The Clinical journal of pain
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Self-report is often represented as "the gold standard" in assessment of pain intensity in children. We evaluate arguments for and against this claim and consider its implications for pain management. ⋯ We conclude that self-report, when available, can be considered a primary source of evidence about pain intensity. However, it cannot be treated as an unquestioned gold standard. Instead, hierarchical or bundled approaches should be used, taking into account self-report as well as the many individual and contextual factors that influence pain including clinical history, patient preferences, and response to previous treatments. Alternate models are presented to guide further practice and research.
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The current study examined the relationship between preoperative anxiety and acute postoperative phantom limb pain (PLP), residual limb pain (RLP), and analgesic medication use in a sample of persons undergoing lower limb amputation. ⋯ These findings suggest that anxiety may be a risk factor for acute postamputation PLP and RLP, and indicate that further research to examine these associations is warranted. If replicated, the findings would support research to examine the extent to which modifying preoperative anxiety yields a reduction in postoperative acute PLP and RLP.
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Attentional biases for pain-related words and images have commonly been reported in individuals with chronic pain. In former studies, however, pain-related stimuli have been presented without context, for example, facial expressions of pain with no accompanying information regarding the location, severity, or cause of pain or injury. The present study investigated attentional biases for pain-related information using complex, real-world scenes in an ecologically valid experimental paradigm. ⋯ This study is the first to show individuals with chronic pain possess attentional biases for pain-related information presented as part of complex, real-world scenes. Possible future research includes the use of real-world scenes in visual-search paradigms modifying attentional biases, and exploration into the relations and effects of combined cognitive biases (eg, attention, memory, and interpretation) in chronic pain.
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Randomized Controlled Trial
Improving the Multidisciplinary Treatment of Chronic Pain by Stimulating Body Awareness: A Cluster-randomized Trial.
Because of methodological flaws and a lack of theoretical foundation of body awareness (BA) in previous effect studies of interventions directed to stimulate BA, it is impossible to attribute treatment effects to this specific component of a multidisciplinary treatment. Therefore, this study evaluated short-term and long-term effects of a multidisciplinary pain rehabilitation program with and without psychomotor therapy (PMT), which focused on BA (measured by the scale of body connection) as a primary target of intervention. ⋯ No clinical meaningful differences were found between treatment conditions in the primary outcome measures health-related quality of life and disability. However, this is the first long-term RCT that has shown that PMT improves BA in patients with chronic pain and shows good effect size and a significant decrease for catastrophizing.