The Key Role of Pain Catastrophizing in the Disability of Patients with Acute Back Pain

Purpose

This study investigated the role of anxiety sensitivity, resilience, pain catastrophizing, depression, pain fear-avoidance beliefs, and pain intensity in patients with acute back pain-related disability.

Method

Two hundred and thirty-two patients with acute back pain completed questionnaires on anxiety sensitivity, resilience, pain catastrophizing, fear-avoidance beliefs, depression, pain intensity, and disability.

Results

A structural equation modelling analysis revealed that anxiety sensitivity was associated with pain catastrophizing, and resilience was associated with lower levels of depression. Pain catastrophizing was positively associated with fear-avoidance beliefs and pain intensity. Depression was associated with fear-avoidance beliefs, but was not associated with pain intensity. Finally, catastrophizing, fear-avoidance beliefs, and pain intensity were positively and significantly associated with acute back pain-related disability.

Conclusion

Although fear-avoidance beliefs and pain intensity were associated with disability, the results showed that pain catastrophizing was a central variable in the pain experience and had significant direct associations with disability when pain was acute. Anxiety sensitivity appeared to be an important antecedent of catastrophizing, whereas the influence of resilience on the acute back pain experience was limited to its relationship with depression.

     

Picture perfect—how seeking perfection influences sleep and romantic relationships

Background

Studies have shown that sleep quality is negatively affected by perfectionism. Moreover, partner- or relationship-oriented perfectionism negatively influences relationship quality.

Objective

This paper aims to investigate the association of general perfectionism with sleep quality and relationship quality.

Materials and methods

A study assessing perfectionism, sleep quality, and relationship quality was performed via analyzing online questionnaires completed by 489 German adults from the general population.

Results

Participants with impaired sleep showed a higher level of maladaptive perfectionism (concern over mistakes and doubts, parental expectations, and criticism) than participants with good sleep, whereby the severity of sleep problems was not determining. Relationship quality is affected by perfectionism. However, this association is mediated by sleep quality.

Conclusion

Perfectionism is associated with worse sleep quality but not with worse relationship quality when sleep quality is integrated into the model as a mediator.

     

Predictors of Daily Pain Medication Use in Individuals with Recurrent Back Pain

Purpose

A key component to chronic pain management regimens is the use of analgesic medications. Psychological factors, such as mood states, may also affect the use of pain medications for individuals with chronic pain, but few observational studies have examined how these factors may predict pain medication use at the daily level.

Methods

Daily assessments from 104 individuals with back pain were used to examine fluctuations in daily pain intensity, mood, sleep quality, and physical activity as predictors of the likelihood of pain medication (opioid and non-opioid) use and levels of medication use on the same day.

Results

Pain intensity and mood ratings significantly predicted whether participants used pain medication on the same day, while only pain intensity predicted whether participants used more medication than usual. Further, current opioid users were more likely to increase the amount of their medication use on days of higher pain.

Discussion

This article identifies fluctuations in daily pain intensity and mood as salient predictors of daily pain medication use in individuals with recurrent back pain. The current study is among the first to highlight both pain and mood states as predictors of daily pain medication use in individuals with back pain, though future studies may expand on these findings through the use of higher-resolution daily medication use variables.

     

Cognitive Mediators of Change in Physical Functioning in Response to a Multifaceted Intervention for Managing Osteoarthritis

Purpose

Although non-pharmacological interventions have been shown to improve physical functioning in individuals with osteoarthritis (OA), the mechanisms by which this occurs are often unclear. This study assessed whether changes in arthritis self-efficacy, perceived pain control, and pain catastrophizing mediated changes in physical functioning following an osteoarthritis intervention involving weight management, physical activity, and cognitive-behavioral pain management.

Method

Three hundred Veteran patients of 30 primary care providers with knee and/or hip OA were cluster randomized to an OA intervention group or usual care. The OA intervention included a 12-month phone-based patient behavioral protocol (weight management, physical activity, and cognitive-behavioral pain management) plus patient-specific OA treatment recommendations delivered to primary care providers.

Results

Using linear mixed models adjusted for provider clustering, we observed that baseline to 6-month changes in arthritis self-efficacy and pain control partially mediated baseline to 12-month physical functioning improvements for the intervention group; catastrophizing did not.

Conclusion

Findings of a mediating role of arthritis self-efficacy and pain control in intervention-related functional changes are consistent with hypotheses and align with theoretical assertions of the role of cognitions in cognitive and behavioral interventions for chronic pain. However, contrary to hypotheses, catastrophizing was not found to be a mediator of these changes.

