Journal of behavioral medicine
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Randomized Controlled Trial Comparative Study
Self-management practices among primary care patients with musculoskeletal pain and depression.
The objective of this study was to assess the effect of clinical depression on pain self-management practices. We employed a cross-sectional analysis of baseline data from the Stepped Care for Affective disorders and Musculoskeletal Pain (SCAMP) study. Participants included 250 patients with pain and comorbid depression and 250 patients with pain only and were enrolled from urban university and VA primary care clinics. ⋯ In contrast, depression and pain severity interacted to increase the use of cognitive strategies. Depression and pain severity have differential effects on self-management practices. Understanding the differences between preferential strategies of pain patients with and without depression may be useful in tailoring pain self-management programs.
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Randomized Controlled Trial Comparative Study
Migraines and meditation: does spirituality matter?
Migraine headaches are associated with symptoms of depression and anxiety (Waldie and Poulton Journal of Neurology, Neurosurgery, and Psychiatry 72: 86-92, 2002) and feelings of low self-efficacy (French et al. Headache, 40: 647-656, 2000). ⋯ Pre-post tests measured pain tolerance (with a cold pressor task), headache frequency, and mental and spiritual health variables. Compared to the other three groups, those who practiced spiritual meditation had greater decreases in the frequency of migraine headaches, anxiety, and negative affect, as well as greater increases in pain tolerance, headache-related self-efficacy, daily spiritual experiences, and existential well being.
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Observer underestimation of others' pain was studied using a concept from evolutionary psychology: a cheater detection mechanism from social contract theory, applied to relatives and friends of chronic pain patients. 127 participants estimated characters' pain intensity and fairness of behaviour after reading four vignettes describing characters suffering from pain. Four cues were systematically varied: the character continuing or stopping liked tasks; continuing or stopping disliked tasks; availability of medical evidence; and pain intensity as rated by characters. ⋯ This combination was also rated least fair. Results support the use of social contract theory as a theoretical framework to explore pain judgements.