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(512) The positive effects of relationship quality and interaction on acute pain following a threat manipulation
S104
The Journal of Pain
Abstracts
(512) The positive effects of relationship quality and interaction on acute pain following a threat manipulation
(514) The relative utility of pacing and committed action for predicting adjustment to chronic pain
A Corley, A Cano, L Goubert, J Vlaeyen, and L Wurm; Wayne State University, Detroit, MI
Y Park, D Kim, and S Cho; Chungnam National University, Daejeon, Republic of Korea
Prior research has shown the importance of threat and social factors in predicting pain adjustment. However, few studies have examined the influence of threat within the social context. The present study investigated the effects of perceived threat on romantic partners and pain adjustment. Participants were 134 undergraduate students and their romantic partners. One individual in each couple, referred to as the participant, was randomly assigned to undergo the cold pressor task. Additionally, couples were randomly assigned to view individuals engaging in the cold pressor task with a great deal of pain behavior (High Threat condition) or no or minimal pain behaviors (Low Threat condition). It was expected that both participants and partners would experience heightened perceived threat following exposure to the High Threat condition, in contrast to the Low Threat condition. It was also expected that threat condition and relationship quality variables would predict participants’ pain severity across the course of the task. After accounting for baseline perceived threat, both participants and partners in the high threat condition reported greater perceived threat compared to those in the low threat condition. Multilevel modeling analyses showed that the discussion with one’s partner immediately before the cold pressor task predicted pain severity during the task, even when accounting for baseline satisfaction with one’s relationship. Specifically, a higher quality interaction was associated with less pain throughout the task, as well as a more gradual increase in pain scores early in the task. These findings have treatment implications for individuals about to undergo an acute pain experience, such as a painful medical procedure.
Pacing is defined as doing a work by diving it into pieces, or slowly or with taking breaks and controlling the pace. Pacing has not shown a consistently positive impact on adjustment to chronic pain. Recently, a psychological flexibility model of acceptance and commitment therapy was proposed as theoretical framework for supplementing such variations. Among the elements of the model, committed action indicates acting flexibly and continuing or stopping the action according to the person’s value or goal. This study aimed to examine the relative utility of committed action in comparison with pacing in predicting adjustment to chronic pain. The participants of this study were 129 patients with chronic pain who visited the Department of Anesthesiology of a university hospital in Suwon, Korea. Results indicated that no significant correlation is found between pacing and all of the outcome variables. On the other hand, committed action showed a negative correlation with depression (r = -.35, p < .001) and anxiety (r = -.31, p < .01) and a positive correlation with physical function (r = .30, p < .01) and psychosocial function (r = .34, p < .001), but not with pain intensity. In the results of hierarchical regression analysis, committed action added a significant increment of explained variance to the prediction of depression (DR2 = .09, p < .01), anxiety (DR2 = .05, p < .01), physical function (DR2 = .06, p < .01), and psychosocial function (DR2 = .07, p < .01), but not pain intensity. Also in the final step, the regression coefficients for committed action were significant in all of the equation, but not the equation for pain intensity. The findings of this study suggest that committed action based on value and goal is relatively more useful than pacing in predicting adjustment to chronic pain.
(513) Does ethnicity associate with distraction analgesia effect in response to Capsaicin?
(515) A cross-sectional survey of pain-related experiences and knowledge in emerging adults
C Odonkor, M Pejsa, M Hand, S Wegener, D Tompkins, E Burton, M Smith, and C Campbell; The Johns Hopkins University, Baltimore, MD Distraction as a form of analgesia continues to gain attention as a plausible mechanism for pain modulation. Recent reports highlight possible individual differences in pain sensitivity, tolerance and coping strategies. However, few studies have examined differences in pain modulation by distraction analgesia. The present study investigated differences within and between ethnic groups with respect to distraction analgesia in response to noxious stimuli (capsaicin). Forty healthy volunteers participated in the study involving measuring response to noxious stimuli (capsaicin application), either in isolation or along with a cognitive distraction task (video games) in two separate sessions. Distraction analgesia was computed by subtracting normalized visual analog scale (VAS)-pain ratings obtained in the pain alone session vs. cognitive distraction condition (video games). Mixed model and repeated measures ANOVA showed an adjusted main effect of duration of exposure (F (1, 27) = 18.4 at P = 0.0003) with distraction analgesia. Intra-class correlation analysis showed that 40% and 60% of the total variance in distraction analgesia-effect could be explained by between and within individual differences, respectively. Between and within ethnic-group differences accounted for 9.5% and 90.5% of the total variance in analgesic effect, respectively. The distraction analgesia effect was not significantly different between African Americans and Caucasians (p=0.22). The results suggest that individual rather than group differences may be more significant in pain modulation by distraction analgesia. These findings support data suggesting that within group differences are larger than between group differences. In contrast to prior reports, which indicate that differences in central pain inhibitory mechanisms may contribute to ethnic differences in pain threshold and tolerance, the present study did not find ethnic differences in distraction analgesia. Exploring these mechanisms may shed further light on pain modulation.
