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Symptoms of posttraumatic stress disorder (PTSD) are highly prevalent among Veterans with chronic pain. Considerable research has examined the intersection of chronic pain and PTSD symptoms. However, it remains unclear whether changes in PTSD may potentially serve a mechanistic role in improving unhelpful pain cognitions for individuals with chronic pain. The present research contributes to the foundational knowledge by addressing this question. Baseline data from a randomized controlled trial targeting pain-related disability for Veterans (n = 103; mean age 43.66; SD = 10.17) with musculoskeletal pain and depression and/or PTSD symptoms were used. Cross-sectional mediation analyses showed that PTSD symptoms mediated the relationship between pain severity and pain catastrophizing, and between pain severity and pain acceptance. After controlling for depression, the mediation involving pain catastrophizing remained significant, while the mediation for pain acceptance did not. Although limitations exist, results point to several treatment recommendations, including ensuring that depressive affect, PTSD-specific symptoms, and attention to both body and mind are included in treatment. Results also provide preliminary evidence for examining these associations longitudinally to improve our understanding of this population and corresponding treatment recommendations. [ABSTRACT FROM AUTHOR]

During pregnancy, increased hormonal levels contribute to ligament laxity of the pelvis and could predispose to lumbopelvic pain. The main objective of this study was to assess changes in pregnancy-related hormones, neuromechanical adaptations and clinical pain status throughout pregnancy. An exploratory objective was to examine the possible association between those variables. Twenty-eight pregnant women participated in the study. At each trimester, they provided a blood sample (to measure relaxin, estrogen and progesterone), completed questionnaires assessing clinical status (functional disability, risk of poor prognosis of prolonged lumbar disability, avoidance behaviors, anxiety and pain catastrophizing), and were asked to perform a flexion-relaxation task (erector spinae electromyography and trunk kinematics). Results showed that throughout pregnancy, nocturnal and diurnal lumbopelvic pain intensity and related-disability, risk of poor lumbopelvic pain prognosis as well as avoidance behaviors increased, while pain catastrophizing decreased. Neuromechanical characteristics of flexion-relaxation task, including low back muscle activity and trunk kinematics, were similar across the three trimesters. Positive correlations were found between disability and estrogen levels (changes between first and second trimester, p = 0.05), and estrogen and diurnal lumbopelvic pain intensity (change between second and third trimester, p = 0.02). A positive correlation was also found between weight and the Pelvic Girdle Questionnaire score (changes between second and third trimester, p = 0.05). Negative correlations were found between weight (change between first and second trimester) and lumbopelvic maximal angle (p = 0.003), FRP onset for pelvic (p = 0.04) and lumbopelvic (p = 0.003) angles as well as FRP cessation for lumbopelvic angle (p = 0.001). These results show that, in pregnant women, pain and disability are associated with hormonal changes rather than trunk neuromechanical characteristics during a flexion-relaxation task. These results suggest that the flexion-relaxation task may not be an appropriate proxy to study vertebral and pelvic muscle control in pregnant women. [ABSTRACT FROM AUTHOR]

Background: Recent advances in thyroid surgery techniques have increased the number of patients undergoing transoral thyroidectomy, and many patients are concerned about post-thyroidectomy cosmetic effects. This study aimed to compare patient satisfaction after transoral versus conventional thyroidectomy. Methods: This study was conducted from August 2021 to January 2022 at Gangnam Severance Hospital (Seoul, South Korea). A total of 91 patients underwent transoral endoscopic thyroidectomy (TOET) or open thyroidectomy performed by a single surgeon. The Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale (PCS), and 15-Item Quality of Recovery (QoR-15) postoperative day (POD)#-1 surveys were administered before the surgery. The QoR-15 POD#1 and #2 surveys were administered after the surgery. The Post-traumatic Stress Disorder Checklist surveys were administered on the first day of the outpatient visit after discharge. The survey results were compared to determine the differences between both groups. Results: Only the HADS-Depression survey scores differed significantly between the TOET and open thyroidectomy groups (4.22 ± 0.781 and 5.52 ± 0.84, respectively; P =.039). Multivariable analysis, adjusted for age and weight differences between the conventional and TOET groups, revealed no differences in any of the survey scores, including the HADS-Depression scores. Therefore, no differences were observed in the survey scores between the TOET and open thyroidectomy groups. Conclusions: The subjective postoperative stress about pain and the degree of recovery after surgery were similar between the two groups. Thus, there would be no difference in the patient's satisfaction for surgery between the two groups. [ABSTRACT FROM AUTHOR]

Background: It is imperative to promote behavior/intention of taking up booster COVID-19 vaccination (BI-BV) among people who have ever contracted COVID-19 (PECC). The aims were to investigate the prevalence of BI-BV and its associations with perceived social support. Guided by the stress coping theory, we tested mediators between perceived social support and BI-BV via self-stigma, active coping, and maladaptive emotion regulation (rumination and catastrophizing). Methods: A random population-based telephone survey was conducted among adult PECC having completed the primary series of COVID-19 vaccination prior to the diagnosis; 230 participants were interviewed from June to August 2022 during the fifth (last) major outbreak in Hong Kong. The associations between the independent variables and BI-BV were tested by logistic regression analysis. A structural equation model (SEM) tested the indirect effects of the latent variables of self-stigma, active coping, and maladaptive emotion regulation between the latent variable of perceived social support and BI-BV. Results: The prevalence of BI-BV was 62.2%. It was associated with age, marital status, full-time employment, and chronic disease status. The logistic regression analysis found that BI-BV was positively associated with perceived social support (ORc = 1.31, 95% CI: 1.12– 1.54), active coping (ORc = 1.40, 95% CI: 1.10– 1.79), rumination (ORc = 1.75, 95% CI: 1.13– 2.70), and catastrophizing (ORc = 3.12, 95% CI: 1.49– 6.51) and negatively associated with self-stigma (ORc = 0.80, 95% CI: 0.72– 0.88). In the SEM analysis, the positive association between perceived social support and BI-BV was fully mediated: 1) via self-stigma (β = 0.07, 95% CI: 0.03– 0.14), 2) via active coping (β = 0.06, 95% CI: 0.02– 0.12), and 3) via self-stigma and then active coping (β = 0.01, 95% CI: 0.002– 0.04). Two of these indirect paths involved active coping. The indirect paths involving maladaptive emotion regulation were all non-significant. Conclusions: Perceived social support was associated with BI-BV, and was mediated via self-stigma, active coping, and serially self-stigma then active coping but not emotion maladaptation. The data supported the stress cognitive coping model in explaining the association between perceived social support and BI-BV. Interventions promoting BI-BV may consider modifying the observed significant factors. Future longitudinal studies are warranted to confirm the findings. [ABSTRACT FROM AUTHOR]

