Multivariate Analysis of Chronic Pain Patients Undergoing Lidocaine Infusions: Increasing Pain Severity and Advancing Age Predict Likelihood of Clinically Meaningful Analgesia

Background: Chronic pain patients often describe their pain in ways that suggest vivid mental images, with some reporting images relating to their pain. Despite these clinical observations, there are few studies describing the nature and consequences of these images. This study examined whether mental imagery of pain is associated with levels of reported distress, cognitions, disability or pain severity. Method: In a postal survey, 83 adult chronic pain patients indicated whether or not they experienced mental images of their pain. They also completed standardized measures of depression, anxiety, cognitions, disability and pain severity. Those reporting images were compared to those not reporting images on their responses to the other variables. Results: People with pain imagery reported significantly higher levels of anxiety, depression and catastrophizing than patients who did not report such images. No differences were found on measures of physical disability. Discussion: Mental images of pain appear to be associated with higher levels of anxiety, depression and catastrophizing. It is possible that these images play a role in maintaining such difficulties. For these patients, imagery may provide a route via which clinicians can work with patients to help them reinterpret or respond more flexibly to their pain.

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Does sleep quality predict pain-related disability in chronic pain patients? The mediating roles of depression and pain severity

Pain ◽

10.1016/j.pain.2006.08.019 ◽

2007 ◽

Vol 127 (3) ◽

pp. 243-252 ◽

Cited By ~ 49

Author(s):

Felix Naughton ◽

Polly Ashworth ◽

Suzanne M. Skevington

Keyword(s):

Chronic Pain ◽

Sleep Quality ◽

Pain Severity ◽

Chronic Pain Patients ◽

Pain Patients

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Anhedonia in chronic pain and prescription opioid misuse

Psychological Medicine ◽

10.1017/s0033291719002010 ◽

2019 ◽

Vol 50 (12) ◽

pp. 1977-1988 ◽

Cited By ~ 5

Author(s):

Eric L. Garland ◽

Martin Trøstheim ◽

Marie Eikemo ◽

Gernot Ernst ◽

Siri Leknes

Keyword(s):

Chronic Pain ◽

Large Scale ◽

Reward Processing ◽

Pain Severity ◽

Prescription Opioid ◽

Opioid Misuse ◽

Opioid Use ◽

Study Results ◽

Chronic Pain Patients ◽

Pain Patients

AbstractBackgroundBoth acute and chronic pain can disrupt reward processing. Moreover, prolonged prescription opioid use and depressed mood are common in chronic pain samples. Despite the prevalence of these risk factors for anhedonia, little is known about anhedonia in chronic pain populations.MethodsWe conducted a large-scale, systematic study of anhedonia in chronic pain, focusing on its relationship with opioid use/misuse, pain severity, and depression. Chronic pain patients across four distinct samples (N = 488) completed the Snaith–Hamilton Pleasure Scale (SHAPS), measures of opioid use, pain severity and depression, as well as the Current Opioid Misuse Measure (COMM). We used a meta-analytic approach to determine reference levels of anhedonia in healthy samples spanning a variety of countries and diverse age groups, extracting SHAPS scores from 58 published studies totaling 2664 psychiatrically healthy participants.ResultsCompared to healthy samples, chronic pain patients showed higher levels of anhedonia, with ~25% of patients scoring above the standard anhedonia cut-off. This difference was not primarily driven by depression levels, which explained less than 25% of variance in anhedonia scores. Neither opioid use duration, dose, nor pain severity alone was significantly associated with anhedonia. Yet, there was a clear effect of opioid misuse, with opioid misusers (COMM ⩾13) reporting greater anhedonia than non-misusers. Opioid misuse remained a significant predictor of anhedonia even after controlling for pain severity, depression and opioid dose.ConclusionsStudy results suggest that both chronic pain and opioid misuse contribute to anhedonia, which may, in turn, drive further pain and misuse.

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Opioid Use Patterns and Association with Pain Severity and Mental Health Functioning in Chronic Pain Patients

Pain Medicine ◽

10.1111/j.1526-4637.2012.01352.x ◽

2012 ◽

Vol 13 (4) ◽

pp. 507-517 ◽

Cited By ~ 5

Author(s):

Michelle A. Skinner ◽

Eleanor T. Lewis ◽

Jodie A. Trafton

Keyword(s):

Mental Health ◽

Chronic Pain ◽

Pain Severity ◽

Opioid Use ◽

Mental Health Functioning ◽

Use Patterns ◽

Health Functioning ◽

Chronic Pain Patients ◽

Pain Patients

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Anhedonia in chronic pain and prescription opioid misuse

10.31234/osf.io/ghrdb ◽

2019 ◽

Author(s):

Eric Garland ◽

Martin Trøstheim ◽

Marie Eikemo ◽

Gernot Ernst ◽

Siri Leknes

Keyword(s):