Smith, J Eyer, and B Thorn; The University of Alabama, Tuscaloosa, AL Chronic pain is a common phenomenon in the U.S., known to occur across the lifespan (Institute of Medicine, 2011). Much remains to be learned, however, about the distribution of pain conditions in emerging adults or the knowledge that they have about pain. Greater knowledge about pain and its management can be effective for improving pain outcomes, even among at-risk individuals (Thorn et al., 2011). To improve this knowledge, we surveyed 200 emerging adults at a large public university in the geographic south about their chronic pain conditions (if present) and knowledge about pain and its management. Participants completed surveys online in exchange for course credit. Measures included a new computer-administered pain interview and two new pain measures, the Pain Knowledge Questionnaire (PKQ) and the Pain Skills Questionnaire (PSQ). The PKQ is a 23-item measure that investigates how much a person knows about the causes and treatments for chronic pain conditions, and the PSQ is a 10-item measure that assesses how often a person uses a variety of skills to manage pain when they experience it. Demographic results indicate that the sample approximated the general student population. The average participant was a white underclasswoman. A range of pain conditions were reported. Analyses indicate that participants demonstrate basic pain knowledge, but are often lacking in important facts associated with better pain outcomes. This knowledge also varies based on participant characteristics, such as the presence or absence of a pain condition. This study provides valuable information about the distribution of chronic pain conditions in a group of emerging adults and their knowledge about pain and pain management. It provides evidence for the lack of core pain information existing in the general student population, even among individuals with chronic pain conditions, and supports the need for greater pain education.
The Journal of Pain
Abstracts
(512) The positive effects of relationship quality and interaction on acute pain following a threat manipulation
(514) The relative utility of pacing and committed action for predicting adjustment to chronic pain
A Corley, A Cano, L Goubert, J Vlaeyen, and L Wurm; Wayne State University, Detroit, MI
Y Park, D Kim, and S Cho; Chungnam National University, Daejeon, Republic of Korea
Prior research has shown the importance of threat and social factors in predicting pain adjustment. However, few studies have examined the influence of threat within the social context. The present study investigated the effects of perceived threat on romantic partners and pain adjustment. Participants were 134 undergraduate students and their romantic partners. One individual in each couple, referred to as the participant, was randomly assigned to undergo the cold pressor task. Additionally, couples were randomly assigned to view individuals engaging in the cold pressor task with a great deal of pain behavior (High Threat condition) or no or minimal pain behaviors (Low Threat condition). It was expected that both participants and partners would experience heightened perceived threat following exposure to the High Threat condition, in contrast to the Low Threat condition. It was also expected that threat condition and relationship quality variables would predict participants’ pain severity across the course of the task. After accounting for baseline perceived threat, both participants and partners in the high threat condition reported greater perceived threat compared to those in the low threat condition. Multilevel modeling analyses showed that the discussion with one’s partner immediately before the cold pressor task predicted pain severity during the task, even when accounting for baseline satisfaction with one’s relationship. Specifically, a higher quality interaction was associated with less pain throughout the task, as well as a more gradual increase in pain scores early in the task. These findings have treatment implications for individuals about to undergo an acute pain experience, such as a painful medical procedure.