     

Glücklich als Paar – glücklicher Schlaf?

Background

Millions of people share a bed with their partner. Sleep und relationship could possibly influence each other.

Objectives

To identify and discuss connections between relationship and sleep quality.

Methods

Review of the literature in electronic databases.

Results

Conflict and violence in relationships lead to decreases in both partners’ sleep quality. Constructive approaches to resolving conflicts is necessary for good sleep, and vice versa. Women prefer partners with sleep-wake rhythms matching their own and report higher relationship satisfactions when the couple’s chronotypes are compatible.

Conclusions

Sleep and circadian rhythms play important roles in relationships. When treating insomnia, the relationship and the partner’s sleep should be taken into account.

     

Understanding Pain and Depression in Back Pain: the Role of Catastrophizing,Help-/Hopelessness,and Thought Suppression as Potential Mediators

Purpose

The cognitive mediation hypothesis describes the influence of psychological factors on the relationship between pain and depression such as cognitions of catastrophizing and help-/hopelessness. More recent research also emphasizes the role of suppression of negative thoughts and experiences such as pain. However, there is little research investigating direct and indirect effects of these contrasting cognitions.

Method

A total of 164 acute and sub-acute non-specific back pain patients participated in this study. Pain intensity, depression, and pain-related cognitions were measured using questionnaires, such as the Beck Depression Inventory and the Kiel Pain Inventory. Data were analyzed using structural equation modeling.

Results

The results of the path analysis support the hypothesis that cognitive coping strategies have a mediating effect on pain and depression. Consistent with previous research, we found that pain had no direct relation with depression. Help-/hopelessness had a direct path to depression, whereas catastrophizing had an indirect effect via increased help-/hopelessness. The current results also indicate that thought suppression mediated the relationship between pain and depression via both direct and indirect effects.

Conclusion

Cognitive mediators, such as help-/hopelessness, catastrophizing, and thought suppression, have a significant impact on depression in patients with acute and sub-acute back pain. The current results may aid in the optimization of treatments for these patients by focusing attention toward the modification of dysfunctional cognitive pain-coping strategies.

     

Do stress coping strategies influence chronotype-related differences in sleep quality?

Background

Chronotype manifestation often has a broad influence on sleep quality. One possible explanation for daytime impairments in evening types is the concept of “social jetlag”. Social jetlag is caused by an incompatibility between circadian preference and the socially accepted rhythm. This can be declared as a social stressor.

Objective

The association between chronotype, stress coping, and sleep quality was assessed in a pilot study.

Materials and methods

A total of 75 female adults aged 20–41 years participated in the study and completely answered all questions. Various questionnaires including sociodemographic data, information about sleep quality (Pittsburgh Sleep Quality Index, PSQI), chronotype (morningness–eveningness questionnaire, MEQ), and stress coping (Stress Coping Style Questionnaire, SVF78) were applied.

Results

Heightened use of maladaptive coping strategies is associated with a reduction in sleep quality. Chronotypes did not differ in terms of sleep quality and the coping strategies used.

Conclusion

Maladaptive coping strategy use seems to have a negative influence on sleep quality. Preventive education in adaptive stress coping strategies and avoidance of maladaptive stress coping thus seems useful to reduce these adverse influences on sleep quality.

     

Federal Response to the Opioid Crisis

Purpose of Review

In light of the current crisis in opioid involved overdose deaths, the federal Department of Health and Human Services operating divisions are working together to implement a data-driven, research-based strategy to reduce opioid misuse and its consequences.

Recent Findings

The strategy has five elements: (1) strengthening public health data collection and reporting; (2) advancing the practice of pain management; (3) improving access to addiction prevention, treatment, and recovery support services; (4) increasing availability of overdose-reversing drugs; and (5) supporting cutting-edge research in treatment of pain, opioid use disorder, and associated conditions.

Summary

The Department of Health and Human Services has developed a concerted, coordinated evidence-based effort across department divisions to reduce opioid misuse, prevalence of opioid use disorder, and reduce deaths due to opioid use.

     

Type D Personality and Sleep Quality in Coronary Artery Disease Patients With and Without Obstructive Sleep Apnea: Mediating Effects of Anxiety and Depression

Purpose

The study aimed to examine the association between type D personality trait and sleep quality in coronary artery disease (CAD) patients with and without obstructive sleep apnea (OSA) and to explore the mediating effects of anxiety and depression symptoms.

