Validation of the Spanish version of the Chronic Pain Acceptance Questionnaire (CPAQ) for the assessment of acceptance in fibromyalgia

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to validate a Spanish version of the Chronic Pain Acceptance Questionnaire (CPAQ). Pain acceptance is the process of giving up the struggle with pain and learning to live a worthwhile life despite it. The Chronic Pain Acceptance Questionnaire (CPAQ) is the questionnaire most often used to measure pain acceptance in chronic pain populations.</p> <p>Methods</p> <p>A total of 205 Spanish patients diagnosed with fibromyalgia syndrome who attended our pain clinic were asked to complete a battery of psychometric instruments: the Pain Visual Analogue Scale (PVAS) for pain intensity, the Hospital Anxiety and Depression Scale (HADS), the Medical Outcome Study Short Form 36 (SF-36), the Pain Catastrophising Scale (PCS) and the Fibromyalgia Impact Questionnaire (FIQ).</p> <p>Results</p> <p>Analysis of results showed that the Spanish CPAQ had good test-retest reliability (intraclass correlation coefficient 0.83) and internal consistency reliability (Cronbach's α: 0.83). The Spanish CPAQ score significantly correlated with pain intensity, anxiety, depression, pain catastrophising, health status and physical and psychosocial disability. The Scree plot and a Principal Components Factor analysis confirmed the same two-factor construct as the original English CPAQ.</p> <p>Conclusion</p> <p>The Spanish CPAQ is a reliable clinical assessment tool with valid construct validity for the acceptance measurement among a sample of Spanish fibromyalgia patients. This study will make it easier to assess pain acceptance in Spanish populations with fibromyalgia.</p

Changes in metabolites in the brain of patients with fibromyalgia after treatment with an NMDA receptor antagonist

The aims of this work were to evaluate whether the treatment of patients with fibromyalgia with memantine is associated with significant changes in metabolite concentrations in the brain, and to explore any changes in clinical outcome measures. Magnetic resonance spectroscopy was performed of the right anterior and posterior insula, both hippocampi and the posterior cingulate cortex. Questionnaires on pain, anxiety, depression, global function, quality of life and cognitive impairment were used. Ten patients were studied at baseline and after three months of treatment with memantine. Significant increases were observed in the following areas: N-acetylaspartate (4.47 at baseline vs. 4.71 at three months, p¿=¿0.02) and N-acetylaspartate+N-acetylaspartate glutamate in the left hippocampus (5.89 vs. 5.98; p¿=¿0.007); N-acetylaspartate+N-acetylaspartate glutamate in the right hippocampus (5.31 vs 5.79; p¿=¿0.01) and the anterior insula (7.56 vs. 7.70; p¿=¿0.033); glutamate+glutamine/creatine ratio in the anterior insula (2.03 vs. 2.17; p¿=¿0.022) and the posterior insula (1.77 vs. 2.00; p¿=¿0.004); choline/creatine ratio in the posterior cingulate (0.18 vs. 0.19; p¿=¿0.023); and creatine in the right hippocampus (3.60 vs. 3.85; p¿=¿0.007). At the three-month follow-up, memantine improved cognitive function assessed by the Cognition Mini-Exam (31.50, SD¿=¿2.95 vs. 34.40, SD¿=¿0.6; p¿=¿0.005), depression measured by the Hamilton Depression Scale (7.70, SD¿=¿0.81 vs. 7.56, SD¿=¿0.68; p¿=¿0.042) and severity of illness measured by the Clinical Global Impression severity scale (5.79, SD¿=¿0.96 vs. 5.31, SD¿=¿1.12; p¿=¿0.007). Depression, clinical global impression and cognitive function showed improvement with memantine. Magnetic resonance spectroscopy could be useful in monitoring response to the pharmacological treatment of fibromyalgia

Effects of attachment-based compassion therapy (ABCT) on self-compassion and attachment style in healthy people.

