scholarly journals Early Changes in Pain Acceptance Predict Pain Outcomes in Interdisciplinary Treatment for Chronic Pain

2019 ◽  
Vol 8 (9) ◽  
pp. 1373 ◽  
Author(s):  
Probst ◽  
Jank ◽  
Dreyer ◽  
Seel ◽  
Wagner ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Pain Perception ◽  
Rating Scale ◽  
Post Treatment ◽  
Interdisciplinary Treatment ◽  
Binary Logistic Regression Analysis ◽  
Pain Acceptance ◽  
Pain Outcomes ◽  
The Impact

Studies have shown that pain acceptance is associated with a better pain outcome. The current study explored whether changes in pain acceptance in the very early treatment phase of an interdisciplinary cognitive-behavioral therapy (CBT)-based treatment program for chronic pain predict pain outcomes. A total of 69 patients with chronic, non-malignant pain (at least 6 months) were treated in a day-clinic for four-weeks. Pain acceptance was measured with the Chronic Pain Acceptance Questionnaire (CPAQ), pain outcomes included pain intensity (Numeric Rating Scale, NRS) as well as affective and sensory pain perception (Pain Perception Scale, SES-A and SES-S). Regression analyses controlling for the pre-treatment values of the pain outcomes, age, and gender were performed. Early changes in pain acceptance predicted pain intensity at post-treatment measured with the NRS (B = −0.04 (SE = 0.02); T = −2.28; p = 0.026), affective pain perception at post-treatment assessed with the SES-A (B = −0.26 (SE = 0.10); T = −2.79; p = 0.007), and sensory pain perception at post-treatment measured with the SES-S (B = -0.19 (SE = 0.08); T = -2.44; p = 0.017) . Yet, a binary logistic regression analysis revealed that early changes in pain acceptance did not predict clinically relevant pre-post changes in pain intensity (at least 2 points on the NRS). Early changes in pain acceptance were associated with pain outcomes, however, the impact was beneath the threshold defined as clinically relevant.

Process-outcome associations in an interdisciplinary treatment for chronic pain and comorbid mental disorders based on Acceptance and Commitment Therapy

Pain Medicine ◽  
2021 ◽  
Author(s):  
Ludwig Ohse ◽  
Ronald Burian ◽  
Eric Hahn ◽  
Hannah Burian ◽  
Thi Minh Tam Ta ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Mental Disorders ◽  
Clinical Outcomes ◽  
Acceptance And Commitment Therapy ◽  
Psychological Flexibility ◽  
Post Treatment ◽  
Interdisciplinary Treatment ◽  
Pain Acceptance ◽  
Acceptance And Commitment ◽  
Comorbid Mental Disorders

Abstract Objective Numerous studies support the effectiveness of Acceptance and Commitment Therapy (ACT) for chronic pain, yet little research has been conducted about its underlying mechanisms of change, especially regarding patients with comorbid mental disorders. The present investigation addressed this issue by examining associations of processes targeted by ACT (pain acceptance, mindfulness, psychological flexibility) and clinical outcomes (pain intensity, somatic symptoms, physical health, mental health, depression, general anxiety). Subjects Participants were 109 patients who attended an ACT-based interdisciplinary treatment program for chronic pain and comorbid mental disorders in a routine care psychiatric day hospital. Methods Pre- to post-treatment differences in processes and outcomes were examined with Wilcoxon signed-rank tests and effect size r. Associations between changes in processes and changes in outcomes were analyzed with correlation and multiple regression analyses. Results Pre- to post-treatment effect sizes were mostly moderate to large (r between |0.21| and |0.62|). Associations between changes in processes and changes in outcomes were moderate to large for both, bivariate correlations (r between |0.30| and |0.54|) and shared variances accounting for all three processes combined (R2 between 0.21 and 0.29). Conclusion The present investigation suggests that changes in pain acceptance, mindfulness and psychological flexibility are meaningfully associated with changes in clinical outcomes. It provides evidence on particular process-outcome associations that had not been investigated in this way before. The focus on comorbid mental disorders informs clinicians about a population of chronic pain patients that often has a severe course of illness and has seldom been studied.