Introduction: Among individuals with dizziness, there is an increased prevalence of psychosocial comorbidity compared to the general population. Increased psychosocial comorbidity among people with dizziness is associated with disability and poorer outcomes in vestibular rehabilitation. However, there is less knowledge regarding the association between psychosocial factors and mobility outcomes in people with dizziness. Therefore, the purpose of this study was to assess the association between psychosocial factors and future activity, participation, and community mobility among people with dizziness. The secondary aim of this study was to explore the constructs measured using patient-reported outcomes associated with psychosocial factors in this population. Materials and methods: We conducted a prospective cohort study with an in-person baseline assessment and a follow-up assessment completed at 3-months via computerized questionnaires. We measured psychosocial factors at baseline using the Hospital Anxiety and Depression Scale (HADS), the Patient Health Questionnaire 4-item (PHQ-4), the Vestibular Activities Avoidance Instrument (VAAI), and the Dizziness Catastrophizing Scale (DCS). We measured community mobility and participation at baseline and 3-month follow-up using the Life Space Assessment (LSA) and Vestibular Activities and Participation Measure (VAP). To determine the associations between baseline anxiety and depression symptoms, fear avoidance, catastrophizing beliefs and mobility and disability measures, we used simple linear regression and repeated measures ANOVA. We used exploratory factor analysis to identify constructs measured using patient-reported outcomes of psychosocial factors. Results: There were 100 participants who completed the baseline assessment [mean age (SD) = 49.2 (15.7) years; 73% female] and 68 participants completed the questionnaire at the 3-month follow-up. In bivariate analyses, baseline VAAI, HADS-A, HADS-D, PHQ-4 depression, and VAP were associated with LSA, and baseline VAAI, HADS-D, PHQ-4 depression, and LSA were associated with VAP at 3-month follow-up (all p < 0.05). In adjusted multivariate analyses, baseline VAP had a large effect (F = 11.65, p = 0.001, η 2 = 0.18) and HADS-D had a moderately large effect (F = 4.09, p = 0.048, η 2 = 0.07) on LSA score at 3-month follow-up. Baseline VAAI had a large effect (F = 23.35, p < 0.001, η 2 = 0.3) on VAP at 3-month follow-up. The exploratory factor analysis of the VAAI, HADS, PHQ-4, and DCS resulted in 4 factors measuring constructs of fear avoidance, anxiety, depression, and catastrophization. Discussion: We found that baseline psychosocial factors were related to future measures of activity and participation as well as community mobility in people with dizziness. Specifically, baseline activity and participation levels and depressive symptoms were significantly associated with future community mobility and baseline fear avoidance beliefs were significantly associated with future activity and participation. Patient-reported outcome measures of psychosocial factors appear to measure unique constructs, which may indicate that a small number of different outcome measures may be needed to gather important prognostic information to manage individuals with dizziness well. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the effectiveness of exercise therapy delivered via a smartphone mobile app, using asynchronous video-based tools, with synchronous telerehabilitation models using videoconferencing for individuals with fibromyalgia syndrome (FMS). Methods: The research, utilizing a randomized clinical study design, involves sixty-six FMS patients in an 8-week exercise program. Participants are divided into synchronous (n: 33) and asynchronous (n: 33) groups. Assessments, pain intensity (VAS), functional limitations (FIQr), health-related quality of life (SF 12), catastrophizing (PCS), anxiety and depression (HADS), functional capacity (6MWT), muscle strength (Arm curl test), and joint position sense (LI-RATT), are conducted at baseline, mid-treatment (week 4), end of treatment (week 8). Results: No significant group-time interaction was found for total VAS, FIQ, SF 12, PCS, HADS, 6MWT, Arm curl tests, LI-RATT extension, LI-RATT flexion, LI-RATT right rotation scores (p > 0.05). Significant effects of time and interactions between groups and time were observed in the neck (p = 0.010, ES = 0.19) and back region (p = 0.039, ES = 0.19) of the Visual Analog Scale, left rotation score of the LI-RATT (p = 0.008, ES = 0.36), and HADS Anxiety Score (p = 0.029, ES = 0.31). Group differences were significant at all-time points for the outcomes (p < 0.001), except for the right rotation of LI-RATT (p = 0.633). Conclusion: The study suggests that asynchronous telerehabilitation is comparable to synchronous methods in addressing pain, quality of life, and other factors in FMS patients. The asynchronous approach may offer advantages in reducing the burden on healthcare professionals and being cost-effective. Future research should explore diverse telerehabilitation protocols and their impact on overall care burdens. Trial registration: NCT06299527 (01/03/2024). [ABSTRACT FROM AUTHOR]

Introduction: Neck pain is a common musculoskeletal disorder, with a prevalence rate (age-standardized) of 27.0 per 1000 in 2019. Approximately 50–85% of individuals with acute neck pain do not experience complete resolution of symptoms, experiencing chronic pain. Manual therapy is a widely employed treatment approach for nonspecific neck pain (NSNP), cervical radiculopathy (CR) and cervicogenic headaches (CGH). This umbrella review synthesized systematic reviews examining manual physical therapy for individuals with cervical disorders. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed with Prospero registration (CRD42022327434). Four databases were searched from January 2016 to May 2023 for systematic reviews with or without meta-analysis examining manual therapy for individuals with neck pain of any stage. Interventions included any manual physical therapy of the cervical or thoracic spine as well as neuromobilization of the upper quarter. Primary outcomes included pain and disability. Two reviewers screened for eligibility and completed data extraction. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR 2) tool. Results: A total of 35 SRs were included: 15 NSNP, 7 cervical radiculopathy, 9 CGH and 4 samples with combined diagnoses. AMSTAR 2 ratings of the SRs support high confidence in results for 10 reviews, moderate confidence in 12 reviews and low to critically low confidence in 13 reviews. For NSNP, there was high confidence in the results showing manual therapy combined with exercise was superior to either treatment in isolation. In cervical radiculopathy, neural mobilization, distraction, soft tissue treatment and mobilization/manipulation to cervical and thoracic spine were supported with moderate confidence in results. For CGH, there was high confidence in the results supporting the use of cervical spine mobilization/manipulation, soft tissue mobilization, and manual therapy combined with exercise. Original authors of SRs reported varying quality of primary studies with lack of consistent high quality/low risk of bias designs. Conclusion: Manual therapy plus exercise, cervical or thoracic mobilization and manipulation, neuromobilization, and other types of manual therapy were supported as effective interventions in the management of pain and disability for individuals with NSNP, CGH, or CR in the short-term. [ABSTRACT FROM AUTHOR]

Objective: Opioid tolerance is a criterion for opioid use disorder, which is currently an epidemic in the US. Individuals with open wounds are frequently administered opioids; however, the phenomenon of opioid tolerance has not been examined in the context of wounds. The purpose of this exploratory study was to compare patient/wound factors, wound microbiome and inflammatory mediators between individuals who were opioid-tolerant versus those who were not opioid-tolerant. Method: Patients with acute open wounds were enrolled in this cross-sectional study. All study data were collected before and during a one-time study dressing change. Results: The study included a total of 385 participants. Opioid-tolerant participants were significantly younger (p<0.0001); had higher levels of depression (p=0.0055) and anxiety (p=0.0118); had higher pain catastrophising scores (p=0.0035); reported higher resting wound pain (p<0.0001); had a higher number of wounds of <30 days' duration (p=0.0486); and had wounds with lower bacterial richness (p=0.0152) than participants who were not opioid-tolerant. A backward elimination logistic regression model showed that four predictors—resting wound pain, age, bacterial richness and depression—were the most important variables in predicting opioid-tolerance status. Conclusion: These findings provide the first insights into the phenomenon of opioid tolerance in the context of open wounds. This study provides findings from which to guide hypothesis-driven research in the future. [ABSTRACT FROM AUTHOR]

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Background: Multidisciplinary programs are the first recommendation for non-specific chronic low-back pain, but implementing this type of program is complicated to get up and running. The primary aim of this study was to assess the feasibility and appropriateness of the PAINDOC multidisciplinary program for subjects with chronic low-back pain. The secondary objectives were to evaluate the decrease in pain intensity, pain-related disability and pain catastrophizing, as well as the improvement in quality of life with this program. Furthermore, another of the secondary objectives was to calculate the sample size for a future randomized clinical trial. Methods: This study was conducted in a hospital pain unit using two successive recruitment waves. First, the feasibility outcomes (recruitment, completion, and drop-out rates) of a 5-month non-random prospective cohort (n = 227) were recorded. Then, the clinical outcomes (pain intensity, quality of life, disability, and pain catastrophizing) were recorded from a prospective, controlled, two-armed and single-blind feasibility study (ClinicalTrials.gov, NCT05974072). It included 41 participants that were randomly allocated to either the pharmacological treatment (n = 21) arm or PAINDOC program (n = 20) arm. Results: The recruitment rate was 66%, with the completion rate standing at 80.7% and the drop-out rate at 19.3%. Significant differences and a medium size effect were observed between groups in terms of pain intensity (p =.017, r =.408) at the 4-month follow-up. The intragroup analysis of the PAINDOC group revealed significant lessening in pain intensity (p = < 0.001) and improvements in quality of life (p =.030). Conclusions: This study showed that the PAINDOC multidisciplinary program is a feasible treatment for patients with non-specific chronic low-back pain. Furthermore, the exploratory results of this study suggest that it could be an effective treatment to reduce pain intensity and improve on self-reported quality of life in these patients, although a future randomized clinical trial is needed to determine its effectiveness. Trial registration: NCT05974072 (registration date July 11, 2023; retrospectively registered; ClinicalTrials.gov). [ABSTRACT FROM AUTHOR]

