Distress intolerance and pain catastrophizing as mediating variables in PTSD and chronic noncancer pain comorbidity.

Objectives: Several studies have demonstrated posttraumatic stress disorder (PTSD) and chronic pain comorbidity. However, there is a lack of research on the psychological variables that might explain their co-occurrence. We investigated the mediating role of distress intolerance and pain catastrophizing in this relationship. Methods: A moderated mediation model was tested. The sample comprised 114 individuals with chronic noncancer pain (90 women and 24 men; mean age, of 60.04 years [SD=9.76]). Results: Catastrophizing had a significant effect on PTSD. Distress intolerance mediated catastrophizing and PTSD, and pain intensity moderated this relationship. Conclusions: New insights are provided into the psychological variables that may explain PTSD and chronic noncancer pain comorbidity

Pain Acceptance Creates an Emotional Context That Protects against the Misuse of Prescription Opioids: A Study in a Sample of Patients with Chronic Noncancer Pain.

There is solid evidence of an association between several psychological flexibility processes, particularly pain acceptance, and adaptation to chronic pain. However, there are relatively few studies on the relationship between pain acceptance and opioid misuse in chronic pain patients. Thus, the aim of the present study was to test a hypothetical model in which pain acceptance would regulate pain sensations and pain-related thoughts and emotions, which would be related to opioid misuse. The sample comprised 140 chronic pain patients attending two hospitals. All patients were receiving pharmacological treatment, including opioid analgesics. Structural equation modelling analyses showed a significant association between higher pain acceptance and lower pain intensity and catastrophizing, and lower levels of anxiety and depression. Only higher anxiety and depression were significantly associated with increased opioid misuse. The results suggest that levels of anxiety, depression, and pain acceptance must be assessed before opioids are prescribed. Pain acceptance implies a relationship with internal events that protects against anxiety and depression and thus against opioid misuse. Acceptance and Commitment Therapy appears to be particularly appropriate for these patients.This study was supported by grants from the Spanish Ministry of Science and Innovation (PID2019-106086RB-I00) and the Regional Government of Andalusia (HUM-566). Partial funding for open access charge: Universidad de Málaga

How do the activity patterns of people with chronic pain influence the empathic response of future health professionals: an experimental study.

Funding for open access charge: Universidad de Málaga / CBU

Empathy among health science undergraduates toward the diagnosis of chronic pain: An experimental study.

Objectives: To analyse the empathetic response of future health professionals toward people diagnosed with chronic pain differentiated by the degree of visibility and credibility of symptoms. Methods: A total of 203 undergraduates performed an experimental task using vignettes depicting different diagnoses of chronic pain and completed questionnaires measuring dispositional and situational empathy. A MANCOVA analysis was conducted. Results: The main effects of chronic pain diagnoses did not significantly affect situational empathy (p = .587, η2 = 0.007, d = 0.229). The dispositional empathy variables perspective-taking and personal distress affected the situational empathy scores (p = .002, η2 = 0.072, d = 0.906, and p = .043, η2 = 0.032, d = 0.547, respectively). Conclusions: It would seem appropriate to foster intra-individual empathy factors among health science undergraduates such that they can more readily understand the process of individual adaptation to chronic pain and thus manage it more effectively. Practice implications: It would be useful for dispositional empathy to form part of the transversal competences of the training programmes of future health professionals from the beginning of their studies

Chronic pain in the time of COVID-19: Stress aftermath and central sensitization.

Se ha pagado la tarifa APC.Objectives.The COVID-19 crisis is a significant stressor worldwide. The physical andemotional condition of individuals with pain sensitization syndromes who are experi-encing the pandemic may worsen. This study investigated the contribution of life changesdue to the coronavirus to emotional distress in individuals with a diagnosis of chroniccentral sensitization pain and tested whether the associations between level of pain andsensitization were independent of or mediated by emotional distress.Methods.Spanish individuals with chronic pain (N=362) completed an online surveyon direct or indirect exposure to the consequences of COVID-19, pain intensity, andemotional distress. They also completed central sensitization questionnaires.Results.An association was found between changes in daily routines and pain intensity,emotional distress, and sensitization scores. Correlations were found between emotionaldistress, sensitization, and pain intensity. Significant predictors of emotional distress wereage, difficulty in receiving medical care, changes in daily routines, and diminished socialsupport. Emotional distress did not mediate the association between sensitization andpain intensity.Conclusion.Due to the COVID-19 situation, individuals with central sensitization painsyndromes may be at higher risk of developing psychological distress. Interdisciplinaryinterventions involving psychologists are urgently needed to provide this population withappropriate health care

Intolerance of Uncertainty Moderates the Relationship between Catastrophizing, Anxiety, and Perceived Pain in People with Chronic Nononcological Pain.

Se ha pagado con un APCObjective.Substantial empirical evidence has shown that intolerance of uncertainty is a central transdiagnostic fea-ture in psychopathology and it has been suggested to be a pain-related psychological factor contributing to the ex-perience of chronic pain. However, research in this area is virtually nonexistent. The objective of this study was to in-vestigate associations between pain severity, catastrophizing, and anxiety in people with chronic nononcologicalpain, while assuming that intolerance of uncertainty moderates these relationships.Methods.A convenience sampleof 188 individuals with nononcological chronic pain (157 women and 32 men) participated in the study. We investi-gated the moderated mediation of intolerance of uncertainty between anxiety and catastrophizing and between cata-strophizing and pain intensity.Results.The full moderated mediation model accounted for significant variance inpain intensity (R2¼0.148,P<.001). Intolerance of uncertainty significantly moderated the interaction between anxi-ety and catastrophizing (B¼0.039, SE¼0.012, 95% CI [0.015, 0.063]) and between catastrophizing and pain intensity(B¼-0.034, SE¼0.010, 95% CI [ 0.054, 0.014]). Anxiety and intolerance of uncertainty did not interact in predictingcatastrophizing, although an interaction effect was found between intolerance of uncertainty and catastrophizing inpredicting pain intensity.Conclusion.This study is the first to address the interrelationship of intolerance of uncer-tainty, catastrophizing, and anxiety in relation to perceived pain intensity. The current findings support intoleranceof uncertainty as a relevant psychological variable that is distinct from other relevant constructs in the setting ofpain research and treatment

Pain Interference, Resilience, and Perceived Well-Being DuringCOVID-19: Differences Between Women With and Without Trauma Exposure Prior to the Pandemic.

