Chronic low back pain and the transdiagnostic process: How do cognitive and emotional dysregulations contribute to the intensity of risk factors and pain?

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_j.sjpain.2017.08.008_s_007_w2aab2b8d116b1b7b1aab1c15b1Aa"><jats:title>Background and aims</jats:title><jats:p>Based on a transdiagnostic approach, this study assesses the impact of cognitive and emotional processes (difficulties in emotional regulation, impulsiveness, rumination and somatosensory amplification) on the psychological risk factors of chronic low-back pain.</jats:p></jats:sec><jats:sec id="j_j.sjpain.2017.08.008_s_008_w2aab2b8d116b1b7b1aab1c15b2Aa"><jats:title>Methods</jats:title><jats:p>The study was carried out with 256 patients with chronic low-back pain. All the variables were assessed through a booklet of 10 validated questionnaires. Multiple regression analysis and moderation analysis were performed.</jats:p></jats:sec><jats:sec id="j_j.sjpain.2017.08.008_s_009_w2aab2b8d116b1b7b1aab1c15b3Aa"><jats:title>Results</jats:title><jats:p>Predictors included in multiple regression models explain 3%-42% (adjusted <jats:italic>R</jats:italic><jats:sup>2</jats:sup>) of the variance in psychological risk factors. Moreover, analyses reveal a significant moderator effect of somatosensory amplification on the link between fear-avoidance beliefs linked to work and pain intensity (<jats:italic>F</jats:italic><jats:sub>(3;250)</jats:sub> = 12.33; <jats:italic>p</jats:italic> = .00), of somatosensory amplification and brooding on the link between depression and functional repercussions (FR) on everyday life (<jats:italic>F</jats:italic><jats:sub>(3;252)</jats:sub> = 13.36; <jats:italic>p</jats:italic> = .000; <jats:italic>F</jats:italic><jats:sub>(1;252)</jats:sub> = 12.42; <jats:italic>p</jats:italic> = .00), of the reflection dimension of rumination on the link between the helplessness dimension of catastrophizing and FRs on sociability (<jats:italic>F</jats:italic><jats:sub>(3;252)</jats:sub> = 37.02; <jats:italic>p</jats:italic> = .00). There is also a moderation analysis with a significant trend concerning the lack of emotional awareness and the difficulties in controlling impulsive behaviours.</jats:p></jats:sec><jats:sec id="j_j.sjpain.2017.08.008_s_010_w2aab2b8d116b1b7b1aab1c15b4Aa"><jats:title>Conclusions</jats:title><jats:p>Our results indicate an important role of some dimensions of difficulties in emotional regulation, somatosensory amplification and rumination in the increase in negative affects and dysfunctional beliefs, and in the links between those psychological risk factors and pain/disability.</jats:p></jats:sec><jats:sec id="j_j.sjpain.2017.08.008_s_011_w2aab2b8d116b1b7b1aab1c15b5Aa"><jats:title>Implications</jats:title><jats:p>This study identifies some cognitive and emotional dysregulations substantially involved in work-related chronic pain. This contribute to put in place psychotherapeutic protocols to tackle these deficits and dysregulations in a relevant way.</jats:p></jats:sec>

Is the widely used two‐factor structure of the Ruminative Responses Scale invariant across different samples of women?

“…Additionally, as mentioned before, ruminative thinking has not only a deleterious influence in psychological and behavioural problems, but is also related to more negative outcomes in medical settings (e.g., Hogan & Linden, ; Le Borgne et al ., ; Sansone & Sansone, ). Hence, this study also extends the existing literature: It includes data on the role of rumination in a medical sample of particular relevance (i.e., overweight or obese women currently in weight loss treatment), as rumination is associated with higher BMI in people with BMI ≥ 25 (Tan et al ., ) and body dissatisfaction is positively related to ruminative thinking in women (e.g., Naumann et al ., ).…”

“…Additionally, despite the known association and impact of rumination in psychological and behavioural problems, its role in medical settings is less considered. However, there is evidence that rumination is associated with poorer outcomes in medical/physical health settings (Sansone & Sansone, ), such as chronic low‐back pain (Le Borgne, Boudoukha, Petit, & Roquelaure, ), arterial hypertension (Hogan & Linden, ), and chronic physical illness (see Soo, Burney, & Basten, ; for a revision). Also, higher scores in rumination are associated with higher BMI in people with overweight and obesity status (Tan, Xin, Wang, & Yao, ).…”

Evaluation of Municipal Fitness Programs for Women with Low Back Pain

“…This study evaluated the effect of municipality sports programs for women considering sociodemographic and lifestyle factors to the improvement or not of the LBP. Measures of the self-declared replies in the beginning and six months after implementation can also provide useful results of the effect of the municipal sports program to the intensity of the LBP (Le Borgne, Boudoukha, Petit, & Roquelaure, 2017).…”

Pain Experiences and Their Relation to Opioid Misuse Risk and Emotion Dysregulation

“…Ruiz-Aranda et al [ 15 ] found that women with the emotion regulation strategy of emotional repair (i.e., attenuate to and value feelings, clarity about feelings, and utilization of positive thinking to repair negative moods) reported having less pain during an experimental pain induction. A lack of emotion regulation plays a role in the increase in negative affect and dysfunctional beliefs related to pain [ 16 ], while regulation of positive and negative affect predicts greater decreases in pain [ 17 ]. Hamilton et al [ 18 ] also found the magnitude of pain reactivity varied as a function of both emotional intensity and ability to regulate emotion.…”