Why and when social support predicts older adults’ pain-related disability

Pain-related social support has been shown to be directly associated with pain-related disability, depending on whether it promotes functional autonomy or dependence. However, previous studies mostly relied on cross-sectional methods, precluding conclusions on the temporal relationship between pain-related social support and disability. Also, research on the behavioral and psychological processes that account for such a relationship is scarce. Therefore, this study aimed at investigating the following longitudinally: (1) direct effects of social support for functional autonomy/dependence on pain-related disability, (2) mediating role of physical functioning, pain-related self-efficacy, and fear, and (3) whether pain duration and pain intensity moderate such mediating processes. A total of 168 older adults (Mage = 78.3; SDage = 8.7) participated in a 3-month prospective design, with 3 moments of measurement, with a 6-week lag between them. Participants completed the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Brief Pain Inventory, the 36-SF Health Survey, behavioral tasks from the Senior Fitness Test, the Pain Self-Efficacy Questionnaire, and the Tampa Scale for Kinesiophobia. Moderated mediation analyses showed that formal social support for functional dependence (T1) predicted an increase in pain-related disability (T3), that was mediated by self-reported physical functioning (T2) and by pain-related self-efficacy (T2) at short to moderate pain duration and at low to moderate pain intensity, but not at higher levels. Findings emphasized that social support for functional dependence is a risk factor for pain-related disability and uncovered the “why” and “when” of this relationship. Implications for the design of social support interventions aiming at promoting older adults' healthy aging despite chronic pain are drawn.info:eu-repo/semantics/acceptedVersio

Empathy beyond the conceptual level core nonspecific factors of psychotherapy

The human mind contains much more than concepts. By only taking into account the conceptual level, a cared-for person may feel utterly lonely and abandoned, not deeply in contact with the caregiver, not deeply understood for who he or she really is. A chronic pain patient, for instance, may react to a purely conceptual-level communication, with its lack of deeper contact, by an increasing sense of loneliness. This in itself may substantially contribute to the suffering of chronic functional pain or even functional disorders in general. In dealing with chronic pain patients, as with any patients, it is therefore very important to develop a sense of empathy that goes beyond this, towards deeply understanding the patient as complete person. This sheds a profound light on the all-important nonspecific factors of psychotherapy, which according to many researchers form the only profoundly active principle in psychotherapy

Helping motivation and well-being of chronic pain couples: a daily diary study

Receiving support from a romantic partner may yield benefits for individuals with chronic pain (ICPs), but may also carry unintended side effects. The conditions under which partner support provision yields (mal) adaptive effects deserve greater attention. Grounded in Self-determination theory, partners may provide help for autonomous or volitional (eg, enjoyment, full commitment) or rather controlled or pressured (eg, avoiding guilt and criticism) motives. This study examined associations between day-to-day fluctuations in partners' type of helping motivation and several outcomes, among partners and ICPs. Seventy couples, with 1 partner having chronic pain (75.7% female), completed a diary for 14 consecutive days. Daily helping motivation was assessed together with daily affect, relational conflict, and relationship-based need satisfaction. Partners (M-age = 55.14) additionally reported on daily helping exhaustion, whereas ICPs (M-age = 54.71) reported on daily pain intensity, disability, satisfaction with received help, and amount of received help. Providing autonomous help related to improvements in partners' affective (eg, positive affect), relational (eg, conflict), and help-specific (eg, exhaustion) functioning, which were accounted for by improvements in daily relationship-based psychological need satisfaction. Similarly, daily autonomously motivated help yielded a direct (ie, relational conflict; perceived amount of help) or indirect (ie, positive and negative affects; relational conflict; satisfaction with help, disability) contribution in explaining ICP outcomes-through improvements in ICPs' relationship-based psychological need satisfaction. Findings highlight the importance of a motivational and dynamic perspective on help provision within chronic pain couples. Considering reasons why a partner provides help is important to understand when partners and ICPs may benefit from daily support

Vicarious experiences and detection accuracy while observing pain and touch: the effect of perspective taking

