CHRONIC PAIN SELF-EFFICACY AS A MEDIATOR OF THE LINK BETWEEN ROMANTIC ATTACHMENT INSECURITY, INDIVIDUAL FUNCTIONING, AND COUPLE SATISFACTION: A PRELIMINARY STUDYS

This preliminary study was inspired by the Attachment-Diathesis Model of Chronic Pain (ADMoCP) and examined pain self-efficacy as a mediator of the relation between people’s insecure romantic attachment and individual functioning, as well couple satisfaction. This study used a sample of 45 adults with chronic pain from the community who have been in couple relationships for at least 6 months. Participants completed self-report measures. Direct links were obtained between 1) insecure romantic attachment (anxiety over abandonment) and pain self-efficacy, 2) pain self-efficacy and individual functioning, 3) insecure romantic attachment and low individual functioning, and 4) insecure romantic attachment and lower couple satisfaction. Results also showed that pain self-efficacy significantly mediates the relation between anxiety over abandonment and individual functioning, thus adding to existing literature as well as providing more support for the ADMoCP. Future research directions are discussed along with clinical implications. Keywords: Chronic Pain. Romantic Attachment. Pain Self-Efficacy. Individual Functioning.   RESUMO Este estudo preliminar foi inspirado no Attachment-Diathesis Model of Chronic Pain – ADMoCP e investigou a autoeficácia no manejo da dor como um mediador da ligação entre estilo de apego inseguro nas relações afetivas, funcionamento individual e satisfação conjugal. Este estudo utilizou uma amostra de 45 adultos da comunidade com dor crônica e que estavam em um relacionamento há pelo menos 6 meses. Participantes responderam a questionários de autorrelato. Foram obtidas relações diretas entre 1) estilo de apego inseguro nas relações afetivas (ansiedade de abandono) e autoeficácia no manejo da dor, 2) autoeficácia no manejo da dor e funcionamento individual, 3) estilo de apego inseguro nas relações afetivas e limitações no funcionamento individual e 4) estilo de apego inseguro nas relações afetivas e menor satisfação conjugal. Os resultados também mostraram que a autoeficácia no manejo da dor interfere significativamente na relação entre ansiedade de abandono e funcionamento individual, corroborando a literatura existente bem como fornecendo mais suporte para a ADMoCP. São discutidas futuras direções de pesquisa bem como implicações clínicas. Palavras-chave: Dor Crônica. Apego nas relações afetivas. Autoeficácia no manejo da dor. Funcionamento Individual

CHRONIC PAIN SELF-EFFICACY AS A MEDIATOR OF THE LINK BETWEEN ROMANTIC ATTACHMENT INSECURITY, INDIVIDUAL FUNCTIONING, AND COUPLE SATISFACTION: A PRELIMINARY STUDYS

This preliminary study was inspired by the Attachment-Diathesis Model of Chronic Pain (ADMoCP) and examined pain self-efficacy as a mediator of the relation between people’s insecure romantic attachment and individual functioning, as well couple satisfaction. This study used a sample of 45 adults with chronic pain from the community who have been in couple relationships for at least 6 months. Participants completed self-report measures. Direct links were obtained between 1) insecure romantic attachment (anxiety over abandonment) and pain self-efficacy, 2) pain self-efficacy and individual functioning, 3) insecure romantic attachment and low individual functioning, and 4) insecure romantic attachment and lower couple satisfaction. Results also showed that pain self-efficacy significantly mediates the relation between anxiety over abandonment and individual functioning, thus adding to existing literature as well as providing more support for the ADMoCP. Future research directions are discussed along with clinical implications.Keywords: Chronic Pain. Romantic Attachment. Pain Self-Efficacy. Individual Functioning. RESUMOEste estudo preliminar foi inspirado no Attachment-Diathesis Model of Chronic Pain – ADMoCP e investigou a autoeficácia no manejo da dor como um mediador da ligação entre estilo de apego inseguro nas relações afetivas, funcionamento individual e satisfação conjugal. Este estudo utilizou uma amostra de 45 adultos da comunidade com dor crônica e que estavam em um relacionamento há pelo menos 6 meses. Participantes responderam a questionários de autorrelato. Foram obtidas relações diretas entre 1) estilo de apego inseguro nas relações afetivas (ansiedade de abandono) e autoeficácia no manejo da dor, 2) autoeficácia no manejo da dor e funcionamento individual, 3) estilo de apego inseguro nas relações afetivas e limitações no funcionamento individual e 4) estilo de apego inseguro nas relações afetivas e menor satisfação conjugal. Os resultados também mostraram que a autoeficácia no manejo da dor interfere significativamente na relação entre ansiedade de abandono e funcionamento individual, corroborando a literatura existente bem como fornecendo mais suporte para a ADMoCP. São discutidas futuras direções de pesquisa bem como implicações clínicas.Palavras-chave: Dor Crônica. Apego nas relações afetivas. Autoeficácia no manejo da dor. Funcionamento Individual

