scholarly journals Endurance and avoidance response patterns in pain patients: Application of action control theory in pain research

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248875
Author(s):  
Jana Buchmann ◽  
Nicola Baumann ◽  
Karin Meng ◽  
Jana Semrau ◽  
Julius Kuhl ◽  
...  

Background Identifying pain-related response patterns and understanding functional mechanisms of symptom formation and recovery are important for improving treatment. Objectives We aimed to replicate pain-related avoidance-endurance response patterns associated with the Fear-Avoidance Model, and its extension, the Avoidance-Endurance Model, and examined their differences in secondary measures of stress, action control (i.e., dispositional action vs. state orientation), coping, and health. Methods Latent profile analysis (LPA) was conducted on self-report data from 536 patients with chronic non-specific low back pain at the beginning of an inpatient rehabilitation program. Measures of stress (i.e., pain, life stress) and action control were analyzed as covariates regarding their influence on the formation of different pain response profiles. Measures of coping and health were examined as dependent variables. Results Partially in line with our assumptions, we found three pain response profiles of distress-avoidance, eustress-endurance, and low-endurance responses that are depending on the level of perceived stress and action control. Distress-avoidance responders emerged as the most burdened, dysfunctional patient group concerning measures of stress, action control, maladaptive coping, and health. Eustress-endurance responders showed one of the highest levels of action versus state orientation, as well as the highest levels of adaptive coping and physical activity. Low-endurance responders reported lower levels of stress as well as equal levels of action versus state orientation, maladaptive coping, and health compared to eustress-endurance responders; however, equally low levels of adaptive coping and physical activity compared to distress-avoidance responders. Conclusions Apart from the partially supported assumptions of the Fear-Avoidance and Avoidance-Endurance Model, perceived stress and dispositional action versus state orientation may play a crucial role in the formation of pain-related avoidance-endurance response patterns that vary in degree of adaptiveness. Results suggest tailoring interventions based on behavioral and functional analysis of pain responses in order to more effectively improve patients quality of life.

Author(s):  
Nagarani Veeraboina ◽  
Dolar Doshi ◽  
Suhas Kulkarni ◽  
Shiva Kumar Patanapu ◽  
Satya Narayana Danatala ◽  
...  

AbstractBackgroundCoping strategies are highly mediated by the environment, in particular when the person deals with the obstacles and impediments to fulfill their goals. This study aimed to investigate the Perceived Stress and Coping Strategies among Undergraduate Dental Students of Panineeya Institute of Dental Sciences Hyderabad, India.Materials and MethodsA cross-sectional study was carried out among 267 undergraduate dental students. The survey tool comprised of Perceived Stress Scale (PSS) and Brief COPE Scale along with demographic variables. Statistical analysis was done using SPSS 20.0.ResultsBased on gender, females had high PSS mean scores (23.8±7.3) than males and to overwhelm these stress levels most of the students followed adaptive coping strategies (40.4±7.8) with no significant difference. But, significant difference noted for maladaptive coping dimension “denial” (p=0.004). On comparison between year of study, higher perceived stress was noted among second year students (26.7± 5.8), and least among first years (21.6±7). In order to defeat the stressors most of the second year undergraduate students used adaptive coping strategies. However, highest mean adaptive coping scores were noted among first years (41.6±7.5) and least scores observed among fourth years (38.6±9.2). However, total PSS score showed significant positive correlation (p<0.001) with maladaptive coping strategies.ConclusionFemales and second year students perceived more stress levels, to overtake those stressors most of them followed adaptive coping strategies. Hence, institutional authorities should take measures to decrease the stress levels and encourage the students to adopt healthy life style such as meditation and exercise to beat their stressors.


2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Taweewat Wiangkham ◽  
Nattawan Phungwattanakul ◽  
Patcharin Tedsombun ◽  
Isara Kongmee ◽  
Wanisara Suwanmongkhon ◽  
...  

