Relationship between Spatiotemporal Dynamics of the Brain at Rest and Self-Reported Spontaneous Thoughts: An EEG Microstate Approach

Rationale: The resting-state paradigm is frequently applied in electroencephalography (EEG) research; however, it is associated with the inability to control participants’ thoughts. To quantify subjects’ subjective experiences at rest, the Amsterdam Resting-State Questionnaire (ARSQ) was introduced covering ten dimensions of mind wandering. We aimed to estimate associations between subjective experiences and resting-state microstates of EEG. Methods: 5 min resting-state EEG data of 197 subjects was used to evaluate temporal properties of seven microstate classes. Bayesian correlation approach was implemented to assess associations between ARSQ domains assessed after resting and parameters of microstates. Results: Several associations between Comfort, Self and Somatic Awareness domains and temporal properties of neuroelectric microstates were revealed. The positive correlation between Comfort and duration of microstates E showed the strongest evidence (BF10 > 10); remaining correlations showed substantial evidence (10 > BF10 > 3). Conclusion: Our study indicates the relevance of assessments of spontaneous thought occurring during the resting-state for the understanding of the intrinsic brain activity reflected in microstates.

Healthy Teleworking: Towards Personalized Exercise Recommendations

Home-based teleworking, associated with sedentary behavior, may impair self-reported adult health status. Current exercise recommendations, based on universal recipes, may be insufficient or even misleading to promote healthy teleworking. From the Network Physiology of Exercise perspective, health is redefined as an adaptive emergent state, product of dynamic interactions among multiple levels (from genetic to social) that cannot be reduced to a few dimensions. Under such a perspective, fitness development is focused on enhancing the individual functional diversity potential, which is better achieved through varied and personalized exercise proposals. This paper discusses some myths related to ideal or unique recommendations, like the ideal exercise or posture, and the contribution of recent computer technologies and applications for prescribing exercise and assessing fitness. Highlighting the need for creating personalized working environments and strengthening the active contribution of users in the process, new recommendations related to teleworking posture, home exercise counselling, exercise monitoring and to the roles of healthcare and exercise professionals are proposed. Instead of exercise prescribers, professionals act as co-designers that help users to learn, co-adapt and adequately contextualize exercise in order to promote their somatic awareness, job satisfaction, productivity, work–life balance, wellbeing and health.

Characterizing Pain and Generalized Sensory Sensitivity According to Trauma History Among Patients With Knee Osteoarthritis

Background Childhood trauma and adversity have been linked to chronic pain and pain sensitivity, particularly centralized pain. Yet, there remain numerous gaps in our understanding of this link. Purpose We explored the association between nonviolent and violent childhood trauma and a component of centralized pain (i.e., generalized sensory sensitivity) and pain sensitivity using self-report measures of centralized pain and quantitative sensory testing (QST). Methods Patients scheduled for a total knee arthroplasty (n = 129) completed questionnaires and QST prior to surgery. Results We found that self-report measures of centralized pain (i.e., widespread pain, somatic awareness, and sensory sensitivity) displayed a graded relationship across trauma groups, with patients with a history of violent trauma reporting the highest scores. Univariable multinomial logistic regression analyses showed that higher sensory sensitivity was associated with increased risk of being in the nonviolent trauma group compared to the no trauma group. Furthermore, higher widespread pain, higher somatic awareness, and higher sensory sensitivity distinguished the violent trauma group from the no trauma group. In multivariable analyses, sensory sensitivity is uniquely distinguished between the violent trauma group and the no trauma group. QST did not distinguish between groups. Conclusions The findings highlight the need for future research and interventions that reduce sensory sensitivity for chronic pain patients with a history of violent childhood trauma.