Perceived Injustice and Chronic Pain Acceptance: Are We Measuring Two Separate Constructs or Opposite Poles of the Same Dimension?

Perceived injustice has recently emerged as an important construct in the chronic pain literature. Perceived injustice has been shown to be a risk factor for various problematic pain outcomes, such as increased pain severity, depressive symptoms, and pain-related disability. At present, research on perceived injustice in chronic pain is lacking a theoretical model to facilitate understanding of its influence on chronic pain outcomes. It has been suggested that it might be useful to conceptualize perceived injustice within the psychological flexibility model of chronic pain.Indeed, there is preliminary evidencethatperceived injustice is negatively related to chronic pain acceptance, which is an important process within this model; however, the nature of this association is uncertain at present. In particular, it is unclear whether current measures of perceived injustice and chronic acceptance simplyreflect different poles of the same dimension, or theoretically separate, but related, constructs. This study aims to further examine the relation between perceived injustice and pain acceptance. The sample consisted of 847adults who suffer from chronic pain. Several competing measurement models were tested by means of confirmatory factor analysis. Results indicate that these two constructs appear to be two closely related constructs rather than two opposite poles of the same dimension. Implications of these findings for future research will be discussed

“Buying into thoughts”: French validation of the Cognitive Fusion Questionnaire

International audienc

How Do Pain Characteristics, Comorbidity Severity and Patient Characteristics Influence Chronic Pain Patients’ Self-Management Priorities?

Introduction/Aim: More than half of chronic pain patients suffer from other chronic health conditions. This study aims to 1) examine the degree to which pain management is a priority among individuals with multiple medical conditions and 2) identify predictors of pain prioritization. Methods: The sample is comprised of 99 patients suffering from chronic pain (≥ 3 months) and ≥ 1 other medical condition recruited through patient associations and social/conventional media. Self-report questionnaires (pain characteristics, patient characteristics, type and severity of comorbidities) were completed at baseline and a pain prioritization diary was completed twice weekly for 6 weeks. Univariate regression models were used to identify pain, patient and comorbidity variables (p > 0.20) that would be included in a final multivariate model to examine pain management priority (model 1) and stability of prioritization (model 2). Results: Pain management prioritization scores ranged from 1.67 to 4.92 out of 5 (SD = 0.76) and 16.2% of participants reported ≥ 20% increase or decrease in the priority given to pain management over a six-week period. Model 1: Perceived illness burden was the only predictor retained in the univariate analysis (p = 0.074) to predict levels of pain management prioritization. Model 2: None of the characteristics examined were significantly associated with stability of prioritization of pain management symptoms. Discussion/Conclusions: Prioritization of pain management is a dynamic process that does not seem to be influenced by severity of pain, individual characteristics or severity of comorbidities. The next step is to examine time-varying predictors of pain management prioritization

Prioritizing chronic pain self-management amid coexisting chronic illnesses: An exploratory qualitative study