scholarly journals Unpredictable pain timings lead to greater pain when people are highly intolerant of uncertainty

2017 ◽  
Vol 17 (1) ◽  
pp. 367-372 ◽  
Author(s):  
Clémence Bélanger ◽  
Bernard Blais Morin ◽  
Andréanne Brousseau ◽  
Nicolas Gagné ◽  
Anne Tremblay ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Pain Perception ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Catastrophizing ◽  
Intolerance Of Uncertainty ◽  
Time Frame ◽  
Added Value ◽  
Subjective Pain ◽  
The Impact

AbstractBackground and purposeMany psychological factors are known to influence pain perception. Among them, intolerance of uncertainty (IU) may play a key modulating role in situations where uncertainty prevails, especially uncertainty regarding the timing of painful events. The objective of this study was to explore the impact of individual differences in IUon pain perception during predictable and unpredictable stimulation timings. We hypothesized that people with high IU, as opposed to those with low IU, would perceive more pain when the timing of painful stimulations cannot be predicted, as compared to when they can.MethodsTwenty (20) healthy adults, aged between 18 and 35 years old, were recruited. Painful sensations were provoked using transcutaneous electrical stimulations of the right sural nerve. By measuring IU (Intolerance of Uncertainty Scale) and subjective pain (verbal numerical rating scale), it was possible to test the relationship between IU and pain perception, by simulating predictable and unpredictable painful experiences. This was done through cued shock interval (CSI) blocks, with either variable timing or fixed timings (long or short time frame). Self-administered questionnaires were also used to measure pain hypervigilance, pain catastrophizing, state anxiety, and trait anxiety.ResultsPearson correlations confirmed the presence of an association (r = 0.63) between IU and the change in pain intensity provoked by unpredictable stimulation timings. Importantly, this association was significant only for stimulations provided at long CSIs, indicating that higher IU scores predicted higher pain intensity scores when stimulation timings became unpredictable, and when the cued delay was long. No association was found between pain scores and other psychological variables.ConclusionsOur results show that IU moderately correlates to the change in pain intensity provoked by unpredictable stimulation timings. High IU scores were associated with a worsening of the subjective pain experience, especially during long delays in an unpredictable situation. These observations suggest that IU could be considered as a psychological variable that is able to influence pain perception in certain situations.ImplicationsAssessing and addressing IU could be an added value in pain-related therapy, especially in chronic pain.

scholarly journals The impact of gender of the examiner on orofacial pain perception and pain reporting among healthy volunteers

2021 ◽  
Author(s):  
A. Lövgren ◽  
B. Häggman-Henrikson ◽  
A. Fjellman-Wiklund ◽  
A. Begic ◽  
H. Landgren ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Pain Perception ◽  
Rating Scale ◽  
Orofacial Pain ◽  
Multivariable Analysis ◽  
Pressure Pain Threshold ◽  
Pain Tolerance ◽  
Pressure Pain ◽  
Pain Reporting ◽  
The Impact

Abstract Objectives Pain on palpation of jaw muscles is a commonly used diagnostic criterion when examining patients with orofacial pain. It is not known, however, if pain reports are affected by the gender of the examiner. Our aim was to investigate if pressure pain threshold (PPT), pressure pain tolerance (PTol), and pain intensity assessed over the masseter muscles in healthy individuals are affected by the gender of the examiner. Materials and methods Healthy, pain-free individuals were recruited on a voluntary basis. PPT and PTol were assessed using pressure algometry. At the PTol level, participants also rated pain intensity on a 0–10 numeric rating scale. Assessments of PPT and PTol were conducted with six repeated measurements performed twice, separately by one female and one male examiner, on each participant. Results In total, 84 participants (43 women; median age 24, IQR 6) were included. With a female examiner, women reported higher pain intensity than men (Mann Whitney U, p = 0.005). In the multivariable analysis, significantly higher PTol was predicted by male examiner. Also, a higher ratio between PTol and reported pain intensity was predicted by male examiner. Conclusions The gender of the examiner influences pain reporting and perception in an experimental setting. This effect on pain perception related to gender of the examiner is probably related to normative gender behaviors rather than to biological alterations within the examined individual. Clinical relevance In clinical and experimental settings, gender of the examiner may affect not only pain perception but also pain reporting, with potential implications for diagnostics in patients with pain.