Background: Ankle joint position sense (AJPS) accuracy and postural control are crucial for maintaining balance and stability, particularly in individuals with plantar fasciitis who may experience proprioceptive and functional impairments. Understanding how psychosocial factors, such as pain catastrophizing, and biomechanical measures, like muscle strength and gait parameters related to proprioception and postural control, can inform more effective treatment approaches. This study aimed to (1) examine the relationship between AJPS accuracy and biomechanical factors—including postural stability, lower limb muscle strength, and gait parameters—in individuals with plantar fasciitis d (2) analyze the impact of psychosocial factors, including pain catastrophizing, physical activity level, and quality of life, on AJPS accuracy and postural control in this population. Methods: A total of 126 participants (63 with plantar fasciitis and 63 controls) were recruited. AJPS was assessed using a digital inclinometer across four movement directions (plantarflexion, dorsiflexion, inversion, eversion). Postural stability metrics (antero-posterior and medio-lateral sway) were measured using computerized posturography, while muscle strength in plantar flexors, dorsiflexors, inverters, and evertors was assessed with a hand-held dynamometer. Gait parameters (step length, cadence, stance time) were captured via 3D motion capture. Pain catastrophizing, physical activity, and quality of life were evaluated using validated questionnaires (PCS, IPAQ, FHSQ). Results: Significant differences were observed in AJPS accuracy between groups, with plantar fasciitis patients showing higher AJPS error in plantarflexion (mean difference = 1.22°, p < 0.001) and dorsiflexion (mean difference = 1.31°, p < 0.001). Pain catastrophizing was a significant predictor of AJPS in plantarflexion (β = -0.05, p = 0.001). Postural stability was negatively correlated with AJPS accuracy, particularly in mediolateral sway (r = -0.32, p = 0.037), while physical activity and quality of life had minimal effects. Conclusion: This study highlights the impact of pain catastrophizing on proprioceptive deficits in plantar fasciitis, emphasizing the importance of addressing psychological as well as biomechanical factors in treatment. Integrating cognitive-behavioral strategies may enhance proprioceptive accuracy and stability outcomes in this population. [ABSTRACT FROM AUTHOR]

Background: Postoperative pain intensity is influenced by various factors, including genetic variations. The SCN10A gene encodes the Nav1.8 sodium channel protein, which is crucial for pain signal transmission in peripheral sensory neurons. Objectives: This study aims to investigate the relationship between genetic mutations in the SCN10A gene (rs6795970) and postoperative analgesic effects following gynecological laparoscopic surgery. Methods: Two hundred female patients undergoing gynecological laparoscopic surgery under general anesthesia were included. pain sensitivity was evaluated using the catastrophizing scale and pain sensitivity questionnaire (PSQ). Patients received patient-controlled intravenous analgesia with sufentanil and dexmedetomidine for 48 h post-surgery. Postoperative pain indicators, such as visual analog scale (VAS) scores, Ramsay scores, and side effects were recorded. SCN10A rs6795970 mutations were identified using MassARRAY SNP typing technology, and patients were categoried into homozygous mutant (AA), wild type (GG), and heterozygous mutation (GA) groups for analysis. Results: Patients in the AA group had higher scores on the pain Catastrophizing Scale, PSQ-total, PSQ-minor, and PSQ-moderate compared to GA and GG groups (P < 0.05). VAS scores at 4, 6, and 12 h post-operation were higher in the AA group than the GG group (P < 0.05). Ramsay scores were lower in AA patients at 2 and 4 h post-operation compared to GA and GG groups (P < 0.05). The AA group exhibited more self-control analgesic pump compressions within the first 24 h post-surgery, quicker depletion of analgesics in the pump, and lower patient satisfaction with pain relief compared to GA and GG groups (P < 0.05). Conclusions: Female patients with homozygous SCN10A mutations may experience higher preoperative pain scores and increased sensitivity to postoperative pain following gynecological laparoscopic surgery with intravenous patient-controlled analgesia. Trial registration: www.chictr.org.cn, registration number: ChiCTR2200062425. [ABSTRACT FROM AUTHOR]

Objectives: Preliminary examination of emotional awareness/expression relationships with pain in people with traumatic brain injury (TBI) and chronic pain (CP) and exploration of psychological factors as mediators or moderators of these relationships. Methods: Cross-sectional study in adults (N = 59) with chronic TBI and CP using Toronto Alexithymia Scale-20 Difficulty Identifying and Describing Feelings subscales; Ambivalence over Emotional Expressiveness Questionnaire; Emotional Approach Coping Scale; PROMIS Pain Intensity and Pain Interference scales, Michigan Body Map (pain widespreadness); headache frequency; Pain Catastrophizing Scale; Brief Symptom Inventory-18 (psychological distress), and Post-traumatic Stress Checklist-Civilian. Results: Difficulty Identifying Feelings was positively associated with pain intensity, pain interference, and headache frequency. Difficulty Describing Feelings was positively correlated with pain interference and headache frequency. Emotional Approach Coping was inversely correlated with headache frequency. Emotional awareness/expression relationships with pain outcomes were mediated by Pain Catastrophizing; Difficulty Describing Feelings relationships with Pain Interference and headache frequency were mediated by psychological distress; and Difficulty Describing Feelings associations with Pain Interference were mediated by post-traumatic stress. No moderators were identified. Conclusion: These preliminary findings suggest that emotional awareness/expression is linked to pain in adults with TBI and CP, which may be connected via pain catastrophizing and psychological distress. If longitudinal studies with larger samples produce similar findings, researchers should explore training emotional awareness/expression for possible pain management after TBI. [ABSTRACT FROM AUTHOR]

The present randomized controlled trial aimed to investigate the effects of home-based telemedicine with wearable devices and usual care on pain-related outcomes in patients with chronic musculoskeletal pain, compared to usual care alone. The patients with chronic musculoskeletal pain were randomly allocated to the usual care group or the telemedicine group, which participated in telemedicine with wearable devices, the objective data from which were recorded, in conjunction with usual care for six months. The primary outcome measure was the Numeric Rating Scale (NRS) for pain. The secondary outcome measures were the Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Disability Assessment Scale (PDAS), and EuroQol-five dimensions-three level (EQ-5D-3L). Seventy-one participants were analyzed. At 1 and 3 months, there were no significant differences in the NRS scores between the groups; however, the telemedicine group had a significantly superior effect on all of the outcome measures at 6 months compared to the usual care group. The number of steps and distance were significantly increased at 6 months compared to baseline in the telemedicine group. Home-based telemedicine with wearable devices and usual care has a modest effect on pain-related outcomes compared to usual care in patients with chronic musculoskeletal pain. This study was registered (UMIN000052994 - 04/12/2023). [ABSTRACT FROM AUTHOR]

Background: Pain catastrophizing, or the interpretation of pain as unbearable or intolerable, can increase pain-related anxiety and severity. High levels of pain catastrophizing have also been linked to substance use, particularly for substances with analgesic properties. Importantly, behavioral treatments can reduce pain catastrophizing, making them promising interventions for mitigating pain-related substance use. The aim of this scoping review is to summarize literature investigating the relationship between pain catastrophizing and substance use in adults. Methods:We performed a scoping review of peer-reviewed literature. Included articles had both a measurement of pain catastrophizing and substance use, and reported analyses characterizing the relationship between the two. Results: Of the 341 abstracts identified, 47 articles met eligibility criteria. Most studies focused on people with chronic pain. Some studies also considered samples with substance use disorders (with and without chronic pain) or acute pain, and general population samples. There was generally a positive association between pain catastrophizing and substance misuse; this association was consistent across multiple samples and substances. Most studies were cross-sectional, although associations were also detected in longitudinal studies. The magnitude of associations tended to be stronger for higher severity substance use and more proximal tests of association. More longitudinal and experimental studies are needed, however, to better delineate these effects. Discussion: Findings indicate a consistent positive association between pain catastrophizing and substance use, highlighting the potential for interventions targeting pain catastrophizing to reduce negative substance-related consequences. [ABSTRACT FROM AUTHOR]

Background Sexual dysfunctions impair the intimate relationships of up to one-third of the population. Virtual reality (VR) offers innovative treatment options for both mental and sexual disorders, such as female orgasmic disorder and erectile disorder. Sexual aversion disorder (SAD)—the anxiety, disgust, and avoidance of sexual contexts—is a chronic condition commonly treated with anxiety-reducing strategies, such as exposure-based therapy. Despite exposure's efficacy in reducing SAD symptoms, VR exposure therapy's (VRET) effectiveness remains unexplored for this condition. Aim This proof-of-concept study examines the acceptability, adequacy, and clinical effects of a VRET's simulation protocol for SAD. Methods In the laboratory, 15 adults suffering from SAD (M age = 35.00; SD  = 11.36) viewed 15 virtual sexual scenarios of increasing intensity (eg, flirting, nudity, genital stimulation) adjusted to their sexual preferences and gender identities. Outcomes Levels of anxiety, disgust, and catastrophizing beliefs were measured throughout the scenarios using standard self-report measures. Participants also completed validated questionnaires on sexual presence and simulation realism, as well as open-ended questions on scenarios' representativeness and adequacy immediately after immersion. Six months after the laboratory visit, participants completed a negative effects questionnaire and were screened for SAD symptoms again. Repeated-measures ANOVAs and descriptive analyses were performed. Results Levels of anxiety and disgust significantly increased with the intensity of sexual scenarios. Catastrophizing levels were high and tended to augment with increasing exposure levels. A significant reduction in symptoms of SAD was found from pre-simulation to the 6-month follow-up assessment. Sexual presence and realism scores were moderate. Qualitative assessment revealed that all participants reported the sexual scenarios were representative of real-life situations that tend to elicit SAD symptoms for them. Reported negative effects were generally mild. Clinical Implications This proof-of-concept study suggests that VRET may have the potential to elicit self-reported emotional and cognitive manifestations of SAD (sex-related anxiety, disgust, and catastrophizing), while also hinting at its acceptability, adequacy, and benefits in alleviating SAD symptoms. Strengths & Limitations While this study marks the first exploration of the clinical relevance of gender-inclusive virtual sexual scenarios for SAD, its design and sample composition may impact observed effects and the generalizability of findings. Conclusion This study invites future clinical trials to assess VRET efficacy for SAD. [ABSTRACT FROM AUTHOR]

