The journal of pain : official journal of the American Pain Society
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A variety of evidence-based psychosocial treatments now exist for chronic pain. However, on average, effect sizes have tended to be modest and there is a high degree of heterogeneity in treatment response. In this focus article, we explore the potential role that therapist quality in delivering treatment may have in accounting for a degree of this variability in outcome. ⋯ PERSPECTIVE: Therapist quality in the delivery of psychosocial treatments for chronic pain has rarely been assessed in clinical trials. We propose that therapist quality indicators are an under-studied mechanism that potentially contributes to the heterogeneity of treatment outcomes. We provide recommendations for assessing and reporting on therapist quality in future trials.
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We aimed to quantify the prospective association between bullying and physical pain in a population-based cohort of adolescents. We assessed 4,049 participants of the 10 and 13 years waves of the Generation XXI birth cohort study in Portugal. Pain history was collected using the Luebeck pain screening questionnaire. ⋯ No differences were seen for the remaining bullying profiles or sensory measures. Our findings suggest that bullying may have long-term influence on the risk of chronic musculoskeletal pain and may interfere with responses to painful stimuli. PERSPECTIVE: We found prospective evidence that bullying victimization in youth: 1) is more likely to lead to negative reported pain experiences than the reverse, 2) may have long-term influence on adverse pain experiences, and 3) may contribute to pain phenotypes partly by interfering with somatosensory responses to painful stimuli.
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Review Meta Analysis
The impact of sleep disturbances on endogenous pain modulation: a systematic review and meta-analysis.
The bidirectional relationship between sleep and pain problems has been extensively demonstrated but despite all the accumulating evidence, their shared mechanisms are currently not fully understood. This review examined the association between sleep disturbances, defined as a broad array of sleep-related outcomes (eg, poor quality, short duration, insomnia), and endogenous pain modulation (EPM) in healthy and clinical populations. Our search yielded 6,151 references, and 37 studies met the eligibility criteria. ⋯ Qualitatively, we found a frequent association between reduced sleep quality and impaired pain inhibition. However, quantitatively such an association was not corroborated. Sex-specific effects were observed, with females presenting sleep-related impaired pain inhibition but not males.
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Randomized Controlled Trial
Understanding the role of expectancy, anticipatory anxiety and attention bias in nocebo hyperalgesia: A gaze-contingent attention bias modification study.
Nocebo effects in pain (nocebo hyperalgesia) have been thoroughly researched, and negative expectancies have been proposed as a key factor in causing nocebo hyperalgesia. However, little is known about the psychological mechanisms by which expectations exacerbate the perception of pain. A potential mechanism that has been proposed within wider pain research is pain-related attention. ⋯ The study shows that expectancy can trigger anticipatory anxiety that exacerbates nocebo hyperalgesia. Further, successful AB training towards pain heightens nocebo hyperalgesia. These findings identify candidate psychological factors to target in minimizing nocebo hyperalgesia.
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Chronic pain (CP) is a debilitating and increasingly common health condition that adversely impacts function, including physical activity (PA). Research using ambulatory assessment (AA) methods (eg, ecological momentary assessment, actigraphy) offers promise for elucidating the relationship between momentary pain and objective PA in CP populations. This study aimed to systematically review articles assessing the association between momentary pain and PA in adults with CP as measured using AA and to make recommendations for the measurement and study of this relationship. ⋯ PERSPECTIVE: This article presents a systematic review of the literature on the association between momentary pain and PA in adults with CP as measured using AA methods. A better understanding of this nuanced relationship could help elucidate areas for timely intervention and may inform clinical recommendations to improve CP outcomes. PROSPERO REGISTRATION NUMBER: CRD42023389913.