Sleep disturbance in patients attending specialized chronic pain clinics in Denmark: a longitudinal study examining the relationship between sleep and pain outcomes

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Henrik Bjarke Vaegter ◽  
Mette Terp Høybye ◽  
Frederik Hjorth Bergen ◽  
Christine E. Parsons
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Sleep Quality ◽  
Pain Intensity ◽  
Sleep Disturbances ◽  
Pain Disability ◽  
Pain Clinics ◽  
Pain Outcomes

Abstract Objectives Sleep disturbances are highly prevalent in patients with chronic pain. However, the majority of studies to date examining sleep disturbances in patients with chronic pain have been population-based cross-sectional studies. The aims of this study were to 1) examine the frequency of sleep disturbances in patients referred to two interdisciplinary chronic pain clinics in Denmark, 2) explore associations between sleep disturbances and pain intensity, disability and quality of life at baseline and follow-up, and 3) explore whether changes in sleep quality mediated the relationships between pain outcomes at baseline and pain outcomes at follow-up. Methods We carried out a longitudinal observational study, examining patients enrolled in two chronic pain clinics assessed at baseline (n=2,531) and post-treatment follow-up (n=657). Patients reported on their sleep disturbances using the sleep quality subscale of the Karolinska Sleep Questionnaire (KSQ), their pain intensity using 0–10 numerical rating scales, their pain-related disability using the Pain Disability Index (PDI), and quality of life using the EuroQol-VAS scale. The average time between baseline and follow-up was 207 days (SD=154). Results At baseline, the majority of patients reported frequent sleep disturbances. We found a significant association at baseline between self-reported sleep disturbances and pain intensity, pain-related disability, and quality of life, where greater sleep disturbance was associated with poorer outcomes. At follow-up, patients reported significant improvements across all pain and sleep outcomes. In two mediation models, we showed that changes in sleep disturbances from baseline to follow-up were significantly associated with (i) pain intensity at follow-up, and (ii) pain disability at follow-up. However, baseline pain intensity and disability scores were not associated with changes in sleep disturbances and, we did not find evidence for significant mediation of either pain outcome by changes in sleep disturbances. Conclusions Self-reported sleep disturbances were associated with pain outcomes at baseline and follow-up, with greater sleep disturbances associated with poorer pain outcomes. Changes in sleep quality did not mediate the relationships between baseline and follow-up scores for pain intensity and disability. These findings contribute to a growing body of evidence confirming an association between sleep and chronic pain experience, particularly suggestive of a sleep to pain link. Our data following patients after interdisciplinary treatment suggests that improved sleep is a marker for a better outcome after treatment.

The buffering role of positive affect on the association between pain intensity and pain related outcomes

2017 ◽  
Vol 14 (1) ◽  
pp. 91-97 ◽  
Author(s):  
Ivan S.K. Thong ◽  
Gabriel Tan ◽  
Mark P. Jensen
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Negative Affect ◽  
Positive Affect ◽  
Pain Intensity ◽  
Sleep Problems ◽  
Cross Sectional Study ◽  
Pain Interference ◽  
Cross Sectional ◽  
The Impact

AbstractObjectivesChronic pain is a significant problem worldwide and is associated with significant elevations in negative affect, depressive symptoms, sleep problems, and physical dysfunction. Positive affect could potentially buffer the impact of pain on patient functioning. If it does, then positive affect could be directly targeted in treatment to benefit individuals with chronic pain. The purpose of this study was to test for such moderating effects.MethodsThis was a cross-sectional study, we administered measures of pain intensity, depressive symptoms, sleep problems, pain interference, and positive and negative affect to 100 individuals with chronic back or knee pain in a single face-to-face assessment session.ResultsThe associations between pain intensity and negative affect, and between pain intensity and depressive symptoms were moderated by positive affect. This moderation effect was explained by the fact that participants with low positive affect evidenced strong associations between pain intensity and both depression and negative affect; participants with high positive affect, on the other hand, evidenced weak and non-significant associations between pain intensity and both depression and negative affect. Positive affect did not moderate the associations between pain intensity and either sleep problems or pain interference.ConclusionThe findings are consistent with the possibility that positive affect may buffer the impact of pain intensity on negative affect and depressive symptoms. Longitudinal and experimental research is needed to determine the potential benefits of treatments that increase positive affect on negative affect and depressive symptoms in chronic pain populations.ImplicationsThe study findings suggest the possibility that “positive psychology” interventions which increase positive affect could benefit individuals with chronic pain by reducing the impact of pain on negative outcomes. Research to test this possibility is warranted.