Background Dyspareunia, defined as pain before, during or after intercourse, is a subset of female sexual dysfunction with overlapping gynecologic, urologic and psychosocial etiologies. Aim This study aimed to evaluate the impact of menstrual pain and visceral hypersensitivity on sexual function and to identify risk factors for sexual pain in healthy reproductive-age females. Methods In this prospective cohort study, we evaluated gynecologic and psychologic self-reported histories, validated sexual function questionnaires, and conducted a standardized gynecologic examination enhanced by quantitative sensory testing in reproductive-aged females with menstrual pain versus pain-free controls. Correlation analysis was conducted between the Female Sexual Function Index (FSFI) pain subdomain score and a priori hypothesized risk factors for dyspareunia: menstrual pain severity, experimentally provoked bladder sensitivity, anxiety, depression, pain catastrophizing, and vaginal pressure-pain sensitivity. Outcomes The primary outcome was severity of sexual pain as measured by the FSFI, comparing participants with moderate-to-severe dysmenorrhea (n = 99), dysmenorrhea with bladder hypersensitivity (n = 49) identified on non-invasive oral water challenge, and pain-free controls (n = 37). Results In our young (median age 22 [IQR 19, 29]), nulliparous, predominantly heterosexual cohort (78.3%, 144/185), 64.3% (119/185) engaged in sexual intercourse within the four-week recall period. The median total FSFI score was 27.2 (22.0, 30.2). Across groups, only the dysmenorrhea with bladder hypersensitivity phenotype met the threshold for sexual dysfunction as measured by total FSFI score (24.6 [20.0, 28.1], p  = 0.008). Dysfunction was driven by difficulties with lubrication and higher pain levels during and after intercourse. On physical examination, those with and without dyspareunia were largely indistinguishable, with little to no tenderness of the pelvic floor, bladder, uterus and uterosacral ligaments. Amongst the six hypothesized risk factors for sexual pain, only experimentally provoked bladder pain was significantly associated with the severity of dyspareunia (r = 0.41, corrected p  < 0.001). Clinical Implications Young, otherwise healthy individuals with dysmenorrhea and occult visceral hypersensitivity exhibit signs of sexual dysfunction and significantly higher rates of dyspareunia in the absence of reliable clinical examination findings. Strengths and Limitations Strengths include the use of a nonclinical sample of almost exclusively nulliparous females with no co-morbid pelvic pain diagnoses and prospective diary confirmation of dysmenorrhea severity. The study is limited by the narrow heteronormative, cisnormative sexual experience of penile-vaginal intercourse captured by the FSFI. Conclusion Sexual pain is more prevalent in those with dysmenorrhea with bladder hypersensitivity than isolated dysmenorrhea, suggesting visceral hypersensitivity may be a non-structural mechanistic driver for dyspareunia. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the validity and reliability of the Turkish version of the Breathlessness Catastrophizing Scale (BCS) in patients with chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: Seventy patients with COPD (55 male/15 female, mean age: 68.7±7.3 years, FEV1%: 45.4±19.5) were included in this methodological study. Internal consistency was measured using Cronbach's α, and intra-rater reliability was assessed using the intraclass correlation coefficient (ICC). Correlations between the BCS and Modified Medical Research Council Dyspnea Scale (mMRCS), COPD Assessment Test (CAT), Hospital Anxiety and Depression Scale (HADS), Breathlessness Beliefs Questionnaire (BBQ), and St. the George Respiratory Questionnaire (SGRQ) scores were assessed for convergent validity. Known-group comparisons were performed according to COPD stage and dyspnea severity using the independent sample t-test. RESULTS: Internal consistency was excellent (Cronbach's α=0.941), and the ICC for reliability was 0.955. The BCS score was correlated with the mMRCS (r=0.745), CAT (r=0.652), HADS anxiety (r=0.556) and depression (r=0.588), the BBQ (r=-0.567), and SGRQ (r=0.550-0.634) scores (P < 0.05). The BCS score was higher in patients with advanced COPD (P = 0.003) and those with severe dyspnea (P < 0.001). CONCLUSION: The Turkish version of the BCS is a valid and reliable tool for evaluating catastrophic dyspnea in patients with COPD. [ABSTRACT FROM AUTHOR]

Objective. To investigate the relationships among neuropathic pain (NP), pain catastrophizing (PC), and central sensitization (CS) in relation to functional status and radiological damage in patients with knee osteoarthritis (OA). Methods. This cross-sectional study included knee OA patients derived from an observational cohort. The Spearman correlation test was used to analyze the relationship between the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the PainDetect Questionnaire (PDQ), Central Sensitization Inventory (CSI), and Pain Catastrophizing Scale (PCS). The Kruskal–Wallis test was employed to compare WOMAC scores according to CSI categories. A multivariate analysis was conducted to identify predictors of functional ability, with the WOMAC score as the dependent variable and the independent variables including pain-related indices such as PCS, PDQ, and CSI, along with Kellgren–Lawrence (K-L) grading and demographic characteristics. Results. This study included 149 patients (76.5% female; mean age 71.5 years; mean duration of pain 8.1 years). In total, 23.5% exhibited NP, 30.9% showed PC, and 33.6% had CS. Higher mean values of WOMAC were correlated with CSI categories (p < 0.0001). WOMAC showed a significant relationship with CSI (rho = 0.791; p < 0.0001), PDQ (rho = 0.766; p < 0.0001), and PCS (rho = 0.536; p < 0.0001). In the multiple regression analysis, WOMAC was independently associated with CSI (p < 0.0001), PDQ (p < 0.0001), and PC (p = 0.0001). No association was observed between the K-L grading and the other variables. Conclusions. A reduced functional capacity in patients with knee OA is correlated with the presence of NP, PC and CS, without being significantly associated with radiological damage. [ABSTRACT FROM AUTHOR]

Aims: To investigate the relationships between parental resilience, illness perception and pain catastrophizing as factors affecting caregiver burden among parents of children with cancer, based on the Transactional Model of Stress and Coping. Background: Parents, as the primary caregivers of children with cancer, often face universal challenges. These include adverse health impacts, work, financial disruptions, strained social and family relationships, and the need for specialised support and intervention. Design: A cross‐sectional design using path analysis. Methods: The STROBE guidelines for cross‐sectional studies were followed. An online questionnaire was distributed through Facebook pages operated by various organisations that support parents of children with cancer, such as 'The Israel Cancer Association', 'Giving Hope' and 'Hayim Association' from October 2021 to February 2022. The participants completed a questionnaire about demographic and child‐related characteristics, resilience, illness perception, pain catastrophizing, social support and caregiver burden. Associations between the variables were explored using Pearson's correlations and path analyses. Results: The study included 67 parents of children with cancer with an average age of 41.79 (SD = 6.31). The majority were mothers (n = 54, 80.6%) with a steady partner (n = 62, 92.5%). The level of caregiver burden was M (SD) = 25.00 (7.15) out of 48 possible, indicating a high burden level. Illness perception was directly positively associated with caregiver burden (β =.280, p =.017) and pain catastrophizing (β =.340, p <.01), and directly negatively with resilience (β = −.318, p <.01). Illness perception and pain catastrophizing serially mediated the relationship between resilience and caregiver burden among parents of children with cancer (β = −.190, p =.001). Conclusions: This study found that both illness perception and pain catastrophizing serially mediated the relationship between personal resilience and caregiver burden. Relevance to clinical practice: To ease caregiver burden for parents of children with cancer, programmes should address their psychological and emotional needs, including managing perceptions of illness and coping with pain‐related distress. [ABSTRACT FROM AUTHOR]

