Psychology

Learning to predict threatening events enables an organism to engage in protective behavior and prevent harm. Failure to differentiate between cues that truly predict danger and those that do not, however, may lead to indiscriminate fear and avoidance behaviors, which in turn may contribute to disability in people with persistent pain. We aimed to test whether people with persistent neck pain exhibit contingency learning deficits in predicting pain relative to pain-free, gender-and age-matched controls.

Sex differences in pain sensitivity have been well documented, such that women often report greater sensitivity than men. However, clinical reports highlighting sex differences often equate gender and sex. This is a particularly critical oversight for those whose gender identity is different than their genetic sex.

Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain disorder that is characterized by persistent and widespread pain. FMS has been associated with sleep disturbance, mood disorders and depression. Racial/ethnic minorities are less likely to receive a diagnosis of FMS than White individuals. Although mood disorders and depression are prevalent among racial/ethnic minority groups, researchers have not examined whether there are differences between racial/ethnic minorities and White individuals with FMS.

Insomnia is a major comorbid symptom of chronic pain and is likely to affect caregiver burden. This cross-sectional study investigated the association between insomnia in chronic pain patients and family caregiver burden. Participants were 60 patients with chronic pain of ≥3 months duration. Demographic and clinical information were collected using the Athens Insomnia Scale (AIS), the Pain Disability Assessment Scale (PDAS), the Hospital Anxiety and Depression Scale (HADS), and a pain intensity numerical rating scale (NRS). Family members who accompanied chronic pain patients to hospital completed the Zarit Burden Interview (ZBI). Univariate regression analysis and multiple regression analysis were conducted to clarify the associations between ZBI scores and total/subscale AIS scores. Covariates were age; sex; pain duration; and scores on the PDAS, HADS anxiety subscale, HADS depression subscale, and NRS. Insomnia was independently associated with ZBI scores [β: 0.27, 95% confidence interval (CI): 0.07-0.52, p = 0.001]. Scores on the AIS subscale of physical and mental functioning during the day were significantly associated with ZBI scores (β: 0.32, 95% CI: 0.05-0.59, p = 0.007). In conclusion, the findings suggest that in chronic pain patients, comorbid insomnia and physical and mental daytime functioning is associated with family caregiver burden independently of pain duration, pain-related disability, and pain intensity.

Distress, suffering, and care-seeking behavior are characteristics of pain-related disease and illness. Pain that transitions from an acute to a chronic phase carries with it the potential of further effects: these include a worsening of the disease or illness; high-impact chronic pain; and substantial personal, societal, and economic burden. The biopsychosocial model directly addresses these multiple processes, yet clinical frameworks supporting this model are not universally implemented. This paper explores barriers to clinical implementation of a full biopsychosocial framework for temporomandibular disorders (TMD) and other orofacial pain (OFP) conditions. In June 2016, INfORM invited OFP researchers to a workshop designed to optimize the DC/TMD Axis-II. Workshop groups identified five sources of implementation barriers: (1) cultures and societies, (2) levels-of-care settings, (3) health services, (4) cross-cultural validity of self-report instruments, and (5) provider and patient health literacy. Three core problems emerged: (A) mental health aspects are seldom fully considered, thus impairing the recognition of illness, (B) training in use of validated multi-axial assessment protocols is under-rated and insufficiently used, and (C) clinical assessment often fails to recognize that sensory and emotional dimensions are fundamental aspects of pain. To improve patient care, these barriers and problems require action. Most importantly, TMD/OFP educators and researchers need to coordinate globally and (i) be educated in the biopsychosocial model, (ii) implement evidence-based biopsychosocial guidelines for assessment and management of OFP conditions at their institutions, (iii) incorporate this model in undergraduate and postgraduate dental curricula, and (iv) be responsive to stakeholders, including regulatory authorities and practitioners. This article is protected by copyright. All rights reserved.

Chronic pain is one of the most prevalent and disabling symptoms associated with multiple sclerosis (MS). Individuals with MS are interested in nonpharmacologic pain management approaches. Cognitive-behavioral therapy (CBT) is efficacious in improving MS-related pain outcomes. Mindfulness-based cognitive therapy (MBCT) is a promising, alternative approach. Little is known about moderators of these treatments' outcomes, however. This article describes the study protocol for the first randomized controlled trial comparing MBCT, CBT, and usual care and examining treatment effect moderators in individuals with chronic pain and MS.

Observing successful pain treatment in others can induce anticipatory neural processes that, in turn, relieve pain. Previous studies have suggested that social learning and observation influence placebo hypoalgesia. Here, we used electroencephalography (EEG) to determine the neurophysiological changes associated with pain relief acquired through the observation. Thirty-one participants observed a demonstrator undergo painful heat stimulations paired with a "control" cream and non-painful ones paired with a "treatment" cream, which actually were both Vanicreams. After their observation, the participants then received the same creams and stimulations. We found that the treatment cream led to lower self-reported pain intensity ratings than the control cream. Anticipatory treatment cues elicited smaller P2 in electrodes F1, Fz, FC1, and FCz than the control condition. The P2 component localization indicated a higher current density in the right middle frontal gyrus, a region associated with attentional engagement. In placebo responders, the sensorimotor cortex activity captured in electrodes C3, Cz, and C4 indicated that hypoalgesia was positively correlated with resting state peak alpha frequency (PAF). These results suggest that observationally-induced placebo hypoalgesia may be driven by anticipatory mechanisms that modulate frontal attentional processes. Furthermore, resting state PAF could serve as a predictor of observationally-induced hypoalgesia.