The Clinical journal of pain
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This study examined the cross-sectional associations among pain intensity, pain catastrophizing, and sleep disturbance among patients receiving methadone maintenance treatment (MMT) for opioid use disorder (OUD) and reporting co-occurring chronic pain. ⋯ Altogether, findings suggest that the sleep disturbance to pain catastrophizing to pain intensity pathway may be a key mechanistic pathway exacerbating pain issues among MMT patients with OUD and chronic pain. These results suggest that interventions targeting sleep disturbance may be warranted among MMT patients with OUD and chronic pain. Future work in this area with longitudinal data is warranted.
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There has been growing interest in examining pain-related activity patterns and their relationships to psychosocial functioning. The Patterns of Activity Measure-Pain (POAM-P) is frequently used to measure 3 pain-related activity patterns: avoidance, overdoing, and pacing. Although the POAM-P possesses excellent psychometric properties, its length may limit its utility where multiple measures of functioning are required or the time available for assessment is limited. The present studies describe the development and evaluation of a short-form version of this measure. ⋯ The short-form of the POAM-P possesses good psychometric properties and correlates well with the long-form of the measure. It appears to be a promising addition to existing measures of pain-related activity. It may be useful as an addition to questionnaire batteries that comprehensively assess the psychosocial functioning of individuals with ongoing pain.
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We recently developed a transdiagnostic exposure treatment (the hybrid treatment) for chronic pain patients with concurrent emotional difficulties. This paper investigates the hypothesized treatment processes, specifically: (1) if changes on pain-related dysregulation (catastrophizing, fear-avoidance, and nonacceptance of pain) and general emotion dysregulation (difficulties to regulate a broad spectrum of emotional responses) mediate effects on outcomes; and (2) if mediation is more pronounced for patients who score higher on these processes pretreatment. ⋯ Our findings provide initial support for the transdiagnostic theoretical underpinnings of the hybrid treatment model. Using a hybrid treatment approach that centers on teaching patients emotion-regulation skills before commencing broad exposure successfully influenced both pain-related dysregulation and general emotion dysregulation, which in turn was associated with better treatment outcomes. It appears central to address these processes in pain patients with comorbid emotional problems, especially among patients scoring high on measures of catastrophizing, fear-avoidance, and nonacceptance of pain.
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Although the great majority of individuals who take opioids for chronic pain use them appropriately and to good effect, a certain minority will develop the problematic outcome of opioid use disorder (OUD). Characteristics associated with the development of OUD in individuals with chronic pain have been described; however, relatively unexplored is how sensitivity to pain is associated with OUD outcomes. ⋯ Despite the small sample size and cross-sectional design, these findings suggest that experimental pain testing may be a novel technique in identifying patients with chronic pain likely to develop OUD, in that they are likely to evidence exacerbated temporal summation and to rate the associated pain as more severe.
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The purpose of this study was to determine the association between presence of chronic pain and school functioning among school-aged children (6 to 17 y) using the most recent United States national data. ⋯ This study extends evidence linking chronic pain status to poorer school functioning in a large, national sample. Poor school functioning is a pressing public concern affecting children with chronic pain. Health care providers, educators, policymakers, and families should work together to ensure that needs are met for this vulnerable population.