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(502) Using a brief biofeedback treatment model for headache pain
S100
Abstracts
The Journal of Pain
for baseline pain intensity and catastrophizing, baseline perceived injustice accounted for an additional 6.7% of the variance in follow-up emotional functioning and an additional 4.8% of the variance in follow-up social functioning. These findings suggest that perceived injustice is an important cognitive-emotional factor in the pain experience of children and adolescents. Moreover, injustice perceptions appear to have prognostic value in predicting future pain-related functioning, suggesting the need to develop interventions that specifically target injustice perceptions early in the pain experience of children and adolescents.
p = .016, and Psychosocial Summary score, t (27) = -35.23, p = .003. Significant improvement in emotional and psychosocial functioning suggests short-term treatment using biofeedback to be effective in improving QOL in a pain population. Gender effects and real-world implementation challenges will be discussed (1. Varni et. al, Ambulatory Pediatrics, 2003.)
(503) Trauma exposure and pain severity among people with chronic lower back pain: moderated mediation by thought suppression and social constraints S Pegram, M Lumley, D Latsch, M Jasinski, E Schuster, and J Burns; Wayne
(501) Examining committed action in chronic pain: further validation and clinical utility of the committed action questionnaire R Bailey, K Vowles, K Witkiewitz, M Pielech, G Sowden, and J Ashworth; University of New Mexico, Albuquerque, NM
Persistent pain avoidance efforts among those suffering from chronic pain conditions can decrease quality of life and overall functioning by narrowing response options and isolating individuals from meaningful activities. Psychosocial treatments have therefore traditionally emphasized altering behavior to maximize effective functioning. Additionally, interventions have highlighted decreasing pain avoidance and increasing engagement with valued activities, a hallmark of Acceptance and Commitment Therapy (ACT). Within ACT, behavior consistent with the pursuit of a meaningful life has been termed committed action, which involves a flexible persistence over time in living according to what one values. Although committed action is considered a core process in ACT, only one study to date has examined a measure of committed action and its association with salient measures of functioning in chronic pain. The purpose of the present study was to analyze the reliability of the Committed Action Questionnaire (CAQ) in a sample of 149 chronic pain patients, confirm the factor structure of the measure, and examine the associations between CAQ scores and measures of pain-related functioning. Confirmatory factor analyses supported the two-factor solution, composed of subscales labeled Values Persistence and Effective Action. The regression analyses, which examined the direct effects of the subscales on psychosocial functioning, indicated that the CAQ subscales had significant associations with important measures of psychological functioning after accounting for appropriate covariates, such as pain intensity, engagement in valued activities, and relevant background variables. The overall findings provide additional support for the CAQ as a measure of adaptive functioning among those with chronic pain conditions.
State University, Detroit, MI
Research links lifetime frequency of traumatic events to chronic pain severity. Attempts to suppress intrusive thoughts about trauma can paradoxically result in increased rumination, distress, and, potentially, pain. Unfortunately, however, many trauma-exposed individuals experience social constraints (e.g., social reactions that minimize the person’s problems or discourage expression), which might result in thought and emotion suppression and increased distress and pain. We examined these cognitive and social mechanisms through which trauma exposure can affect pain severity. Data were obtained for 292 adults with chronic lower back pain recruited from Detroit and Chicago (55% female, Mage = 47.24 years; 62% African American, 34% Caucasian, 4% other). Patients completed self-report measures of lifetime frequency of traumatic events (Life Stressor Checklist-Revised), thought suppression (White Bear Suppression Inventory), social constraints (General Social Constraints Scale), and pain severity (Multidimensional Pain Inventory). Consistent with hypotheses, results from moderated-mediation conditional process analysis indicated that trauma exposure predicted suppression of intrusive thoughts (b = 0.59, t = 3.70, p < .001), which then predicted pain severity (b = 0.04, t = 2.07, p = .04). Moreover, experiencing social constraints exacerbated the effect of thought suppression on pain severity (b = 0.05, t = 2.43, p = .02). The conditional indirect effect of trauma exposure on pain severity through thought suppression was consistently positive, but was stronger with relatively high social constraints (95% bias-corrected CI excluded zero). We conclude that modulating intrusive thoughts is one mechanism through which trauma exposure contributes to chronic pain. Further, the combination of high social constraints against disclosing one’s trauma and suppressing one’s thoughts can be particularly deleterious for pain. These findings suggest that chronic low back pain might be reduced by providing social environments that support the expression of trauma-related thoughts and feelings. Funding: NIH R01 AR057047.
