Psychological Trauma Exposure and Pain-Related Outcomes Among People with Chronic Low Back Pain: Moderated Mediation by Thought Suppression and Social Constraints

Pegram, Sheri E.; Lumley, Mark A.; Jasinski, Matthew J.; Burns, John W.

doi:10.1007/s12160-016-9838-0

Cited by 16 publications

(12 citation statements)

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“…Regarding the functionality of ER in LBP, pain‐related thought suppression (PTS) was associated with higher disability, which is in accordance to previous studies in (sub)acute (Hasenbring, Hallner, Klasen, et al, ; Held et al, ) and chronic LBP (Pegram et al, ; Scholich et al, ). Experimental research suggests that pain‐related thought suppression results in thought intrusions and increases of the very painful sensations that were sought to be suppressed (Cioffi & Holloway, ; Sullivan et al, ).…”

Section: Discussionsupporting

confidence: 88%

“…To this end, pain‐related thought suppression may serve to enable pain persistence, also known as overactivity, eventually resulting in overuse (Andrews et al, ; Hasenbring & Verbunt, ) and depressive mood (Hülsebusch, Hasenbring, & Rusu, ; Konietzny et al, ) (Figure ). Thus, endurance‐related responses (ER) are, like FAR, associated with disability (Andrews et al, ; Hasenbring, Hallner, Klasen, et al, ; Held et al, ; Pegram, Lumley, Jasinski, & Burns, ; Scholich, Hallner, Wittenberg, Hasenbring, & Rusu, ) and pain intensity (Hasenbring, Marienfeld, Kuhlendahl, & Soyka, ; Held et al, ; Pegram et al, ; Scholich et al, ), (see Figure ).…”

Section: Introductionmentioning

confidence: 99%

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Psychological pain responses in athletes and non‐athletes with low back pain: Avoidance and endurance matter

Gajsar

Titze

Levenig

et al. 2019

European Journal of Pain

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Background Dysfunctional psychological pain responses, namely fear‐avoidance (FAR), including catastrophizing and helplessness, as well as endurance‐related responses (ER), including thought suppression and overactivity, have been shown to be risk factors for persistent low back pain (LBP). Literature suggests that athletes may differ from non‐athletes regarding psychological responses to pain. Objectives This study set out to compare FAR and ER between athletes and non‐athletes with LBP. It was hypothesized that athletes would report less frequent FAR and more frequent ER, and that both FAR and ER are associated with LBP intensity and disability. Methods The 173 athletes and 93 non‐athletes cross‐sectionally reported how frequently they employ FAR and ER on the Avoidance‐Endurance Questionnaire (AEQ), as well as LBP intensity and disability on the Chronic Pain Grade Questionnaire (CPGS). MANOVA was applied to compare FAR and ER between athletes and non‐athletes. Hierarchical multiple linear regression models were used to determine the unique associations between FAR and ER with LBP intensity and disability. Results Athletes reported lower frequencies of behavioural avoidance than non‐athletes, but no other FAR variables differed between the groups. Frequencies of ER did not differ between athletes and non‐athletes. Regression analysis indicated substantial associations of FAR with LBP intensity, as well as of FAR and ER with disability in athletes and non‐athletes. Conclusions The results of the present study suggest that athletes and non‐athletes with LBP differ regarding behavioural avoidance, but overall, differences regarding pain responses are marginal. FAR and ER are both reported in athletes and non‐athletes and contribute to disability in both groups. Significance Athletes train to endure pain in the course of athletic socialization, at least in the context of exercise. However, there is sparsity of knowledge about psychological pain responses in athletes with low back pain and whether they differ from those in non‐athletes. The results of this comparative study suggest that endurance responses are more frequent than avoidance responses among athletes and non‐athletes alike. However, both types of responses seem relevant to clinical pain management in athletes as well as non‐athletes.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Psychological pain responses in athletes and non‐athletes with low back pain: Avoidance and endurance matter

