scholarly journals The “self” in pain: high levels of schema-enmeshment worsen fibromyalgia impact

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Myrella Paschali ◽  
Asimina Lazaridou ◽  
Eric S. Vilsmark ◽  
Jeungchan Lee ◽  
Michael Berry ◽  
...  

Abstract Objective Chronic pain can have detrimental effects on quality of life and a profound impact on one’s identity. The Pictorial Representation of Illness- and Self-Measure (PRISM), is a visual tool designed to measure the self-illness separation (SIS) that represents the degree of schema-enmeshment (i.e., the degree to which the self-schema and the illness-schema come to overlap). Our aim was to investigate the relationship between schema-enmeshment and pain-related outcomes in patients with fibromyalgia. Methods In this cross-sectional study, 114 patients with fibromyalgia completed self-report assessments of pain catastrophizing, pain severity and interference, impact of symptoms, anxiety, and depression. SIS was assessed using an iPad version of PRISM. Mediation analyses evaluated the mediating role of schema-enmeshment on the association between pain catastrophizing and fibromyalgia impact. Results A higher degree of schema-enmeshment was associated with greater pain catastrophizing, pain severity and interference, impact of symptoms, and depression. Moreover, a mediation analysis revealed that schema-enmeshment significantly mediated the association between pain catastrophizing and fibromyalgia impact (p < 0.001). Conclusions Our results indicate that schema-enmeshment is associated with greater intrusiveness of chronic pain on everyday life, thereby posing significant limitations on the emotional and physical well-being of fibromyalgia patients. Schema-enmeshment also appears to partly account for the deleterious effect of pain catastrophizing on disease impact. The PRISM is a simple tool that may uniquely capture the extent to which chronic pain and illness infiltrates and affects one’s self-concept.

Ból ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 25-40
Author(s):  
Valerie Hruschak ◽  
K. Mikayla Flowers ◽  
Desiree R. Azizoddin ◽  
Robert N. Jamison ◽  
Robert R. Edwards ◽  
...  

The COVID-19 pandemic has had a tremendous impact, including on individuals with chronic pain. The social distancing policies necessary to slow the spread of SARS-CoV-2 have involved increased levels of social isolation. This cross-sectional survey study examined pain severity and interference among individuals with chronic pain during an early phase of social distancing mandates and identified characteristics of individuals who were most impacted. Approximately 4 to 8 weeks after social distancing mandates commenced in the state ofMassachusetts, 150 patients with fibromyalgia, chronic spine, and postsurgical pain completed demographic, pain, social distancing, and validated psychosocial questionnaires. Patients self-reported an overall significant increase in pain severity and pain interference, compared with before social distancing, although both pain severity and interference were quite variable among individuals under conditions of social distancing. Several demographic, socioeconomic, and psychosocial factors were associated with greater pain severity and interference during social distancing. Multivariable linear regression demonstrated that female sex, nonwhite race, lower education, disability, fibromyalgia, and higher pain catastrophizing were independently associated with greater pain severity, while female sex and pain catastrophizing were independently associated greater pain interference. The findings suggest that individual differences among patients with chronic pain should be considered in the planning, development, and prioritization of interventions to improve pain care and to prevent worsening of symptoms during the continuing COVID-19 pandemic.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Geneviève Chaput ◽  
Susanne P. Lajoie ◽  
Laura M. Naismith ◽  
Gilles Lavigne

Background.Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI) is a difficult clinical challenge.Objectives.To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome.Methods.This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1) and 8 weeks (Time 2) after MTBI. Pain severity, psychological distress, level of functionality, and pain catastrophizing were measured by self-report at Time 2.Results.The pain catastrophizing subscales of rumination, magnification, and helplessness were significantly correlated with pain severity (r=.31to.44), number of postconcussion symptoms reported (r=.35to.45), psychological distress (r=.57to.67), and level of functionality (r=-.43to-.29). Pain catastrophizing scores were significantly higher for patients deemed to be at high risk of postconcussion syndrome (6 or more symptoms reported at both Time 1 and Time 2).Conclusions.Higher levels of pain catastrophizing were related to adverse early MTBI outcomes. The early detection of pain catastrophizing may facilitate goal-oriented interventions to prevent or minimize the development of chronic pain and other postconcussion symptoms.


