Effects of a Tailored Positive Psychology Intervention on Well-Being and Pain in Individuals With Chronic Pain and a Physical Disability

Müller, Rachel; Gertz, Kevin J.; Molton, Ivan; Terrill, Alexandra L.; Bombardier, Charles H.; Ehde, Dawn M.; Jensen, Mark P.

doi:10.1097/ajp.0000000000000225

Cited by 138 publications

(142 citation statements)

References 84 publications

(92 reference statements)

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“…Such interventions could include web-based learning programs that teach simple well-being exercises and that require few resources to maintain once they are established (eg, Ref. 45). Clinicians who interact with these individuals when providing basic or general health care could be taught strategies that could enhance pain acceptance, such as pain neuroscience education interventions (eg, Ref.…”

Section: Discussionmentioning

confidence: 99%

The role of pain acceptance on function in individuals with disabilities

Jensen

Smith

Alschuler

et al. 2016

Pain

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Having higher levels of pain acceptance has been shown to be associated positively with quality of life in patients with chronic pain, but its role in adjustment to chronic pain among individuals with physical disabilities living in the community is not known. Moreover, issues related to item overlap between measures of pain acceptance and measures of patient function have limited the conclusions that can be drawn from previous research in this area. To better understand the role that pain acceptance plays in patient function, we administered measures of pain acceptance, pain intensity, depressive symptoms, and function to 392 individuals with physical disabilities, and the pain, symptom, and function measures were readministered 3.5 years later. Analyses evaluated the main and interaction effects of initial pain acceptance on subsequent changes in pain and function. Having higher levels of pain acceptance-in particular as reflected by a willingness to engage in activities despite pain-resulted in less increase in pain intensity and more improvements in pain interference, physical function, depressive symptoms, and sleep quality. The findings indicate that previous research supporting the importance of pain acceptance to function in patients from health care settings extends to individuals with chronic pain living in the community. Moreover, they indicate that pain acceptance may have long-lasting (up to 3.5 years) beneficial effects on subsequent pain and function and on the association between change in pain and depression. Research to examine the potential benefits of community-based treatments that increase pain acceptance is warranted.

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Section: Discussionmentioning

confidence: 99%

The role of pain acceptance on function in individuals with disabilities

Jensen

Smith

Alschuler

et al. 2016

Pain

Self Cite

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“…A recent feasibility study suggests that other interventions focused on building assets may also be of benefit to people with chronic pain. Muller et al (2015) evaluated the effects of a web-based positive psychology intervention for chronic pain, which was designed in part to increase positive affect, and found that it not only improved positive affect but also pain-specific outcomes, including pain intensity, pain interference, and mood post-treatment, with the effects on pain intensity, mood, and pain control maintained at a 2.5 month follow-up. Even though they are not typically conceptualized as building assets as much as they are thought to address maladaptive behaviors and thoughts, traditional behavioral therapies for chronic pain, including CBT, may also increase resilience factors and should be studied for such benefits.…”

Section: Discussionmentioning

confidence: 99%

Resilience and vulnerability in individuals with chronic pain and physical disability.

Alschuler¹,

Kratz²,

Ehde³

2016

Rehabilitation Psychology

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Objective To examine the independent contributions of vulnerability and resilience factors to pain interference, self-efficacy for managing pain, global mental health, and global physical health. Research Method/Design Secondary analysis of baseline data from individuals with a spinal cord injury (N=73), amputation (N=33), or multiple sclerosis (N=82) and chronic pain who participated in a randomized controlled trial comparing two chronic pain interventions. Participants completed a comprehensive battery of pain-related outcomes that assessed for both psychosocial assets and maladaptive cognitions and behaviors. Results Results suggested that vulnerability and resilience factors together account for a considerable amount of variance in the physical outcomes, but that neither set of factors was able to make a substantial contribution above and beyond the other. In contrast, for mental health related outcomes, results indicated that resilience factors did make a meaningful contribution above and beyond vulnerability factors, suggesting the important contribution of resilience factors to the psychological experience of chronic pain. Conclusions The present study suggested a valuable contribution of both resilience and vulnerability factors to pain outcomes, with the additional caveat that resilience factors uniquely impact specific outcomes – particularly those that are more psychosocially focused – above and beyond vulnerability factors. Taken together, this highlights the importance of considering resilience factors in addition to vulnerability factors for individuals with chronic pain. Additional research is needed to explore other factors that could be considered representative of the resilience construct and more attention should be focused on evaluating the effects of interventions that seek to build an individual’s assets.

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“…These interventions have attempted to encapsulate traditional positive psychological approaches by targeting mechanisms that bolster positive emotional states and improve social relations. These activities may include exercises that promote forgiveness of others for prior harms, sharing of gratitude with supportive others, promoting prosocial behaviors (e.g., performing random acts of kindness), cultivating compassion toward the self and others, savoring positive experiences, enhancing optimism and pursuing personally meaningful goals [78,79]. These interventions constitute a promising step away from treating pain using strictly a problem-focused approach and instead promoting overall health and meaningful function.…”

Section: Future Directions For Studymentioning

confidence: 99%

Social Pain and Physical Pain: Shared Paths To Resilience

2015

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Although clinical models have traditionally defined pain by its consequences for the behavior and internal states of the sufferer, recent evidence has highlighted the importance of examining pain in the context of the broader social environment. Neuroscience research has highlighted commonalities of neural pathways connecting the experience of physical and social pain, suggesting a substantial overlap between these phenomena. Further, interpersonal ties, support and aspects of the social environment can impair or promote effective adaptation to chronic pain through changes in pain perception, coping and emotional states. The current paper reviews the role of social factors in extant psychological interventions for chronic pain, and discusses how greater attention to these factors may inform future research and clinical care.

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Effects of a Tailored Positive Psychology Intervention on Well-Being and Pain in Individuals With Chronic Pain and a Physical Disability

Cited by 138 publications

References 84 publications

The role of pain acceptance on function in individuals with disabilities

The role of pain acceptance on function in individuals with disabilities

Resilience and vulnerability in individuals with chronic pain and physical disability.

Social Pain and Physical Pain: Shared Paths To Resilience

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