Pain
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Comparative Study
Gender differences in patient-spouse interactions: a sequential analysis of behavioral interactions in patients having osteoarthritic knee pain.
Theory and research suggest that spousal responses to displays of pain behavior can vary markedly. To our knowledge, observational research on spousal responses to pain behavior has been carried out only in chronic low back pain patients, but not in other populations. In this study systematic observations were conducted of interactions occurring between 50 married osteoarthritis patients (25 male and 25 female) and their respective spouses. ⋯ Contrary to prior research on chronic low back pain this study found that in osteoarthritis patients spouse facilitative behavior preceded and followed patient pain behavior significantly more often than did spouse solicitous behavior. A gender difference in spousal responding to pain behavior also was observed in that wives were significantly more likely to show facilitative behavior preceding and following patient pain behavior than were husbands. The implications of these findings for future research and clinical interventions focused on patient-spouse interactions are discussed.
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The present study investigated the effects of two attributes of the experimenter (gender and professional status) on the report and tolerance of pain in male and female subjects. 160 non-psychology students (80 male and 80 female, aged 17-59 years) participated in a cold-pressor task. Subjects were assigned to one of 8 groups: male (M) and female (F) experimenters tested male (m) and female (f) students. In each combination (Mm, Mf, Fm, Ff), the cold-pressor task was conducted by either one of two faculty members (high professional) or one of two students (low professional). ⋯ Further, a significant interaction of experimenter gender and subject gender on pain tolerance indicated that subjects also tolerated pain longer when they were tested by an experimenter of the opposite sex. Additionally, a significant main effect for experimenter gender showed higher pain intensities for subjects tested by female experimenters. The observation that pain responsivity is influenced by the professional status of the experimenter might have implications for the study of pain in general and should be addressed in more detail in future experiments.
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A neuropathic-like pain syndrome was produced in rats following prolonged hindpaw ischemia and reperfusion, creating an animal model of complex regional pain syndrome-Type I (CRPS-I; reflex sympathetic dystrophy) that we call chronic post-ischemia pain (CPIP). The method involves placing a tourniquet (a tight fitting O-ring) on one hindlimb of an anesthetized rat just proximal to the ankle joint for 3 h, and removing it to allow reperfusion prior to termination of the anesthesia. Rats exhibit hyperemia and edema/plasma extravasation of the ischemic hindpaw for a period of 2-4 h after reperfusion. ⋯ The rats also exhibit spontaneous pain behaviors (hindpaw shaking, licking and favoring), and spread of hyperalgesia/allodynia to the uninjured contralateral hindpaw. Light-microscopic examination of the tibial nerve taken from the region just proximal to the tourniquet reveals no signs of nerve damage. Consistent with the hypothesis that the generation of free radicals may be partly responsible for CRPS-I and CPIP, two free radical scavengers, N-acetyl-L-cysteine (NAC) and 4-hydroxy-2,2,6,6-tetramethylpiperydine-1-oxyl (Tempol), were able to reduce signs of mechanical allodynia in this model.
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Comparative Study
Validation of a screener and opioid assessment measure for patients with chronic pain.
There has been a need for a brief assessment tool for providers who treat chronic pain patients to determine potential risk of abuse when prescribed opioids for pain. The purpose of this study was to develop and begin the validation of a self-administered screening tool (Screener and Opioid Assessment for Patients with Pain, SOAPP) for chronic pain patients considered for long-term opioid therapy. A consensus of 26 pain and addiction experts was obtained on important characteristics of chronic pain patients that predict future medication misuse using concept mapping. ⋯ Coefficient alpha for these 14 items was acceptable for a short scale (0.74). Receiver operating characteristics curve analysis yielded an area under the curve of 0.881 (P<0.001), suggesting adequate sensitivity and specificity for a screening device. These reliability and predictive validity results suggest that the SOAPP is a promising step toward screening risk potential for substance misuse among persons with chronic pain.