2002 ◽  
Vol 8 (6) ◽  
pp. 527-531 ◽  
Author(s):  
C-H Chang ◽  
D Cella ◽  
O Fernández ◽  
G Luque ◽  
P de Castro ◽  
...  

Objective: The cross-sectional study evaluated the psychometric properties of the Functional Assessment of Multiple Sclerosis (FAMS) Spanish version and its use in measuring quality of life (QOL) of multiple sclerosis (MS) patients in Spain. Methods: The FAMS is a factorially derived self-report scale designed to assess six primary aspects of QOL of patients with MS: Mobility, Symptoms, Emotional Well-Being, General Contentment, Thinking and Fatigue, and Family/Social Well-Being. Its Spanish translated version was used to assess QOL of 625 MS patients recruited in an outpatient clinic setting from 58 hospitals in Spain. Internal consistency of the Spanish FAMS was evaluated. Multiple regression analyses were performed to identify significant predictors from demographic, clinical and treatment characteristics, and Kurtzke Expanded Disability Status Scale (EDSS) scores in predicting FAMS scale scores. Results: Most of the patients are females (66%), and 74% were of the relapsing-remitting (RR) clinical subtype. Cronbach’s alpha coefficients were high (range=0.78-0.96), indicating subscale homogeneity comparable to that of the original English version. Linear multivariate regression analyses revealed that the EDSS is a dominant variable in predicting all the FAMS subscales, especially mobility (R2=0.51) and the total scores. Conclusions: The Spanish FAMS is a psychometrically valid instrument that allows clinicians and clinical researchers the ability to measure the QOL concerns of MS patients in Spain.


Author(s):  
Alessandro Borghi ◽  
Maria Elena Flacco ◽  
Alberto Monti ◽  
Lucrezia Pacetti ◽  
Michela Tabanelli ◽  
...  

Abstract Purpose The impact of malignant melanoma (MM) on patients’ psychophysical well-being has been poorly addressed. We aimed to assess the perceived burden in patients with a diagnosis of MM, using two different tools, one generic and one specific for MM, such as Pictorial Representation of Illness and Self Measure (PRISM) and Melanoma Concerns Questionnaire (MCQ-28), respectively. The correlation between PRISM and MCQ-28 subscales and the relevance of disease and patient-related variables were also investigated. Methods This single-centre, cross-sectional study included all adult consecutive MM patients who attended our Dermatology Unit from December 2020 to June 2021. Demographics and disease-related data were recorded. PRISM and MCQ-28 were administered. Results One hundred and seventy-one patients were included (mean age: 59.5 ±14.9 years.; 48.0% males). Median time from MM diagnosis to inclusion was 36 months. Nearly 80% of the patients had in situ or stage I MM. Overall, 22.2% of the patients reported a PRISM score <100mm and similar percentages provided scores indicating impaired quality of life, as assessed with MCQ-28 subscales. A weak, albeit significant, correlation was found between PRISM scores and ACP, CON and SOC2 subscales. The most relevant association found was that between lower PRISM scores and higher-stage MM. Conclusions In the study population, mostly affected with superficial MM, their perception of the burden associated with MM did not appear either particularly dramatic or disabling. PRISM seems a reliable system for capturing and quantifying the domains correlated with the emotive dimension of MM, especially MM-related concerns and willingness to face life


2019 ◽  
Vol 21 (3) ◽  
pp. 181-189 ◽  
Author(s):  
Candice A. Wray ◽  
Sharlene Beckford Jarrett

