Childhood trauma has been linked to the development and severity of psychiatric disorders as well as deficits in cognitive functioning. This study aimed to investigate the performance of bipolar disorder (BD) patients and healthy controls (HC), with or without a history of childhood trauma, on a parametric Go/No-Go (PGNG) task measuring important aspects of executive functions, namely attention and inhibitory control. Two hundred and thirty-three individuals with BD and 90 HC completed diagnostic interview, childhood trauma questionnaire (CTQ), symptom severity scales, and a PGNG task. Four comparison groups were created using a 1.0 standard deviation cut-off of the mean of the HC total CTQ score: BD-trauma, BD-normative, HC-trauma and HC-normative. We assessed interactions between diagnosis and trauma on Go/No-Go levels of interest by using a two-way multivariate analysis of covariance. Results showed a significant main effect of trauma on inhibitory control accuracy, as the trauma group exhibited significantly poorer accuracy on inhibition trials compared to the normative group. There was also a main effect of diagnosis on response time. These findings suggest that early trauma might adversely impact the development of cognitive systems and brain circuits that support inhibitory aspects of executive functioning in individuals with a history of trauma.
This study has explored the influence of cognitive reserve on preservation of specific cognitive abilities over time in BP. The BP group did not demonstrate accelerated cognitive decline over 5 years compared to the HC group. Although the trajectory of cognitive change over time was similar between BP patients and HCs, higher overall intellectual ability may be a protective factor against cognitive decline, particularly for BP patients.
Objective
Although evidence-based psychological interventions improve chronic pain, many patients do not engage in behavioral health services. Offering a brief intervention in a medical setting may provide benefits to patients with chronic pain. The purpose of this study was to examine preliminary outcomes of a brief psychological intervention for chronic pain delivered in primary care.
Design
Pilot randomized controlled trial.
Setting
Primary care clinic.
Subjects
Sixty participants with chronic pain were randomized to a 5-session psychological intervention or treatment-as-usual control group.
Methods
Participants completed pre- and post-intervention measures assessing pain severity, pain interference, pain catastrophizing, depression, and anxiety.
Results
Most participants (76.7%) randomized to the intervention completed all sessions. Compared to the control group, those in the intervention had decreases in pain severity (P = .048), pain catastrophizing (P = .04), and depression (P = .01) from pre- to post-intervention. Within the intervention group, there was a significant improvement in pain interference scores (P = 0.02). Within the intervention group, effect sizes were medium to large for changes in pain severity, pain interference, pain catastrophizing, and depression scores. There were no significant changes in anxiety scores.
Conclusion
Results suggest that delivery of a brief psychological intervention for chronic pain in primary care appears to offer improvements in pain severity, pain interference, pain catastrophizing, and depression. Findings suggest that shorter-term psychological interventions may offer similar benefits as longer-term ones. Furthermore, offering a brief intervention in primary care may increase access and engagement in behavioral pain management services. Future research should examine this through a fully-powered trial with longer-term outcomes.
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