Annals of behavioral medicine : a publication of the Society of Behavioral Medicine
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Vulvodynia is an idiopathic vulvovaginal pain condition that has significant sexual and relational consequences. Most women with vulvodynia continue to have intercourse, possibly because of a desire to approach positive outcomes (e.g., intimacy) and avoid negative outcomes (e.g., partner disappointment). ⋯ Interventions should target cognitive-affective processes during sexual activity as one pathway by which sexual goals impact pain and adjustment.
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Medications targeting stroke risk factors have shown good efficacy, yet adherence is suboptimal. To improve adherence, its determinants must be understood. To date, no systematic review has mapped identified determinants into the Theoretical Domains Framework (TDF) in order to establish a more complete understanding of medication adherence. ⋯ This review provides foundations for evidence-based intervention design by establishing psychological determinants most influential in stroke survivors' medication adherence. Six TDF domains do not appear to have been tested, possibly representing gaps in research design. Future research should standardise and clearly report determinant and medication adherence measurement to facilitate meta-analysis. The range of determinants explored should be broadened to enable more complete understanding of stroke survivors' medication adherence.
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Observational Study
Depressive Symptoms and Sleep Efficiency Sequentially Mediate Racial Differences in Temporal Summation of Mechanical Pain.
Racial differences in endogenous pain facilitatory processes have been previously reported. Evidence suggests that psychological and behavioral factors, including depressive symptoms and sleep, can alter endogenous pain facilitatory processes. Whether depressive symptoms and sleep might help explain racial differences in endogenous pain facilitatory processes has yet to be determined. ⋯ This study underscores the importance of examining the contribution of psychological and behavioral factors when addressing racial differences in pain processing. Additionally, it lends support for the deleterious impact of depressive symptoms on sleep efficiency, suggesting that both sequentially mediate racial differences in endogenous pain facilitation.
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Randomized Controlled Trial
Distress is Interdependent in Patients and Caregivers with Newly Diagnosed Incurable Cancers.
Individuals with advanced, incurable cancer often experience high physical and psychological symptom burden. Family and friend caregivers are at risk for emotional distress. ⋯ In the context of newly diagnosed incurable cancer, caregivers experience more pronounced anxiety, while patients report greater depressive symptoms. Findings indicate that anxiety and depressive symptoms are interrelated among dyads facing newly diagnosed incurable disease. Results emphasize the importance of addressing distress in both patients and caregivers. Future research should discern when dyadic versus individual psychosocial interventions would be optimal.
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Poor sleep quality among people with chronic low back pain appears to be related to worse pain, affect, poor physical function, and pain catastrophizing. The causal direction between poor sleep and pain remains an open question, however, as does whether sleep quality exerts effects on low back pain differently across the course of the day. ⋯ Sleep quality appears related not only to pain intensity but also to a wide range of patient mood and function factors. A good night's sleep also appears to offer only temporary respite, suggesting that comprehensive interventions for chronic low back pain not only should include attention to sleep problems but also focus on problems with pain appraisals and coping.