Higher levels of pain readiness to change and more positive affect reduce pain reports – A weekly assessment study on arthritis patients

Strand, Elin Bolle; Kerns, Robert D.; Christie, Anne; Haavik-Nilsen, Kjell; Klokkerud, Mari; Finset, Arnstein

doi:10.1016/j.pain.2006.08.015

Cited by 45 publications

(43 citation statements)

References 37 publications

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“…For instance, experimental induction of NA is associated with increased pain intensity and decreased pain tolerance, whereas the induction of positive affect (PA) decreases pain intensity and increases pain tolerance [20, 21, 22, 23]. Furthermore, the relationship between pain and affect in RA patients is consistent with the experimental literature [24]. For example, Connelly et al [25] had RA patients record positive and negative affect and pain daily over the course of 30 days.…”

Section: Introductionsupporting

confidence: 55%

Pain, Executive Functioning, and Affect in Patients With Rheumatoid Arthritis

Abeare

Cohen

Axelrod³

et al. 2010

The Clinical Journal of Pain

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Objectives Rheumatoid arthritis (RA) is a chronic inflammatory disease resulting in substantial pain. The physical and emotional effects of RA are well known, but little attention has been given to the potential cognitive effects of RA pain, although intact executive functioning in patients with chronic illness is crucial for the successful completion of many daily activities. We examined the relationship between pain and executive functioning in patients with RA, and also considered the influence of positive and negative affect in the relationship between pain and executive functioning. Methods A sample of 157 adults with RA completed measures of pain and positive and negative affect and were tested for working memory and selective attention using the Letter Number Sequencing subtest from the WAIS-III and the Stroop Color Word Test tests, respectively. Results: Consistent with prior research, pain was inversely related to executive functioning, with higher pain levels associated with poorer performance on executive functioning tasks. This relationship was not moderated or mediated by negative affect; however, positive affect moderated the relationship between pain and executive functioning. For patients high in positive affect there was a significant inverse relationship between pain and executive functioning, whereas there was no such relationship for patients low in positive affect. Discussion These findings are discussed in the context of cognitive research on the effects of positive affect on executive functioning as well as functional neuroanatomical research suggesting neurocognitive mechanisms for such moderation.

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Section: Introductionsupporting

confidence: 55%

Pain, Executive Functioning, and Affect in Patients With Rheumatoid Arthritis

Abeare

Cohen

Axelrod³

et al. 2010

The Clinical Journal of Pain

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“…Finally, as precontemplation scores decreased and action and maintenance scores increased, desired outcomes such as reduced pain severity, disability, and depression, and increased goal achievement tended to improve [62]. These findings have generally been supported in subsequent research employing this measure [58,[66][67][68][69][70][71].…”

Section: Improving Adherence By Increasing Patient Knowledge Motivatmentioning

confidence: 78%

Providers' roles in enhancing patients' adherence to pain self management

Dorflinger

Kerns

Auerbach

2012

Behav. Med. Pract. Policy Res.

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Practice guidelines and empirical research related to pain management encourage clinicians to take active roles in providing education about self management and promoting adoption of a self-management approach. The purpose of the study was to review the relevant literature, summarize aspects of the patientprovider interaction that influence patient engagement in self management for chronic pain, and outline practice recommendations in this area. Review of the literature on aspects of the patient-provider interaction that promote engagement in pain self-management was used. Findings are synthesized into recommendations for providers. Patients benefit from a biopsychosocial and patient-centered approach. Patients are more likely to fully disclose when providers respond empathically, which can improve conceptualization and treatment. Patient education and motivation play important roles in engaging patients in self management. Self management is influenced in part by the patient-provider communication process. Suggestions for communication strategies to facilitate patient engagement in self-management techniques, including empathic discussion of barriers and motivation enhancement, are provided. KEYWORDSChronic pain, Self management, Doctor-patient communication, Patient-centered care, Adherence Pain is one of the most common presenting problems in medical settings [1], and the majority of pain treatment tends to be carried out in the primary care context [2]. Pain that persists beyond 3 months and that does not remit with typical treatments for acute pain, such as rest, non-steroidal anti-inflammatory drugs, and heat or ice, is considered chronic pain. It is estimated that more than 100 million Americans have chronic pain [3], and prevalence in other countries varies from about 10-50 % of the general population [4]. Not only is chronic pain a prevalent health issue but it also significantly impacts quality of life [5][6][7][8] and the costs of care, and lost productivity are estimated to total almost $635 billion each year [3].Pain guidelines have recommended selfmanagement strategies in the treatment of chronic pain [9,10]. Self management differs from other treatments such as surgery and medication in that it emphasizes the patient's own control over his/her pain experience rather than relying on external factors to treat pain symptoms. At its most rudimentary level, self management consists of basic methods such as distraction, physical activity, and ice or heat to manage pain. Many patients use these practices on their own or are able to easily implement them after receiving reassurance and encouragement from their providers. Other patients may benefit from additional self-management techniques, such as those emphasized in cognitivebehavioral treatment for chronic pain, that aim to modify the thoughts and behaviors that contribute to the maintenance and exacerbation of pain. Such self-management skills include time-based pacing, relaxation, stress management, and identifying and modifying catastrophic ...

