A comprehensive model of adjustment to pain in the co-occurrence of PTSD and chronic musculoskeletal pain: vulnerability and protective pathways

There are a significant comorbidity between PTSD and chronic pain. Thus, studies clarifying the vulnerability and protective variables and mechanisms associated with PTSD and chronic pain are needed. The aim of this study was to examine the association between trauma, resilience, PTSD symptoms, and the variables included in the fear-avoidance models (anxiety sensitivity, catastrophizing, fear-avoidance beliefs, fear of pain, pain hypervigilance) as well as pain acceptance and experiential avoidance in explaining adjustment to chronic pain (pain intensity, pain-related disability and emotional distress). Method: the sample consisted of 229 patients with chronic musculoskeletal back pain. Results: Structural Equation Modelling was used. Statistical tests indicated that the hypothesized model adequately fitted the data (RMSEA = .07; CFI = .99; NNFI = .98; TLI = .96). The χ2 test was significant (χ2 (8) = 19.25, χ2 /dl = 2.40, p = .014). The results provided support for the hypothesized model. All the standardized path coefficients were significant (p < .05). Conclusions: This study provides empirical support for the potential role of PTSD symptoms in fear-avoidance models of chronic pain, and may provide support for the diathesis-stress model of pain. It is the first comprehensive model of adjustment to pain to consider vulnerability and protective adaptation mechanisms in patients who have undergone a traumatic event. The study highlights the importance of a comprehensive framework of reference to understand the comorbidity of PTSD and chronic musculoskeletal pain, and the need to provide well-designed treatment programs for the simultaneous treatment of these conditions.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Skills acquisition: Transference of cooperative learning experiences from the University to Secondary Education

[SPA] La sociedad necesita ciudadanos capaces de adaptarse y cooperar con otros. Estas habilidades necesitan ser desarrolladas, pero hasta qué punto el uso de ciertas metodologías de aprendizaje, tales como el aprendizaje cooperativo (AC), permiten el desarrollo de dichas habilidades es todavía una incógnita. En este trabajo realizamos un ejercicio de transferencia de nuestra experiencia en la aplicación del AC en la Universidad de Murcia a centros de enseñanza secundaria de Murcia. Aunque se trata de un proyecto a largo plazo, el primer análisis de esta experiencia a nivel de enseñanza secundaria nos muestra una mejora en los resultados académicos de los alumnos. A fin de cumplir nuestros objetivos, este estudio se efectúa en dos etapas. En la primera, se aplica el AC a una muestra de 208 estudiantes de tres institutos de Murcia con el objetivo de determinar si se produce una mejora en los resultados académicos en aquellas unidades didácticas impartidas mediante AC frente al uso del método tradicional. El análisis de los resultados muestra un mayor porcentaje de alumnos aprobados (90,38% vs. 50%), así como una mejora en las notas medias en las actividades trabajadas a través del AC (6,71 frente a 4,7). En una segunda etapa, aún en fase de realización y con una nueva muestra de estudiantes, comprobaremos la mejora en las habilidades sociales de los estudiantes y su impacto en la integración de los estudiantes de diferente etnia o raza. [ENG] Society needs citizens able to adapt to and cooperate with others, and these abilities need to be developed. However, how some learning methodologies, such as cooperative learning, help to the development of the abovementioned abilities is still unknown. In this research we transfer our knowledge and experience in cooperative learning methodology in the University of Murcia to a group of secondary schools in Murcia. Although this is a long-term project, the first analyses of this experience in secondary school education show an improvement in students’ academic performance after the implementation of cooperative learning in class. To reach our objectives the paper has been divided into two stages. First, we implemented cooperative learning in a sample of 208 students from three different secondary schools, in order to test if the students get better academic results in those didactic units where the teacher used cooperative learning. Quantitative analysis of the data confirm that students not only got a higher pass rate (90.38% vs. 50%) but also a higher average mark (6.71 vs 4.7). In the second stage, still on process, and with a new sample of students, we will check the students’ social skills improvement and the impact of this methodology on class integration of students from different ethnic and race groups

Development of an Activity Patterns Scale (APS)

Six activity patterns were identified across various self-report measures in participants with chronic pain: Pain Avoidance, Activity Avoidance; Task Contingent Persistence; Excessive Persistence, Pain Contingent Persistence and Pacing (Kindermans et al., 2011). It was proposed that instruments assessing “pacing” should include items addressing one specific pacing behavior (breaking tasks into smaller pieces; taking frequent short rests and speeding up or slowing down) with a single goal (increasing activity level, conserve energy for valued activities and pain reduction) (Nielson et al., 2013). The aim of the present study was to develop an instrument to assess the activity patterns identified by Kindermans et al. (2011). The instrument also included three pacing scales one for each of the aforementioned goals. Methods A sample of 229 patients with fibromyalgia and 62 suffering other rheumatic diseases answered online the APS and the “Patterns of Activity Measure-Pain” (POAM-P) (Cane et al., 2007). Three alternative factor structures were tested by confirmatory factor analyses performed via structural equation modelling. . Results The structure with the best fit had 8 factors corresponding to the hypothesized scales: Pain Avoidance (α=.60), Activity Avoidance (α=.60); Task Contingent Persistence (α=.81); Excessive Persistence (α=.84), Pain Contingent Persistence (α=.70), Pacing for increasing activity (α=.76), Pacing for energy conservation (α=.72) and Pacing for pain reduction (α=.65). The correlations with the POAM-P scales were high and in the postulated direction. Conclusions The APS showed adequate reliability and structural validity. According to these results, Avoidance, Persistence and Pacing seem to be multidimensional constructs.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

A structural model of the relationships between optimism and perceived emotional intelligence on bullying victimization and health.

