Catastrophizing and fear of tinnitus predict quality of life in patients with chronic tinnitus

Objectives: It is well established that catastrophic misinterpretations and fear are involved in the suffering and disability of patients with chronic pain. This study investigated whether similar processes explain suffering and disability in patients with chronic tinnitus. We hypothesized that patients who catastrophically (mis)interpret their tinnitus would be more fearful of tinnitus, more vigilant toward their tinnitus, and report less quality of life. Moreover, tinnitus-related fear was expected to act as a mediator in reduced quality of life. Design: Sixty-one tinnitus patients from an outpatient ENT department of the University Hospital of Antwerp (Belgium) completed a number of questionnaires about their tinnitus. Hierarchical regression analyses were performed to test hypothesized associations and to assess mediation by tinnitus-related fear. Results: Analyses revealed significant associations between catastrophizing and fear and between catastrophizing and increased attention toward the tinnitus. Furthermore, both tinnitus-related catastrophizing and fear were negatively associated with quality of life; moreover, tinnitus-related fear fully mediated the association between catastrophizing about the tinnitus and quality of life. Conclusions: The findings confirm earlier suggestions that tinnitus-related concerns and fears are associated with impaired quality of life, which is in line with a cognitive behavioral account of chronic tinnitus. Future research avenues and clinical applications are discussed

The stigmatisation of people with chronic back pain

This study responded to the need for better theoretical understanding of experiences that shape the beliefs, attitudes and needs of chronic back patients attending pain clinics. The aim was explore and conceptualise the experiences of people of working age who seek help from pain clinics for chronic back pain. Methods. This was a qualitative study, based on an interpretative phenomenological approach (IPA). During in-depth interviews in their homes, participants were invited to 'tell their story' from the time their pain began. Participants were twelve male and six female patients, aged between 28 and 62 years, diagnosed as having chronic benign back pain. All had recently attended one of two pain clinics as new referrals. The interview transcripts were analysed thematically. Findings. Stigmatisation emerged as a key theme from the narrative accounts of participants. The findings expose subtle as well as overt stigmatising responses by family, friends, health professionals and the general public which appeared to have a profound effect on the perceptions, self esteem and behaviours of those interviewed. Conclusions. The findings suggest that patients with chronic back pain feel stigmatised by the time they attend pain clinics and this may affect their attitudes and behaviours towards those offering professional help. Theories of chronic pain need to accommodate these responses, while pain management programmes need to address the realities and practicalities of dealing with stigma in everyday life

Heritability of pain catastrophizing and associations with experimental pain outcomes: a twin study

This study used a twin paradigm to examine genetic and environmental contributions to pain catastrophizing and the observed association between pain Catastrophizing and cold-pressor task (CPT) outcomes. Male and female monozygotic (n = 206) and dizygotic twins (n = 194) torn the University of Washington Twin Registry completed a measure of pain catastrophizing and performed a CPT challenge, As expected, pain catastrophizing emerged as a significant predictor of several CPT outcomeS, including cold-pressor Immersion Tolerance, Pain Tolerance, and Delayed Pain Rating. The heritability estimate for pain catastrophizing was found to be 37% with the remaining 63% of variance attributable to unique environmental influence. Additionally, the Observed associations between pain catastrophizing and CPT outcomes were not found attributable to shared genetics or environmental exposure, which suggests a direct relationship between catastrophizing and experimental pain. outcomes. This Study is the first to examine the heritability of pain catastrophizing and potential processes by which pain catastrophizing is related to experimental pain response

Affective and emotional dysregulation as pre-dementia risk markers: exploring the mild behavioral impairment symptoms of depression, anxiety, irritability, and euphoria

Background: Affective and emotional symptoms such as depression, anxiety, euphoria, and irritability are common neuropsychiatric symptoms (NPS) in pre-dementia and cognitively normal older adults. They comprise a domain of Mild Behavioral Impairment (MBI), which describes their emergence in later life as an at-risk state for cognitive decline and dementia, and as a potential manifestation of prodromal dementia. This selective scoping review explores the epidemiology and neurobiological links between affective and emotional symptoms, and incident cognitive decline, focusing on recent literature in this expanding field of research. Methods: Existing literature in prodromal and dementia states was reviewed, focusing on epidemiology, and neurobiology. Search terms included: “mild cognitive impairment,” “dementia,” “prodromal dementia,” “preclinical dementia,” “Alzheimer's,” “depression,” “dysphoria,” “mania,” “euphoria,” “bipolar disorder,” and “irritability.” Results: Affective and emotional dysregulation are common in preclinical and prodromal dementia syndromes, often being harbingers of neurodegenerative change and progressive cognitive decline. Nosological constraints in distinguishing between pre-existing psychiatric symptomatology and later life acquired NPS limit historical data utility, but emerging research emphasizes the importance of addressing time frames between symptom onset and cognitive decline, and age of symptom onset. Conclusion: Affective symptoms are of prognostic utility, but interventions to prevent dementia syndromes are limited. Trials need to assess interventions targeting known dementia pathology, toward novel pathology, as well as using psychiatric medications. Research focusing explicitly on later life onset symptomatology will improve our understanding of the neurobiology of NPS and neurodegeneration, enrich the study sample, and inform observational and clinical trial design for prevention and treatment strategies

Multidimensional screening for predicting pain problems in adults : a systematic review of screening tools and validation studies

