Pain
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Identification of different patterns of change in pain over time - trajectories - has the potential to provide new information on the course of pain. Describing trajectories among adolescents would improve understanding of how pain conditions can develop. This prospective cohort study identified distinct trajectories of pain among adolescents (11-14 years) in the general population (n=1336). ⋯ Trajectories did not differ significantly at baseline in physical activity levels or BMI. Agreement of trajectory membership among pain sites was moderate. In summary, reporting a painful trajectory was common among adolescents, but persistent pain was reported by a small minority, and was usually experienced at a single pain site.
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The goals of the current study were to examine the associations between patient-reported spouse responses to pain and well behaviors as assessed by the Spouse Response Inventory (SRI) [22] and (1) patient-reported pain behavior, (2) depression, and (3) physical dysfunction, independent of patient demographics and pain severity. Moreover, we sought to examine the potential moderating influence of marital satisfaction on these relationships. We also evaluated the construct and concurrent validity and internal reliability of the SRI. ⋯ In summary, our results support the internal reliability and validity of the SRI scales as measures of spousal responses to both pain and well behaviors. The current study also supports the importance of examining the potential impact of responses to both well and pain behaviors. Further research is needed to examine the potential impact of other contextual variables and marital satisfaction on the relationship of spouse responses to both well and pain behaviors.
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This study aimed to (1) identify differences in sleep behaviors, sleep quality, pre-sleep arousal and prevalence of insomnia symptoms in adolescents with chronic pain compared to a healthy age and sex-matched cohort and (2) examine pain intensity, pubertal development, depression, and pre-sleep arousal as risk factors for insomnia symptoms. Participants included 115 adolescents, 12-18 years of age (73.0% female), 59 youth with chronic pain and 56 healthy youth. During a home-based assessment, adolescents completed validated measures of pain, sleep quality, sleep hygiene, pre-sleep arousal, depressive symptoms, and pubertal development. ⋯ Level of pain intensity did not predict insomnia. While sleep disruption may initially relate to pain, these symptoms may persist into a separate primary sleep disorder over time due to other behavioral and psychosocial factors. Assessment of insomnia may be important for identifying behavioral targets for the delivery of sleep-specific interventions to youth with chronic pain.
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The effects of depression and smoking on pain severity and opioid use in patients with chronic pain.
Depression and smoking are common comorbid conditions among adults with chronic pain. The aim of this study was to determine the independent effects of depression on clinical pain and opioid use among patients with chronic pain according to smoking status. A retrospective design was used to assess baseline levels of depression, clinical pain, opioid dose (calculated as morphine equivalents), and smoking status in a consecutive series of patients admitted to a 3-week outpatient pain treatment program from September 2003 through February 2007. ⋯ However, status as a current smoker was independently associated with greater opioid use (by 27mg/d), independent of depression scores. The relationship between depression, smoking status, opioid use, and chronic pain is complex, and both depression and smoking status may be potentially important considerations in the treatment of patients with chronic pain who utilize opioids. This study found that pain severity was associated with greater depression but not smoking; however, smoking was associated with greater opioid use, independent of depression.
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Recent research has demonstrated that parental behaviors have an important impact upon child and adolescent pain outcomes. At present, however, we do not know which parents engage in particular behaviors and why. In 2 studies, the impact of parental catastrophizing about their child's pain upon parental tendency to stop their child's pain-inducing activity was investigated. ⋯ Further, parental feelings of distress mediated the relationship between parental catastrophic thinking and parents' tendency to restrict their child's activity. The findings are discussed in light of an affective-motivational conceptualization of pain and pain behavior. Parental catastrophizing was associated with parental tendency to restrict their child's engagement in a painful test, and this relationship was mediated by parental distress.