Background: Patients with fibromyalgia experience chronic, widespread pain. It remains a misunderstood disorder with multimodal treatments providing mixed results. Objectives: To examine the effects of radial shockwave therapy (RSWT) compared to placebo on pain, pain catastrophizing, psychological indices, blood markers, and neuroimaging. Study-related experiences were also explored qualitatively. Methods: Quantitative sensory testing (QST), Visual Analog Scale (VAS), Beighton Scoring Screen (BSS), Pain Catastrophizing Scale (PCS), blood biomarker (Interleukin (IL)-6 and IL-10), and brain fMRI were measured pre- and post-treatment along with a post-treatment survey. The RSWT group received five treatments (one week apart over five-week period) to the three most painful areas (500 shocks at 1.5 bar and 15 Hz, then 1000 shocks at 2 bar and 8 Hz, and finally 500 shocks at 1.5 bar and 15 Hz) versus sham treatment for the placebo group. Results: There were no statistically significant differences in the BSS for hypermobility (p =.21; d =.74), PCS (p =.70; d =.22), VAS (p =.17–.61; d =.20–.83) scores, QST for skin temperature and stimuli (p =.14–.65; d =.25–.88), and for the pressure pain threshold (p =.71–.93; d =.05–.21). The VAS scores had clinically significant changes (MCID greater than 13.90) with improved pain scores in the RSWT group. Neuroimaging scans revealed no cortical thickness changes. Post-treatment surveys revealed pain and symptom improvements and offered hope to individuals. Conclusion: RSWT was implemented safely, without any negative treatment effects reported, and acted as a pain modulator to reduce sensitivity. Clinical Trials Registration: ClinicalTrials.gov identification number NCT02760212 [ABSTRACT FROM AUTHOR]

Background: Previous studies have evaluated the implementation of behavioral approaches in individuals with chronic temporomandibular disorders (TMDs). Objective: To evaluate the benefits of a behavioral approach to craniofacial pain. Second, we assessed the benefits of kinesiophobia, catastrophizing, mouth opening without pain, and forward head posture. Methods: Individuals with chronic TMDs were treated for five weeks. The intervention group (n = 17) underwent pain neuroscience education, manual therapy, and therapeutic exercise, whereas the control group (n = 17) underwent manual therapy only. Outcomes were evaluated immediately, at seven and 19 weeks follow-up. The assessment tools used were the Craniofacial Pain Disability Inventory, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Mandibular Range of Motion Scale, and Cervical Range of Motion Tool. Results: The interventions did not influence the differences in the improvements between the groups observed for craniofacial pain disability (inter-subject p 0.4). The intervention had a moderate influence on the improvement of kinesiophobia and catastrophizing (Inter-subject p 0.09 and 0.1 respectively) with a clinically significant effect size (Estimated mean (EM) −8.6 standard deviation (SD) ±3.48 p 0.019; and EM −7.6 SD ± 5.11 p 0.15 respectively). Conclusion: The behavioral approach improved catastrophizing and kinesiophobia outcomes in individuals with chronic TMDs. [ABSTRACT FROM AUTHOR]

Introduction: Widespread pain may be related to psychosocial aspects in several musculoskeletal conditions, but the literature on carpal tunnel syndrome (CTS) is scarce. Objective: To determine the relationship between pain extent and psychological factors (catastrophizing, kinesiophobia, anxiety symptoms, and depression) in people with CTS. Methods: A cross-sectional study was conducted. The independent variables were: pain intensity, disability (QuickDASH), duration of symptoms, anxiety and depressive symptoms, catastrophizing, and kinesiophobia. The main outcome was: pain extent (% of total area and categories "pain within the median nerve-innervated territory" versus "extra-median nerve pain"). Correlation analysis was performed using Spearman's correlation coefficient. A linear regression model and binary logistic regression (both with forward selection) were performed to determine the main predictors of pain extent. Results: Forty-eight participants were included. A moderate positive correlation was found between catastrophizing (r = 0.455; p = 0.024) and disability (r = 0.448; p = 0.024) with total pain extent area. Regression models indicated that catastrophizing explained 22% of the variance in the pain extent (β = 0.003; 95% CI: 0.002–0.005), while kinesiophobia was the variable that best explained the distribution of pain in the extra-median territory (R2 Nagelkerke = 0.182). Null or weak correlations were found for the rest of the associations. Conclusion: Catastrophizing and kinesiophobia were the main indicators of pain extent in people with CTS. Clinicians are advised to use specific questionnaires to check for the presence of catastrophizing or kinesiophobia in people with CTS and wider pain extension. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the psychometric properties of the Silhouettes Fatigue Scale (SFS) when used to assess fatigue in undergraduates and middle-aged adults with chronic pain. Materials and methods: A total of 426 undergraduates and 207 middle-aged individuals with chronic pain participated in this study. Participants were asked to respond to a survey including the SFS as well as another validated measure of fatigue, questionnaires about pain catastrophizing and pain interference, and questions about pain (i.e., location, duration, and intensity). Convergent, discriminant, criterion and known-groups validity were evaluated. Results: Convergent validity was supported by a strong association between the two scales measuring fatigue. Discriminant validity was supported by stronger associations between the two fatigue scales scores compared to those between the SFS and pain catastrophizing scores. Criterion validity was supported by moderate associations between the SFS and measures of pain intensity and pain interference. Finally, known-groups validity was supported by significant differences in the SFS scores between students without chronic pain, students with chronic pain, and middle-aged individuals with chronic pain. Conclusions: The findings support the validity of the SFS scores when used to assess fatigue in undergraduates and middle-aged adults with chronic pain. IMPLICATIONS FOR REHABILITATION: Fatigue is a significant problem among people with chronic pain that can lead to disability. Assessing and treating fatigue in people with pain is essential. The Silhouettes Fatigue Scale (SFS) is a new single-item self-report of fatigue, fast and easy to use. Results support convergent and discriminant validity as well as sensibility to detect differences in fatigue between groups. [ABSTRACT FROM AUTHOR]

In Parkinson's disease (PD), a large number of individuals are confronted with pain. This issue has been receiving increasing attention in literature in recent years, as the complexity of pain in this disease makes its evaluation and treatment challenging. However, psychological variables related to the pain experience have received limited attention, especially when it comes to the exploration of beliefs regarding pain which, to our knowledge, remains unexplored in PD. Pain beliefs are defined as a subset of a patient's belief system which represents a personal understanding of the pain experience. Four dimensions of pain beliefs have been isolated in literature: mystery, pain permanence, pain constancy and self-blame. Thus, the goal of this study was first to describe pain beliefs in individuals with PD and second, to explore the relationships between pain beliefs and clinical and psychological variables. One hundred and sixty-nine international individuals with PD completed an online survey with socio-demographic and medical data. Participants completed self-report instruments to assess their pain (King's Parkinson's Disease Pain Questionnaire, McGill Pain Questionnaire and Brief Pain Inventory), psychological distress (Beck Depression Inventory, short-form and Parkinson Anxiety Scale), pain catastrophizing (Pain Catastrophizing Scale) and pain beliefs catastrophizing (Pain Beliefs and Perception Inventory). The study's findings revealed that most participants' beliefs are marked by the dimension of permanence, suggesting that individuals with PD perceive the pain experience as chronic and enduring. Meanwhile, pain is minimally perceived as constant, mysterious, or a source of guilt. Our finding concerning the permanence dimension deserves specific attention: even though this belief is prevalent in our population, it is not, or only weakly, associated with an impact on mood or pain catastrophizing. These results bring forth several hypotheses for understanding, highlighting the role of acceptance, and offer new perspectives toward improving clinical practices in terms of assessing and managing pain in PD. [ABSTRACT FROM AUTHOR]

Background: Chronic pain affects about 20% of total knee arthroplasty (TKA) patients, with high pain catastrophizing being a key predictor. Screening and addressing this modifiable factor may improve postoperative outcomes. Objective: We aimed to compare the effectiveness of two preoperative home-based multimodal physical therapy interventions on pain catastrophizing in high-catastrophizing TKA patients. Secondarily, the study aimed to assess postoperative outcomes over six months. Methods: A total of 40 patients with symptomatic osteoarthritis and moderate pain catastrophizing were randomly allocated to the control, therapeutic patient education (TPE), and multimodal physiotherapy (MPT) groups. Preoperative interventions comprised pain neuroscience education, coping skills training, and therapeutic exercise, differing in the number of sessions and degree of supervision. All outcomes were assessed before and after the treatment in the preoperative period, and 1, 3, and 6 months post-surgery. The primary outcome measure was pain catastrophizing. Results: Both intervention groups showed a preoperative reduction in pain catastrophizing. TPE patients had lower pain ratings at rest and lower catastrophizing scores at 1 and 6 months post-surgery, reduced kinesiophobia and improved dynamic balance at 3 and 6 months post-surgery, and higher self-efficacy at 1 month post-surgery. MPT patients exhibited lower pain catastrophizing and pain intensity during walking at 1 month post-surgery, and better outcomes in kinesiophobia, self-efficacy, and dynamic balance at 1, 3, and 6 months post-surgery, along with higher walking speed at 6 months post-surgery. Conclusions: Preoperative physiotherapy reduces preoperative pain catastrophizing and improves postoperative pain-related outcomes, behaviors, and cognitions in high-catastrophizing TKA patients. Registration is with the United States Clinical Trials Registry (NCT03847324). [ABSTRACT FROM AUTHOR]

