The new assessment protocol in the app allows for an easy and rapid multidimensional assessment of chronic pain patients.
In recent decades, emotion regulation (ER) has been one of the most widely studied constructs within the psychological field. Nevertheless, laboratory experiments and retrospective assessments have been the two most common strands of ER research, thus leaving open several crucial questions about ER antecedents and consequences in daily life. Beyond traditional methods, ecological momentary assessment (EMA) has the potential to capture ER dynamics during the flow of daily experiences, in real-life settings and through repeated measurements. Here, we discuss what we currently know about ER antecedents and consequences. We will compare findings from previous literature to findings from EMA studies, pointing out both similarities and differences, as well as questions that can be answered better with the EMA approach.
Background According to a growing body of literature, people are quite inaccurate in recalling past affective experiences. Nevertheless, the mechanism underlying this recall bias (i.e., the tendency to overestimate and/or underestimate positive or negative past emotional experiences) remains unclear, and its association with mental health has not been studied yet. Methods We adopted a smartphone-based Ecological Momentary Assessment to monitor daily affect (n = 92) and investigate the association between affect recall bias, mental health and resilience. Results While the tendency to overestimate negative affective experiences was observed in participants reporting mild depressive symptoms, positive affect (PA) overestimation as compared to PA underestimation was associated with better mental health (i.e. higher psychological well-being and lower depressive and anxiety symptoms) through the enhancement of resilience. Furthermore, positively biased participants (i.e. PA over estimators) benefited from greater well-being, even when compared to accurate individuals. Conclusions While people appear to use retrospective PA overestimation as a strategy to enhance well-being and resilience, they are not likely to underestimate past negative experiences to feel better. Accordingly, owning an optimistic vision of the past may represent an adaptive "distortion" of reality that fosters people's mental health. The clinical implications of cultivating PA and learning strategies to regulate both negative and positive emotions are discussed.
HighlightsThis is the first study to explore the psychometric properties of the OASIS and ODSIS, screening tools for anxiety and mood disorders, in a Spanish sample of patients diagnosed with emotional disorders in a specialized mental health setting. The OASIS and ODSIS are easily administered screening tools with an excellent internal consistency, favorable convergent and discriminant validity, and good sensitivity to therapeutic change. A cut-off point of 10 for both instruments results in the best rate of correct clinical/nonclinical classifications. The Spanish adaptations of the OASIS and the ODSIS demonstrated their cross-cultural utility. The OASIS and ODSIS should make screening of anxiety and depressive symptoms in public health settings more feasible and could facilitate adequate referrals and routine evaluation. AbstractBackground: Anxiety and depressive disorders are the most frequent disorders for which patients seek care in public health settings in Spain. This study aimed at validating the Overall Anxiety Severity and Impairment Scale (OASIS) and the Overall Depression Severity and Impairment Scale (ODSIS), which are brief screening scales for anxiety and depression consisting of only five items each.Methods: The study was conducted in a Spanish clinical sample receiving outpatient mental health treatment (N = 339). A subsample of participants (n = 219) was assessed before and after receiving a course of cognitivebehavioral treatment.Results: The results revealed excellent internal consistency estimates (Cronbach's alpha for the OASIS and the ODSIS was .87 and .94, respectively), along with promising convergent and discriminant validity and testcriterion relationships (i.e., moderate correlation with other measures of depression and anxiety, as well as with neuroticism, quality of life, adjustment, and negative affect). A one-dimensional structure was obtained for the OASIS and the ODSIS. The ROC analyses indicated an area under the curve of .83 for the OASIS and the ODSIS when predicting moderate-to-severe anxiety and depression, respectively. Good sensitivity to therapeutic change was also evidence and the analysis of the sensitivity as a function of 1-specificity area suggested a cutoff value of 10 for both scales.Limitations: Inter-rater reliability of diagnoses with the ADIS-IV interview could not be investigated and the results obtained may not be generalizable to other samples and health settings.Conclusions: The availability of these two short and psychometrically sound measures should make screening of anxiety and depressive symptoms in routine care more feasible.
