regression analysis (P=0.001). General PCS and its subscales mediated the correlation between Restgeneral and chronic postthoracotomy pain intensity (Ps<0.006). Conclusions: Findings may elucidate the unique role of the rumination subscale in reflecting an individual's postopertive acute and chronic pain responsiveness. The transition from acute to chronic postoperative pain seems to be facilitated by enhanced pain catastrophizing.

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