Background: Effective pain management is crucial for both comfort and outcomes, yet predicting and managing this pain is difficult. This study aimed to analyze postoperative pain in patients undergoing hand surgery at the Mayo Clinic Florida, examining how patient characteristics and anxiety affect pain outcomes. Methods: We conducted a single-arm clinical trial at Mayo Clinic Florida, recruiting patients undergoing hand surgery. Preoperative pain and anxiety were assessed using the Pain Catastrophizing Scale (PCS) and State-Trait Anxiety Inventory (STAI). Postoperatively, patients used an iPhone app to record pain levels and medication use every four hours. Devices were collected three days after surgery. We analyzed the relationship between demographics, PCS, STAI scores, and pain levels using linear and logistic regression models. All statistical tests were two-sided with significance set at p < 0.05, analyzed with R4.2.2. Results: Data were collected from 62 patients (62.9% women, 37.1% men) undergoing hand surgery. Participants were mainly White (90.3%), with 50% being in the middle-aged adult group. Most had low anxiety levels (80.6% STAI-S, 82.3% STAI-T) and low catastrophizing (61.3% PCS). Postoperative pain was low, with median scores between 1.0 and 2.0 over three days. Demographics, anxiety, and catastrophizing were not significant predictors of pain levels. Logistic regression showed time as a significant factor, with pain levels peaking on Day 3. Conclusions: Postoperative pain after hand surgery was generally low, with time being a significant predictor of increased pain. Demographic factors, anxiety, and catastrophizing did not significantly affect pain levels. Pain management should emphasize time-sensitive interventions and ongoing monitoring. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. The relationship between perception of harm, emotional valence in movement images, and their impact on disability in shoulder pain. Perception of harm correlates with disability. Recent studies highlight an interplay between pain perception and emotional responses. This necessitates a thorough investigation into how beliefs and motivational influences respond to visual stimuli of movements. Such an analysis is crucial for understanding the extent to which these factors contribute to disability levels associated with shoulder pain. We aimed to investigate the relationship between the perception of harm and the valence in images depicting shoulder movements and determine how these perceptions are linked to disability levels associated with shoulder pain. This cross-sectional study recruited 42 individuals with chronic shoulder pain. Participants were presented with 58 shoulder movements images. Each participant evaluated these images for emotional valence and arousal using the self-assessment manikin. For every image, they provided their level of avoidance, fear, and perception of harm in a numerical scale. We measured disability levels and pain catastrophizing using the Shoulder Pain and Disability Index and the Pain Catastrophizing Scale. A direct acyclic graph was used. Multiple linear regression analysis was conducted with shoulder disability as the dependent variable and perception of harm and valence as independent variables, adjusted for the confounders catastrophizing and arousal. This analysis resulted in a significant model (F 4,37 = 11.44; adjusted R 2 = 0.547; P < 0.01). The perception of harm to shoulder movement (β = 0.11; P < 0.001; 95% confidence interval = 5.6-11.8) was significantly associated with the level of shoulder disability, whereas valence did not show a significant association (β = 0.26; P = 0.15; 95% confidence interval = 1.7-10.8). The perception of harm associated with shoulder movements images during daily activities was associated with disability. Individuals who believe that shoulder movements are harmful have greater disability. [ABSTRACT FROM AUTHOR]

Unveils long-term postoperative pain outcomes in Spanish youth for the first time. Offers novel perspectives and vital cross-cultural implications, enriching global pain management approaches. Supplemental Digital Content is Available in the Text. Pediatric chronic pain, particularly chronic postsurgical pain (CPSP), poses a significant public health challenge, impacting 20% of pediatric populations. While several presurgical predictors have been identified, there is a scarcity of data on long-term outcomes, especially beyond 1 to 2 years postsurgery. Previous research primarily focuses on North American children, creating gaps in understanding CPSP outcomes in diverse health systems, such as in Spain. This study, registered as NCT04735211, investigates CPSP in 159 children and adolescents (mean age = 12.4 years, 37.1% girls, retention rate = 65%) undergoing various surgeries in Spain. The objectives include examining CPSP prevalence (Numerical Rating Scale ≥ 4) at 3, 6, 12, and 24 months, exploring postsurgical pain trajectories through group-based trajectory modeling, and identifying potential presurgical predictors for CPSP (pain intensity, pain catastrophizing, pain anxiety, fear of pain, kinesiophobia, health-related quality of life, pain interference, and physical activity), using multiple logistic regressions. Results show a CPSP prevalence of 41% at 3 months, decreasing to 14% at 24 months. Presurgical factors including pain intensity (adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI] = 1.02-1.53), pain catastrophizing (aOR = 1.06, 95% CI = 1.00-1.13), and pain anxiety (aOR = 1.06, 95% CI = 1.02-1.11) were associated with CPSP at 3 months. Group-based trajectory modeling revealed 3 postsurgical pain trajectories: Low Pain with Rapid Recovery Group (30.2%), Moderate Pain with Recovery Group (53.5%), and High Pain with Slow Recovery Group (16.3%), with group differences in presurgical predictors, excluding physical activity. This study contributes valuable insights into CPSP, emphasizing the need for long-term follow-up. The findings could inform the implementation of preventive programs for CPSP into diverse health systems. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. We explored phenotypes of young people with chronic pain. Three phenotypes emerged characterized by increasing severity gradient showing meaningful differences across clinical, sociodemographic factors and service utilization. Using the Australiasian electronic Persistent Pain Outcomes Collaboration, a binational pain registry collecting standardized clinical data from paediatric ePPOC (PaedsePPOC) and adult pain services (AdultePPOC), we explored and characterized nationally representative chronic pain phenotypes and associations with clinical and sociodemographic factors, health care utilization, and medicine use of young people. Young people ≥15.0 and <25.0 years captured in PaedePPOC and AdultePPOC Australian data registry were included. Data from 68 adult and 12 paediatric pain services for a 5-year period January 2018 to December 2022 (first episode, including treatment information) were analysed. Unsupervised latent class analysis was applied to explore the existence of distinct pain phenotypes, with separate models for both services. A 3-phenotype model was selected from both paediatric and adult ePPOC data, with 693 and 3518 young people included, respectively (at least one valid indicator variable). Indicator variables for paediatric models were as follows: pain severity, functional disability (quasisurrogate "pain interference"), pain count, pain duration, pain-related worry (quasisurrogate "catastrophizing"), and emotional functioning; and, for adult models: pain severity, pain interference, pain catastrophizing, emotional functioning, and pain self-efficacy. From both services, 3 similar phenotypes emerged ("low," "moderate," "high"), characterized by an increasing symptom-severity gradient in multidimensional pain-related variables, showing meaningful differences across clinical and sociodemographic factors, health service utilization, and medicines use. Derived phenotypes point to the need for novel care models that differentially respond to the needs of distinct groups of young people, providing timely, targeted, age-appropriate care. To effectively scale such care, digital technologies can be leveraged to augment phenotype-informed clinical care. [ABSTRACT FROM AUTHOR]

We validated a clinical algorithm to predict the response to motor cortex repetitive transcranial magnetic stimulation in peripheral neuropathic pain, which is potentially applicable to other chronic pains. Motor cortex repetitive transcranial magnetic stimulation (M1-rTMS) induces analgesic effects in neuropathic pain, but not all patients are good responders, and no clinical predictors of the response have been identified. The present study aimed to develop and validate a simple and easy-to-use predictive algorithm for the individual response to M1-rTMS in peripheral neuropathic pain that may be potentially applicable to any chronic pain condition. This was based on a secondary analysis from a recent double-blind, placebo-controlled trial demonstrating the efficacy of high-frequency M1-rTMS against placebo-rTMS and rTMS of the dorsolateral prefrontal cortex in 149 patients with peripheral neuropathic pain. Baseline variables were entered in the model without preconception, and categorized into sociodemographic, pain, and psychological variables. Good responders to rTMS were defined based on 50% pain relief on average pain intensity (rated on a 0-10 numerical rating scale) at 25 weeks. Ridge regression, feature selection, and Monte Carlo cross-validation were used to build and validate a predictive model specific for the response to M1-rTMS at 25 weeks. The algorithm included 3 variables: 2 were psychological variables (depressive symptoms, magnification dimension of the Pain Catastrophizing Scale) and 1 was related to pain distribution (distal lower extremity pain). It demonstrated 85% sensitivity (P = 0.005) and 84% specificity (P < 0.0001) to predict a good response to M1-rTMS at 25 weeks. It was not predictive of the response to placebo or dorsolateral prefrontal cortex-rTMS. This simple and user-friendly algorithm may contribute to individualize treatment with M1-rTMS in patients with peripheral neuropathic pain in routine and in further clinical trials. Clinical trial registration: NCT02010281. [ABSTRACT FROM AUTHOR]