Method

A cross-sectional study was performed in 879 CAD patients attending cardiac rehabilitation program (mean age 57.8 years; SD?=?9.0; 75% men). Participants underwent full-night polysomnography and were classified in OSA (n?=?349) and no OSA (n?=?530) groups. Patients were evaluated for type D personality, subjective sleep quality (Pittsburgh sleep quality index), and symptoms of anxiety and depression (hospital anxiety and depression scale).

Results

Patients with type D personality reported poorer subjective sleep quality than non-type D patients irrespective of the presence of OSA. Type D and negative affectivity (NA) were associated with worse subjective sleep quality in patients with OSA and without OSA. The mediational analysis revealed that type D and NA were indirectly associated with Pittsburgh sleep quality index through anxiety and depression symptoms in no OSA and OSA patients.

Conclusion

In CAD patients, type D personality and NA are associated with worse subjective sleep quality and this association is mediated by depression and anxiety symptoms irrespective of OSA presence.

     

Through thick and thin?

Background

A good romantic relationship quality increases resilience against mental and physical health problems. Regarding correlates of relationship quality, research has focused mostly on attachment style and personality traits such as the Big Five.

Objective

The current study aims to find further predictors of a good relationship quality, such as sleep, demographics, and the boundary concept.

Materials and methods

For the study, 336 subjects were recruited, most of them women (79.76%). Only participants who were in a relationship were included in the analyses (N?=?216). The effects of sleep (Pittsburgh Sleep Quality Index, PSQI), demographics, and thin or thick boundaries (Boundary Personality Questionnaire, BPQ) on relationship quality (Partnerschaftsfragebogen—Kurzversion, PFB-K) were assessed using multiple regression.

Results

Age and thickness of boundaries were significantly connected with relationship quality. Sleep quality, gender, body mass index, and accommodation were not related to relationship quality.

Conclusion

The current study confirms the importance of age and provides new insight into the effects of boundaries in terms of relationship quality. Methodological limitations (e.g., homogenous and healthy sample) might compromise the findings regarding sleep. Future studies should include a more diverse sample and investigate further correlates of the boundary concept.

     

Sleep Quality in Ulcerative Colitis: Associations with Inflammation,Psychological Distress,and Quality of Life

Purpose

Treatment of ulcerative colitis (UC), given its chronicity and its associated disruptive and often distressing symptoms, is increasingly focusing on maximizing patient quality of life. Poorer quality of life has been found among patients with poor sleep quality, which is much more common in patients with UC than in the general population and may be associated with inflammation and psychological distress.

Method

Forty-seven patients with UC (n?=?11 flaring) completed measures of sleep quality, depression, state anxiety, gastrointestinal-related anxiety, perceived stress, and quality of life. Measures of inflammation were also obtained.

Results

Patients endorsed high rates of poor sleep quality, which was highly correlated with depression and poorer inflammatory bowel disease-related quality of life, but was generally not related to other areas of psychological functioning or inflammation. Sleep quality was significantly independently associated with depression and female gender.

Conclusion

Poor sleep quality is prevalent in patients with UC and is strongly related to depression, suggesting that sleep and mood are important areas to assess in patients with UC in order to inform tailored treatment to improve quality of life.

     

Nichtinvasive Beatmung und Schlaf

Background

Noninvasive ventilation (NIV) is the therapy of choice for nocturnal hypoventilation due to pulmonary or extra-pulmonary diseases by correcting hypercapnia and improving clinical symptoms as well as sleep quality. Various ventilator modes and settings are available ranging from a spontaneous mode to a control mode.

Assessment

During NIV, mask leakages and patient–ventilator asynchrony may result from insufficient mask adaptation or as a consequence of the chosen ventilator setting and may worsen not only respiratory function but may also disturb sleep quality. Therefore, a sophisticated selection of ventilator modality is mandatory.

Conclusion

The effectiveness of NIV should be assessed by sleep studies during the initiation of non-invasive ventilation.

     

The association of sleep with inflammatory bowel disease in children and adolescents

Aim

To systematically review literature investigating sleep quality in children and adolescents with inflammatory bowel disease (IBD).

Methods

Electronic databases were searched (BASE, Cochrane Database of Systematic Reviews, DIMDI, PsychArticles, PsychInfo, Psychjournals, Psychline, PSYNDEX, Pubmed, Science Direct, Web of Science, Wiley Online Library) by two researchers. Eligible studies were all that studied sleep disorders in the context of IBD in children and adolescents (6–17 years of age).