In this study, we investigated the effects of observing pain and touch in others on vicarious somatosensory experiences and the detection of subtle somatosensory stimuli. Furthermore, the effect of taking a first- versus a third-person perspective was investigated. Undergraduates (N = 57) viewed videos depicting hands being pricked (pain), hands being touched by a cotton swab (touch), and control scenes (same approaching movement of a hand as in the other video categories, but without the painful/touching object) while experiencing vibrotactile stimuli themselves on the left, on the right, or on both hands. Participants reported the location at which they felt a somatosensory stimulus. The vibrotactile stimuli and visual scenes were applied in a spatially congruent or incongruent way, and other trials were presented without vibrotactile stimuli. The videos were depicted in first-person perspective and third-person perspective (i.e., the videos were shown upside down). We calculated the proportions of correct responses and false alarms (i.e., numbers of trials on which a vicarious somatosensory experience was reported congruent or incongruent to the site of the visual information). Pain-related scenes facilitated the detection of tactile stimuli and augmented the number of vicarious somatosensory experiences, as compared with observing the touch or control videos. Detection accuracy was higher for videos depicted in first-person perspective than for those in third-person perspective. Perspective had no effect on the number of vicarious somatosensory experiences. This study indicates that somatosensory detection is particularly enhanced during the observation of pain-related scenes, as compared to the observation of touch or control videos. These research findings further demonstrate that perspective taking impacts somatosensory detection, but not the report of vicarious experiences

Buffer or amplifier? Longitudinal effects of social support for functional autonomy/dependence on older adults’ chronic-pain experiences

Objective: This longitudinal study aimed to investigate (a) the moderating role of formal social support for functional autonomy versus dependence on the relationship between pain intensity and pain-related disability among older adults with chronic pain and (b) the mediating role of pain-related self-efficacy and pain-related fear in this moderation. Method: One hundred and seventy older adults (Mage = 78.0; SD = 8.7) with chronic musculoskeletal pain participated in a 3-month prospective study, with 3 measurement moments. Participants filled out the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Portuguese versions of the Brief Pain Inventory, the Pain Self-Efficacy Questionnaire, and the Tampa Scale of Kinesiophobia. Results: Using structural equation modeling, it was found that perceived promotion of autonomy, at Time 1, moderated the relationship between pain intensity (T1) and pain-related disability (T2); this moderation was fully mediated by pain-related self-efficacy (T2). Perceived promotion of dependence was not a significant moderator. Conclusions: These findings highlight the importance of social support for functional autonomy in buffering the impact of pain intensity on older adults’ pain-related disability. Also, they clarify the role of pain-related self-efficacy in this effect. Implications for the development of intervention programs, with formal caregivers, to reduce the impact of chronic pain on older adults’ healthy ageing process, are discussed.info:eu-repo/semantics/acceptedVersio

The role of the right tempoparietal junction in the elicitation of vicarious experiences and detection accuracy while observing pain and touch

This study investigated the effects of observing pain and touch in others upon vicarious somatosensory experiences and the detection of subtle somatosensory stimuli. Furthermore, transcranial direct current stimulation (tDCS) was used to assess the role of the right temporoparietal junction (rTPJ), as this brain region has been suggested to be involved in perspective taking and self-other distinction. Undergraduates (N = 22) viewed videos depicting hands being touched, hands being pricked, and control scenes (same approaching movement as in the other video categories but without the painful/touching object), while experiencing vibrotactile stimuli themselves on the left, right, or both hands. Participants reported the location at which they felt a somatosensory stimulus. Vibrotactile stimuli and visual scenes were applied in a congruent or incongruent way. During three separate testing sessions, excitability of the rTPJ was modulated with tDCS (cathodal, anodal, or sham). We calculated the proportion of correct responses and false alarms (i.e., number of trials in which a vicarious somatosensory experience was reported congruent to the site of the visual information). Pain-related scenes facilitated the correct detection of tactile stimuli and augmented the number of vicarious somatosensory experiences compared with observing touch or control videos. Stimulation of the rTPJ had no reliable influence upon detection accuracy or the number of vicarious errors. This study indicates that the observation of pain-related scenes compared to the observation of touch or control videos increases the likelihood that a somatosensory stimulus is detected. Contrary to our expectations, the rTPJ did not modulate detection accuracy