Background: Chronic pain is an important medical problem that is associated with significant negative effects in many aspects of life. Based on prior studies, certain religious behaviors and having religion-based beliefs help coping with chronic diseases. this research aimed to investigate the effectiveness of Islamic spiritual therapy on the perception of pain intensity and catastrophizing of pain in patients with pain. Methods: The research population included all female patients suffering from chronic pain who referred to physiotherapy and pain clinics in Shiraz in 2022; finally, 30 female patients were selected from 3 clinics using available sampling method. After meeting the inclusion criteria, they entered into the treatment process. In the pretest stage, research questionnaires including Pain catastrophizing questionnaire (pcs) (1995) and Pain Intensity Perception Questionnaire were completed and randomly assigned. The participants underwent 10 sessions of Islamic spirituality therapy, each lasted 45 min; during this time, the control group did not receive any intervention. After the end of the treatment program, the questionnaires were administered again to both groups in the form of a post-test. The data were analyzed using multivariate analysis of covariance (MANCOVA) in SPSS version 22. Result: the average values of pain intensity and pain catastrophizing exhibited a reduction in the post-assessment in contrast to the pre-assessment. This disparity demonstrated statistical significance within the experimental cohort, whereas the difference between the mean values of the pre- and post-assessment in the control group were not statistically significant. It affirmed the efficacy of the intervention on the experimental group. Conclusions: Based on the findings of this study, Islamic spiritual therapy approaches decrease pain intensity and pain catastrophizing in women with chronic pain and represents new horizons in clinical interventions and thus could be used as an effective interventional method to reduce psychosocial problem and increase pain tolerance. [ABSTRACT FROM AUTHOR]

Objective: Pain catastrophizing has dimensions of magnification, rumination, and helplessness, being an important evaluator of chronic pain. Studies with mindfulness intervention point to a possible modulation of chronic pain catastrophizing behavior. However, how these facets of mindfulness are associated with the catastrophizing subscales is uncertain. The scope of this study is to verify how the association of mindfulness facets and catastrophizing subdimensions occurs. Methods: Women with chronic TMD answered the Pain Catastrophizing Scale (PCS) and Five Facets of Mindfulness Questionnaire (FFMQ). Results: Magnification was inversely correlated with "not reacting," "not judging," and the total FFMQ score. Total PCS was also inversely correlated with "not reacting." Conclusion: It is necessary to consider such possible correlations between mindfulness facets and the catastrophizing subdimensions in mindfulness-based interventions for this population. [ABSTRACT FROM AUTHOR]

Objective: The objective was to examine potential pathways linking neighborhood disadvantage to pain severity in individuals with knee pain consistent with or at risk for knee osteoarthritis (KOA). Methods: The current investigation is a cross‐sectional analysis. Data were collected from 140 middle‐aged to older non‐Hispanic White and non‐Hispanic Black adults from the Understanding Pain and Limitations in Osteoarthritic Disease Study 2 (UPLOAD‐2). Relationships among neighborhood disadvantage, sleep efficiency, pain catastrophizing, and pain severity were assessed. Neighborhood disadvantage was quantified using the Area Deprivation Index, and actigraphy data were used to assess sleep efficiency. The Coping Strategies Questionnaire–Revised catastrophizing subscale and the Western Ontario and McMaster Universities Osteoarthritis Index pain severity scale were used to assess pain catastrophizing and pain severity, respectively. A serial mediation model assessed the neighborhood–sleep–catastrophizing–pain pathway, as well as the neighborhood–sleep–pain and the neighborhood–catastrophizing–pain pathways. Results: Greater neighborhood disadvantage was associated with worse sleep efficiency, ultimately contributing to greater pain severity. Although neither neighborhood disadvantage nor sleep efficiency were associated with pain catastrophizing, pain catastrophizing itself was associated with greater KOA pain. Conclusion: Neighborhood disadvantage impacts KOA pain outcomes through sleep efficiency but not pain catastrophizing, thereby highlighting environmental aspects that impact sleep as potential targets for intervention. [ABSTRACT FROM AUTHOR]

Background and Objectives: The International Society for Modulation defines persistent spinal pain syndrome type 2 (PSPS-type 2), formerly known as failed back surgery syndrome, as a condition where patients continue to experience pain or develop new pain following spinal surgery intended to alleviate back or lower-limb discomfort. PSPS-type 2 is characterized by pain and significant disability, affecting quality of life. Spinal cord stimulation has proven effective in treating this syndrome, although the role of psychological factors, such as pain catastrophizing and central sensitization, remain unclear. This study seeks to examine the potential connection between psychosocial responses and both functionality and pain perception in patients with persistent spinal pain syndrome type 2 who have undergone spinal cord stimulation treatment. Materials and Methods: A single-site, cross-sectional study was conducted on individuals diagnosed with persistent spinal pain syndrome type 2 who were receiving spinal cord stimulation. Study participants were required to meet specific eligibility criteria and were assessed for disability, pain perception, fear of movement, pain catastrophizing, and central sensitization. The spinal cord stimulation procedure involved the placement of electrodes at vertebral levels T8–T11 for precise pain control, with a particular focus on targeting the dorsal root ganglion to alleviate chronic pain. Results: Thirty-seven patients with persistent spinal pain syndrome type 2 have undergone spinal cord stimulation treatment for 4.68 ± 5.25 years. Clinical assessments indicated a pain perception score of 5.6 ± 1.96, Central Sensitization Inventory score of 42.08 ± 18.39, disability score of 37.62 ± 16.13, fear of movement score of 33.11 ± 8.76, and pain catastrophizing score of 28.43 ± 13.14. Finally, pain catastrophizing was significantly associated with pain perception (β = 0.075 and p = 0.008) and disability (β = 0.90 and p < 0.01). Conclusions: Catastrophizing plays a crucial role in pain perception and disability among patients with persistent spinal pain syndrome type 2 receiving spinal cord stimulation. Integrating psychological interventions may improve clinical outcomes for these patients. [ABSTRACT FROM AUTHOR]

BackgroundThis study explores the relationship between primary dysmenorrhea (PD), pain, pain catastrophizing, and menstruation-related quality of life in young women.MethodsA cross-sectional study was conducted involving 44 young women, both with and without PD. Various variables including pain intensity, pain catastrophizing, and menstruation-related quality of life were assessed using validated questionnaires. Correlation and regression analyses were performed to examine the relationships between the variables.ResultsSignificant associations were found between the presence of PD, tendency to catastrophize pain, and decreased menstruation-related quality of life. A high correlation was observed between pain intensity and catastrophizing, indicating mutual influence between these variables. Menstruation-related quality of life was affected in terms of health perception, psychological aspect, and symptoms among women with PD. The linear regression model demonstrated that catastrophizing explained 42.8% of the variance in menstruation-related quality of life.ConclusionsThese findings underscore the importance of addressing dysmenorrhea in young women, as it significantly impacts their quality of life related to menstruation. Understanding the factors contributing to dysmenorrhea and its effects on quality of life can inform more effective, patient-centered treatment strategies.

The article discusses the role of negative thinking and catastrophizing in the experience of withdrawal from substances. It explores the development of new assessment tools, such as the Withdrawal Catastrophizing Scale (WCS) and Withdrawal Interference Scale (WIS), to measure emotional and cognitive responses to withdrawal symptoms. These tools aim to bridge the gap between withdrawal discomfort, craving, and the concept of hyperkatifeia, offering a holistic approach to evaluating and managing withdrawal. The study suggests that these scales could enhance treatment effectiveness by targeting specific aspects of withdrawal and predicting outcomes. [Extracted from the article]