Results

Out of 40 references identified, five studies (all cross-sectional, three of them controlled) were eligible and included in this study. The publications showed that children and adolescents with IBD have significant sleep problems, adding to their impaired quality of life.

Conclusion

The published data provide evidence suggesting an impact of IBD and its severity on sleep in children and adolescents. However, with regard to the low methodological quality, the incongruity of the studies concerning outcome measure, and their focus of exploration, further studies are warranted to highlight the interrelationship.

     

Subjektive schlafbezogene Parameter bei Patienten mit Autismus-Spektrum-Störung

Background

Sleep disorders are common in children and adolescents with autism spectrum disorder. Little is known, however, about sleep in adult patients.

Objectives

Cross-sectional analysis of subjective sleep-related parameters in patients with autism spectrum disorder and healthy control participants.

Materials and methods

Twenty-nine patients with autism spectrum disorder and 50 healthy control participants were investigated using a questionnaire battery and sleep diaries. All analyses were controlled for depression and anxiety.

Results

Patients with autism spectrum disorder had more severe insomnia symptoms, stronger dysfunctional beliefs and attitudes about sleep, an increased sleep effort, and a higher cognitive arousal compared to the control group. In addition to this, the sleep diary data showed earlier bedtimes in those with autism spectrum disorder.

Conclusions

In patients with autism spectrum disorder, sleep onset and sleep maintenance difficulties seem to be accompanied by cognitive alterations that are typically observed in insomnia patients. In light of this, it appears to be worthwhile to investigate the efficacy of cognitive behavioral treatment for insomnia in this patient group.

     

Schlafbezogene Interventionen zur Augmentation von Psychotherapie

Background

The neurobiological augmentation of psychotherapy has drawn increasing attention in research on psychotherapy over the past years. In this context, the manipulation of sleep with its beneficial effect on memory formation and underlying neuronal plasticity is of particular interest as a non-invasive intervention.

Objectives

How do sleep and its selective manipulation influence the effectiveness of psychotherapy and how can sleep be used as an intervention to augment learning processes in psychotherapy?

Materials and methods

Important studies that examine the effects of sleep on processes of memory formation and psychotherapy are presented and discussed.

Results

Sleep represents a promising approach to augment the effects of psychotherapy. Sleep patterns are relevant both before and after psychotherapy. Another possibility is the manipulation of sleep and associated neuronal processes, e.?g. by transcranial direct current stimulation (tDCS) or drugs, which might influence learning processes and neuronal plasticity in the context of psychotherapy.

Conclusion

Sleep represents a promising approach to augment psychotherapy. Future studies are needed to further unravel the underlying mechanisms and to test whether this approach can be transferred to clinical practice.

     

Psychological Treatments for Chronic Pain in East and Southeast Asia: A Systematic Review

Background

Psychological treatments are recognised as generally effective for chronic pain. However, little is known about the evidence for psychological treatments for chronic pain in Asia.

Purpose

This study aimed (1) to identify all treatment outcome studies in the area of psychological approaches to chronic pain in adult populations of East Asia and Southeast Asia and (2) to evaluate the treatment types, the evidence for treatment outcomes and research design quality with regard to these studies.

Methods

We identified all psychologically based treatment outcome studies for chronic pain in East and Southeast Asia by searching CENTRAL, EMBASE, PsycINFO, MEDLINE (via Ovid), Global Health and Web of Science from the beginning of each abstracting service until December 2014 (week 4).

Results

Seventeen studies met inclusion criteria including a total of N?=?1,890 participants. Four were randomised controlled trials (RCTs), five controlled clinical trials (CCTs) and eight cohort studies. Treatment outcomes included pain, disability, depression and anxiety. Overall, the studies included in this review showed small to medium within-group effect sizes for all four outcomes. A majority of the studies were rated as weak in design quality. Three RCTs were found to be of strong quality, one of moderate quality and only one CCT of moderate quality.

Conclusion

The current available literature on psychological treatments for chronic pain in East and Southeast Asia is generally small in scale, mostly preliminary and lags behind on some developments occurring in North America and Europe. Further development of treatment methods and research designs is warranted.

     

Sleep benefits emotional and neutral associative memories equally

Background

Emotions modulate memory. It has been suggested that sleep contributes to improved memory of emotional events by preferentially consolidating emotional memories, presumably because of a selective off-line reactivation of information relevant to future behavior.

Objectives

We aimed to validate sleep-dependent memory consolidation in a new associative emotional memory paradigm suitable for inducing memory reactivations during sleep. We hypothesized that sleep preferentially might benefit the consolidation of emotional associations independently of their negative vs positive emotional valence.

