European journal of pain : EJP
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The experience of pain constitutes a complex phenomenon that is determined by and reflects the interplay of many factors, including cognitive functions. Little is known, however, about the precise role of executive functions in pain sensitivity. Importantly, these functions may be directly related to the ability to control pain. ⋯ The results revealed a unique association between cognitive inhibition (i.e. the Stroop interference score), but not other executive functions, and immersion time, pain intensity, and pain unpleasantness. Specifically, better cognitive inhibition was related to a reduction in pain sensitivity as evident by an increased immersion time and decreased pain intensity and pain unpleasantness ratings. As such, cognitive inhibition may be an important determinant of pain sensitivity.
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This study examined the relationship between chronic pain acceptance and affective well-being from a coping perspective. One hundred-fifty patients from a multidisciplinary pain centre provided self-report data including measures of pain acceptance, positive and negative affect, and accommodative flexibility. ⋯ Moderation analyses showed that accommodative flexibility (the general readiness to adjust personal goals to situational constraints) facilitates both pain willingness and activity engagement--especially when average pain intensity is high. In sum, the results support the view that chronic pain patients' well-being is closely tied to the maintenance of life activities which presupposes an accepting attitude towards pain.
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The study evaluated the ability of the Pain Stages of Change Questionnaire (PSOCQ) to classify subjects into specific profiles of readiness to adopt a self-management approach to pain. An analysis was made of whether the five earlier described PSOCQ-profiles Precontemplation, Contemplation, Non-contemplative Action, Participation and Ambivalent could be reproduced by two different methods, cluster analysis and visual analysis. The 184 included subjects completed the PSOCQ, the Hopkins Symptom Checklist (HSCL-25), the Tampa scale of Kinesiophobia (TSK) and five self-efficacy questions from the arthritis self-efficacy questionnaire (ASES). ⋯ Non-contemplative Action share characteristics with Precontemplation, and the Contemplation group has scores in between. In conclusion, more research on the validity of the PSOCQ is needed. Outcome studies after pain treatment programmes could focus three main states that differ on measures for concurrent validity: Profiles that can be identified as Precontemplation or Non-contemplative action, Contemplators, and subjects with Participation profiles.
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Following peripheral nerve injury sensory loss is taken as a sign of denervation. However, based on reports of improved sensitivity following relief of pain it has been suggested that a functional block produced by the activity in the nociceptive system itself may be responsible for at least part of the sensory aberrations. The aim was to examine if pain reduction by high-frequency TENS influenced somatosensory functions in patients with long-term unilateral painful traumatic peripheral partial nerve injury. ⋯ Before and following TENS there was no difference in sensory functions between nine patients with ≥ 50% pain reduction and nine patients with a smaller or no reduction in pain. Compared to baseline, only minor TENS-induced alterations in somatosensory functions were found at BE in conjunction with decreased sensitivity to light touch at QST (p < 0.01) in both groups alike. In conclusion ≥ 50% pain reduction by TENS did not alter sensory functions differentially compared to a smaller or no reduction in pain.
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Comparative Study
Comparison of daily and weekly retrospectively reported pain intensity in patients with localized and generalized musculoskeletal pain.
The purpose of the study was to compare daily and weekly recalled pain intensity over time and their correspondence with real-time pain intensity in patients with localized (LP) and generalized (GP) musculoskeletal pain. Daily recalled pain, averaged over seven consecutive days, and weekly recalled pain at day 8 were recorded on 100 mm visual analogue scales monthly over 4 months for 40 LP and 50 GP patients. Multiple real-time pain ratings on numerical rating scales (0-10) were averaged over the week for 23 LP and 33 GP patients in Month 4. ⋯ Weekly ratings were higher than real-time ratings in the GP group, and the overestimation increased with increasing pain intensity. The results of the present study indicated that reliability was improved by using ratings of daily recalled pain averaged over a week rather than single ratings of weekly recalled pain in subjects with localized or generalized pain. Weekly recalled pain was overestimated in subjects exhibiting generalized pain and high pain intensity.