Journal of behavioral medicine
-
Randomized Controlled Trial
Hypoalgesia associated with elevated resting blood pressure: evidence for endogenous opioid involvement.
This study used a placebo-controlled, between-subjects opioid blockade design to evaluate endogenous opioid involvement in the hypoalgesia associated with elevated resting blood pressure (BP) in 163 healthy individuals. Participants were randomly assigned to Drug condition (placebo, naltrexone) and Task Order (computerized maze task with harassment followed by an ischemic pain task or vice versa). Resting BP was assessed, followed by drug administration, and then the pain and maze tasks. ⋯ A significant Gender x Drug x SBP x Task Order interaction was observed for VAS pain intensity (P < .02). Examination of simple effects comprising this interaction suggested that BP-related hypoalgesia occurred only in male participants who experienced the pain task in the absence of emotional arousal, and indicated that this hypoalgesia occurred under placebo but not under opioid-blockade. Results suggest that under some circumstance, BP-related hypoalgesia may have an endogenous opioid-mediated component in healthy individuals, particularly men.
-
Randomized Controlled Trial Comparative Study
Social influence and pain response in women and men.
The purpose of this study was to examine the effects of social influence on responses to acute pain in women and men in a randomized experimental design. Sixty-eight undergraduates (32 women; 36 men) were randomly assigned to perform a cold pressor task either alone or in the presence of a same-sex friend. Expressions of pain were assessed with the short form of the McGill Pain Questionnaire. ⋯ Persons who reported high levels of social support on the Krause scale also reported greater cold pressor pain. Results suggest that the presence of a friend can increase pain report to an acute laboratory pain stimulus in women. These findings are consistent with models of social reinforcement in chronic pain syndromes.
-
Randomized Controlled Trial Comparative Study
Migraines and meditation: does spirituality matter?
Migraine headaches are associated with symptoms of depression and anxiety (Waldie and Poulton Journal of Neurology, Neurosurgery, and Psychiatry 72: 86-92, 2002) and feelings of low self-efficacy (French et al. Headache, 40: 647-656, 2000). ⋯ Pre-post tests measured pain tolerance (with a cold pressor task), headache frequency, and mental and spiritual health variables. Compared to the other three groups, those who practiced spiritual meditation had greater decreases in the frequency of migraine headaches, anxiety, and negative affect, as well as greater increases in pain tolerance, headache-related self-efficacy, daily spiritual experiences, and existential well being.
-
Randomized Controlled Trial Comparative Study
Self-management practices among primary care patients with musculoskeletal pain and depression.
The objective of this study was to assess the effect of clinical depression on pain self-management practices. We employed a cross-sectional analysis of baseline data from the Stepped Care for Affective disorders and Musculoskeletal Pain (SCAMP) study. Participants included 250 patients with pain and comorbid depression and 250 patients with pain only and were enrolled from urban university and VA primary care clinics. ⋯ In contrast, depression and pain severity interacted to increase the use of cognitive strategies. Depression and pain severity have differential effects on self-management practices. Understanding the differences between preferential strategies of pain patients with and without depression may be useful in tailoring pain self-management programs.
-
Randomized Controlled Trial
The relationship between resting blood pressure and acute pain sensitivity: effects of chronic pain and alpha-2 adrenergic blockade.
This study tested for alpha-2 adrenergic mediation of the inverse relationship between resting blood pressure and acute pain sensitivity in healthy individuals. It also replicated limited prior work suggesting this inverse blood pressure/pain association is altered in chronic pain, and provided the first test of whether chronic pain-related changes in alpha-2 adrenergic function contribute to these alterations. Resting blood pressure was assessed in 32 healthy controls and 24 chronic low back pain participants prior to receiving placebo or an intravenous alpha-2 adrenergic receptor antagonist (yohimbine hydrochloride, 0.4 mg/kg) in a randomized crossover design. ⋯ Significant Participant Type x Systolic Blood Pressure interactions (P's < .05) were noted for finger pressure visual analog scale pain intensity and unpleasantness, ischemic pain threshold, and heat pain threshold, reflecting absence or reversal of inverse blood pressure/pain associations in chronic pain participants. Results suggest that blood pressure-related hypoalgesia can occur even when alpha-2 adrenergic systems are blocked. The possibility of upregulated alpha-2 adrenergic inhibitory function in chronic pain patients with lower blood pressure warrants further evaluation.