Journal of behavioral medicine
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The psychological flexibility model appears to be useful for organizing research into chronic pain. One component of the model is called "cognitive defusion." A process referred to as decentering, measured by the Experiences Questionnaire (EQ), appears similar to cognitive defusion. The purpose of this study is to extend previous investigations of the EQ, to evaluate its factor structure, and examine both indirect and direct roles for decentering in relation to key clinical outcomes. 352 people seeking pain treatment participated in this study. ⋯ SEM revealed that both decentering and rumination have direct effects on functioning and indirect effects through measures of acceptance. A shortened 12-item measure of decentering warrants further study. Combined models of acceptance and the type of cognitive-defusion-related process reflected in decentering may improve our understanding social and emotional functioning in relation to chronic pain.
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Little research has examined etiological factors associated with pain in patients with the hepatitis C virus (HCV). The purpose of this study was to evaluate the relationship between biopsychosocial factors and pain among patients with HCV. ⋯ In adjusted models, factors associated with pain severity include pain catastrophizing and social support, whereas variables associated with pain interference were age, pain intensity, prescription opioid use, and chronic pain self-efficacy (all p values <0.05). The results provide empirical support for incorporating the biopsychosocial model in evaluating and treating chronic pain in patients with HCV.
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Building on the Cognitive-Social Health Information-Processing model, this paper provides a theoretically guided review of monitoring (i.e., attend to and amplify) cancer-related threats. Specifically, the goals of the review are to examine whether individuals high on monitoring are characterized by specific cognitive, affective, and behavioral responses to cancer-related health threats than individuals low on monitoring and the implications of these cognitive-affective responses for patient-centered outcomes, including patient-physician communication, decision-making and the development of interventions to promote adherence and adjustment. A total of 74 reports were found, based on 63 studies, 13 of which were intervention studies. ⋯ Finally, individuals high on monitoring tend to be more demanding of the health providers in terms of desire for more information and emotional support, are more assertive during decision-making discussions, and subsequently experience more decisional regret. Psychoeducational interventions improve outcomes when the level and type of information provided is consistent with the individual's monitoring style and the demands of the specific health threat. Implications for patient-centered outcomes, in terms of tailoring of interventions, patient-provider communication, and decision-making, are discussed.
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Randomized Controlled Trial
Anger regulation style, anger arousal and acute pain sensitivity: evidence for an endogenous opioid "triggering" model.
Findings suggest that greater tendency to express anger is associated with greater sensitivity to acute pain via endogenous opioid system dysfunction, but past studies have not addressed the role of anger arousal. We used a 2 × 2 factorial design with Drug Condition (placebo or opioid blockade with naltrexone) crossed with Task Order (anger-induction/pain-induction or pain-induction/anger-induction), and with continuous Anger-out Subscale scores. ⋯ Namely, when angered prior to pain, high anger-out participants appeared to exhibit low pain intensity under placebo that was not shown by high anger-out participants who received naltrexone. Results hint that people with a pronounced tendency to express anger may suffer from inadequate opioid function under simple pain-induction, but may experience analgesic benefit to some extent from the opioid triggering properties of strong anger arousal.