Attachment-based compassion therapy (ABCT) is a new protocol of compassion based on attachment theory. The aim of this study was to assess the efficacy of this protocol for improving self-compassion in a healthy population and determine whether improvements in self-compassion mediate changes towards a more secure attachment style. The study consisted of a non-randomized controlled trial with an intervention group (ABCT) and a waiting list control group. In addition to pre- and post-intervention assessments, a 6-month follow-up assessment was included. Participants were healthy adults attending ABCT courses who self-rated as not having any psychological disorders and self-reported as not receiving any form of psychiatric treatment. Compared to the control condition, ABCT was significantly more effective for improving self-compassion as evidenced by changes on all subscales on the Self-Compassion Scale (SCS), except isolation. Effect sizes were in the moderate to large range and correlated with the number of sessions received. ABCT also led to improvements across all subscales of the Five Facets of Mindfulness Questionnaire (FFMQ), except describing. ABCT decreased psychological disturbance assessed using the General Health Questionnaire (GHQ-28) and decreased experiential avoidance assessed using the Acceptance and Action Questionnaire (AAQ-II). Furthermore, ABCT led to significant reductions in levels of anxiety and avoidance. Secure attachment style significantly increased in the ABCT group and was mediated by changes in self-compassion. In summary, ABCT may be an effective intervention for improving self-compassion and attachment style in healthy adults in the general populations.Spanish Research Network on Preventative Activities and Health Promotion (RD06/0018/0017) and the Aragon Health Sciences Institute

Correlational analysis and predictive validity of psychological constructs related with pain in fibromyalgia

<p>Abstract</p> <p>Background</p> <p>Fibromyalgia (FM) is a prevalent and disabling disorder characterized by a history of widespread pain for at least three months. Pain is considered a complex experience in which affective and cognitive aspects are crucial for prognosis. The aim of this study is to assess the importance of pain-related psychological constructs on function and pain in patients with FM.</p> <p>Methods</p> <p>Design</p> <p>Multicentric, naturalistic, one-year follow-up study.</p> <p><it>Setting and study sample</it>. Patients will be recruited from primary care health centres in the region of Aragon, Spain. Patients considered for inclusion are those aged 18-65 years, able to understand Spanish, who fulfil criteria for primary FM according to the American College of Rheumatology, with no previous psychological treatment.</p> <p>Measurements</p> <p>The variables measured will be the following: main variables (pain assessed with a visual analogue scale and with sphygmomanometer and general function assessed with Fibromyalgia Impact Questionnaire, and), psychological constructs (pain catastrophizing, pain acceptance, mental defeat, psychological inflexibility, perceived injustice, mindfulness, and positive and negative affect), and secondary variables (sociodemographic variables, anxiety and depression assessed with Hospital Anxiety and Depression Scale, and psychiatric interview assessed with MINI). Assessments will be carried at baseline and at one-year follow-up.</p> <p>Main outcome</p> <p>Pain Visual Analogue Scale.</p> <p>Analysis</p> <p>The existence of differences in socio-demographic, main outcome and other variables regarding pain-related psychological constructs will be analysed using Chi Square test for qualitative variables, or Student <it>t </it>test or variance analysis, respectively, for variables fulfilling the normality hypothesis. To assess the predictive value of pain-related psychological construct on main outcome variables at one-year follow-up, use will be made of a logistic regression analysis adjusted for socio-demographic and clinical variables. A Spearman Rho non-parametric correlation matrix will be developed to determine possible overlapping between pain-related psychological constructs.</p> <p>Discussion</p> <p>In recent years, the relevance of cognitive and affective aspects for the treatment of chronic pain, not only in FM but also in other chronic pain diseases, has been widely acknowledged. However, the relative importance of these psychological constructs, the relationship and possible overlapping between them, or the exact meaning of them in pain are not enough known.</p

Brain Changes in Long-Term Zen Meditators Using Proton Magnetic Resonance Spectroscopy and Diffusion Tensor Imaging: A Controlled Study

Introduction: This work aimed to determine whether 1H magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are correlated with years of meditation and psychological variables in long-term Zen meditators compared to healthy non-meditator controls. Materials and Methods: Design. Controlled, cross-sectional study. Sample. Meditators were recruited from a Zen Buddhist monastery. The control group was recruited from hospital staff. Meditators were administered questionnaires on anxiety, depression, cognitive impairment and mindfulness. 1H-MRS (1.5 T) of the brain was carried out by exploring four areas: both thalami, both hippocampi, the posterior superior parietal lobule (PSPL) and posterior cingulate gyrus. Predefined areas of the brain were measured for diffusivity (ADC) and fractional anisotropy (FA) by MR-DTI. Results: Myo-inositol (mI) was increased in the posterior cingulate gyrus and Glutamate (Glu), N-acetyl-aspartate (NAA) and N-acetyl-aspartate/Creatine (NAA/Cr) was reduced in the left thalamus in meditators. We found a significant positive correlation between mI in the posterior cingulate and years of meditation (r = 0.518; p = .019). We also found significant negative correlations between Glu (r =20.452; p = .045), NAA (r =20.617; p = .003) and NAA/Cr (r =20.448; P = .047) in the left thalamus and years of meditation. Meditators showed a lower Apparent Diffusion Coefficient (ADC) in the left posterior parietal white matter than did controls, and the ADC was negatively correlated with years of meditation (r =20.4850, p = .0066). Conclusions: The results are consistent with the view that mI, Glu and NAA are the most important altered metabolites. This study provides evidence of subtle abnormalities in neuronal function in regions of the white matter in meditators

