Pain
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Assessing the experience and impact of pain in adolescents with chronic pain is necessary to guide both individual treatment and to inform treatment development. Ideally, to obtain a comprehensive understanding of the impact of pain, assessment should be multidimensional, should be sensitive to contextual variables, and should allow for multiple informants (in particular, parents). The purpose of this study was to develop a standardized parent-report measure of chronic pain in adolescents, the Bath Adolescent Pain Questionnaire - Parent report (BAPQ-P). ⋯ Validity was examined in relation to existing validated child report measures of anxiety, depression, catastrophizing, disability, family, and social functioning and parent report measures of disability and family functioning. Psychometric evaluation suggests that the BAPQ-P is a reliable and valid parental report tool for assessing the multidimensional impact of adolescent chronic pain. It can be used in conjunction with the previously established adolescent self-report measure, the BAPQ, alone where adolescent self report is not possible, in studies where parent report is the focus, or in studies where concordance between parent and adolescent reports is of interest.
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Multicenter Study Comparative Study
Fear of movement and (re)injury in chronic musculoskeletal pain: Evidence for an invariant two-factor model of the Tampa Scale for Kinesiophobia across pain diagnoses and Dutch, Swedish, and Canadian samples.
The aims of the current study were twofold. First, the factor structure, reliability (i.e., internal consistency), and validity (i.e., concurrent criterion validity) of the Tampa Scale for Kinesiophobia (TSK), a measure of fear of movement and (re)injury, were investigated in a Dutch sample of patients with work-related upper extremity disorders (study 1). More specifically, examination of the factor structure involved a test of three competitive models: the one-factor model of all 17 TSK items, a one-factor model of the TSK (Woby SR, Roach NK, Urmston M, Watson P. ⋯ The TSK factors showed reasonable internal consistency, and were modestly but significantly related to disability, supporting the concurrent criterion validity of the TSK scales. Results from study 2 showed that the two-factor model of the TSK-11 was invariant across pain diagnoses and Dutch, Swedish, and Canadian samples. Altogether, we consider the TSK-11 and its two subscales a psychometrically sound instrument of fear of movement and (re)injury and recommend to use this measure in future research as well as in clinical settings.
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Randomized Controlled Trial Multicenter Study
Randomized controlled trial of exercise for chronic whiplash-associated disorders.
Whiplash-associated disorders are common and incur considerable expense in social and economic terms. There are no known effective treatments for those people whose pain and disability persist beyond 3 months. We conducted a randomized, assessor-blinded, controlled trial at two centres in Australia. ⋯ High levels of baseline pain intensity were associated with greater treatment effects at 6 weeks and high levels of baseline disability were associated with greater treatment effects at 12 months. In the short-term exercise and advice is slightly more effective than advice alone for people with persisting pain and disability following whiplash. Exercise is more effective for subjects with higher baseline pain and disability.
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Multicenter Study
Pain-related catastrophizing and perceived social responses: Inter-relationships in the context of chronic pain.
Pain-related coping, particularly catastrophizing, plays a significant role in shaping pain responses. One way catastrophizing is hypothesized to amplify pain and disability is via its effect on patients' social environments (e.g., communal coping model), though empirical support is limited. The present study tested whether the association between catastrophizing and deleterious pain-related outcomes was mediated by patients' perceptions of significant others' responses to their pain in a sample of 1356 pain patients. ⋯ In sum, perceived social responses were found to play a small role in mediating the relationship between catastrophizing and pain-related outcomes, and these mediational effects may be strongest in particular patient subgroups. The present data suggest that interpersonal mechanisms may not constitute a primary route by which catastrophizing exerts its maladaptive effects on pain responses. The study and further understanding of what principal factors mediate catastrophizing's deleterious effects on pain will be important in illuminating the biopsychosocial model of pain.
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Multicenter Study
Determining behavioural and physiological responses to pain in infants at risk for neurological impairment.
Multiple researchers have validated indicators and measures of infant pain. However, infants at risk for neurologic impairment (NI) have been under studied. Therefore, whether their pain responses are similar to those of other infants is unknown. ⋯ A significant Phase effect for low/high frequency Heart Rate Variability (HRV) ratio (F(2,216)=4.97, p=0.008) was found with the greatest decrease in Cohort A. Significant Cohort by Phase interactions existed for low and high frequency HRV. All infants responded to the most painful phase of the heel lance; however, infants at moderate and highest risk for NI exhibited decreased responses in some indicators.