Chronic Pain ◽

Large Scale ◽

Age Groups ◽

Reward Processing ◽

Pain Severity ◽

Prescription Opioid ◽

Opioid Misuse ◽

Opioid Use ◽

Chronic Pain Patients ◽

Pain Patients

BACKGROUND:Both acute and chronic pain can disrupt reward processing. Moreover, prolonged prescription opioid use and depressed mood are common in chronic pain samples. Despite the prevalence of these risk factors for anhedonia, little is known about anhedonia in chronic pain populations.METHODS:We conducted a large-scale, systematic study of anhedonia in chronic pain, focusing on its relationship with opioid use/misuse, pain severity, and depression. Chronic pain patients across four distinct samples (N = 488) completed the Snaith-Hamilton Pleasure Scale (SHAPS), measures of opioid use, pain severity and depression, as well as the Current Opioid Misuse Measure (COMM). We used a meta-analytic approach to determine reference levels of anhedonia in healthy samples spanning a variety of countries and diverse age groups, extracting SHAPS scores from 58 published studies totaling 2664 psychiatrically healthy participants.RESULTS:Compared to healthy samples, chronic pain patients showed higher levels of anhedonia, with ~25% of patients scoring above the standard anhedonia cut-off. This difference was not primarily driven by depression levels, which explained less than 25% of variance in anhedonia scores. Neither opioid use duration, dose, nor pain severity alone was significantly associated with anhedonia. Yet, there was a clear effect of opioid misuse, with opioid misusers (COMM ⩾13) reporting greater anhedonia than non-misusers. Opioid misuse remained a significant predictor of anhedonia even after controlling for pain severity, depression and opioid dose.CONCLUSIONS:Study results suggest that both chronic pain and opioid misuse contribute to anhedonia, which may, in turn, drive further pain and misuse.

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Pain-related cognitions, pain severity, and pain behaviors in chronic pain patients

Pain ◽

10.1016/0304-3959(87)91887-2 ◽

1987 ◽

Vol 30 ◽

pp. S416 ◽

Cited By ~ 1

Author(s):

H. Flor ◽

D. C. Turk

Keyword(s):

Chronic Pain ◽

Pain Severity ◽

Pain Behaviors ◽

Chronic Pain Patients ◽

Pain Patients

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The relationship between chronic musculoskeletal pain, anxiety and mindfulness: Adjustments to the Fear-Avoidance Model of Chronic Pain

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2017.08.006 ◽

2017 ◽

Vol 17 (1) ◽

pp. 156-166 ◽

Cited By ~ 6

Author(s):

Katherine B. Curtin ◽

Deborah Norris

Keyword(s):

Chronic Pain ◽

Musculoskeletal Pain ◽

Pain Catastrophizing ◽

Pain Severity ◽

Fear Avoidance ◽

Pain Anxiety ◽

Fear Avoidance Model ◽

Chronic Pain Patients ◽

The Relationship ◽

Pain Patients

AbstractBackground and purposeThe Fear-Avoidance Model of Chronic Pain proposed by Vlaeyen and Linton states individuals enter a cycle of chronic pain due to predisposing psychological factors, such as negative affectivity, negative appraisal or anxiety sensitivity. They do not, however, address the closely related concept of anxious rumination. Although Vlaeyen and Linton suggest cognitive-behavioral treatment methods for chronic pain patients who exhibit pain-related fear, they do not consider mindfulness treatments. This cross-sectional study investigated the relationship between chronic musculoskeletal pain (CMP), ruminative anxiety and mindfulness to determine if (1) ruminative anxiety is a risk factor for developing chronic pain and (2) mindfulness is a potential treatment for breaking the cycle of chronic pain.MethodsMiddle-aged adults ages 35-50 years (N = 201) with self-reported CMP were recruited online. Participants completed standardized questionnaires assessing elements of chronic pain, anxiety, and mindfulness.ResultsRuminative anxiety was positively correlated with pain catastrophizing, pain-related fear and avoidance, pain interference, and pain severity but negatively correlated with mindfulness. High ruminative anxiety level predicted significantly higher elements of chronic pain and significantly lower level of mindfulness. Mindfulness significantly predicted variance (R2) in chronic pain and anxiety outcomes. Pain severity, ruminative anxiety, pain catastrophizing, pain-related fear and avoidance, and mindfulness significantly predicted 70.0% of the variance in pain interference, with pain severity, ruminative anxiety and mindfulness being unique predictors.ConclusionsThe present study provides insight into the strength and direction of the relationships between ruminative anxiety, mindfulness and chronic pain in a CMP population, demonstrating the unique associations between specific mindfulness factors and chronic pain elements.ImplicationsIt is possible that ruminative anxiety and mindfulness should be added into the Fear-Avoidance Model of Chronic Pain, with ruminative anxiety as a psychological vulnerability and mindfulness as an effective treatment strategy that breaks the cycle of chronic pain. This updated Fear-Avoidance Model should be explored further to determine the specific mechanism of mindfulness on chronic pain and anxiety and which of the five facets of mindfulness are most important to clinical improvements. This could help clinicians develop individualized mindfulness treatment plans for chronic pain patients.

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