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The main goal of the study was to evaluate Orbach's multidimensional model of mental pain in Italy, while constructing a reliable and valid Italian version of the 40-item Orbach and Mikulincer Mental Pain scale (OMMP) in a non-clinical sample. The sample consisted of 544 Italian adults. Findings indicated that the original 8-factor structure of the OMMP scale was not validated in our Italian version of the scale. Confirmatory factor analyses yielded a 31-item solution, with five main factors (Irreversibility, Lack of control and Freezing, Narcissistic wounds, Emotional flooding, Emptiness). Women scored higher than men in emotional flooding and lack of control, age was inversely related to the reported level of mental pain, and participants who were married or had a long, stable couple relationship showed lesser emotional suffering than singles. This study has shown the OMMP to be a valid and reliable scale for assessing mental pain in the general population. Future studies are needed in order to examine the replicability of the 5-factor model as well as the validity of the OMMP factors in clinical samples in the Italian context., Author(s): Eliana Tossani [sup.1] [sup.2] , Maria Grazia Ricci Garotti [sup.1] , Mario Mikulincer [sup.3] , Sara Giovagnoli [sup.2] , Gloria Calzolari [sup.1] , Giulia Landi [sup.1] [sup.2] , Silvana [...]

Byline: James Elander (1,6), Malgorzata Marczewska (2), Roger Amos (3), Aldine Thomas (4), Sekayi Tangayi (5) Keywords: vignette study; pain judgments; addiction; pseudoaddiction; analgesics; sickle cell disease. Abstract: Judgments about people with pain are influenced by contextual factors that can lead to stigmatization of patients who present in certain ways. Misplaced staff perceptions of addiction may contribute to this, because certain pain behaviors superficially resemble symptoms of analgesic addiction. We used a vignette study to examine hospital staff judgments about patients with genuine symptoms of analgesic addiction and those with pain behaviors that merely resemble those symptoms. Nurses and doctors at hospitals in London, UK, judged the level of pain, the likelihood of addiction, and the analgesic needs of fictitious sickle cell disease patients. The patient descriptions included systematic variations to test the effects of genuine addiction, pain behaviors resembling addiction, and disputes with staff, which all significantly increased estimates of addiction likelihood and significantly decreased estimates of analgesic needs. Participants differentiated genuine addiction from pain behaviors resembling addiction when making judgments about addiction likelihood but not when making judgments about analgesic needs. The treatment by staff of certain pain behaviors as symptoms of analgesic addiction is therefore a likely contributory cause of inadequate or problematic hospital pain management. The findings also show what a complex task it is for hospital staff to make sensitive judgments that incorporate multiple aspects of patients and their pain. There are implications for staff training, patient education, and further research. Author Affiliation: (1) Thames Valley University, London, UK (2) Newham Primary Care Trust, London, UK (3) Homerton University Hospital, London, UK (4) Barts and the Royal London Hospital, London, UK (5) Newham University Hospital, London, UK (6) Psychology Department, Thames Valley University, St Mary's Road, London W5 5RF, UK Article History: Registration Date: 02/11/2005 Accepted Date: 02/11/2005 Online Date: 22/02/2006

Byline: Stephen Bruehl (1,3), Ok Y. Chung (1), Brian S. Donahue (1), John W. Burns (2) Keywords: anger regulation; anger-in; anger-out; pain; opioid; genetic; A118G. Abstract: Greater trait anger-out is associated with elevated pain responsiveness. Previous work suggests this effect may be mediated by deficient endogenous opioid analgesia, possibly reflecting diminished opioid receptor sensitivity. The A118G single nucleotide polymorphism (SNP) of the mu opioid receptor gene influences both opioid receptor sensitivity and clinical responsiveness to opioid analgesics. Therefore, this study tested whether this SNP either mediated or moderated the effects of anger-out on postsurgical pain outcomes. Forty-eight patients undergoing coronary artery bypass graft surgery provided genetic samples, and completed measures of anger-out and postsurgical pain. Postsurgical opioid analgesic use was also recorded. Anger-out was positively associated with postsurgical pain ratings (p &lt 0.05). Anger-out was not associated with A118G SNP status (p &gt 0.10), suggesting the latter is unlikely to mediate anger-out's pain-related effects. A significant anger-out x A118G interaction was observed on analgesic use (p &lt 0.05), due to a much stronger positive relationship between anger-out and analgesic demands in patient with the A118G SNP (b = 0.53) than those with the wild-type receptor (b = 0.07). These results suggest that the A118G SNP may moderate but not mediate the effects of anger-out on postoperative pain responses. Author Affiliation: (1) Department of Anesthesiology, Vanderbilt University School of Medicine, Tennessee, Nashville, USA (2) Department of Psychology, Rosalind Franklin University of Medicine and Science, Illinois, North Chicago, USA (3) Vanderbilt University Medical Center, 701 Medical Arts Building, 1211 Twenty-First Avenue South, Nashville, USA Article History: Registration Date: 23/09/2005 Received Date: 23/06/2005 Accepted Date: 01/09/2005 Online Date: 07/01/2006

Byline: Dawn Dannenbring (1), Michael J. Stevens (1), Alvin E. House (2) Keywords: childbirth pain; maternal satisfaction; predictors Abstract: There is little multivariate, multiphasic research on childbirth pain and satisfaction. We explored the relationship of demographic, medical, psychological, and environmental variables at different times to multiple indices of pain and satisfaction in 70 primiparae and multiparae. Induced labor, desirability of pregnancy, and coach's helpfulness predicted sensory pain. Duration of labor, depression, and outcome expectancy that childbirth education would facilitate medication-free childbirth predicted affective pain. Physician-anticipated complications, induced labor, and motivation to be medication-free predicted pain intensity. Grade level predicted satisfaction. The results also demonstrated differences between primiparae and multiparae in the pattern of variables that explained pain and satisfaction as well as the temporal sensitivity of pain predictors. We discuss the implications of our findings for research and practice. Author Affiliation: (1) DeWitt County Mental Health Center, Clinton, Illinois (2) Department of Psychology, Illinois State University, Normal, Illinois Article History: Registration Date: 22/09/2004