The Clinical journal of pain
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Acceptance and Commitment Therapy and the psychological flexibility model on which it is based are growing interests for those researching and treating chronic pain. One part of this model is a therapeutic process called cognitive defusion. Cognitive defusion is a process of experiencing a distinction between thoughts and the events or people they describe. This process is intended to reduce the dominating psychological influence of thoughts without necessarily changing the content or frequency of the thoughts. There are recently developed measures of this process but little study of it in people with chronic pain. ⋯ The CFQ may be a useful measure for further research and treatment development.
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Research-derived evidence about the impact of sickle cell disease (SCD) on the lives of affected adults is lacking. We conducted formative research to provide the basis for a comprehensive description of how SCD affects the lives of adults, with the goal of developing a SCD-specific quality-of-life measurement system. ⋯ Our conceptual model was similar to previous models with the effects of pain predominating, interwoven with emotional distress, quality of care, and stigmatization. We found a broad range of emotions reflected, including positive effects of SCD. Items for the quality-of-life measure were derived from the taxonomy and the conceptual model may be of use in generating hypotheses for clinical research and improving understanding for clinicians of the lived experience of adults with SCD.
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Quantitative sensory testing (QST) has been used to elucidate the peripheral and central mechanisms that underlie changes in pain sensitivity associated with low back pain (LBP). However, it remains unclear to what degree peripheral and central changes contribute to the generation and maintenance of LBP. The aim of this study was to compare thermal pain sensitivity, measured using QST, in participants with acute LBP, chronic LBP, and pain-free controls. ⋯ We found evidence for localized and generalized cold hyperalgesia in chronic, but not acute LBP. We might speculate that hyperalgesia develops as a consequence of long-lasting LBP, but prospective studies are needed to confirm this assumption.
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Studies have associated chronic low back pain (cLBP) with grey matter thinning. But these studies have not controlled for important clinical variables (such as a comorbid affective disorder, pain medication, age, or pain phenotype), which may reduce or eliminate these associations. ⋯ Our pilot results suggest that controlling for affect, age, and concurrent medications may reduce or eliminate some of the previously reported structural brain alterations in cLBP.
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The purpose of this study was to examine differences in precollision, pericollision, and postcollision clinical variables across litigating motor vehicle collision (MVC) patients who were classified as Dysfunctional (DYS), Interpersonally Distressed (ID), or Adaptive Copers (ACs) based on Multidimensional Pain Inventory (MPI) profile classifications. ⋯ This study extends the MPI literature by establishing the usefulness of the measure in determining those reports of MVC-related pain and emotional distress that are most likely to be associated with postcollision psychological disability. The current study supports the usefulness of MPI profile classifications in identifying MVC patients who are likely to require and benefit from intensive psychological and other rehabilitative interventions.