Jamaican police officers often encounter organizational and societal stressors through their work in high-crime and low-resource settings. Repeated exposure to stressors, with limited opportunities for support, can compromise emotional well-being and increase the risk of experiencing burnout and suicidal ideation. This cross-sectional study examines the relationship between burnout (emotional exhaustion, depersonalization and personal accomplishment) and suicidal ideations among Jamaican police officers surveyed in 2017. Jamaican police officers ( N = 305) from five major urban divisions completed two self-report questionnaires. The results revealed significant relationships between emotional exhaustion and suicidal ideations ( r = .17, p < .01) and depersonalization and suicidal ideations ( r = .18, p < .01). However, there was no significant relationship between personal accomplishment and suicidal ideations ( p > .01). Implementing programmes that offer access to adaptive coping or stress management skills and social support systems may reduce burnout and decrease risk for suicidal ideation.


2009 ◽  
Vol 2 (3) ◽  
pp. 155
Author(s):  
TedD Nirenberg ◽  
Janette Baird ◽  
Magdalena Harrington ◽  
MichaelJ Mello ◽  
Robert Woolard ◽  
...  

Author(s):  
Mariana Ceravolo Ferreira ◽  
Nathália Ribeiro Garcia ◽  
Cejane Oliveira Martins Prudente ◽  
Maysa Ferreira Martins Ribeiro

Objective: to assess the quality of life (QOL) of adolescents with cerebral palsy (CP) by self-report and by the caregiver’s report, and to analyze the agreement between these reports. Method: cross-sectional study conducted with 101 adolescents with CP and 101 caregivers. Both answered the Pediatric Quality of Life Inventory (PedsQL), module 4.0 - Generic (PedsQL 4.0) and module 3.0 - PC (PedsQL 3.0). Agreement between reports was analyzed using the Mann-Whitney test and the intra-class correlation coefficient (ICC) (p<0.05). Results: the lowest scores were in physical health, school activities and fatigue in the self-report. The lowest scores were in physical health and daily activities, in the caregivers’ report. Perceptions among adolescents and caregivers differed in physical health, movement and equilibrium, daily and school activities, with a lower score for caregivers in all of them. The agreement between the self-report and the caregivers’ report was poor (ICC<0.44) and in both instruments, the caregivers’ report was less optimistic. Conclusion: physical health is the most impaired domain of the QOL of adolescents with CP, both in the self-report and in the caregivers’ report. However, there is poor agreement between these reports, emphasizing that the use of the caregivers’ report should be cautious.


2021 ◽  
Vol 10 (1) ◽  
pp. 17-23
Author(s):  
Maryam Mirmotalebi ◽  
◽  
Behshid Garrusi ◽  
Mina Danaei

Background and Objective: Evaluation of the severity of pain in children can help the medical team diagnose the type of disease. In this study, anxiety and pain intensity in children were examined based on self-report. Materials and Methods: This cross-sectional study was performed in 2018 on 300 children aged 3 to 12 years, referring to outpatient treatment centres in Kerman. To measure the severity of pain felt by children, FPS-R was used. The level declared by children was evaluated by the pain intensity estimated by parents and doctors using a visual analogue scale (VAS) and the standard FLACC (Face, Legs, Activity, Cry, Consolability scale) for correlation. The data were analysed using SPSS software version 25. Results: The pain reported by children was obtained by VAS (4.16 ± 3.49), and the estimated pain by the doctor was obtained by FPS-R (2.87±1.68). The pain severity estimated by the doctor using FLACC had the highest correlation with the pain estimated by the doctor using VAS and the lowest correlation with the pain estimated by the mother using VAS. Conclusion: The results of this study showed that FPS-R could be used as a suitable self-report tool in children and, along with the standard FLACC, can help the medical team recognize the severity of children's pain.