AbstractObjectivesFear-avoidance beliefs questionnaire (FABQ) is a self-report, valid and reliable questionnaire to quantify fear and avoidance beliefs related to physical activity and work. Furthermore, it can be used to predict prolong disability in patients with non-specific neck pain. Although it was originally developed to manage patients with low back pain, it has also been studied in individuals with neck pain. This questionnaire was translated into several languages following reports of potential benefits in patients with neck pain. Recently, Thai neck clinical trials, international multi-centre trials and data sharing are growing throughout the world but no validated Thai version of the FABQ is available for clinical and research uses. Our objectives were to translate and cross-culturally adapt the FABQ into Thai version and evaluate its psychometric properties in Thai patients with non-specific neck pain.MethodsCross-cultural translation and adaptation of the FABQ were conducted according to standard guidelines. A total of 129 participants with non-specific neck pain were invited to complete the Thai versions of the FABQ (FABQ-TH), neck disability index and visual analogue scale for pain intensity. Psychometric evaluation included exploratory factor analysis, internal consistency, test-retest reliability, agreement, and convergent validity. Thirty participants completed the FABQ-TH twice with a 48-h interval between tests to assess the test-retest reliability.ResultsFactor analysis identified four components for the FABQ-TH (66.69% of the total variance). The intraclass correlation coefficient of test-retest reliability was excellent for the total score (0.986), work attitudes (0.995), physical activity attitudes (0.958), physical activity experiences (0.927), and expected recovery (0.984). Cronbach’s alpha for internal consistency was excellent (range 0.87–0.88) for all items. The minimal detectable change of the FABQ-TH was 5.85. The FABQ-TH correlated to its subscales (range 0.470–0.936), indicating the strongest association with work attitude. The weakest correlation was observed between the FABQ-TH and disability (rs=0.206, p=0.01). Missing data and significant floor or ceiling effects were not found.ConclusionsThe Thai version of the FABQ for non-specific neck pain was successfully adapted. It is a valid and reliable instrument to quantify fear and avoidance beliefs among patients with non-specific neck pain who speak and read Thai.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Andra Kurnianto ◽  
Deni Kurniadi Sunjaya ◽  
Fedri Ruluwedrata Rinawan ◽  
Dany Hilmanto

Background. Given that hypertension in adulthood has its onset in childhood, it is not surprising that the prevalence of hypertension among adolescents has also increased in recent years. However, there are limited data on the prevalence of hypertension and also the new AAP guideline has not yet been applied to the Indonesian adolescent population. Thus, this study aimed to evaluate the prevalence of hypertension using the new AAP guideline and to assess the occurrence of its associated factors among Indonesian adolescents. Methods. This was a cross-sectional study conducted at twelve senior high schools in Palembang, South Sumatera, Indonesia, from June to December 2019. The study included adolescents aged 13 to 18 years old. Anthropometric measurements were obtained. Multiple logistic regression was used to assess the risk factors most associated with hypertension among adolescents, and then an equation model was created. The prevalence of hypertension was evaluated, together with several factors such as age group, sex, ethnicity, family history of hypertension, nutritional status, physical activity, perceived stress, sleep duration, nutritional intake, and smoking. Results. In total, 1200 adolescents aged 15.9 ± 0.99 years were evaluated. The prevalence of hypertension and elevated blood pressure among adolescents was 8% and 12.2%, respectively. There were significant associations between sex, family history of hypertension, hypertensive father, nutritional status, physical activity, perceived stress, and hypertension among Indonesian adolescents (p<0.05). Stress was the most powerful risk factor of hypertension with an odds ratio of 5.83 (95% confidence interval 2.91–11.6). Conclusions. Nowadays, the prevalence of hypertension among Indonesian adolescents is quite high. This may be caused by lifestyle or behavior changes among adolescents. Sex, family history of hypertension, nutritional status, physical activity, and perceived stress influenced the 27% hypertension prevalence rate among Indonesian adolescents, particularly in Palembang, South Sumatera. In order to decrease the prevalence of hypertension in adults, concern about lifestyle or behavior changes and hypertension among adolescents should be given.


2017 ◽  
Vol 46 (3) ◽  
pp. 251-264 ◽  
Author(s):  
Suzanne H. Lease ◽  
Christina L. Ingram ◽  
Emily L. Brown

The negative effects of stress and burnout on mental and physical health are widely known, as are the beneficial effects of physical activity. While the organizational literature emphasizes the value of meaningful work for employers and employees alike, the stress-buffering role of meaningful work in combination with physical activity is not known. The present study examined the (a) mediating role of burnout in the relationships between perceived stress and health risk behaviors (i.e., poor diet, tobacco use, and alcohol use) and depressive symptoms and (b) moderating roles of meaningful work and physical activity on the relationships between perceived stress and health outcomes. Participants were 229 employed adults. Perceived stress predicted physical health risk behaviors and depressive symptoms, but the direct and indirect negative effects of stress were stronger when meaningful work scores were lower. Findings offer support for the development of interventions that include enhancing work meaningfulness.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Sanaz Aazami ◽  
Khadijah Shamsuddin ◽  
Syaqirah Akmal

We examined the mediating role of behavioral coping strategies in the association between work-family conflict and psychological distress. In particular, we examined the two directions of work-family conflict, namely, work interference into family and family interference into work. Furthermore, two coping styles in this study were adaptive and maladaptive coping strategies. This cross-sectional study was conducted among 429 Malaysian working women using self-reported data. The results of mediational analysis in the present study showed that adaptive coping strategy does not significantly mediate the effect of work-family conflict on psychological distress. However, maladaptive coping strategies significantly mediate the effect of work-family conflict on psychological distress. These results show that adaptive coping strategies, which aimed to improve the stressful situation, are not effective in managing stressor such as work-family conflict. We found that experiencing interrole conflict steers employees toward frequent use of maladaptive coping strategies which in turn lead to psychological distress. Interventions targeted at improvement of coping skills which are according to individual’s needs and expectation may help working women to balance work and family demands. The important issue is to keep in mind that effective coping strategies are to control the situations not to eliminate work-family conflict.


