Quality of Well-Being Scale and Chronic Low Back Pain

Outcome measures that assess quality of life for use in health policy decisions need to be investigated in chronic pain patients. In the present study, the validity of the Quality of Well-Being Scale (QWB) was evaluated on 67 adult chronic low back pain (CLBP) patients who were enrolled in a 12-week multidisciplinary pain treatment program. Participants completed the QWB, a battery of pain measures, a behavioral observation task, and a medical exam. The findings indicated that CLBP patients have a low level of functioning or quality of life (M = .567, SD = .08) compared with persons with life-threatening diseases. The QWB score was significantly correlated with observational measures of pain behavior and pain-related coping strategies. Multivariate analysis indicated that interference in daily activities, distorted ambulation, affective distress, pain duration, and guarding were the most significant predictors of quality of well-being (multiple R = .84, p < .0001). Patients with medically incongruent physical signs had significantly lower QWB scores than patients with congruent signs. Overall, the data supported the validity of the QWB in a sample of CLBP patients.     

注意线索对自闭特质个体疼痛共情的影响：来自事件相关电位的证据

自闭特质个体在日常生活中表现出共情缺损, 但其程度较自闭症谱系障碍个体低, 并且注意线索和特异性的面孔加工可能会影响他们的共情加工进程。因此, 本研究采用事件相关电位(ERP)技术, 以疼痛面孔图片作为刺激材料, 让自闭特质组和控制组分别完成疼痛判断任务(该任务中被试的注意指向疼痛线索)和吸引力判断任务(该任务中被试的注意不指向疼痛线索)。结果发现, 相比控制组, 自闭特质组在吸引力判断任务中疼痛面孔图片诱发的P3波幅更大, 而在疼痛判断任务中两组没有显著差异。这表明注意线索会影响自闭特质个体对他人疼痛面孔的共情反应, 当自闭特质个体不注意他人面孔的疼痛线索时, 其疼痛共情能力会减弱。     

Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis

Individual differences in emotional functioning, pain appraisal processing, and perceived social support may play a relevant role in the subjective experience of pain. Due to the paucity of data regarding individuals with Rheumatoid Arthritis (RA), the present study aimed to examine pain intensity, emotional functioning (psychological distress and alexithymia), pain appraisal (pain beliefs, pain catastrophizing, and pain-related coping strategies) and social support, and their relationships with the health-related quality of life (HRQoL) in patients with RA. Data were collected from 108 female patients diagnosed with RA. Clinically relevant levels of depressive and anxiety symptoms assessed by the HADS subscales were present in 34% and 41% of the patients, respectively, and about 24% of them exhibited the presence of alexithymia. The results of hierarchical multiple regression analyses showed that pain intensity, alexithymia, the maladaptive beliefs regarding the stability of pain and the coping strategy of guarding explained 54% of the variance in the physical component of HRQoL (p < 0.001). Depression subscale of the HADS, alexithymia, the coping strategy of resting, and the rumination factor of pain catastrophizing significantly explained 40% of the variance in the mental component of HRQoL (p < 0.001). The present findings provide evidence regarding the importance of emotional functioning and pain appraisal in the negative impact of RA on patients’ quality of life. These findings provide additional evidence for the biopsychosocial model of chronic pain, further supporting the complex interaction between emotional, cognitive, and behavioral processes in patients with chronic pain.     

疼痛背景下时距知觉的变化

时距知觉指对数百毫秒到数个小时时长的知觉, 是日常生活中许多活动的基础。时距知觉受到相当多因素的影响, 如唤醒、注意、动机等。疼痛是一种多维度的心理及生理现象, 包含有感觉分辨、情绪动机、认知评价三个成分。近期研究证明时距知觉会在疼痛背景下发生改变。疼痛背景下时距知觉的相关研究主要涉及三个方面：(1)健康被试对疼痛面孔的时距知觉; (2)实验室诱发疼痛对健康被试时距知觉的影响; (3)临床疼痛患者的时距知觉变化。探索疼痛背景下时距知觉的变化, 可以为理解疼痛的发生发展机制以及时间知觉的机制提供一个新视角。     

