Chronic Pain and Psychopathology: Research Findings and Theoretical Considerations

Dersh, Jeffrey; Polatin, Peter B.; Gatchel, Robert J.

doi:10.1097/01.psy.0000024232.11538.54

Cited by 334 publications

(203 citation statements)

References 66 publications

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“…As predicted, trait anxiety was significantly correlated with chronic pain during intercourse, this variable also being identified as a statistical predictor. While the relationship between anxiety and chronic pain problems is well-known (Dersh, Polatin, & Gatchel, 2002), anxiety has also been shown to increase experimental pain perception (Tsao, Lu, Kim, & Zeltzer, 2006), predict hypervigilance to coital pain (Payne, Binik, Amsel, & Khalifé, 2005), and reduce physiological sexual arousal (Payne et al, 2007). In addition, the fear-avoidance model posits that pain catastrophizing, fear of pain, and escape/avoidance, may partly explain the transition from acute to chronic pain (Leeuw et al, 2007;Vlaeyen & Linton, 2000).…”

Section: Discussionmentioning

confidence: 97%

Biopsychosocial Factors Associated with Dyspareunia in a Community Sample of Adolescent Girls

Landry

Bergeron

2010

Arch Sex Behav

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Although various biopsychosocial factors have been associated with dyspareunia, research to date has focused on retrospective reports of adult women, and lack of consensus regarding etiology remains. By targeting girls at the beginning of their reproductive life, this study aimed to examine the biomedical, behavioral, and psychosocial correlates of chronic painful intercourse in sexually active adolescents compared to pain-free girls. With written informed consent, data were obtained from 1425 girls (12-19 year olds) from seven metropolitan high schools using self-report questionnaires pertaining to gynaecologic/biomedical history, physical/psychological/sexual abuse, anxiety, depression, attitudes towards sexuality, and social support. While the chronic painful intercourse (n = 51) and pain-free comparison group (n = 167) did not differ significantly on biomedical variables, painful intercourse was associated with significantly more pain during tampon insertion, and avoidance of tampons was linked to a fourfold risk of experiencing pain during sex. Cases also reported engaging in significantly more detrimental vulvar hygiene habits than pain-free girls, whereas no significant group differences were observed for self-treatment using over-the-counter antifungal preparations. Sexual abuse, fear of physical abuse, and trait anxiety were identified as significant psychosocial correlates of chronic painful intercourse. A logistic regression further identified pain during first tampon insertion and trait anxiety as statistical predictors of adolescent pain during intercourse. In addition to a possible intrinsic dysfunction in central pain processing, findings suggest that psychological variables, such as anxiety, play a significant role in painful intercourse's very first manifestations in adolescent girls.

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Section: Discussionmentioning

confidence: 97%

Biopsychosocial Factors Associated with Dyspareunia in a Community Sample of Adolescent Girls

Landry

Bergeron

2010

Arch Sex Behav

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“…Although these conditions often cause severe pains, knowing the origin of the pain and/or having an opportunity to receive adequate treatment could influence how the subjects deal with suffering from a long-standing chronic pain condition. According to Dersh and colleagues [59], there are several reasons for considering chronic pain and mood disorders as distinct disorders even though the underlying patho-physiologies may share common factors. The onset of pain and mild psychological disturbances do not typically coincide, and each condition could be mutually independent for many individuals [59].…”

Section: Discussionmentioning

confidence: 99%

“…According to Dersh and colleagues [59], there are several reasons for considering chronic pain and mood disorders as distinct disorders even though the underlying patho-physiologies may share common factors. The onset of pain and mild psychological disturbances do not typically coincide, and each condition could be mutually independent for many individuals [59]. While those with chronic pain and psychological distress frequently tend to consult health services, not all those with chronic pain experience psychological distress as anxiety or depression [60], which might explain the weak associations in our study.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and long-term predictors of persistent chronic widespread pain in the general population in an 11-year prospective study: the HUNT study