2021 ◽  
Vol 162 (49) ◽  
pp. 1968-1976

Összefoglaló. Bevezetés: A coeliakia és a kapcsolódó terhek befolyásolják az érintettek életminőségét. A krónikus betegségekkel járó stigmatizáció hozzájárul a fizikai tünetek és a lelki panaszok fokozódásához, valamint az egészségmagatartás csökkenéséhez. Mindez szükségessé teszi a krónikus megbetegedések kapcsán a stigmatizáció felismerését, felmérését és kezelését. Célkitűzések: Fő célunk a 8 tételes Stigmatizáció Krónikus Betegségekben Kérdőív (SSCI-8) magyar adaptációja és pszichometriai vizsgálata volt coeliakiások körében. További célunk volt megvizsgálni a szégyen közvetítő szerepét a stigmatizáció és a jóllét között. Módszerek: A kutatás önbeszámolós, online kérdőíves, keresztmetszeti vizsgálatként zajlott (n = 85, átlagéletkor: 37,64, 91,8% nő). Az SSCI-8 mellett felvételre kerültek a szégyenélményt, a coeliakiás életminőséget, a jóllétet mérő kérdőívek. A kutatási célok tesztelése megerősítő faktorelemzéssel, korrelációs és mediációs elemzésekkel történt. Eredmények: Az SSCI-8 faktorelemzése során az egydimenziós modell megfelelő illeszkedést mutatott magas belső konzisztenciaértékek mellett. A mediációs modellek szerint a magasabb stigmatizáció a magasabb szégyenélményen keresztül járulhat hozzá a pszichés jóllét (coeliakiás életminőség, jóllét) csökkenéséhez. Megbeszélés: Az SSCI-8 rövid, átfogó kérdőívként megbízhatóan és érvényesen mérte a krónikus betegségben tapasztalt stigmatizációt a jelen coeliakiás mintán. Eredményeink alátámasztják, hogy a stigmatizáció és a szégyen fontos szerepet tölt be a jóllét csökkenésében. Következtetés: A nemzetközileg széles körben alkalmazott SSCI-8 adaptálására került sor, mely hazai kutatásokban és az egészségügyi ellátásban is hasznos mérőeszköz lehet. Az eredmények rávilágítanak, hogy a stigmatizáció és a szégyenélmény további kutatása szükséges, különösen a hatékony pszichoszociális intervenciók kifejlesztését megcélozva. Hatékony pszichológiai segítség révén a szégyen és a stigmatizáltság mérséklésével javulhat a coeliakiával élők fizikai és lelki állapota, ami a gluténmentes diéta betartása révén hozzájárulhat a betegség okozta tünetek és szövődmények mérsékléséhez. Orv Hetil. 2021; 162(49): 1968–1976. Summary. Introduction: Coeliac disease can detrimentally affect well-being. Stigmatization related to a chronic disease can enhance physical and psychological symptoms and negatively influence health behaviour, hence, stigma in chronic diseases needs to be addressed. Objectives: Our main goal was to psychometrically evaluate the Hungarian adaptation of the Stigma Scale for Chronic Illness-8 (SSCI-8). Further aim was to examine the mediating role of shame on the relationship between stigmatization and well-being aspects among individuals with coeliac disease. Methods: This cross-sectional study collected data using online questionnaires based on self-reports (n = 85, mean age: 37.64 years, 91.8% women). Instruments assessed levels of stigmatization, shame experience, quality of life in coeliac disease and well-being. Confirmatory factor, correlation and mediation analyses were used. Results: Factor analysis showed adequate fit for a unidimensional model with high internal consistency. Mediation models showed that higher levels of stigmatization can contribute to decreased levels of quality of life in coeliac disease and well-being via increased levels of shame. Discussion: The SSCI-8 is a short, valid, reliable instrument measuring stigmatization in the current sample of people with coeliac disease. The results highlight the role of stigma and shame in the decrease of well-being. Conclusion: The adapted version of the SSCI-8 can be a useful tool in Hungarian research and healthcare. The results suggest that stigmatization and shame need further attention to develop effective intervention which can reduce their effect and enhance adherence to gluten-free diet and improve physical and psychological well-being. Orv Hetil. 2021; 162(49): 1968–1976.


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