This randomized controlled trial investigated the effectiveness of an online self-management program, "Take Charge of Burn Pain (TCBP)," for 96 individuals living with chronic burn pain. Participants were randomly assigned to either the 7-week TCBP program integrating cognitive-behavioral therapy techniques, pain education, and self-management strategies or an attention control group focused on general burn recovery information. Assessments conducted at baseline, post-treatment, and 2- and 5-month follow-ups included measures of pain severity, pain interference, pain self-efficacy, posttraumatic stress disorder symptoms, and depression. Compared to the control group, participants in the TCBP program demonstrated greater reductions in pain severity (mean difference: −1.24, 95 % CI: −1.93 to −0.55, p = 0.0007) and pain catastrophizing (mean difference: −5.41, 95 % CI: −10.33 to −0.49, p = 0.0318) post-treatment when adjusting for key variables. At the two-month follow-up, the TCBP group showed significant improvements in pain interference (P = 0.0123), self-efficacy (P = 0.0269), functional abilities (P = 0.0014), and social role participation (P = 0.0498) compared to the control group. Treatment effects were not sustained at 5-month follow-up. Participants in both groups reported high levels of satisfaction with the online intervention, with the majority finding the program helpful and easy to use, and being willing to recommend it to others with pain. Findings suggest preliminary support for short-term benefits of TCBP for managing certain facets of chronic burn pain. This underscores the need to refine digital approaches to maintain and promote long-term improvements. The potential of self-guided online psychological interventions to enhance pain coping strategies for burn survivors persists. • Online self-management intervention for chronic burn pain reduces pain severity and catastrophizing short-term. • Improvements in pain interference, function, and self-efficacy at 2 months. • High participant satisfaction with online platform despite retention challenges. • Digital interventions offer potential for accessible burn pain management. [ABSTRACT FROM AUTHOR]

Spiritual wellbeing correlates with improved pain perception. We hypothesize that pain catastrophizing, which correlates with worsened pain, partially explains this relationship. In this cross-sectional, human laboratory-based study, 120 US Americans with chronic pain completed self-report measures of spiritual wellbeing, pain catastrophizing, and their subconstructs. A cold pressor task measured pain perception (i.e. pain sensitivity and pain tolerance). Multiple regressions evaluated the relationship between spiritual wellbeing (and its subconstructs) and pain perception with and without the inclusion of pain catastrophizing (and its subconstructs). No direct relationships were found between spiritual wellbeing or its subconstructs and pain sensitivity, although helplessness significantly altered regression coefficients. Spiritual wellbeing, meaning, and peace associated less strongly with pain tolerance controlling for pain catastrophizing, helplessness, and (for peace) magnification. This shows that many of the links between spiritual wellbeing and pain perception are indirect, through pain catastrophizing and especially helplessness. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of an evidence-based pre-, peri- and postoperative rehabilitation pathway (i.e. the REACT rehabilitation pathway) on disability in patients undergoing lumbar fusion surgery (LFS), compared to usual care.A prospective, nonrandomized controlled trial included 72 patients scheduled for one- or two-level LFS for degenerative conditions or adult isthmic spondylolisthesis. Participants were allocated to usual care (N = 36) or the REACT rehabilitation pathway (N = 36). The REACT rehabilitation pathway includes prehabilitation, early mobilization and avoidance of unsubstantiated postoperative restrictions, early postoperative physiotherapy, patient empowerment, case manager guidance, and support towards an early return to activity. The primary outcome was disability; key secondary outcomes were back and leg pain intensity, and return-to-work rate. Additional secondary outcomes included fear of movement, pain catastrophizing, negative emotional states, sit-to-stand performance, analgesic use, length of stay, and adverse events. Data were collected preoperatively and at five time points up to one year postoperatively.Participants in the REACT group demonstrated significantly greater improvements in disability (p = 0.003), back pain intensity (p = 0.007), and return-to-work rates (88% vs 56%, p = 0.34) compared to the control group. The REACT group also showed greater improvements in fear of movement (p = 0.038), pain catastrophizing (p < 0.001), combined negative emotional states (p = 0.007), sit-to-stand performance (p = 0.021), and reduced analgesic use (p = 0.001). No significant differences were observed in leg pain intensity (p = 0.042), length of hospital stay (p = 0.095) or adverse events (p = 1.00).The REACT rehabilitation pathway significantly reduced disability in the first postoperative year after LFS compared to usual care. The most promising result is the significantly higher return-to-work rate in the REACT group.Methods: To evaluate the effectiveness of an evidence-based pre-, peri- and postoperative rehabilitation pathway (i.e. the REACT rehabilitation pathway) on disability in patients undergoing lumbar fusion surgery (LFS), compared to usual care.A prospective, nonrandomized controlled trial included 72 patients scheduled for one- or two-level LFS for degenerative conditions or adult isthmic spondylolisthesis. Participants were allocated to usual care (N = 36) or the REACT rehabilitation pathway (N = 36). The REACT rehabilitation pathway includes prehabilitation, early mobilization and avoidance of unsubstantiated postoperative restrictions, early postoperative physiotherapy, patient empowerment, case manager guidance, and support towards an early return to activity. The primary outcome was disability; key secondary outcomes were back and leg pain intensity, and return-to-work rate. Additional secondary outcomes included fear of movement, pain catastrophizing, negative emotional states, sit-to-stand performance, analgesic use, length of stay, and adverse events. Data were collected preoperatively and at five time points up to one year postoperatively.Participants in the REACT group demonstrated significantly greater improvements in disability (p = 0.003), back pain intensity (p = 0.007), and return-to-work rates (88% vs 56%, p = 0.34) compared to the control group. The REACT group also showed greater improvements in fear of movement (p = 0.038), pain catastrophizing (p < 0.001), combined negative emotional states (p = 0.007), sit-to-stand performance (p = 0.021), and reduced analgesic use (p = 0.001). No significant differences were observed in leg pain intensity (p = 0.042), length of hospital stay (p = 0.095) or adverse events (p = 1.00).The REACT rehabilitation pathway significantly reduced disability in the first postoperative year after LFS compared to usual care. The most promising result is the significantly higher return-to-work rate in the REACT group.Results: To evaluate the effectiveness of an evidence-based pre-, peri- and postoperative rehabilitation pathway (i.e. the REACT rehabilitation pathway) on disability in patients undergoing lumbar fusion surgery (LFS), compared to usual care.A prospective, nonrandomized controlled trial included 72 patients scheduled for one- or two-level LFS for degenerative conditions or adult isthmic spondylolisthesis. Participants were allocated to usual care (N = 36) or the REACT rehabilitation pathway (N = 36). The REACT rehabilitation pathway includes prehabilitation, early mobilization and avoidance of unsubstantiated postoperative restrictions, early postoperative physiotherapy, patient empowerment, case manager guidance, and support towards an early return to activity. The primary outcome was disability; key secondary outcomes were back and leg pain intensity, and return-to-work rate. Additional secondary outcomes included fear of movement, pain catastrophizing, negative emotional states, sit-to-stand performance, analgesic use, length of stay, and adverse events. Data were collected preoperatively and at five time points up to one year postoperatively.Participants in the REACT group demonstrated significantly greater improvements in disability (p = 0.003), back pain intensity (p = 0.007), and return-to-work rates (88% vs 56%, p = 0.34) compared to the control group. The REACT group also showed greater improvements in fear of movement (p = 0.038), pain catastrophizing (p < 0.001), combined negative emotional states (p = 0.007), sit-to-stand performance (p = 0.021), and reduced analgesic use (p = 0.001). No significant differences were observed in leg pain intensity (p = 0.042), length of hospital stay (p = 0.095) or adverse events (p = 1.00).The REACT rehabilitation pathway significantly reduced disability in the first postoperative year after LFS compared to usual care. The most promising result is the significantly higher return-to-work rate in the REACT group.Conclusion: To evaluate the effectiveness of an evidence-based pre-, peri- and postoperative rehabilitation pathway (i.e. the REACT rehabilitation pathway) on disability in patients undergoing lumbar fusion surgery (LFS), compared to usual care.A prospective, nonrandomized controlled trial included 72 patients scheduled for one- or two-level LFS for degenerative conditions or adult isthmic spondylolisthesis. Participants were allocated to usual care (N = 36) or the REACT rehabilitation pathway (N = 36). The REACT rehabilitation pathway includes prehabilitation, early mobilization and avoidance of unsubstantiated postoperative restrictions, early postoperative physiotherapy, patient empowerment, case manager guidance, and support towards an early return to activity. The primary outcome was disability; key secondary outcomes were back and leg pain intensity, and return-to-work rate. Additional secondary outcomes included fear of movement, pain catastrophizing, negative emotional states, sit-to-stand performance, analgesic use, length of stay, and adverse events. Data were collected preoperatively and at five time points up to one year postoperatively.Participants in the REACT group demonstrated significantly greater improvements in disability (p = 0.003), back pain intensity (p = 0.007), and return-to-work rates (88% vs 56%, p = 0.34) compared to the control group. The REACT group also showed greater improvements in fear of movement (p = 0.038), pain catastrophizing (p < 0.001), combined negative emotional states (p = 0.007), sit-to-stand performance (p = 0.021), and reduced analgesic use (p = 0.001). No significant differences were observed in leg pain intensity (p = 0.042), length of hospital stay (p = 0.095) or adverse events (p = 1.00).The REACT rehabilitation pathway significantly reduced disability in the first postoperative year after LFS compared to usual care. The most promising result is the significantly higher return-to-work rate in the REACT group. [ABSTRACT FROM AUTHOR]