Screening tools allowing to predict poor pain outcomes are widely used. Often these screening tools contain psychosocial risk factors. This review (1) identifies multidimensional screening tools that include psychosocial risk factors for the development or maintenance of pain, pain-related distress, and pain-related disability across pain problems in adults, (2) evaluates the quality of the validation studies using Prediction model Risk Of Bias ASsessment Tool (PROBAST), and (3) synthesizes methodological concerns. We identified 32 articles, across 42 study samples, validating 7 screening tools. All tools were developed in the context of musculoskeletal pain, most often back pain, and aimed to predict the maintenance of pain or pain-related disability, not pain-related distress. Although more recent studies design, conduct, analyze, and report according to best practices in prognosis research, risk of bias was most often moderate. Common methodological concerns were identified, related to participant selection (eg, mixed populations), predictors (eg, predictors were administered differently to predictors in the development study), outcomes (eg, overlap between predictors and outcomes), sample size and participant flow (eg, unknown or inappropriate handling of missing data), and analysis (eg, wide variety of performance measures). Recommendations for future research are provided

Spouse Beliefs about Partner Chronic Pain

While research has shown that patients’ beliefs about their pain are related to pain adjustment and treatment outcomes, little is known about the beliefs of their significant others. The purpose of this study was to develop a measure of pain beliefs in significant others and to examine the correlates of these beliefs. Participants were 104 married couples in which one partner reported chronic pain. Spouses completed an amended version of the Survey of Pain Beliefs (SOPA) [14]. The scale development procedure described in Jensen et al.[12] was used to select appropriate items for the significant other version of the SOPA. This procedure yielded 7 subscales that closely resembled the original SOPA. Spousal pain beliefs about disability, emotion, control, and medication were significantly correlated with partners’ pain severity and other indicators of pain adjustment. Emotion, disability, and other beliefs were related to spouse responses to pain, and spouses’ depressive symptoms and marital dissatisfaction. Spouses’ personal experiences with pain were not related to their beliefs about their partners’ pain. Additional research on the pain-related beliefs of significant others may extend cognitive-behavioral theory concerning the social context of pain and provide an additional avenue through which clinicians can address cognition in patients and families

The Effects of Sulphur Dioxide on Selected Hepatics

Extensive studies have been reported on the air pollutant sulphur dioxide (SO2), and its effects on vascular and nonvascular plants. It has been shown to interrupt normal physiology, metabolism, reproduction, and alter the plant’s morphology. Of the cryptogams, lichens have been extensively used as biological indicators of air pollution. More recently, bryophytes have been shown to be as sensitive to contaminates as lichens, and may exhibit responses to the pollutant similar to those of vascular and nonvascular plants. The threshold sensitivity of these cryptogams is about 0.5 ppm over a 12 hour period. However no study to date has investigated the utilization of hepatics as possible pollution indicators. The intent of this research was to investigate the general responses of selected liverworts to sulphur dioxide. The liverworts used were: Blasia pusilla L., Lophocolea heterophylla (Schrad.) Dum., Scapania nemorosa (L.) Dum. and Jamesoniella autumnalis (D.C.) Steph. The thalli were fumigated under varying SO2 concentrations in an ecological chamber for 8 hours. All thalli exhibited a marked discoloration (chlorosis) which varied directly with the SO2 concentration. Chlorophyll analysis showed a 34-37% decrease in total chlorophyll content at 0.4 ppm SO2 concentration. Numerical data concerning Blasia reflects a conflict with chlorophyll extraction procedures of a plant and an algae. The SO2 caused degradation in chlorophylla whether plant or algal, which did account for the loss in total chlorophyll. These liverworts exhibit a typical response to SO2 and have a threshold equal to, or slightly less than, other cryptogams

Body image/imagining bodies: Trauma, control, and healing in graphic memoirs about anorexia

Over the past decade, there has been a significant increase of graphic narratives focusing on the intersection of comics and medicine, a subgenre known as graphic medicine. These memoirs, known as graphic pathographies, are written from those who interact with disease in various capacities from patient, to doctor, to caregiver. This project closely examines three graphic pathographies written about the eating disorder anorexia nervosa. Prior writing, both fictional and personal memoir, on anorexia has often been considered as problematic for its ability to function as a how-to manual for anorexics. Anorexia is a complex disease that exists largely within the mind of the anorexic, yet its toll can be visibly seen on the body. Graphic pathographies, with their ability to simultaneously show through the visual format and tell through the verbal format, offer a more nuanced and holistic representation of one’s encounter with anorexia

The Effects of Sulphur Dioxide on Selected Hepatics

Extensive studies have been reported on the air pollutant sulphur dioxide (SO2), and its effects on vascular and nonvascular plants. It has been shown to interrupt normal physiology, metabolism, reproduction, and alter the plant’s morphology. Of the cryptogams, lichens have been extensively used as biological indicators of air pollution. More recently, bryophytes have been shown to be as sensitive to contaminates as lichens, and may exhibit responses to the pollutant similar to those of vascular and nonvascular plants. The threshold sensitivity of these cryptogams is about 0.5 ppm over a 12 hour period. However no study to date has investigated the utilization of hepatics as possible pollution indicators. The intent of this research was to investigate the general responses of selected liverworts to sulphur dioxide. The liverworts used were: Blasia pusilla L., Lophocolea heterophylla (Schrad.) Dum., Scapania nemorosa (L.) Dum. and Jamesoniella autumnalis (D.C.) Steph. The thalli were fumigated under varying SO2 concentrations in an ecological chamber for 8 hours. All thalli exhibited a marked discoloration (chlorosis) which varied directly with the SO2 concentration. Chlorophyll analysis showed a 34-37% decrease in total chlorophyll content at 0.4 ppm SO2 concentration. Numerical data concerning Blasia reflects a conflict with chlorophyll extraction procedures of a plant and an algae. The SO2 caused degradation in chlorophylla whether plant or algal, which did account for the loss in total chlorophyll. These liverworts exhibit a typical response to SO2 and have a threshold equal to, or slightly less than, other cryptogams