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SUPER scale to the rescue: reconciling what parents say and what they communicate during their child’s pain.

Fully illuminating mechanisms relating parent behaviors to child pain require examining both verbal and nonverbal communication. We conducted a multimethod investigation into parent nonverbal communication and physiology, and investigated the psychometric properties of the Scheme for Understanding Parent Emotive Responses Scale to assess parent nonverbals accompanying reassurance and distraction. 23 children (7-12 years) completed the cold pressor task with their parent (predominately mothers). Parent heart rate and heart rate variability were monitored and assessed. The Scheme for Understanding Parent Emotive Responses Scale coding of parent nonverbal behaviors (i.e., vocal cues, facial expressions, posture) was used to detect levels of fear, warmth, disengagement and humor. : Preliminary evidence for the psychometric properties of the scale are offered. Parent reassurance was associated with more fear, less warmth and less humor compared with distraction.

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Alcohol use problems and opioid misuse and dependence among adults with chronic pain: The role of distress tolerance.

Alcohol use has been associated with opioid misuse and dependence among adults with chronic pain. Yet, mechanisms underlying the relation between alcohol use problems and opioid misuse and dependence have yet to be fully explored among this population. Distress tolerance, reflecting the perceived ability to withstand negative emotional states, has demonstrated independent associations with alcohol use problems and opioid misuse, but these associations have not been explored among persons with chronic pain. The present study examined the moderating role of distress tolerance in terms of the association between alcohol use problems with opioid misuse and severity of opioid dependence. Participants included 424 adults (74.1% female; = 38.3, = 11.1) reporting current chronic pain and opioid medication use. Results indicated that alcohol use problems were significantly associated with current opioid misuse ( = 0.54, < .001) and severity of opioid dependence ( = 0.08, = .002) only for those with lower distress tolerance. These findings suggest that among individuals with chronic pain, the association between alcohol use problems and opioid misuse as well as opioid dependence severity is amplified among those with lower perceived distress tolerance. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

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Pain: Integration of Sensory and Affective Aspects of Pain.

Painful stimuli are detected by peripheral nociceptors, and the brain processes this nociceptive input into an unpleasant sensation. A new study identifies a brain circuit that integrates sensory and affective aspects of inflammatory and neuropathic pain.

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Prevalence and sites of pain in remote-living older Aboriginal Australians, and associations with depressive symptoms and disability.

Pain is a growing public health problem associated with significant health and functional implications. Limited data exist for Aboriginal Australians.

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Readiness to Change Among Adolescents with Chronic Pain and Their Parents: Is the German Version of the Pain Stages of Change Questionnaire a Useful Tool?

The Pain Stages of Change Questionnaire (PSOCQ) measures patients' willingness to engage in active self-management of their pain. The present study aimed to create validated German short versions of the PSOCQ for adolescents (PSOCQ-A) and their parents (PSOCQ-P). Additionally, an investigation of stages of change regarding pain characteristics and treatment outcomes was undertaken. In Study 1, the data of adolescents aged 11 to 18 years and their parents were collected prior to intake ( = 501) and at admission ( = 240) to specialist inpatient pain treatment. Confirmatory factor analyses indicated a poor fit of the full PSOCQ measures prior to intake, but an acceptable fit at admission. Short PSOCQ-A and PSOCQ-P versions were identified. In Study 2, these results were cross-validated with data from an additional = 150 patients and their parents, collected during and 3 months after interdisciplinary inpatient pain treatment. Model fits for both short versions were acceptable, although low internal consistency for the PSOCQ-A Precontemplation and Contemplation subscales was identified. During treatment, both patients' and their parents' readiness to change increased. Stage of change at discharge did not predict treatment non-response 3 months later. This study indicates that the PSOCQ is neither meaningful prior to admission nor predictive of non-response to treatment. While some value may exist in monitoring treatment progress, based on the results of this study, it is not recommended that the PSOCQ-A and PSOCQ-P be used as a measure of stage of change in German pediatric pain populations.

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Effects of Biopsychosocial Education on the Clinical Judgments of Medical Students and GP Trainees Regarding Future Risk of Disability in Chronic Lower Back Pain: A Randomized Control Trial.