Methods

Seventy-two healthy young participants performed an associative emotional memory task in either the evening or the morning. During the task, they were asked to associate neutrally spoken words to neutral, negative or positive pictures. Cued recall was tested after a 12-h retention interval filled with either night-time sleep or daytime wakefulness.

Results

Generally, emotional associations were better remembered than neutral ones. However, we were not able to replicate a selective benefit of sleep on emotional memory. Sleep robustly improved the cued recall performance of all picture types compared with wakefulness, without any modulating influence of emotional arousal or valence.

Conclusions

We conclude that the consolidation of explicitly learned associations benefits from sleep, independent of emotional arousal or valence. Selective emotional memory consolidation during sleep may be restricted to non-associative item memory or incidentally learned emotional associations.

     

Machen Smartphones Jugendliche und junge Erwachsene schlaflos?

Background

The dissemination of smartphones among adolescents and young adults is increasing. They are not only used during the day, but also in the evening and at night.

Objectives

The goal of the present study is to perform an exploratory survey on adolescents and young adults regarding their use of smartphones in the bedroom. It was hypothesized that the use of smartphones shortens or interrupts sleep and correlates with increased daytime sleepiness and poorer sleep quality.

Method

Using an online questionnaire, 148 adolescents and young adults between 14 and 20 years of age were asked about their use of smartphones in the evening and at night, their subjective sleep quality, and daytime sleepiness.

Results

The results indicated a high use of smartphones in the last ten minutes before the adolescents and young adults went to bed, keeping the mobile device at or in the bed. Furthermore, an association was found between adolescents being intentionally or unintentionally woken up by smartphone notifications and the subjectively reported daytime sleepiness.

Conclusions

The frequent use and handling of the smartphone, as well as the association with daytime sleepiness, indicates a need for education on responsible media contact. Further research is needed on the user profile and the consequences on performance and concentration abilities of adolescents.

     

Sleep problems in adolescents with Asperger syndrome or high-functioning autism

Background

Autism is a neurodevelopmental disorder defined by deficits in social interaction, communication, and restricted repetitive behavior. Research studies indicate that children with autism spectrum disorders suffer from more sleep problems than the general population.

Objective

The aim of the study was to investigate sleep problems in adolescents with Asperger syndrome (AS) or high-functioning autism (HFA) and to further examine the association between sleep problems and problem behavior as well as autism symptom severity.

Methods

In this study, 15 adolescents diagnosed with AS or HFA (aged between 10–19 years) and one parent of each answered questions about sleep and sleep disturbances.

Results

A high prevalence of sleep problems (80?%) was found. The most frequently reported sleep problems were insomnia symptoms (80?%) and parasomnias (53?%). More sleep problems were associated with decreased daytime functioning, more precisely with more externalizing problem behavior and a higher autism symptom severity.

Conclusion

The results suggest that sleep problems are common in adolescents with AS or HFA and are connected to lower daytime functioning. Therefore, in clinical practice, individuals should routinely be screened for sleeping difficulties.

     

Perseverative Cognition as an Explanatory Mechanism in the Relation Between Job Demands and Sleep Quality

Purpose

The aim of this longitudinal three-wave study was to examine (i) reciprocal associations among job demands, work-related perseverative cognition (PC), and sleep quality; (ii) PC as a mediator in-between job demands and sleep quality; and (iii) continuous high job demands in relation to sleep quality and work-related PC over time.

Method

A representative sample of the Swedish working population was approached in 2010, 2012, and 2014, and 2316 respondents were included in this longitudinal full-panel survey study. Structural equation modelling was performed to analyse the temporal relations between job demands, work-related PC, and sleep quality. Additionally, a subsample (N = 1149) consisting of individuals who reported the same level of exposure to job demands during all three waves (i.e. stable high, stable moderate, or stable low job demands) was examined in relation to PC and sleep quality over time.

Results

Analyses showed that job demands, PC, and poor sleep quality were positively and reciprocally related. Work-related PC mediated the normal and reversed, direct across-wave relations between job demands and sleep quality. Individuals with continuous high job demands reported significantly lower sleep quality and higher work-related PC, compared to individuals with continuous moderate/low job demands.

Conclusion

This study substantiated reciprocal relations between job demands, work-related PC, and sleep quality and supported work-related PC as an underlying mechanism of the reciprocal job demands-sleep relationship. Moreover, this study showed that chronically high job demands are a risk factor for low sleep quality.