(502) Using a brief biofeedback treatment model for headache pain
(504) Rates of physical activity and perceived social support among young adult women with juvenile-onset fibromyalgia
L Garbacz and C Butz; Nationwide Children’s Hospital, Columbus, OH
K Suorsa, A Lynch-Jordan, S Tran, N Edwards, and S Kashikar-Zuck;
Headaches in children and adolescents are common, with weekly prevalence rates estimated at 6-31%. Children with headaches tend to have lower quality of life (QOL) scores than healthy controls. Biofeedback has been suggested as an effective treatment modality to improve symptoms for patients with headaches. The current study’s objective was to examine whether a short-term, four to five session biofeedback treatment model can improve the functioning for pediatric patients with headaches. Fifty-seven patients, ages 7-17, were referred for treatment of headache pain. Thirtyfour patients (82% female) completed treatment (M = 4.73 sessions). There were more boys in the non-completer group (58% female). The PedsQL 4.0 was completed by parents at baseline and at the fourth session for 28 completers. The PedsQL includes four subscales: Physical, Emotional, Social, and School; the latter three comprise the Psychosocial Summary score. Score changes $ 4 points represent clinically meaningful change in QOL.1 Questionnaire data was incomplete for six completers. Baseline scores and age differences were non-significant between completers and non-completers. However, boys were significantly more likely to drop out of treatment than girls. Among completers, overall parent ratings demonstrated a change of $ 4 points for the Total score (M D = 5.29) and Psychosocial Summary (M D= 8.82). Physical scores showed minimal change (M D= 1.82). 71% of completers showed clinically significant change in emotional functioning, and 57% improved $ 4 points in school and social functioning. T-tests with a Bonferroni adjustment indicated statistically significant change for the Total, t (27) = -2.57,
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
The social-ecological theory of physical activity (PA) suggests environmental factors, such as social support (SS), influence participation in PA. Within the general population, SS has been identified as the most important predictor of engaging in PA. Improving PA participation in fibromyalgia patients can be challenging and understanding the relationship between SS and PA in this population may provide useful information to improve current approaches to treatment. The purpose of this cross-sectional study was to assess how SS relates to PA for young adults previously diagnosed with fibromyalgia in adolescence. Participants were women (N=89; Mage=21.69; SD=1.99) completing a longitudinal study on juvenile-onset fibromyalgia. Participants completed the International Physical Activity Questionnaire (IPAQ), Social Network Index (SNI), and MOS Social Support Scale (MOS) as part of a larger battery of questionnaires. Analysis of variance (ANOVA) revealed significant differences in the number of individuals in one’s High Contact Social Network on the SNI based on low-, medium-, or high-activity classification, F(2,86)=4.17, p<.05. Those in the high activity group had significantly more individuals with whom they maintained frequent contact (M=5.54; SD=1.50) than those in the low-activity group (M=4.23; SD=2.11). An additional ANOVA revealed significant group differences between IPAQ groups on positive social interactions (MOS), F (2,50.03) =3.46, p<.05, such that those in the medium-activity group had significantly higher scores (M=3.67; SD=.59) than those in the low-activity group (M=3.05; SD=1.14). Results suggest
Abstracts
The Journal of Pain
for baseline pain intensity and catastrophizing, baseline perceived injustice accounted for an additional 6.7% of the variance in follow-up emotional functioning and an additional 4.8% of the variance in follow-up social functioning. These findings suggest that perceived injustice is an important cognitive-emotional factor in the pain experience of children and adolescents. Moreover, injustice perceptions appear to have prognostic value in predicting future pain-related functioning, suggesting the need to develop interventions that specifically target injustice perceptions early in the pain experience of children and adolescents.
p = .016, and Psychosocial Summary score, t (27) = -35.23, p = .003. Significant improvement in emotional and psychosocial functioning suggests short-term treatment using biofeedback to be effective in improving QOL in a pain population. Gender effects and real-world implementation challenges will be discussed (1. Varni et. al, Ambulatory Pediatrics, 2003.)
(503) Trauma exposure and pain severity among people with chronic lower back pain: moderated mediation by thought suppression and social constraints S Pegram, M Lumley, D Latsch, M Jasinski, E Schuster, and J Burns; Wayne
(501) Examining committed action in chronic pain: further validation and clinical utility of the committed action questionnaire R Bailey, K Vowles, K Witkiewitz, M Pielech, G Sowden, and J Ashworth; University of New Mexico, Albuquerque, NM
Persistent pain avoidance efforts among those suffering from chronic pain conditions can decrease quality of life and overall functioning by narrowing response options and isolating individuals from meaningful activities. Psychosocial treatments have therefore traditionally emphasized altering behavior to maximize effective functioning. Additionally, interventions have highlighted decreasing pain avoidance and increasing engagement with valued activities, a hallmark of Acceptance and Commitment Therapy (ACT). Within ACT, behavior consistent with the pursuit of a meaningful life has been termed committed action, which involves a flexible persistence over time in living according to what one values. Although committed action is considered a core process in ACT, only one study to date has examined a measure of committed action and its association with salient measures of functioning in chronic pain. The purpose of the present study was to analyze the reliability of the Committed Action Questionnaire (CAQ) in a sample of 149 chronic pain patients, confirm the factor structure of the measure, and examine the associations between CAQ scores and measures of pain-related functioning. Confirmatory factor analyses supported the two-factor solution, composed of subscales labeled Values Persistence and Effective Action. The regression analyses, which examined the direct effects of the subscales on psychosocial functioning, indicated that the CAQ subscales had significant associations with important measures of psychological functioning after accounting for appropriate covariates, such as pain intensity, engagement in valued activities, and relevant background variables. The overall findings provide additional support for the CAQ as a measure of adaptive functioning among those with chronic pain conditions.