Background: In Canada, one out of five people lives with chronic pain, a condition frequently co-occurring with other chronic illnesses. As with most chronic illnesses, successful engagement in symptom management is key. In the context of multiple illnesses, self-management involves daily prioritization of symptoms and conditions and decision-making, which can be challenging. Self-management of chronic illnesses can require more complex competence and tasks to address the different implications of each condition. Objective: Our research objective was to explore types and processes of self-management symptom prioritization among adults living with chronic pain and other chronic illnesses. Design: This research was carried out as part of a larger study that adopted an explanatory sequential mixed-methods design. This study focused more specifically on the qualitative part of the study. Setting(s): Participants recruited for the qualitative component took part in a semi-structured individual interview online or in-person at the center hospitalier de l'Université de Montréal. Participants: In total, 25 participants were interviewed, including 18 women and 7 men. Methods: To participate in the qualitative part of the study, participants were selected from the larger study and were eligible if they were 18 years old or older and experiencing pain for more than 3 months and had at least one other chronic illness for which they were receiving treatment or engaged in symptom management. Semi-structured interviews were conducted in-person or virtually and were transcribed verbatim. Reflexive thematic analysis was used to explore patients’ narratives, and an open and iterative approach was adopted to code interviews and generate themes. Findings: The first theme, focus on symptom prioritization, showed different prioritization processes, including prioritizing a dominant illness, prioritizing multiple illnesses to avoid undesirable consequences, and finally absence of or automatic processes of prioritization. In the second theme, we identified several characteristics of an illness, in this case chronic pain that made it a self-management priority: uncontrollable and disabling nature, omnipresence, unpredictability, unpleasantness, and invisibility to others. In the last theme, we highlighted that some psychosocial factors influenced levels of engagement in self-management and prioritization processes, including social support and the patient-physician relationship. Conclusions: Chronic pain was the medical condition most often prioritized by participants in their self-management tasks. Because of its characteristics, it was the medical condition that had the most negative impact on day-to-day functioning

“Buying into thoughts”: French Validation of the Cognitive Fusion Questionnaire

International audienc

M2HepPrEP: study protocol for a multi-site multi-setting randomized controlled trial of integrated HIV prevention and HCV care for PWID

Opioid use is escalating in North America and comes with a multitude of health consequences, including HIV and hepatitis C virus (HCV) outbreaks among persons who inject drugs (PWID). HIV pre-exposure prophylaxis (PrEP) and HCV treatment regimens have transformative potential to address these co-occurring epidemics. Evaluation of innovative multi-modal approaches, integrating harm reduction, opioid agonist therapy (OAT), PrEP, and HCV treatment is required. The aim of this study is to assess the effectiveness of an on-site integrated care model where delivery of PrEP and HCV treatment for PWID takes places at syringe service programs (SSP) and OAT programs compared with referring PWID to clinical services in the community through a patient navigation model and to examine how structural factors interact with HIV prevention adherence and HCV treatment outcomes.The Miami-Montreal Hepatitis C and Pre-Exposure Prophylaxis trial (MThe results of this study have the potential to demonstrate the effectiveness and cost-effectiveness of offering PrEP and HCV treatment in healthcare venues frequently attended by PWID. Testing the intervention in two urban centers with high disease burden among PWID, but with different healthcare system dynamics, will increase generalizability of findings.Clinicaltrials.gov NCT03981445 . Trial registry name: Integrated HIV Prevention and HCV Care for PWID (M2HepPrEP). Registration date: June 10, 201

Low risk of embryonic and other cancers in PIK3CA ‐related overgrowth spectrum: Impact on screening recommendations

International audienceThe PIK3CA ‐related overgrowth spectrum (PROS) encompasses various conditions caused by mosaic activating PIK3CA variants. PIK3CA somatic variants are also involved in various cancer types. Some generalized overgrowth syndromes are associated with an increased risk of Wilms tumor (WT). In PROS, abdominal ultrasound surveillance has been advocated to detect WT. We aimed to determine the risk of embryonic and other types of tumors in patients with PROS in order to evaluate surveillance relevance. We searched the clinical charts from 267 PROS patients for the diagnosis of cancer, and reviewed the medical literature for the risk of cancer. In our cohort, six patients developed a cancer (2.2%), and Kaplan Meier analyses estimated cumulative probabilities of cancer occurrence at 45 years of age was 5.6% (95% CI = 1.35%–21.8%). The presence of the PIK3CA variant was only confirmed in two out of four tumor samples. In the literature and our cohort, six cases of Wilms tumor/nephrogenic rests (0.12%) and four cases of other cancers have been reported out of 483 proven PIK3CA patients, in particular the p.(His1047Leu/Arg) variant. The risk of WT in PROS being lower than 5%, this is insufficient evidence to recommend routine abdominal imaging. Long‐term follow‐up studies are needed to evaluate the risk of other cancer types, as well as the relationship with the extent of tissue mosaicism and the presence or not of the variant in the tumor samples