The journal of pain : official journal of the American Pain Society
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Personality disorders (PDs) are prevalent among individuals with chronic pain, but less is known about the prevalence of pain in the PD population. This study therefore sought to explore the prevalence of current or everyday pain among individuals referred to outpatient PD treatment, and further explore the mediating role of negative affect in the relationship between PD severity and current pain. Data was retrieved from the Norwegian Network for PDs' quality register which included 4361 participants. ⋯ The findings reveal that moderate to extreme pain is prevalent among persons with PDs and that this co-occurrence is driven by negative affect. PERSPECTIVE: Pain is a prevalent and potentially underrecognized symptom in personality disorders and persists until treatment termination for a large group of patients. This co-occurrence may be driven by a susceptibility to negative affect that is enhanced by personality disorder features.
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Temporomandibular disorders (TMDs) are a common musculoskeletal condition, presenting treatment challenges due to their non-specific nature. Categorizing patients with TMDs into clusters based on neurobiological pain mechanisms could provide a promising approach to facilitate targeted treatments. This observational study (1) used a network analysis (NA) to explore the complexity of TMDs by investigating relationships among biopsychosocial variables, and (2) validated potential TMD subgroups based on mechanism-specific pain categories. ⋯ This knowledge may facilitate clinical reasoning and personalized treatments. PERSPECTIVE: This study used a network analysis to explore the complex biopsychosocial interactions present in people with TMDs, identifying important variables such as the Central Sensitization Inventory and pain-free maximal mouth opening. The findings distinguish potential nociceptive and nociplastic pain subgroups, offering important insights for targeted therapeutic strategies.
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Untreated or undertreated pain is well established as a significant problem, but unidentified pain is a distinct construct that still needs to be clearly modeled or fully described. This paper aims to develop a conceptual model of unidentified pain in humans with the goal of future development of an unidentified pain risk tool. A multi-phase process was employed consisting sequentially of 1) brainstorming followed by consensus building, 2) peer-review and publication of an integrative theoretical review protocol for "unidentified pain," 3) conduct of the integrative review, and 4) a repeated brainstorming session to identify areas of risk for unidentified pain to produce a conceptual model. ⋯ The development of this conceptual model will be used for future development and psychometric testing of a tool to recognize the risk for unidentified pain in humans. PERSPECTIVE: This focus article describes the development a conceptual model for the concept of unidentified pain in humans. This pain may occur in individuals who experience one or more interactive and cumulative hazards: cognition/communication problems, being alone, absence of a surrogate/proxy report, or presence of known painful conditions or treatments.