Gajsar

Titze

Levenig

et al. 2019

European Journal of Pain

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“…A significant proportion of patients with chronic pain also suffer with multiple psychological conditions, specifically depression and anxiety (12,110,567,. Numerous investigators have shown the relationship between psychological and emotional distress and increased levels of pain-related disability, chronicity, and use of health care services (587)(588)(589)(590)(591)593,595,(600)(601)(602). Symptoms of depression and anxiety also have been studied regarding long-term physical health outcomes in rheumatoid arthritis (596), showing that baseline and persistent symptoms of depression and anxiety were associated with poorer health outcomes over time, as well as reduced treatment response.…”

Section: Psychological Evaluationmentioning

confidence: 99%

Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines

Kaye²,

et al. 2017

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Background: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl. Contrary to scientific evidence of efficacy and negative recommendations, a significant proportion of physicians and patients (92%) believe that opioids reduce pain and a smaller proportion (57%) report better quality of life. In preparation of the current guidelines, we have focused on the means to reduce the abuse and diversion of opioids without jeopardizing access for those patients suffering from non-cancer pain who have an appropriate medical indication for opioid use. Objectives: To provide guidance for the prescription of opioids for the management of chronic non-cancer pain, to develop a consistent philosophy among the many diverse groups with an interest in opioid use as to how appropriately prescribe opioids, to improve the treatment of chronic non-cancer pain and to reduce the likelihood of drug abuse and diversion. These guidelines are intended to provide a systematic and standardized approach to this complex and difficult arena of practice, while recognizing that every clinical situation is unique. Methods: The methodology utilized included the development of objectives and key questions. The methodology also utilized trustworthy standards, appropriate disclosures of conflicts of interest, as well as a panel of experts from various specialties and groups. The literature pertaining to opioid use, abuse, effectiveness, and adverse consequences was reviewed, with a best evidence synthesis of the available literature, and utilized grading for recommendation as described by the Agency for Healthcare Research and Quality (AHRQ).

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“…Thought suppression was shown to moderate the relationship between depression and pain in acute and subacute [161] and in chronic back pain [162]. In chronic low back pain, thought suppression is further seen as a risk factor for poorer pain outcomes, heightened pain severity, increased pain interference, and depressive symptoms [163]. Experiencing pain, many patients show a suppression reaction, followed by an emergence of different negative consequences, such as distress, depressive moods, and increased pain [137,147,158,164,165].…”

Section: A C C E P T E Dmentioning

confidence: 99%

Endogenous Modulation of Pain

Vægter

Fehrmann

Gajsar

et al. 2019

The Clinical Journal of Pain

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Pain is a complex and highly subjective phenomenon that can be modulated by several factors. Based on results from experimental and clinical studies, the existence of endogenous pain modulatory mechanisms that can increase or diminish the experience of pain is now accepted. In this narrative review, the pain modulatory effects of exercise, stress, and cognitions in humans are assessed. Experimental studies on the effect of exercise have revealed that pain-free subjects show a hypoalgesic response after exercise. However, in some patients with chronic pain this response is reduced or even hyperalgesic in nature. These findings will be discussed from a mechanistic point of view. Stress is another modulator of the pain experience. Although acute stress may induce hypoalgesia, ongoing clinical stress has detrimental effects on pain in many patients with chronic pain conditions, which have implications for the understanding, assessment and treatment of stress in patients with pain. Finally, cognitive strategies play differing roles in pain inhibition. Two intuitive strategies, thought suppression and focused distraction, will be reviewed regarding experimental, acute, and chronic pain. Based on current knowledge on the role of exercise, stress, and cognitive pain control strategies on modulation of pain, implications for treatment will be discussed.

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Psychological Trauma Exposure and Pain-Related Outcomes Among People with Chronic Low Back Pain: Moderated Mediation by Thought Suppression and Social Constraints

Cited by 16 publications

References 16 publications

Psychological pain responses in athletes and non‐athletes with low back pain: Avoidance and endurance matter

Psychological pain responses in athletes and non‐athletes with low back pain: Avoidance and endurance matter

Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines

Endogenous Modulation of Pain

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