A Network Analysis of the Links Between Chronic Pain Symptoms and Affective Disorder Symptoms

Thompson, Emma; Broadbent, Jaclyn; Fuller‐Tyszkiewicz, Matthew; Bertino, Melanie D.; Staiger, Petra K.

doi:10.1007/s12529-018-9754-8

Cited by 25 publications

(27 citation statements)

References 64 publications

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“…The most surprising findings of the present study were that depressive symptoms preceded fear, and fear preceded pain catastrophizing. Both of the present findings stand in contrast to the FAM [17], but had empirical support from the literature [71,72]. In a study of general musculoskeletal pain, Thompson et al [72] reported that more depression was positively correlated with more fear, although their analysis cannot determine if depression preceded or proceeded fear.…”

Section: Discussionsupporting

confidence: 54%

“…Both of the present findings stand in contrast to the FAM [17], but had empirical support from the literature [71,72]. In a study of general musculoskeletal pain, Thompson et al [72] reported that more depression was positively correlated with more fear, although their analysis cannot determine if depression preceded or proceeded fear. Depressive symptoms were found to have a substantial direct influence on fear in individuals with low back pain [48].…”

Section: Discussionsupporting

confidence: 54%

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Investigating the Causal Mechanisms of Symptom Recovery in Chronic Whiplash-associated Disorders Using Bayesian Networks

Liew

Scutari

Peolsson

et al. 2019

The Clinical Journal of Pain

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Objectives: The present study's objective is to understand the causal mechanisms underpinning the recovery of individuals with whiplash-associated disorders (WAD). We applied Bayesian Networks (BN) to answer two study aims: 1) to identify the causal mechanism(s) of recovery underpinning neck-specific exercise, and 2) quantify if the cyclical pathway of the fear avoidance model (FAM) is supported by the present data. Methods: We analysed a prospective cohort dataset of 216 individuals with chronic WAD. Fifteen variables were used to build a BN model: treatment group (neck-specific exercise with or without a behavioural approach, or general physical activity), muscle endurance, range of motion, hand strength, neck proprioception, pain catastrophizing, fear, anxiety, depression, self-efficacy, perceived work ability, disability, pain intensity, sex, and follow-up time. Results: The BN model showed that neck pain reduction rate was greater after neck-specific exercise compared to physical activity prescription (β = 0.59 points/month [P < 0.001]) only in the presence of two mediators: global neck muscle endurance and perceived work ability. We also found the following pathway of variables that constituted the FAM: anxiety, followed by depressive symptoms, fear, catastrophizing, self-efficacy, and consequently pain Conclusion: We uncovered two mediators which explained the mechanisms of effect behind neck-specific exercise, and proposed an alternative FAM pathway. The present study is the first to apply BN modelling to understand the causal mechanisms of recovery in WAD. In doing so, it is anticipated that such analytical methods could increase the precision of treatment in individuals with chronic WAD.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionsupporting

confidence: 54%

Investigating the Causal Mechanisms of Symptom Recovery in Chronic Whiplash-associated Disorders Using Bayesian Networks

Liew

Scutari

Peolsson

et al. 2019

The Clinical Journal of Pain

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“…It is well established in psychiatry that depression and anxiety are comorbid in many people (140), and cross-sectional network analysis studies have illustrated how major depressive disorder and generalized anxiety disorder are interconnected, entangled, and amplifying (141–143). Moreover, chronic pain and depression often co-occur (116–119), and new studies are examining associations between symptom networks in chronic pain and depression (144), and how self-efficacy, fear avoidance, and perceived disability might link the pain experience with affective disorder symptoms (145).…”

Section: Network Analysis In Psychiatry and Psychologymentioning

confidence: 99%

Network Analysis and Precision Rehabilitation for the Post-concussion Syndrome

Iverson

2019

Front. Neurol.

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Some people experience persistent symptoms following a mild traumatic brain injury (MTBI), and the etiology of those symptoms has been debated for generations. Post-concussion-like symptoms are caused by many factors both before and after MTBI, and this non-specificity is the bedrock of the conundrum regarding the existence of the post-concussion syndrome. A latent model or common cause theory for the syndrome is inconsistent with the prevailing biopsychosocial conceptualization. It is the thesis of this paper that adopting a network perspective for persistent symptoms following MTBI, including the post-concussion syndrome, could lead to new insights and targeted treatment and rehabilitation strategies. The network perspective posits that symptoms co-occur because they are strongly inter-related, activating, amplifying, and mutually reinforcing, not because they arise from a common latent disease entity. This approach requires a conceptual shift away from thinking that symptoms reflect an underlying disease or disorder toward viewing inter-related symptoms as constituting the syndrome or disorder. The symptoms do not arise from an underlying syndrome—the symptoms are the syndrome. A network analysis approach allows us to embrace heterogeneity and comorbidity, and it might lead to the identification of new approaches to sequenced care. The promise of precision rehabilitation requires us to better understand the interconnections among symptoms and problems so that we can produce more individualized and effective treatment and rehabilitation.

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“…Older people report more pain than younger people, 6 and women tend to report more pain than men. 7,8 Mental health problems are common in patients with chronic pain disorders. [9][10][11][12] Anxiety and depression are more common in patients with neck pain than in healthy controls, 13 and are important predictors of pain and disability.…”

Section: Introductionmentioning

confidence: 99%

Pain and Depression Are Associated With More Anxiety in ME/CFS: A Cross-Sectional Cohort Study Between Norway and Spain

Strand

Castro-Marrero

Helland

et al. 2020

Clinical Medicine Insights: Psychiatry

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Objectives: Lasting, unexplained and high levels of pain may cause anxiety in patients with chronic fatigue syndrome. The objectives of the current study were to test assumptions of the association between pain and anxiety in patients diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and to clarify the role of depression in this relationship. Methods: Data were collected from 664 participants (age 18-65 years) with 133 ME/CFS patients and 201 healthy controls from Norway and 330 CFS patients from Spain. Binary logistic regression model was applied to test relationships between the included variables in the samples. Results: Both pain and depression made significant direct contributions to the level of anxiety. The strongest risk for higher levels of anxiety was the combination of high levels of depression and high levels of pain in the overall sample (OR = 49.70; P < 0.001), not so much in the Spanish cohort (OR = 11.99; P < 0.0001) and most of all in the Norwegian cohort (OR = 88.21; P < 0.001) sample. Conclusions: It was the combination of high pain levels and high levels of depression that to the greatest extent increased the risk of anxiety in patients with CFS/ME. Whatever diagnostic criterion that is applied, anxiety and depression should be mandatory to assess in the clinical assessments performed for diagnosing the ME/CFS. Approaches addressing anxiety-related pain and treatment of depression should be warranted.

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A Network Analysis of the Links Between Chronic Pain Symptoms and Affective Disorder Symptoms

Cited by 25 publications

References 64 publications

Investigating the Causal Mechanisms of Symptom Recovery in Chronic Whiplash-associated Disorders Using Bayesian Networks

Investigating the Causal Mechanisms of Symptom Recovery in Chronic Whiplash-associated Disorders Using Bayesian Networks

Network Analysis and Precision Rehabilitation for the Post-concussion Syndrome

Pain and Depression Are Associated With More Anxiety in ME/CFS: A Cross-Sectional Cohort Study Between Norway and Spain

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