2021 ◽  
Author(s):  
Breanne Michelle Laird ◽  
Megan Puzia ◽  
Linda Larkey ◽  
Diane Ehlers ◽  
Jennifer Huberty

BACKGROUND Middle-aged adults (40 to 65 years) report higher stress than most age groups. There is a need to test the feasibility of using a meditation app to reduce stress and improve stress-related outcomes in both middle-aged men and women. OBJECTIVE Therefore, the purpose of this study was to: (1) determine the feasibility (i.e., acceptability and demand) of a consumer-based meditation app (i.e., Calm) to reduce stress in middle-aged adults reporting elevated stress; and (2) explore the preliminary effects of Calm on perceived stress, psychological outcomes (i.e., anxiety, depressive symptoms, mindfulness, general coping), health behaviors (i.e., physical activity, eating habits), and perceptions of COVID-19. METHODS The current study is a double-blind randomized controlled feasibility study testing a brief app-based meditation (i.e., Calm) intervention in middle-aged adults (N=83) with elevated stress levels (i.e., score greater than or equal to 15 on the Perceived Stress Scale) and limited or no previous experience with meditation. Participants were randomized to an app-based meditation intervention (Calm) or app-based education control group (POD). Participants completed self-report assessments at baseline and post-intervention (Week 4). Feasibility was measured as acceptability and demand using Bowen’s framework. Feasibility and COVID-19 perceptions data were examined via descriptive statistics. Preliminary effects were examined using repeated-measures analysis of variance. RESULTS Participants were satisfied with the meditation intervention (96.4%; 27/28) and found it appropriate/useful (92.9%; 26/28). Most reported that they were likely to continue using Calm in the future (64.3%; 18/28). More participants in the Calm group reported satisfaction, appropriateness/usefulness, and intent to continue use compared to the control. Calm participants (n=33) averaged 20.0±31.1 minutes of meditation on the days they meditated and 103±109.1 minutes of meditation per week during the study. On average there was a 70.8% adherence rate to the prescribed meditation, compared to 62.2% in POD. Recruitment of men into the study was 34.9% (29/83). Of those randomized to Calm, 55.2% (15/29) were men. Retention among men was 93.3% (14/15) compared to 60% (12/20) for women. No significant within or between group differences in stress or psychological outcomes related to stress were observed nor were significant differences in health behaviors related to stress. CONCLUSIONS A four-week, app-based mindfulness meditation intervention (i.e., Calm) may be feasible in middle-aged adults. Calm participants expressed satisfaction with the intervention and felt it was appropriate and useful. However, significant improvements in perceived stress and psychological outcomes (i.e., anxiety, depressive symptoms, mindfulness and general coping) or health behaviors related to stress (i.e., physical activity, eating habits) were not observed. The majority of participants reported that COVID-19 negatively impacted their stress, mental health, and physical health. More research is needed for improving stress and stress related outcomes in middle-aged men and women using mindfulness meditation apps. CLINICALTRIAL ClinicalTrials.gov NCT04272138; http://clinicaltrials.gov/ct2/show/NCT04272138.


2021 ◽  
Vol 12 ◽  
Author(s):  
Corina Berli ◽  
Urte Scholz

Keeping a physically active lifestyle requires consistent self-regulatory effort such as action control (e.g., continuously monitoring and evaluating a behavior in terms of one’s goals). Involving the romantic partner in interventions might be particularly effective in the long run. The present study examined the long-term and transfer effects of an action control intervention in couples using text messaging for promoting target persons’ and partners’ physical activity, anthropometric measures and physical fitness 6 months post baseline. A total of 121 overweight and obese romantic couples, randomly allocated to an intervention (n = 60; information + action control text messages) or a control group (n = 61; information only) and to participating as target person or partner, completed baseline assessments (T1). 100 couples (82.6%) completed the 6-month follow-up (T3) assessment. Primary outcomes included self-reported moderate-to-vigorous physical activity (MVPA) and objective MVPA and MVPA adherence using triaxial accelerometers across a diary period of 14 days after T3. Secondary outcomes included BMI, waist-to-hip circumference and physical fitness (target persons only) using a submaximal aerobic cycle test. At T3, there were no significant between-group differences between target persons and partners with regard to their objective MVPA, self-reported MVPA, BMI, waist-hip ratio or physical fitness. No significant changes in outcomes were observed from T1 to T3; however, changes in BMI from T1 to T3 between target persons and partners in the intervention group were associated. Overall, the brief 14-days action control intervention was not effective in improving target person’s physical activity, body measures and physical fitness in the long-term. Moreover, no long-term benefits for partners emerged. While brief ecological momentary interventions might be a promising tool for short-term effects, future studies are needed to test features enhancing long-term effectiveness. Associations in romantic partners’ changes suggest that dyadic interventions can be a promising approach, as changes induced in one partner may then transfer over to the other (controlled-trials.com ISRCTN15705531).


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