Pain
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Other people can have a significant impact on one's pain. Although correlational data abound, causal relationships between one's pain experience, individual traits of social relating (e.g. attachment style), and social factors (e.g. empathy) have not been investigated. Here, we studied whether the presence of others and 'perceived empathy' (defined as participants' knowledge of the extent to which observers felt they understood and shared their pain) can modulate subjective and autonomic responses to pain; and whether these influences can be explained by individual traits of pain coping and social attachment. ⋯ In addition, social presence decreased autonomic responses to pain irrespective of individual personality traits. To our knowledge this is the first time that adult attachment style has been shown to modulate the effects of social presence and 'perceived empathy' on experimentally induced pain. The results are discussed in relation to recent cognitive models of pain coping and attachment theory.
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Sensory neuropathy (HIV-SN) is a common cause of pain in HIV-infected people. Establishing a diagnosis of HIV-SN is important, especially when contemplating opioid use in high-risk populations. However physical findings of HIV-SN may be subtle, and sensitive diagnostic tools require specialized expertise. ⋯ Increasing intensity of pain measured on a visual analog scale was associated with increasing severity of sensory abnormality. In summary, our results suggest that HIV-infected patients reporting symptoms consistent with HIV-SN, such as tingling, pins and needles, or aching or stabbing pain in the distal lower extremities, usually have objective evidence of HIV-SN on neurologic examination or with neurophysiologic testing. This finding holds true regardless of demographic factors, depression or substance use history.
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Widespread pain and pain hypersensitivity are the hallmark of fibromyalgia, a complex pain condition linked to central sensitization. In this study the painDETECT questionnaire (PDQ), validated to identify neuropathic pain and based on pain quality items, was applied in a cross-sectional sample of patients with chronic widespread pain (CWP). The aims of the study were to assess the patient-reported sensory neuropathic symptoms by PDQ and to correlate these with tender point (TP) count and pressure-pain thresholds. ⋯ The study indicates that pain in CWP has neuropathic features, and that the presence and number of tender points are associated with neuropathic pain symptoms. A high mean PDQ score was found to correlate with TP count and pressure-pain thresholds. The PDQ may become a useful tool assisting in the identification of central sensitization in patients with CWP and in the future diagnostic assessment fibromyalgia.
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We recently reported that women report greater pain adaptation and habituation to moderately painful heat stimuli than men (Hashmi and Davis [16]); but slightly lower temperatures were needed to evoke moderate pain in the women. Hardy et al (1962) and LaMotte (1979) suggested that pain adaptation is most prominent at modest noxious heat temperatures and may occur at temperatures close to pain thresholds. Thus, as a follow-up to our previous study, we examined the role of absolute temperature in pain adaptation and habituation in men and women and assessed whether pain threshold impacts these findings. ⋯ There were no sex differences in inter-stimulus habituation and both men and women reported habituation to temperatures less than 46°C. Pain thresholds did not correlate with pain adaptation. These data highlight the temperature-sensitivity and sex differences of pain adaptation and habituation.
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The social context surrounding chronic pain is important, particularly in the case of pain in adolescents, where caregivers can be a key influence on adolescent social and physical activities. In general, greater adolescent difficulties are related to greater caregiver difficulties, and vice versa, although the strength of these relations has not been consistent across studies. Further, existing analyses have not evaluated more complex multivariate models involving both direct and indirect relations among adolescents and caregivers. ⋯ This indirect relation may explain previous inconsistency across studies. Perhaps more importantly, the model tested may allow for an improved understanding of the complex relations among adolescents and caregivers factors. Finally, the need to adequately understand caregiver experiences in response to adolescent pain is highlighted and calls for appropriate intervention in young people struggling with chronic pain are reinforced within these analyses.