Abstract 15709: Older and Younger Patients’ Perceptions, Evaluations, and Responses to Worsening Heart Failure Symptoms

Background: Adequate self-care abilities, such as early recognition of and appropriate responses to worsening heart failure (HF) symptoms, are important to prevent further deterioration and avoid unnecessary hospitalization. Patients with HF have difficulty recognizing and responding to worsening symptoms promptly and this problem seems to be worse in older compared to younger patients. Objective: The aims of this study were (1) to compare perceptions, evaluations, and responses to worsening HF symptoms before a hospital admission between older and younger patients, and (2) to compare older and younger patients’ responses when they perceived higher symptom distress. Methods: Data on patients’ perceptions, evaluations, and responses to worsening HF symptoms were collected using HF Somatic Awareness Scale and Modified Response to Symptoms Questionnaire from 185 patients hospitalized with HF (mean age 62 ± 13 years; 51% male; 66% New York Heart Association class III/IV). We compared data between younger and older patients using a cutoff at age 65. Independent t -test, chi-square, and two-way ANOVA were performed. Results: Compared with younger patients, older patients were more likely to attribute their symptoms to aging ( p = 0.003) and to have lower somatic awareness ( p = 0.014); however, there were no significant differences between older and younger patients in their responses to worsening HF symptoms. In response to higher perceived symptom distress, regardless of age grouping, patients at first did nothing and hoped their symptoms would go away ( p = 0.004), ignored symptoms and continued doing what was doing ( p = 0.002), or laid down and tried to relax ( p < 0.001). No other strategies such as self-medicated, contacted doctors, and went to hospital were significantly associated with higher symptom distress. Conclusions: Regardless of age, patients with HF do not respond appropriately to worsening HF symptoms. Older patients have lower somatic awareness, which may partially explain their lack of appropriate response, but younger patients with better somatic awareness do not respond any more appropriately. Interventions should be tested that target better symptom appraisal and promote appropriate symptom responses in patients with HF across all ages.

Shitsu-taikan-sho (alexisomia): a historical review and its clinical importance

“Shitsu-taikan-sho” is a clinical concept that refers to characteristics of having difficulty in the awareness and expression of somatic feelings or sensations. This concept was first proposed in 1979 by Dr. Yujiro Ikemi, the founder of psychosomatic medicine in Japan, as a characteristic observed in patients with psychosomatic diseases, i.e. physical diseases in which psychosocial factors are closely involved in their onset and progress. Soon after Dr. Ikemi introduced to Japan the concept of alexithymia, coined by P. E. Sifneos in 1973, he noticed that patients with psychosomatic diseases have difficulty in describing not only their emotions, but also somatic feelings and sensations. Dr. Ikemi proposed naming the concept of the trait of lacking somatic awareness “shitsu-taikan-sho” in Japanese (“alexisomia” in English), meaning “shitsu” a lack, “taikan” bodily feelings/sensations, and “sho” condition/symptoms. Dr. Ikemi observed characteristics of both alexithymia and alexisomia in patients with psychosomatic diseases, but considered alexisomia to have a more fundamental pathophysiological role in the understanding of psychosomatic diseases. He also emphasized the importance of treating alexisomia when treating psychosomatic diseases. Recently, alexisomia has again come into focus for various reasons. One is the availability of the Shitsu-taikan-sho Scale (STSS), a self-rating questionnaire to evaluate alexisomic tendency. Another is recent advances in basic research on interoception. The former will facilitate clinical studies on alexisomia, and the latter will enable a deeper understanding of alexisomia. This article is an overview of the historical development of the concept of alexisomia which was conceptualized by Dr. Ikemi, introduces the STSS, and discusses the current understanding and clinical importance of alexisomia in psychosomatic medicine.

The Experience of the Authentic Self: A Cooperative Inquiry

This article presents the process and findings of a cooperative inquiry exploring the experience of the authentic self—a prominent theoretical construct in humanistic psychology and diverse spiritual traditions. Despite theoretical prominence and emergent psychological research interest, there has been little qualitative research into the authentic self as it is experientially encountered and lived. The present study addresses this gap in the literature using an experiential and participatory research approach. Seven co-inquirers joined in nine cycles of action and reflection over the course of 6 months to inquire, “What is my (the) experience of my (the) authentic self?” In collaboration with the co-inquirers, the initiating coresearcher generated six themes using thematic analysis in response to this primary research question: (a) presence and flow, (b) somatic awareness and vitality, (c) expression of truth, (d) multidimensionality and integration, (e) values and impulses, and (f) dynamism and relationality. In addition, the transformative and practical outcomes of the inquiry are discussed. Finally, several implications of these outcomes and suggestions for future research are outlined.