Effects of Eight-Week-Web-Based Mindfulness Training on Pain Intensity, Pain Acceptance, and Life Satisfaction in Individuals With Chronic Pain

2016 ◽  
Vol 119 (3) ◽  
pp. 586-607 ◽  
Author(s):  
Jessica Henriksson ◽  
Emma Wasara ◽  
Michael Rönnlund
Keyword(s):  
Chronic Pain ◽  
Life Satisfaction ◽  
Treatment Group ◽  
Pain Intensity ◽  
Mindfulness Training ◽  
Control Group ◽  
Web Based ◽  
Pain Acceptance ◽  
Mindfulness Skills ◽  
Online Discussion Forum

This study examined the effects of an eight-week-web-based mindfulness program designed for individuals with chronic pain. A sample of 107 participants with chronic pain ( M = 51.0 years, SD = 9.3) were randomly assigned to a treatment group and a control group. The mindfulness program involved 20 minutes of training per day, six days a week, for eight weeks. During this period, the control group was invited to an online discussion forum involving pain-related topics. A total of 77 participants completed the postintervention assessment ( n = 36 in the treatment group, n = 41 in the control group). The group assigned to mindfulness training showed increased mindfulness skills (Cohen’s d = 1.18), reduced pain intensity ( d = 0.47–0.82), reduced pain-related interference/suffering ( d = 0.39–0.85), heightened pain acceptance ( d = 0.66), reduced affective distress ( d = 0.67), and higher ratings of life satisfaction ( d = 0.54) following the training with no or minor changes up for the control group ( d values 0.01–0.23), a pattern substantiated by significant group-by-time interactions. Despite limitations of this study, including a less than ideal control group to isolate effects of mindfulness and lack of a long-term follow-up, the results appear promising and may motivate further investigations.

The impact of pain anxiety on chronic pain among elders

2011 ◽  
Vol 26 (S2) ◽  
pp. 1006-1006 ◽  
Author(s):  
M. Tsatali ◽  
M. Gouva
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Statistical Significance ◽  
Well Being ◽  
Linear Regression Method ◽  
Pain Anxiety ◽  
Education Levels ◽  
Geriatric Pain ◽  
Pain Anxiety Symptoms Scale ◽  
The Impact

IntroductionPain is a complex and multifacial phenomenon, which interferes in almost every person's life, while in case it turns into chronic, can cause a significant disturbance in individual's physical, psychological and social sphere. That means the intense communication and interaction between ache biome, living conditions and state of health. Cognitive factors play a significant role on the recurrent dysphoria levels, while cognitive functions participate actively in pain intensity, sense of disability and medicine response.AimEstimate the possible significance between pain anxiety and pain intensity.Materials and methodsEighty six elders suffering from various types of chronic pain were examined by the Pass-20 (Pain Anxiety Symptoms Scale) scale, and GPM (Geriatric Pain Measure), while the results were assessed by SPSS 14 and specifically the Linear Regression method.ResultsIt was found statistical significance between the four sub-scales and the presence and existence of chronic pain among participants. Specifically the first subcale (avoidance of pain) was linked with the intensity of pain (p = ,00), the second scale (fearfull thinking) was associated with the prevalence of pain and the gender (p = ,014), the third scale (cognitive anxiety) showed a statistic significance with GPM results and education levels (p = ,00) and the forth scale (psychological responses) was found to affect the pain sense, while it was depended by gender (p = ,0015).DiscussionAmong elders pain anxiety can deteriorate the pain sense affecting the general well-being. For that reason non-pharmacological interventions can be very helpful both for the patient and clinician.

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