Mindfulness, physical impairment and psychological well-being in people with amyotrophic lateral sclerosis

Pagnini, Francesco; Phillips, Deborah; Bosma, Colin M.; Reece, Andrew; Langer, Ellen J.

doi:10.1080/08870446.2014.982652

Cited by 46 publications

(44 citation statements)

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“…It has been noted that psychological approaches to symptom management in ALS are under-explored and under-utilized. Mindfulness has been shown to impact QoL and psychological well-being but other psychologically-based studies are rare (28,29). The results of our study point to the importance of acknowledging the role of selfefficacy in the pain experience.…”

Section: Discussionmentioning

confidence: 50%

The role of mental health and self-efficacy in the pain experience of patients with amyotrophic lateral sclerosis

Stephens

Lehman

Raheja

et al. 2016

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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Complex interactions between pain, depression, and anxiety impact quality of life in patients with ALS. Psychological approaches to pain control may be useful. This study explored the role of self-efficacy in mitigating pain. Individuals registered with the Agency for Toxic Substances and Disease Registry National ALS Registry and who experienced pain were invited to participate in an online survey. Subjects completed the Brief Pain Inventory-Short Form, Hospital Anxiety and Depression Scale, and Chronic Pain Self-Efficacy Scale. Correlations between variables were determined. Multiple linear regression models assessed relationships between depression, anxiety and self-efficacy predictions, and pain severity, interference, and relief. Results recorded that there were 197 participants (58% males, mean age 59 AE 10 years). Cases or borderline cases of depression or anxiety were common. Mean levels of pain were moderate. Higher pain self-efficacy scores predicted lower pain severity, lower pain interference, and higher pain relief with treatment. As depression scores increased, pain interference with daily life was higher. In conclusion, anxiety and depression are common in patients with ALS and pain. Self-efficacy appears to mitigate pain. A multifactorial approach to pain management should be considered in these patients, addressing mental health and self-efficacy to augment pharmacologic pain treatments.

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Section: Discussionmentioning

confidence: 50%

The role of mental health and self-efficacy in the pain experience of patients with amyotrophic lateral sclerosis

Stephens

Lehman

Raheja

et al. 2016

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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“…Finally, given that PF includes processes implicit in other therapeutic modalities, such as mindfulness-based approaches (Pagnini, Phillips, Bosma, Reece, & Langer, 2015), the results infer that investigation of mindfulness processes may also be warranted.…”

Section: Limitations and Suggestions For Future Researchmentioning

confidence: 91%

The influence of psychological flexibility on life satisfaction and mood in muscle disorders.

Graham¹,

Gouick²,

Ferreira³

et al. 2016

Rehabilitation Psychology

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Impact and Implications-Psychological interventions offer a potential way to improve outcomes in MDs, which are progressive and mostly without disease modifying treatment. Yet, a dearth of a research using longitudinal designs means that we are unsure which psychological variables represent viable treatment targets in this context.-In line with the theoretical assumptions implicit in Acceptance and Commitment Therapy (ACT), this study suggests that psychological flexibility is a distinct process, which influences life satisfaction and anxiety in muscle disorders. Results: A sample of 137 people with a range of muscle disorders participated. In crosssectional analyses, psychological flexibility explained significant unique variance in addition to illness perceptions ( R 2 = 0.17-0.34, p = <.001). In prospective analyses, psychological flexibility alone was predictive of change in life satisfaction ( R 2 = 0.04, p = .01) and anxiety ( R 2 = 0.03 p = .04) over four months. No independent variables were predictive of change in depression over four months, and disability level had no significant influence on outcomes.Conclusions: Psychological flexibility influences important outcomes in muscle disorders.Experimental studies are required to establish if increased psychological flexibility leads to improved outcomes.