State University, Detroit, MI
Research links lifetime frequency of traumatic events to chronic pain severity. Attempts to suppress intrusive thoughts about trauma can paradoxically result in increased rumination, distress, and, potentially, pain. Unfortunately, however, many trauma-exposed individuals experience social constraints (e.g., social reactions that minimize the person’s problems or discourage expression), which might result in thought and emotion suppression and increased distress and pain. We examined these cognitive and social mechanisms through which trauma exposure can affect pain severity. Data were obtained for 292 adults with chronic lower back pain recruited from Detroit and Chicago (55% female, Mage = 47.24 years; 62% African American, 34% Caucasian, 4% other). Patients completed self-report measures of lifetime frequency of traumatic events (Life Stressor Checklist-Revised), thought suppression (White Bear Suppression Inventory), social constraints (General Social Constraints Scale), and pain severity (Multidimensional Pain Inventory). Consistent with hypotheses, results from moderated-mediation conditional process analysis indicated that trauma exposure predicted suppression of intrusive thoughts (b = 0.59, t = 3.70, p < .001), which then predicted pain severity (b = 0.04, t = 2.07, p = .04). Moreover, experiencing social constraints exacerbated the effect of thought suppression on pain severity (b = 0.05, t = 2.43, p = .02). The conditional indirect effect of trauma exposure on pain severity through thought suppression was consistently positive, but was stronger with relatively high social constraints (95% bias-corrected CI excluded zero). We conclude that modulating intrusive thoughts is one mechanism through which trauma exposure contributes to chronic pain. Further, the combination of high social constraints against disclosing one’s trauma and suppressing one’s thoughts can be particularly deleterious for pain. These findings suggest that chronic low back pain might be reduced by providing social environments that support the expression of trauma-related thoughts and feelings. Funding: NIH R01 AR057047.
(502) Using a brief biofeedback treatment model for headache pain
(504) Rates of physical activity and perceived social support among young adult women with juvenile-onset fibromyalgia
L Garbacz and C Butz; Nationwide Children’s Hospital, Columbus, OH
K Suorsa, A Lynch-Jordan, S Tran, N Edwards, and S Kashikar-Zuck;
Headaches in children and adolescents are common, with weekly prevalence rates estimated at 6-31%. Children with headaches tend to have lower quality of life (QOL) scores than healthy controls. Biofeedback has been suggested as an effective treatment modality to improve symptoms for patients with headaches. The current study’s objective was to examine whether a short-term, four to five session biofeedback treatment model can improve the functioning for pediatric patients with headaches. Fifty-seven patients, ages 7-17, were referred for treatment of headache pain. Thirtyfour patients (82% female) completed treatment (M = 4.73 sessions). There were more boys in the non-completer group (58% female). The PedsQL 4.0 was completed by parents at baseline and at the fourth session for 28 completers. The PedsQL includes four subscales: Physical, Emotional, Social, and School; the latter three comprise the Psychosocial Summary score. Score changes $ 4 points represent clinically meaningful change in QOL.1 Questionnaire data was incomplete for six completers. Baseline scores and age differences were non-significant between completers and non-completers. However, boys were significantly more likely to drop out of treatment than girls. Among completers, overall parent ratings demonstrated a change of $ 4 points for the Total score (M D = 5.29) and Psychosocial Summary (M D= 8.82). Physical scores showed minimal change (M D= 1.82). 71% of completers showed clinically significant change in emotional functioning, and 57% improved $ 4 points in school and social functioning. T-tests with a Bonferroni adjustment indicated statistically significant change for the Total, t (27) = -2.57,
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
The social-ecological theory of physical activity (PA) suggests environmental factors, such as social support (SS), influence participation in PA. Within the general population, SS has been identified as the most important predictor of engaging in PA. Improving PA participation in fibromyalgia patients can be challenging and understanding the relationship between SS and PA in this population may provide useful information to improve current approaches to treatment. The purpose of this cross-sectional study was to assess how SS relates to PA for young adults previously diagnosed with fibromyalgia in adolescence. Participants were women (N=89; Mage=21.69; SD=1.99) completing a longitudinal study on juvenile-onset fibromyalgia. Participants completed the International Physical Activity Questionnaire (IPAQ), Social Network Index (SNI), and MOS Social Support Scale (MOS) as part of a larger battery of questionnaires. Analysis of variance (ANOVA) revealed significant differences in the number of individuals in one’s High Contact Social Network on the SNI based on low-, medium-, or high-activity classification, F(2,86)=4.17, p<.05. Those in the high activity group had significantly more individuals with whom they maintained frequent contact (M=5.54; SD=1.50) than those in the low-activity group (M=4.23; SD=2.11). An additional ANOVA revealed significant group differences between IPAQ groups on positive social interactions (MOS), F (2,50.03) =3.46, p<.05, such that those in the medium-activity group had significantly higher scores (M=3.67; SD=.59) than those in the low-activity group (M=3.05; SD=1.14). Results suggest