Pacing is defined as doing a work by diving it into pieces, or slowly or with taking breaks and controlling the pace. Pacing has not shown a consistently positive impact on adjustment to chronic pain. Recently, a psychological flexibility model of acceptance and commitment therapy was proposed as theoretical framework for supplementing such variations. Among the elements of the model, committed action indicates acting flexibly and continuing or stopping the action according to the person’s value or goal. This study aimed to examine the relative utility of committed action in comparison with pacing in predicting adjustment to chronic pain. The participants of this study were 129 patients with chronic pain who visited the Department of Anesthesiology of a university hospital in Suwon, Korea. Results indicated that no significant correlation is found between pacing and all of the outcome variables. On the other hand, committed action showed a negative correlation with depression (r = -.35, p < .001) and anxiety (r = -.31, p < .01) and a positive correlation with physical function (r = .30, p < .01) and psychosocial function (r = .34, p < .001), but not with pain intensity. In the results of hierarchical regression analysis, committed action added a significant increment of explained variance to the prediction of depression (DR2 = .09, p < .01), anxiety (DR2 = .05, p < .01), physical function (DR2 = .06, p < .01), and psychosocial function (DR2 = .07, p < .01), but not pain intensity. Also in the final step, the regression coefficients for committed action were significant in all of the equation, but not the equation for pain intensity. The findings of this study suggest that committed action based on value and goal is relatively more useful than pacing in predicting adjustment to chronic pain.
(513) Does ethnicity associate with distraction analgesia effect in response to Capsaicin?
(515) A cross-sectional survey of pain-related experiences and knowledge in emerging adults
C Odonkor, M Pejsa, M Hand, S Wegener, D Tompkins, E Burton, M Smith, and C Campbell; The Johns Hopkins University, Baltimore, MD Distraction as a form of analgesia continues to gain attention as a plausible mechanism for pain modulation. Recent reports highlight possible individual differences in pain sensitivity, tolerance and coping strategies. However, few studies have examined differences in pain modulation by distraction analgesia. The present study investigated differences within and between ethnic groups with respect to distraction analgesia in response to noxious stimuli (capsaicin). Forty healthy volunteers participated in the study involving measuring response to noxious stimuli (capsaicin application), either in isolation or along with a cognitive distraction task (video games) in two separate sessions. Distraction analgesia was computed by subtracting normalized visual analog scale (VAS)-pain ratings obtained in the pain alone session vs. cognitive distraction condition (video games). Mixed model and repeated measures ANOVA showed an adjusted main effect of duration of exposure (F (1, 27) = 18.4 at P = 0.0003) with distraction analgesia. Intra-class correlation analysis showed that 40% and 60% of the total variance in distraction analgesia-effect could be explained by between and within individual differences, respectively. Between and within ethnic-group differences accounted for 9.5% and 90.5% of the total variance in analgesic effect, respectively. The distraction analgesia effect was not significantly different between African Americans and Caucasians (p=0.22). The results suggest that individual rather than group differences may be more significant in pain modulation by distraction analgesia. These findings support data suggesting that within group differences are larger than between group differences. In contrast to prior reports, which indicate that differences in central pain inhibitory mechanisms may contribute to ethnic differences in pain threshold and tolerance, the present study did not find ethnic differences in distraction analgesia. Exploring these mechanisms may shed further light on pain modulation.
Smith, J Eyer, and B Thorn; The University of Alabama, Tuscaloosa, AL Chronic pain is a common phenomenon in the U.S., known to occur across the lifespan (Institute of Medicine, 2011). Much remains to be learned, however, about the distribution of pain conditions in emerging adults or the knowledge that they have about pain. Greater knowledge about pain and its management can be effective for improving pain outcomes, even among at-risk individuals (Thorn et al., 2011). To improve this knowledge, we surveyed 200 emerging adults at a large public university in the geographic south about their chronic pain conditions (if present) and knowledge about pain and its management. Participants completed surveys online in exchange for course credit. Measures included a new computer-administered pain interview and two new pain measures, the Pain Knowledge Questionnaire (PKQ) and the Pain Skills Questionnaire (PSQ). The PKQ is a 23-item measure that investigates how much a person knows about the causes and treatments for chronic pain conditions, and the PSQ is a 10-item measure that assesses how often a person uses a variety of skills to manage pain when they experience it. Demographic results indicate that the sample approximated the general student population. The average participant was a white underclasswoman. A range of pain conditions were reported. Analyses indicate that participants demonstrate basic pain knowledge, but are often lacking in important facts associated with better pain outcomes. This knowledge also varies based on participant characteristics, such as the presence or absence of a pain condition. This study provides valuable information about the distribution of chronic pain conditions in a group of emerging adults and their knowledge about pain and pain management. It provides evidence for the lack of core pain information existing in the general student population, even among individuals with chronic pain conditions, and supports the need for greater pain education.