Bullying is a relationship in which an individual, or a group of individuals, intentionally and repeatedly perpetrates aggressive behaviors towards someone unable to defend himself/herself. Traditional forms of bullying consist of physical, verbal and covert forms of aggressive behaviors. Recently, the new phenomenon of cyberbullying has emerged. This relatively new form of bullying is defined as a behavior displayed through electronic or digital media. Multiple variables have been related to bullying victimization including perceived emotional intelligence (PEI) and optimism. Both variables have implications on the manner in which people cope with stressful experiences as could be bullying, which in turn could affect the level of perceived health. However, there are no studies that have considered all these variables simultaneously. Therefore, the aim of the current study was to examine, via structural equation modelling, the independent contribution of EI and optimism on bullying victimization and perceived physical health in adolescents. A total of 650 secondary school students (317 boys and 333 girls, with ages ranged from 11 to 18) participated in the study. The participants completed measures of PIE (TMMS-24; Fernández-Berrocal et al., 2004), optimism (General Mood Subscale of the Emotional Quotient Inventory-Youth Version; Bar-On and Parker, 2000), bullying (School Victimization Scale; Cava et al., 2010), cyberbullying (Cyber-Victimization Scale; Buelga et al., 2012), and physical health (KIDSCREEN-10 Index; Raven-Sieberer et al., 2004). Results gave partial empirical support to the hypothesized model, and shows significant relationships between the variables: optimism on clarity and repair dimensions of IE (but not on the attention subscale), optimism and attention (but not clarity and repair dimensions) on bullying, and bullying on health. Together these findings shed light on those factors that should be considered when developing prophylactic strategies within adolescents to become more resilient to the adverse effects of bullying behavior.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Impacto de la pandemia de COVID-19 en la salud mental

The purpose of the present monograph is to provide a compilation of studies that demonstrate how the COVID-19 pandemic has affected the mental health of various groups of the population in Iberoamerican countries. The nine articles of this special issue analyse subjects such as isolation due to confinement, post-traumatic stress derived from exposure to the coronavirus, the differences in the level of well-being according to social class, the increase of depressive symptoms and suicidal ideation, the effect of the infection on psychological disorders, such as obsessive-compulsive disorder, the increase of anxiety symptoms and the resulting greater demand for psychological care, the effects of healthcare pressure on burnout experienced by healthcare workers, and the role of self-forgiveness and compassion in relation to personal growth and life satisfaction during the pandemic. In sum, this special issue is a sample of the scientific evidence on how this unusual crisis is affecting citizens' psychological health.El propósito del monográfico es presentar un compendio de estudios que muestran cómo la pandemia por la COVID-19 ha impactado la salud mental de diversos sectores de la población de países iberoamericanos. Nueve artículos analizan la soledad a causa del confinamiento, el estrés postraumático derivado de la exposición al coronavirus y sus consecuencias, las diferencias en el nivel de bienestar en función de la clase social, el incremento de la sintomatología depresiva y la ideación suicida, el impacto de la infección en trastornos psicológicos como el obsesivo compulsivo, el incremento de los síntomas de ansiedad y el aumento consecuente de la demanda de atención psicológica, la relación entre el ejercicio físico, pasear al perro y el estado afectivo durante el confinamiento, los efectos de la presión asistencial sobre el desgaste profesional de los trabajadores sanitarios y, finalmente, el papel del perdón a uno mismo y la compasión en relación al crecimiento personal y la satisfacción con la vida durante la pandemia. En suma, este número especial constituye una muestra de la evidencia científica acerca de cómo está afectando a la salud psicológica de la ciudadanía esta inusitada crisis

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

New and potential strategies for the treatment of PMM2-CDG

Background: Mutations in the PMM2 gene cause phosphomannomutase 2 deficiency (PMM2; MIM# 212065), which manifests as a congenital disorder of glycosylation (PMM2-CDG). Mutant PMM2 leads to the reduced conversion of Man-6-P to Man-1-P, which results in low concentrations of guanosine 5′-diphospho-D-mannose, a nucleotide-activated sugar essential for the construction of protein oligosaccharide chains. To date the only therapeutic options are preventive and symptomatic. Scope of review: This review covers the latest advances in the search for a treatment for PMM2-CDG. Major conclusions: Treatments based on increasing Man-1-P levels have been proposed, along with the administration of different mannose derivates, employing enzyme inhibitors or repurposed drugs to increase the synthesis of GDP-Man. A single repurposed drug that might alleviate a severe neurological symptom associated with the disorder is now in clinical use. Proof of concept also exists regarding the use of pharmacological chaperones and/or proteostatic regulators to increase the concentration of hypomorphic PMM2 mutant proteins. General significance: The ongoing challenges facing the discovery of drugs to treat this orphan disease are discussedThe authors are grateful to the Spanish families affected by PMM2- CDG who actively participated in this work. Financial support was provided by grant PI19/01155, PI17/00101, B2017/BMD-3721, the Fundación Isabel Gemio/Fundación La Caixa (LCF/PR/PR16/11110018), and the European Regional Development Fund. MS research is supported by the Generalitat de Catalunya (PERIS SLT008/18/0019

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

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