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“…Several studies suggest, conversely, that ALS patients' QoL is independent of physical impairment (Simmons et al, 2000; Palmieri et al, 2010b; Pagnini, 2013), a phenomenon known as “disability paradox” (Carr and Higginson, 2001), although this relationship is still unclear and motor disability or ALS physical consequences are likely to play a crucial role in determining QoL (Ganzini et al, 1999; Lo Coco et al, 2005). QoL has also been negatively associated to psychological variables such as suffering, sense of burden and hopelessness and positively related mainly to spirituality (McLeod and Clarke, 2007; Pagnini et al, 2011), caregiver relations (Chiò et al, 2004), and mindful attitude (i.e., not evaluating a situation or a context only through previous categorizations, but actively making new distinctions by assuming multiple viewpoints and perspectives; Pagnini et al, 2014a). Fegg et al (2005) and Roach et al (2009), highlight a usually undervalued viewpoint, i.e., personality and personal attitudes strongly modulate and shape in a unique manner the possible reactions to ALS.…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, Johnston et al (1999) and Krampe et al (2008) found that mood and personality traits can strongly influence the survival rate of ALS patients. Recently, Pagnini et al (2014a) showed on a large sample of people with ALS that a mindful attitude attenuates the ALS progression.…”

Section: Introductionmentioning

confidence: 99%

“…As a first hypothesis, in line with previous data (Palmieri et al, 2013), we expected positive changes on patients' anxiety, depression, and QoL and that these changes, as measured after the psychodynamic hypnosis-based intervention, would keep stable after 3 and 6 months. Secondly, on the basis of previous results linking psychological well-being and disease progression (McDonald et al, 1994; Johnston et al, 1999; Krampe et al, 2008; Pagnini et al, 2014a), we investigated the possibility of a positive physical effect on disease progression in the treatment group in comparison to the control group. Thirdly, we further hypothesized that these effects of the treatment on patients would also have, as well, an indirect beneficial impact on caregivers' anxiety and depression levels.…”

Section: Introductionmentioning

confidence: 99%

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Hypnosis-based psychodynamic treatment in ALS: a longitudinal study on patients and their caregivers

et al. 2015

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Background: Evidence of psychological treatment efficacy is strongly needed in ALS, particularly regarding long-term effects.Methods: Fifteen patients participated in a hypnosis treatment and self-hypnosis training protocol after an in-depth psychological and neurological evaluation. Patients' primary caregivers and 15 one-by-one matched control patients were considered in the study. Measurements of anxiety, depression and quality of life (QoL) were collected at the baseline, post-treatment, and after 3 and 6 months from the intervention. Bayesian linear mixed-models were used to evaluate the impact of treatment and defense style on patients' anxiety, depression, QoL, and functional impairment (ALSFRS-r), as well as on caregivers' anxiety and depression.Results: The statistical analyses revealed an improvement in psychological variables' scores immediately after the treatment. Amelioration in patients' and caregivers' anxiety as well as caregivers' depression, were found to persist at 3 and 6 months follow-ups. The observed massive use of primitive defense mechanisms was found to have a reliable and constant buffer effect on psychopathological symptoms in both patients and caregivers. Notably, treated patients decline in ALSFRS-r score was observed to be slower than that of control group's patients.Discussion: Our brief psychodynamic hypnosis-based treatment showed efficacy both at psychological and physical levels in patients with ALS, and was indirectly associated to long-lasting benefits in caregivers. The implications of peculiar psychodynamic factors and mind-body techniques are discussed. Future directions should be oriented toward a convergence of our results and further psychological interventions, in order to delineate clinical best practices for ALS.

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Mindfulness, physical impairment and psychological well-being in people with amyotrophic lateral sclerosis

Abstract: The available data indicate that a psychological construct - mindfulness - can attenuate the progress of a disease that is believed to be almost solely biologically driven. The potential implications of these results extend well beyond ALS.

Cited by 46 publications

References 48 publications

The role of mental health and self-efficacy in the pain experience of patients with amyotrophic lateral sclerosis

The role of mental health and self-efficacy in the pain experience of patients with amyotrophic lateral sclerosis

The influence of psychological flexibility on life satisfaction and mood in muscle disorders.

Hypnosis-based psychodynamic treatment in ALS: a longitudinal study on patients and their caregivers

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