Cognición social y mindfulness. Estudio comparativo entre sujetos con esquizofrenia, trastorno obsesivo compulsivo y participantes no clínicos

Cognición social hace referencia al conjunto de operaciones mentales que subyacen a las interacciones sociales, y se compone de cuatro áreas o dominios: procesamiento de emociones, percepción social, teoría de la mente (ToM) y estilo / sesgo atribucional.Los estudios indican que un peor rendimiento en cognición social se asocia a psicopatología, como es el caso de la esquizofrenia y del trastorno obsesivo-compulsivo (TOC).Mindfulness se define como el tipo de consciencia que surge al prestar atención de un modo particular, con propósito, al momento presente y sin juzgar. La investigación sugiere que las habilidades mindfulness estarían relacionadas con la cognición social. Por tanto, las MIBs podrían ser una técnica útil de especial relevancia en pacientes cuyas capacidades de cognición social se encuentren deterioradas como el TOC o la esquizofrenia.Proponemos la existencia de un continuum en cognición social en el que las personas sanas con experiencia en meditación y las personas con patología mental (TOC o esquizofrenia) se situarían en los polos opuestos, mientras que las personas sin patología mental ni experiencia meditativa se situarían en una posición intermedia.Para ello hemos diseñado dos estudios, el primero con el objetivo de explorar la relación entre mindfulness y cognición social, comparando un grupo meditadores (n=30) con grupo de no meditadores (n = 30). Un total de 60 participantes completaron las siguientes medidas de evaluación: Mindful Attention Awareness Scale (MAAS), Short form of the Five Facet Minffulness Questionnarie (FFMQ-SF), Interpersonal Reactivity Index (IRI), Eyes Test, Hinting Task, Ambiguous Intentions and Hostility Questionnaire (AIHQ), Hospital Anxiety and Depression Scale (HADS) y Screen for Cognitive Impairment in Psychiatry (SCIP). Los resultados mostraron que la muestra de meditadores obtuvo un mejor rendimiento en ciertas cualidades (empatía, reconocimiento emocional, ToM, estilo/sesgo de atribución hostil) en comparación con no meditadores y, además, respaldan la teoría de la conexión entre mindfulness y cognición social, lo que puede tener implicaciones para diseñar enfoques basados en mindfulness para su uso en entornos clínicos y no clínicos. En el segundo estudio el objetivo principal fue comparar muestras de pacientes con esquizofrenia (n=30) y TOC (n= 31) con controles sanos (n=30) en varios dominios de cognición social y medidas de mindfulness. En total 91 pacientes completaron las siguientes medidas de evaluación Mindful Attention Awareness Scale (MAAS), Short form of the Five Facet Minffulness Questionaire (FFMQ-SF), Interpersonal Reactivity Index (IRI), Eyes Test, Hinting Task, Ambiguous Intentions and Hostility Questionnaire (AIHQ), Hospital Anxiety and Depression Scale (HADS). Los resultados mostraron que las habilidades en cognición social se vieron afectadas en los grupos esquizofrenia y TOC en comparación con el grupo control, lo que sugiere un patrón de alteración similar.La principal conclusión de nuestros estudios es que los grupos clínicos (TOC, esquizofrenia) muestran peores resultados en las medidas de cognición social que el grupo control, siendo el grupo de meditación el que obtiene la mayor puntuación en estas medidas.<br /

Voxel placement in the different brain regions.

<p>The thalamus (<b>a,b</b>), hippocampus (<b>c,d</b>), posterior superior parietal lobule (<b>e</b>) and posterior cingulate gyrus (<b>f</b>).</p

Comparison of findings in Diffusion Tensor Imaging in non-meditator healthy controls and meditators.

<p>Mann-Whitney U.</p

Differences on Myo-Inositol levels in Posterior Cingulate between meditators and healthy non-meditators.

<p>Differences on Myo-Inositol levels in Posterior Cingulate between meditators and healthy non-meditators.</p