Keeping violent offender rehabilitation on track: How the diffusion and redirecting of attentional focus/mood work in the GRIP program

There is an urgent need to understand how programming inside prisons can facilitate rehabilitation and reentry processes, especially among men convicted of violent offenses. GRIP (Guiding Rage into Power) is a year-long “Offender Accountability” program presently spreading through the California prison system. GRIP is a group-therapy and trauma-healing program that follows a somatic-awareness-centered model. We use audiovisual data to investigate the sequenced, second-to-second inner workings of what actually constitutes operational excellence in this evidence-based in-prison rehabilitation program. Making use of interaction ritual theory and conversation analysis, we demonstrate how two processes—the diffusion and the redirecting of attentional focus/mood—transpire in GRIP classrooms. The conclusion argues that these two processes may be the “hidden” building blocks, or what is lacking, in countless rehabilitation programs and other social work interventions—both inside and outside of correctional facilities.

Can People with Chronic Neck Pain Recognize Their Own Digital Pain Drawing?

Background: Although the reliability of pain drawings (PDs) has been confirmed in people with chronic pain, there is a lack of evidence about the validity of the PD, that is, does the PD accurately represent the pain experience of the patient? Objectives: We investigate whether people with chronic neck pain (CNP) can recognize their own PD to support the validity of the PD in reporting the experience of pain. Moreover, we examined the association between their ability to recognize their own PD with their levels of pain intensity and disability and extent of psychosocial and somatic features. Study Design: Experimental. Setting: University Laboratory. Methods: Individuals with CNP completed their PD on a digital body chart, which was then automatically modified with specific dimensions using a novel software, providing an objective range of distortion and eliminating errors, which could potentially occur in manually controlled visual-subjective based methods. Following a 10-minute break listening to music, a series of 20 PDs were presented to each patient in a random order, with only 2 being their original PD. For each PD, the patients rated its likeliness to their own original PD on a scale from 0 to 100, with 100 representing “this is my pain.” Results: Overall, the patients rated their original PD with a median score of 92% similarity, followed by 91.8% and 89.5% similarity when presented with a PD scaled down to 75% and scaled up by 150% of the original size, respectively; these scores were not significantly different to the ratings given for their original PD. The PD with horizontal translation by 40 pixels (8%) and vertical translation by 70 pixels (12.8%) were rated as the most dissimilar to their original PD; these scores were significantly different to their original PD scores. The Spearman correlation coefficient revealed a significant negative association between their ability to recognize their original PD and their Modified Somatic Perceptions Questionnaire scores. Limitations: The patients in the study presented with relatively mild CNP, and the results may not be generalized to those with more severe symptoms. Conclusions: People with CNP are generally able to identify their own PD but that their ability to recognize their original PD is negatively correlated with the extent of somatic awareness. Key words: Chronic pain, perception, pain drawings, somatic awareness

The role of coping styles in temporomandibular disorder patients with myalgia

Background Patients suffering pain related temporomandibular disorders (TMD) exhibit greater levels of psychological distress, environmental stress, somatic symptoms, anxiety, depression, somatic awareness, pain catastrophizing, and pain coping strategies compared to pain-free controls. However, little is known about psychological factors involved in the different TMD types fulfilling DC/TMD criteria. Furthermore, regardless of the severity, the role of general coping strategies and styles in TMD is not yet well understood. The main goal of this study was to investigate anxiety, personality traits, and coping behavior in a group of dentistry students suffering from temporomandibular disorder with myalgia. Methods A total of 102 participants were recruited for this study. Following clinical evaluation, a mylagic TMD group (24 participants) and a control group (25 participants) were formed. Participants were later assessed in anxiety, stress coping strategies, and personality measures. Results The myalgic TMD group presented greater levels of trait anxiety and neuroticism in comparison to the control group. In addition, participants with myalgia showed higher levels of avoidance coping. Conclusions Avoidance coping strategies are generally considered maladaptive, as they seem to increase perceived stress, a robust predictor of TMD. Interventions to reduce stress levels and prevent maladaptive coping styles, tailored to the needs of myalgic TMD patients, might improve temporomandibular health and prevent the myalgic TMD and its chronification.