Journal of behavioral medicine
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Randomized Controlled Trial Clinical Trial
Psychological coping with acute pain: an examination of the role of endogenous opioid mechanisms.
This study examined the relationship among endogenous opioids, Monitoring and Blunting coping styles, and acute pain responses. Fifty-eight male subjects underwent a 1-min pressure pain stimulus during two laboratory sessions. Subjects experienced this pain stimulus once under endogenous opioid blockade with naltrexone and once in a placebo condition. ⋯ Results for coping behaviors subjects used to manage the experimental pain were generally consistent with the Blunting results, indicating that cognitive coping was related more strongly to decreased pain ratings and cardiovascular stress responsiveness under opioid blockade. Overall, the beneficial effects of Blunting and cognitive coping on pain responses did not depend upon endogenous opioids and, in fact, became stronger when opioid receptors were blocked. The relationship between endogenous opioids and coping appears to be dependent upon situational and stimulus characteristics.
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This study investigated the relation of cognitive coping and catastrophizing to acute postoperative pain and analgesic use. Fifty-nine women who had just undergone breast cancer surgery rated their pain on 3 consecutive days and completed a self-report measure of cognitive coping and catastrophizing prior to hospital discharge. Analgesic use over the 3-day period was tabulated from pharmacy records. ⋯ Additional analyses indicated that age was a significant predictor of both catastrophizing and postoperative pain. Specifically, younger patients were more likely to catastrophize and to report increased postoperative pain. Theoretical and clinical implications of these findings are discussed.
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The purposes of this study were to determine: (1) the prevalence of psychoactive medication and alcohol use and (2) the relationship among psychoactive medications, alcohol use, and falls in a sample of 1028 independently living women and men, aged 55 and older. Twenty-six percent of the sample reported falling, 28% were taking one or more psychoactive drugs, and 38% drank alcohol during the past year. Analyses with logistic regression indicate that predictors of falls were psychoactive drug use, age, and number of illnesses. Living alone, frequency of alcohol use, and gender were not significant predictors.
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Intensity of angry feelings and styles of expressing anger were examined for their relationship to measures of the chronic pain experience. Subjects were 142 chronic pain patients. ⋯ More conservative hierarchical regression analyses supported these findings. Results are consistent with explanatory models of pain and disability that hypothesize an etiologic role of a pervasive inability to express intense negative emotions, particularly anger.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cognitive distraction and relaxation training for the control of side effects due to cancer chemotherapy.
Sixty cancer chemotherapy patients were randomly assigned to one of six conditions formed by a 3(cognitive distraction, relaxation training, no intervention) x 2(high anxiety, low anxiety) factorial design. All patients were followed for five consecutive chemotherapy sessions. Outcome measures included patient reports, nurse observations, and physiological indices. ⋯ There were no significant differences between distraction and relaxation training patients on any measure. Patients with high initial levels of anxiety exhibited continually elevated levels of distress throughout the chemotherapy experience; however, anxiety level did not interact with the effectiveness of the treatment interventions. Overall, the data support the use of both cognitive distraction and relaxation training for reducing the distress of chemotherapy with both high and low-anxiety patients and suggest that at least some of the effects of relaxation training can be achieved with distraction alone.