Mundal

Gråwe

Bjørngaard

et al. 2014

BMC Musculoskelet Disord

107

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BackgroundChronic widespread pain (CWP) is common and associated with prominent negative consequences. The aim of this study was to assess the prevalence of persistent CWP in an 11-year prospective cohort study in the general population, and to examine anxiety, depression, alcohol use, poor sleep, body mass index (BMI) and chronic disease, along with demographic, lifestyle and other health-related variables as possible predictors for the assumed CWP persistence.MethodsCWP was defined as having pain at three or more predefined sites (involving the trunk and upper and lower limbs) for at least three months in the last year. We used a Norwegian general population cohort of 28,367 individuals who responded to both the second (1995–1997) and the third (2006–2008) waves of the Nord-Trøndelag Health Study (HUNT2 and HUNT3, respectively). Data were analysed with logistic regression models.ResultsCWP prevalence in HUNT2 was 17%. Of those reporting CWP in HUNT2, 53% still reported CWP at follow-up in HUNT3. Adjusted analyses revealed that depression and alcohol consumption were not substantially associated with the 11-year prospective CWP outcome. Poor sleep, obesity and chronic disease predicted persistent CWP, and being male and/or 60 years or older was protective.ConclusionsThis cohort study revealed that nearly half of the participants with baseline CWP resolved from CWP 11 years later. Among those whose CWP did not resolve, obesity, sleeping problems and chronic disease predicted CWP persistence, while aging and male sex was protective. Anxiety, mixed anxiety and depression, former smoking, and overweight were weakly associated, while depression, moderate exercise, and alcohol use were not associated with persistent CWP.

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“…39,40 These affect up to 50% of chronic pain patients 11,41,42 and impair both quality of life and response to treatment. 43 In addition, CRPS patients reportedly demonstrate diminished capacity for tactile perceptual learning 44 and altered performance in a gambling task, implying changes in emotional influences on decision making and risk taking.…”

Section: Discussionmentioning

confidence: 99%

Brain Neuroplastic Changes Accompany Anxiety and Memory Deficits in a Model of Complex Regional Pain Syndrome

Tajerian

Leu²,

Zou³

et al. 2014

Anesthesiology

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Background Complex regional pain syndrome (CRPS) is a painful condition with ~50,000 annual new cases in the United States. It is a major cause of work-related disability, chronic pain after limb fractures and persistent pain after extremity surgery. Additionally, CRPS patients often experience cognitive changes, anxiety and depression. The supraspinal mechanisms linked to these CRPS-related comorbidities remain poorly understood. Methods We used a previously-characterized mouse model of tibia fracture/cast immobilization showing the principal stigmata of CRPS (n=8–20/group) observed in humans. Our central hypothesis was that fracture/cast mice manifest changes in measures of thigmotaxis (indicative of anxiety) and working memory reflected in neuroplastic changes in amygdala, perirhinal cortex, and hippocampus. Results We demonstrate that nociceptive sensitization in these mice is accompanied by altered thigmotactic behaviors in the zero maze but not open field assay, and working memory dysfunction in novel object recognition and social memory but not in novel location recognition. Furthermore, we found evidence of structural changes and synaptic plasticity including changes in dendritic architecture and decreased levels of synaptophysin and brain derived neurotrophic factor in specific brain regions. Conclusions Our findings provide novel observations regarding behavioral changes and brain plasticity in a mouse model of CRPS. In addition to elucidating some of the supraspinal correlates of the syndrome, this work supports the potential use of therapeutic interventions that not only directly target sensory input and other peripheral mechanisms, but also attempt to ameliorate the broader pain experience by modifying its associated cognitive and emotional comorbidities.

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Chronic Pain and Psychopathology: Research Findings and Theoretical Considerations

Cited by 334 publications

References 66 publications

Biopsychosocial Factors Associated with Dyspareunia in a Community Sample of Adolescent Girls

Biopsychosocial Factors Associated with Dyspareunia in a Community Sample of Adolescent Girls

Prevalence and long-term predictors of persistent chronic widespread pain in the general population in an 11-year prospective study: the HUNT study

Brain Neuroplastic Changes Accompany Anxiety and Memory Deficits in a Model of Complex Regional Pain Syndrome

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