婴儿的痛觉

婴儿痛觉对婴儿的生长发育有重要意义, 已经日益引发研究者的兴趣。痛觉本质上是一种不愉悦的感官和情绪体验, 是通过早年与伤害有关的经历习得的。在心理学角度, 在介绍婴儿痛觉概念、神经生理机制、评估工具的基础上, 系统梳理痛觉对婴儿生长发育的影响及其影响因素十分必要。后续研究需继续完善婴儿痛觉的测量方法, 考察疼痛反应在不同文化和不同群体间的差异。     

Assessing pain behaviour of low-back pain patients in real time: concurrent validity and examiner sensitivity

Several systems for measuring pain behaviour have been developed for clinical settings. The present study reports on a real-time system for coding five categories of pain behaviour for low-back pain patients: guarding, touching, sounds, words, and facial expression. Unique features of the system are the use of refined measures of facial expression and integration of the measurements with a standardized physical examination. 176 sub-acute and chronic low-back pain patients underwent a physical examination while their pain behaviour was coded. Concurrent measures of subjective pain, medically-incongruent signs, and independent global ratings of pain behaviour were taken. Analyses indicated that the pain behaviours, particularly guarding and facial expression, varied systematically with the alternative measures, supporting the concurrent validity of the behaviour observation system. While pain behaviours, especially use of words and facial expressions, were significantly associated with the examiners' independent ratings, the strength of the associations suggested that, in the absence of direct training, examiners' performance was relatively poor. Implications for training of clinicians in detecting pain behaviour are discussed.     

Quality of Life and Sense of Coherence in People with Arthritis

This study investigated the physical and psychological impact of arthritis on people's quality of life. A range of variables were examined in a sample of 375 participants who comprised three groups: people with arthritis receiving a support-based service from the Arthritis Foundation of Victoria, people with arthritis receiving standard treatment, and a group of people from the general population. The results revealed that the two arthritis groups reported a significantly higher level of functional impairment, pain, and negative affectivity, and lowered mood, positive affect, and Sense of Coherence, compared to the general population group. They also reported normal levels of importance, but lower levels of satisfaction on various life domains. After statistically controlling for pain however, group differences were eliminated on all variables except for functional impairment and for all satisfaction domains except health. These data are interpreted as evidence that the combination of low domain satisfaction coupled with high domain importance yields a negative psychological state. This, then suggests the possibility of a therapy based on reducing the perceived importance of health.     

Cost-Effectiveness and Health Care Utilization in a Multidisciplinary Pain Center: Comparison of Three Treatment Groups

Recent literature supports the efficacy of multidisciplinary pain management in treating persons suffering from chronic pain. However, the components of multidisciplinary pain management need to be evaluated in terms of effects on patients' quality of life as well as saving of future health care dollars. Therefore, cost-effectiveness of three treatment groups was compared by examining treatment outcome, posttreatment health care costs, and posttreatment health care visits. Results revealed that patients receiving both medical and psychological treatment (multidisciplinary pain management) exhibited the largest improvements in functional capacity, while being the least costly after their treatment program had ended. In contrast, patients who received only medical treatment exhibited significant deterioration in outcome after their treatment ended, and consumed substantially more posttreatment health care dollars.     

Stress Induced Oral Behaviors and Facial Pain

Facial pain is frequently associated with environmental stress and emotional distress. One hypothetical mechanism by which stress is translated into pain is through stress induced motor function (e.g., teeth clenching, grinding, nail biting). Existent data partially supports these stress-hyperactivity models although they have also come under theoretical and empirical attack. The purpose of this study was to examine the relationship between oral behaviors and pain in an analog sample of facial pain sufferers and student controls. Subjects engaged in a controlled clenching task and reported on subjective facial pain intensity and unpleasantness at 5 specified times over the subsequent 48 hours. A one-way ANCOVA indicated group differences in self reported oral habits (p < .05) with the facial pain group reporting great frequency of oral habits. Two repeated measures ANCOVAs (i.e., pain intensity and pain unpleasantness), controlling for baseline pain ratings, indicated a between groups effect with facial pain sufferers experiencing significantly greater pain over the 48 hours postexperiment (p < .05). This study supports a hyperactivity model of facial pain and provides clues about relevant factors in facial pain development.