Pain catastrophizing is known to contribute to physical and mental functioning, even when controlling for the effect of pain intensity. However, research has yet to explore whether the strength of the relationship between pain catastrophizing and pain-related outcomes varies across pain intensity levels (i.e., moderation). If this was the case, it would have important implications for existing models of pain and current interventions. The present investigation explored whether pain intensity moderates the relationship between pain catastrophizing and pain-related outcomes. Participants were 254 patients (62% women) with heterogeneous chronic pain. Patients completed a measure of pain intensity, pain interference, pain catastrophizing, and physical and mental health. Pain intensity moderated the relationship between pain catastrophizing and pain interference and between pain catastrophizing and physical health status. Specifically, the strength of the correlation between pain catastrophizing and these outcomes decreased considerably as pain intensity increased. In contrast, pain intensity did not moderate the relationship between pain catastrophizing and mental health. Study findings provide a new insight into the role of pain intensity (i.e., moderator) in the relationship between pain catastrophizing and various pain-related outcomes, which might help develop existent models of pain. Clinical implications are discussed in the context of personalized therapy.
The use of Information and Communication Technologies (web pages and apps) in mental health has boosted. However, it is unknown which of these two devices can be better in terms of feasibility and acceptability. Our aim is to compare the feasibility, usability, and user satisfaction of two devices (web vs mobile application) of an online program for perinatal depression screening called HappyMom. In total, 348 and 175 perinatal women registered into HappyMom web and app version, respectively. The assessment protocol included different biopsychosocial evaluations (twice during pregnancy and thrice in the postpartum) and a satisfaction questionnaire. Results showed that a higher percentage of women in the web sample (27.3-51.1%) responded to each assessment compared to the app sample (9.1-53.1%). A smaller proportion of women in web sample never responded to any assessments. By contrast, the percentage of women who responded to all assessments was higher in app sample (longitudinal retention sample was 4.6% of web users and 9.1% of app users). In general, high satisfaction was found in both web and app users. Our result showed that online assessment methods are feasible and acceptable by perinatal women. However, dropout rates are a real problem that urge a solution that will be discussed further in the paper. Web and App devices present different advantages and limitations. The choice of one of them must be made taking into account the study's objective, the sample characteristics, and the dissemination possibilities.
Differences in fibromyalgia impact on functioning exist and appear to be influenced by numerous factors, including symptomatology severity, as well as the cognitive profile of the individual. The contribution of these elements, however, tends to be explored in a fragmented manner. To address this issue, we tested a comprehensive structural equation model in which associations of cognitive fusion and pain catastrophizing with function limitations are investigated through fibromyalgia symptomatology (i.e., fatigue, pain severity, and depression) in 231 women with fibromyalgia. In the model, cognitive fusion and two catastrophizing components (magnification and helplessness) were associated with poorer functioning indirectly through fibromyalgia symptomatology. Only the rumination component of catastrophizing had a direct association with functional limitations. All fibromyalgia symptoms were linked to increased functional limitations. A parsimonious model with significant associations only obtained an excellent fit (S-B χ2 = 774.191, df = 543, p < 0.001; CFI = 0.943; RMSEA = 0.043; CAIC = −2724.04) and accounted for 50% of the variance of functional limitations. These results suggest that the relationship between psychological cognitive processes, fibromyalgia symptomatology, and functional limitations is complex and support the need for comprehensive models such as the present. The findings are discussed in the context of personalized psychological treatments (i.e., the need to address certain cognitive processes according to the problematic symptomatology or outcome).
Background Fibromyalgia (FM) is a prevalent and highly disabling chronic pain syndrome. However, differences among patients regarding how pain impacts on daily life are remarkable. The main aim of this study was to identify clinical and pain‐related cognitive variables characterizing patients reporting high adaptability despite experiencing severe chronic pain. Methods Two hundred and eighty‐three Spanish patients with FM with high levels of pain were classified into 2 groups: (1) those reporting low impact of the syndrome, and (2) those with moderate‐to‐high impact. Perceived stress, anxiety, and depressive symptoms along with pain catastrophizing, psychological inflexibility, and perceived control over pain were evaluated. Differences in sociodemographics, years with FM, past/current major depressive disorder comorbidity, and health‐related economic costs (ie, medications, use of medical services, lost productivity due to sick leave) were also assessed. Stepwise logistic regression analyses predicting group membership from clinical variables and pain‐related cognitive processes as predictors were performed. Results Lower stress, anxiety, and depressive symptoms, along with reduced pain catastrophism, psychological inflexibility, and perceived control over pain, were found in the low‐impact group. Significant predictors of group membership (low‐impact vs. moderate‐to‐high impact) in regression analyses were “cognitive fusion” (psychological inflexibility), “helplessness” (pain catastrophizing), and depressive symptomatology, together with pain intensity and other FM symptoms. Conclusions The present study provides further evidence on resilience resources in chronic pain by identifying some variables (ie, reduced depressive symptomatology, pain catastrophizing, and psychological inflexibility) differentially characterizing a profile of patients with FM who are especially able to adapt to high levels of pain.
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