Chronic lower back pain (CLBP) is a major health care burden and often results in workplace absenteeism. It is a priority for appropriate management of CLBP to get individuals back to work as early as possible. Interventions informed by the flags approach, which integrates cognitive and behavioral approaches via identification of biopsychosocial barriers to recovery, have resulted in reduced pain-related work absences and increased return to work for individuals with CLBP. However, research indicates that physicians' adherence to biopsychosocial guidelines is low.

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Characterizing and Understanding the Low Back Pain Experience Among Persons with Lower Limb Loss.

This study preliminarily characterizes and compares the impact of lower limb loss and development of chronic low back pain (cLBP) on psychosocial factors, as well as the relationship between these factors and low back pain-related functional disability.

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Caregiver-Child Discrepancies in Reports of Child Emotional Symptoms in Pediatric Chronic Pain.

Pediatric chronic pain evaluation includes self-reports and/or caregiver proxy-reports across biopsychosocial domains. Limited data exist on the effects of caregiver-child discrepancies in pediatric pain assessment. In children with chronic pain, we examined associations among discrepancies in caregiver-child reports of child anxiety and depressive symptoms and child functional impairment.

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Blunted Pain Modulation Response to Induced Stress in Women with Fibromyalgia with and without Posttraumatic Stress Disorder Comorbidity: New Evidence of Hypo-Reactivity to Stress in Fibromyalgia?

There is evidence regarding the presence of alterations in both the stress response and the endogenous pain modulation systems of people with fibromyalgia (FM). However, research on pain modulation under induced stress on FM patients is scarce and contradictory. The present study analyzes stress-induced changes in pain and intolerance thresholds among FM patients, examining the possible existence of differences linked to PTSD comorbidity and gaining insights into the role of cardiovascular reactivity. Eighteen women diagnosed with FM and comorbid PTSD (FM + PTSD), 18 women diagnosed with FM and no PTSD (FM-PTSD), and 38 healthy women (HC) were exposed to the Social Stress Test task. Pressure pain thresholds and intolerance thresholds were measured before and during stress induction, and after a recovery period, while systolic blood pressure and heart rate were simultaneously recorded. Overall, while pain thresholds decreased during stress and recovery for HC, no significant changes were observed for women with FM. The intolerance threshold decreased for HC during stress, but was maintained at basal level during recovery. FM-PTSD women exhibited a delayed response, with a drop at recovery. For FM + PTSD, tolerance levels remained unchanged. In addition, cardiovascular reactivity did not seem to explain these results. This performance of the pain modulation system seems to follow the same pattern of hypoactive responsiveness under stressors that has previously been observed in FM patients on the autonomic and neuroendocrine axes. Such a hypoactive pattern may involve a non-adaptive response that may contribute to the development and maintenance of chronic pain.

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A qualitative study of the experience and impact of neuropathic pain in people living with HIV.

Painful distal symmetrical polyneuropathy is common in HIV and is associated with reduced quality of life. Research has not explored the experience of neuropathic pain in people with HIV from a person-centred perspective. Therefore, a qualitative interview study was conducted to more deeply understand the experience and impact of neuropathic pain in this population. Semi-structured interviews were conducted with 26 people with HIV and peripheral neuropathic pain symptoms. Interviews explored the impact of pain and participants' pain management strategies. Interviews were transcribed verbatim and analysed using thematic analysis. Four themes and 11 subthemes were identified. Theme one reflects the complex characterisation of neuropathic pain, including the perceived unusual nature of this pain and diagnostic uncertainty. Theme two centred on the interconnected impacts of pain on mood and functioning and includes how pain disrupts relationships and threatens social inclusion. Theme three reflects the struggle for pain relief, including participants' attempts to 'exhaust all options' and limited success in finding lasting relief. The final theme describes how pain management is complicated by living with HIV; this theme includes the influence of HIV stigma on pain communication and pain as an unwanted reminder of HIV. These data support the relevance of investigating and targeting psychosocial factors to manage neuropathic pain in HIV.

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