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“…The DPM's clarification of the activation of the accommodative mode following stress thus complements the DMA. Also, Strand et al (2007) showed that high pain readiness to change (action/maintenance) interacted with low weekly positive emotion in predicting high concurrent weekly average pain reports. The authors explained these apparently surprising results in terms of active pain coping efforts reflecting personal stipulates that a lack of coherence between the various emotional and cognitive illness interpretations within the individual's belief system and also in relation to the broader psychological and social context may impede adequate illness management (Leventhal, Diefenbach, & Leventhal, 1992).…”

Section: Coping and Emotion Regulation -Context-dependence In Chronicmentioning

confidence: 96%

Dynamic pain–emotion relations in chronic pain: a theoretical review of moderation studies

Dima

Gillanders

Power

2013

Health Psychology Review

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Running head: DYNAMIC PAIN-EMOTION RELATIONS 2Current developments in chronic pain research are changing the focus in the study of pain-emotion relations from the identification of general patterns to the study of dynamic and context-related interactions manifesting both within and between individuals. This shift towards understanding variation at both intra-and interpersonal levels has significant clinical implications for psychological adjustment to chronic pain conditions, and thus represents an important topic for both clinical and health psychology. The present article reviews the existing theoretical explanations of these dynamics and their emerging empirical support, and suggests further areas of investigation. A literature search identified research on moderators of pain-emotion relations in chronic pain; existing theories were also examined from this perspective.A theoretical analysis revealed several important contributions, including the concepts of affect differentiation, generalized discrimination ability, resilience, vulnerability, coping, emotion regulation and desynchrony, which are described here together with the relevant empirical research and clinical implications. Important areas for development are the clarification of the common elements and opposing predictions and the empirical examination of mediating mechanisms. Several methodological issues are discussed. This review identifies a rich theoretical basis for research into pain-emotion moderation, and suggests that further examinations of such relationships might hold important clinical consequences. ; moderation; chronic pain; pain-affect Running head: DYNAMIC PAIN-EMOTION RELATIONS 3 In comparison to other health conditions, chronic pain is a special case, in that its main symptom, pain itself, is simultaneously a sensory and emotional experience. Keywords: pain; emotionTherefore, understanding the role of emotion in pain is central to our efforts of improving psychosocial adjustment to chronic pain. Moreover, since pain is a prevalent symptom in most health complaints, the study of pain-emotion relations can be considered a topic of strategic interest to health psychologists. However, chronic pain research and pain management interventions have focused predominantly on cognition and behaviour, and by comparison our understanding of emotion is still incipient. Although numerous studies have tackled pain-emotion relations from different perspectives, a coherent image is yet to emerge. The present review attempts to bring together various theoretical contributions in an effort to clarify one important aspect of this relationship: its dynamic quality, as shown by the increasing number of studies reporting moderating factors for pain-emotion relations. Thus, our review aims also to contribute to the current shift from solely cognitive and behavioural models towards recognising the contribution of emotion in chronic pain management.Emotion has been studied from various perspectives in chronic pain research.In the study of pain perceptio...

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Higher levels of pain readiness to change and more positive affect reduce pain reports – A weekly assessment study on arthritis patients

Cited by 45 publications

References 37 publications

Pain, Executive Functioning, and Affect in Patients With Rheumatoid Arthritis

Pain, Executive Functioning, and Affect in Patients With Rheumatoid Arthritis

Providers' roles in enhancing patients' adherence to pain self management

Dynamic pain–emotion relations in chronic pain: a theoretical review of moderation studies

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