Pain
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Comparative Study
Chronic pain in adults with an intellectual disability: prevalence, impact, and health service use based on caregiver report.
This study examined chronic pain in adults with an intellectual disability (ID), in terms of its prevalence, impact on physical and psychological functioning, and treatments used. Questionnaires were distributed to 2378 primary caregivers (caregivers) of community-dwelling adults with an ID. The questionnaires were used to gather data on demographics, general health, nature of pain, impact of pain, treatment, and health-related decision making. ⋯ A significant proportion of individuals with chronic pain also experienced limitations in several aspects of daily living, and more than 78% of caregivers reported that the service user had become upset or distressed by pain. More than 80% of service users were receiving some form of treatment for their pain, with most seeing a family physician and using analgesics as the primary form of pain treatment. Results indicate that chronic pain is a significant problem for persons with an ID, with a proportion of service users living with daily pain for many years and experiencing limitations in daily functioning, emotional well-being, and quality of life.
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Comparative Study
Reliability and validity of the Child Pain Anxiety Symptoms Scale (CPASS) in a clinical sample of children and adolescents with acute postsurgical pain.
Pain anxiety refers to the cognitive, emotional, physiological, and behavioural reactions to the experience or anticipation of pain. The Child Pain Anxiety Symptoms Scale (CPASS) has recently been developed and validated in a pediatric community sample. The goal of the present study was to examine the psychometric properties of the CPASS in a sample of children and adolescents with acute postsurgical pain. ⋯ Pain anxiety was significantly associated with pain intensity (r = 0.44) and unpleasantness (r = 0.32) 48–72 hours after surgery (concurrent validity) and with pain unpleasantness (r = 0.29) and functional disability (r = 0.50; but not pain intensity, r = 0.20) 2 weeks later (predictive validity). The CPASS showed adequate sensitivity to change over time (mean change = 9.52; effect size = 0.49) and good sensitivity and specificity. The results of the present study provide initial validity and reliability of the CPASS in a clinical sample of children and adolescents after major surgery.
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Comparative Study
Sex differences in perceived pain are affected by an anxious brain.
Decades of research confirm that women have greater pain sensitivity than men. Women also show greater overall anxiety sensitivity than men. Given these differences, we hypothesized that sex differences in anxiety would explain sex differences in experienced pain and physiological responses to pain (at both spinal and cortical levels). ⋯ This means that stable predispositions to respond with heightened apprehension contribute to baseline pain sensitivity differences between the sexes. These results indicate that the modulatory effect of affect on pain-related brain processes may explain why men and women experience painful shocks so differently. In our study, the mediating role of anxiety on sex differences in pain was tested and confirmed using path analysis.
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Randomized Controlled Trial Comparative Study
The effects of total and REM sleep deprivation on laser-evoked potential threshold and pain perception.
We investigated the effects of total and rapid eye movement (REM) sleep deprivation on the thermal nociceptive threshold and pain perception using the objective laser-evoked potential (LEP) and the subjective visual analogue scale (VAS). Twenty-eight male adult volunteers were assigned into Control (CTRL), Total (T-SD), and REM (REM-SD) Sleep Deprivation groups. The T-SD and REM-SD volunteers were totally or selectively deprived of sleep for 2 and 4 consecutive nights, respectively. ⋯ No significant variations were observed in the REM-SD group, suggesting a predominant role for slow wave sleep rather than selective REM-SD in pain perception. Also, for both sleep-deprived groups, the mean values of the LEP threshold and VAS ratings showed a gradual increase that was proportional to the SD deprivation time, followed by a decrease after 1 night of sleep restoration. These findings demonstrate a hyperalgesic modification to pain perception (as reflected by the augmented VAS) and a concomitant increase in the LEP threshold following T-SD, an apparently contradictory effect that can be explained by differences in the ways that attention affects these pain measurements.