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.     

Unattractive people are unaware of their (un)attractiveness

Past research has shown that how people rate their physical attractiveness is only moderately correlated with how they are rated by others, suggesting that at least some people have little insight into their true level of attractiveness. The present research tests the hypothesis that unattractive people are not aware of their unattractiveness. In fact, six studies (overall N = 1,180) showed that unattractive participants considerably overestimated their attractiveness compared to ratings by strangers. In contrast, attractive participants were more accurate. If anything, they underestimated their attractiveness. It was also examined why unattractive people overestimate their attractiveness. As expected, unattractive participants differentiated less between attractive and unattractive stimulus persons than did attractive participants. They were also more likely than attractive participants to select unattractive stimulus persons to compare themselves to. However, these tendencies did not account for why unattractive participants overestimated their attractiveness, nor did affirming participant’s self-worth. Limitations and avenues for future research are discussed.     

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。     

Violence against women: Mental health effects. Part II. Conceptualizations of posttraumatic stress

A broad range of psychological aftereffects have been noted among women who have experienced male-perpetrated violence. These symptoms vary considerably among individuals, across social contexts, and across different types of violent encounters (Coley & Beckett, 1988; Goodman, Koss, & Russo, 1992; Koss, 1988; Straus, Gelles, & Steinmetz, 1980). Nevertheless, a remarkably consistent picture of the psychological sequelae of violence—particularly sexual and physical assault—emerges from the empirical and clinical literature (Koss, 1988). In this article, we use the posttraumatic stress disorder diagnosis—a frame that captures many of the disparate symptoms described by researchers—as a basis for exploring several conceptual models that have been developed to explain women's responses to violence.     

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.     

Psychosocial Subgroups, Coping, and Chronic Low-Back Pain

The purpose of this study was to compare psychosocial subgroups in terms of pain coping strategies, pain severity, physical impairment, pain behavior, affective distress, and response to pain management treatment. The Multidimensional Pain Inventory (MPI) was used to classify 67 chronic low-back pain (CLBP) patients into the following psychosocial subgroups: Dysfunctional, Interpersonally Distressed, Adaptive Coping, and Anomalous. These MPI subgroups were compared on the Pain Behavior Checklist, Behavioral Observation Measure of Pain Behavior, Revised Coping Strategies Questionnaire, and Chronic Disease Index. The Dysfunctional subgroup reported significantly more pain behavior, disability, affective distress, and catastrophizing than either the Interpersonally Distressed subgroup or Adaptive Copers, but were not significantly different on measures of adaptive coping strategies. The percentage of dropouts from treatment was significantly less among Adaptive Copers (11%) than among the Dysfunctional (33%) or Interpersonally Distressed (47%) subgroups. Differences in affective distress found among the MPI subgroups at baseline were not evident at the posttreatment assessment. The present findings support the use of MPI psychosocial subgroup analysis to enhance our understanding of differential response to chronic pain and pain management intervention.