Objectives: The aim of this study was to investigate the consequences of the COVID-19 pandemic in women with non-malignant chronic pain, and to determine whether women exposed to traumatic situations prior to the outbreak would be at a higher risk of negative health impacts.Methods: A total of 365 women were divided into three subgroups according to whether or not they had experienced a traumatic event prior to COVID-19. They completed an online survey.Results: Significant differences were found between groups during lockdown: 1) more psychological abuse was experienced by the group of women who had experienced an interpersonal traumatic event prior to the pandemic than in the other subgroups; 2)physical activity levels were higher and scores on pain interference were lower in women in the non-traumatized subgroup than in the other subgroups; 3) pain interference was predicted by pain intensity, decreased social support, and resilience, whereas perceived well-being was predicted by pain interference.Conclusion: Women who had experienced a traumatic event prior to the pandemic suffered worse consequences of the COVID-19 lockdown, particularly greater pain interference, although resilience was shown to both mitigate pain interference and enhance perceived well-bein

Relaciones entre el uso de la voz y el burnout en los docentes de educación infantil y primaria de Málaga

Se analiza la relación existente entre el perfil de uso vocal y el síndrome burnout en una muestra de 244 maestros de Educación Infantil y Primaria de los colegios públicos de Málaga. Estos profesores obtienen bajas puntuaciones en las escalas de Cansancio Emocional (CE), Despersonalización (DP) y Realización Personal (RP). Se han encontrado relaciones significativas entre el perfil vocal y las escalas del burnout: CE se relaciona con el uso vocal en clase y la tensión muscular cervical; DP se asocia a la intensidad vocal usada en actividades fuera del aula; RP muestra una tendencia a la significación con la tensión cervical durante la jornada laboral

Physicians’ perception about predictors of opioid abuse in patients with chronic non-cancer pain: a Delphi study.

APC realizado, el artículo está en Open accessBackground: Opioids are being prescribed widely, and increasingly, for the treatment of chronic non-cancer pain (CNCP). However, several side effects are associated with mid- and long-term opioid use and, for certain patients, with the risk of problematic opioid use. The aim of this study is to know the perception of the physicians about which variables could be associated within creased risk of patients with CNCP developing a problem of abuse or misuse of the prescribed opioid medication. Methods: Twenty-nine physicians with experience in CNCP pain management and opioids prescription participated in a two-round Delphi study focused on the risk factors for opioid misuse and abuse.Results: The variables that reached consensus regarding their relationship with the increased risk of suffering a problem of opioid abuse or misuse were: (1)Experiencing pain on a daily basis, (2) previous use of high-dose opioids, (3)generalized anxiety, (4) hopelessness, (5) benzodiazepine intake, (6) use of opioids for reasons other than pain, (7) family problems, family instability or family breakdown, and (8) having access to several opioid prescribers. The only variable that reached consensus regarding it not being associated to a possible risk of abuse or misuse was having mild pain intensity (0–4 on a NRS-11).Conclusions: This study provides useful information that could help make decisions about the use of opioids for CNCP treatment and prevent future difficulties. Prospective studies testing the relationship of the variables that reached consensus with the risk of opioid misuse and abuse are warranted. Significance: This study shows the variables of CNCP that the professional must take into account in order to avoid possible problems when prescribing opioidsThis work was partly funded by grants from the Spanish Ministry of Science and Competitiveness, PID2019-106086RBI00; the Regional Government of Andalusia, UMA20-FEDERJA118. SG’s salary is supported by a Sara Borrell grant (CD19/ 00022), from ISCIII; RV’s salary is supported by a RYC2018- 024722-I from the Spanish Ministry of Science and Innovation

The Silhouettes Fatigue Scale: a validity study with individuals with physical disabilities and chronic pain.

Purpose: Fatigue is known to interfere with function in individuals with physical disabilities. In order to monitor changes in fatigue over time and evaluate the efficacy of treatments, psychometrically sound measures of fatigue are needed. The aim of this work was to evaluate the validity of the Silhouettes Fatigue Scale with English instructions (SFS-EN) in a sample of adults with physical disabilities living in the USA. Methods: Individuals with medical conditions associated with physical disabilities responded to an online survey that included the SFS-EN as well as another validated measure of fatigue (PROMIS short form-4a Fatigue Scale), and measures of pain intensity and pain catastrophizing. Results: 523 individuals participated (mean age ¼ 59.1 years; SD¼11.4). Most participants were Caucasian (89%), women (59%) and unemployed (71%). Results showed strong positive correlations between both measures of fatigue, supporting the convergent validity of the SFS-EN. In addition, the magnitude of this association was significantly greater than the association between the scores of the SFS-EN and the measures of pain intensity and pain catastrophizing, supporting the former’s discriminant validity. Conclusions: The findings extend previous results supporting the SFS as a brief, easy to administer and understand, and valid measure of fatigue