In vitro isolation and characterization of a calicivirus causing a vesicular disease of the hands and feet

Cognitive-behavioral and physical therapies are incorporated into multidisciplinary chronic pain programs because changes in pain cognitions and physical capacity may represent therapeutic processes that facilitate favorable outcome. Decreases in depression, however, may explain treatment responses more parsimoniously. Measures of pain helplessness, lifting capacity, walking endurance, depression, pain severity, and activity level were collected from 94 chronic pain patients at pre- and posttreatment and at 3- to 6-month follow-up evaluations. Decreases in pain helplessness were linked to pain severity reduction, whereas walking endurance increases were related to improvements in activity levels and downtime even after controlling for effects of depression decreases. Thus, cognitive and physical capacity changes that occur through pain treatment may make unique contributions to long-term outcome.     

Cognitive and physical capacity process variables predict long-term outcome after treatment of chronic pain.

Cognitive–behavioral and physical therapies are incorporated into multidisciplinary chronic pain programs because changes in pain cognitions and physical capacity may represent therapeutic processes that facilitate favorable outcome. Decreases in depression, however, may explain treatment responses more parsimoniously. Measures of pain helplessness, lifting capacity, walking endurance, depression, pain severity, and activity level were collected from 94 chronic pain patients at pre- and posttreatment and at 3- to 6-month follow-up evaluations. Decreases in pain helplessness were linked to pain severity reduction, whereas walking endurance increases were related to improvements in activity levels and downtime even after controlling for effects of depression decreases. Thus, cognitive and physical capacity changes that occur through pain treatment may make unique contributions to long-term outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of anger suppression on pain severity and pain behaviors among chronic pain patients: Evaluation of an ironic process model.

Objective: Evidence for links between anger inhibition or suppression and chronic pain severity is based mostly on studies with correlation designs. Following from ironic process theory, we proposed that attempts to suppress angry thoughts during provocation would increase subsequent pain intensity among chronic low back pain (CLBP) patients, and do so through paradoxically enhanced accessibility of anger. Design: CLBP patients (N = 58) were assigned to suppression and nonsuppression conditions while performing a computer maze task with a harassing confederate. A structured pain behavior task (SPBT) followed. Main outcome measures: Self-reported anger, anxiety, and sadness following maze task. Self-reported pain severity and number of observed pain behaviors during SPBT. Results: Patients told to suppress during provocation: (a) reported greater anger following the maze task, reported greater pain intensity during the SPBT, and exhibited more pain behaviors than patients not suppressing; (b) postmaze anger levels significantly mediated group differences on pain behaviors. Conclusion: Attempts by CLBP patients to suppress anger may aggravate pain related to their clinical condition through ironically increased feelings of anger. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repression predicts outcome following multidisciplinary treatment of chronic pain.

This study examined whether repression predicts outcome following multidisciplinary treatment for chronic pain and whether links between anxiety and outcome are obscured by repressors. Ninety-three chronic pain patients completed a 4-week pain program. Lifting capacity, walking endurance, depression, pain severity, and activity were measured at pre- and posttreatment. Low-anxious, repressor, high-anxious, and defensive/high-anxious groups were formed from median splits of Anxiety Content (ACS) and Lie scales of the Minnesota Multiphasic Personality Inventory–2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Significant ACS?×?Lie interactions were found for lifting capacity, depression, and pain severity changes. Planned comparisons showed that both repressors and high-anxious patients performed poorly on lifting capacity; repressors alone recovered poorly on depression and pain severity. Results imply that repression may interfere with the process and outcome of pain programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Linking symptom-specific physiological reactivity to pain severity in chronic low back pain patients: A test of mediation and moderation models.

Symptom-specific reactivity to stress (lower paraspinal muscle reactivity) among chronic low back pain (CLBP) patients may exacerbate chronic pain. It was hypothesized that among CLBP patients (N?=?107) only stress-induced lower paraspinal reactivity, and not reactivity in other indexes, would predict pain severity (PS), and that lower paraspinal reactivity would mediate or moderate links between depression and PS. Electromyogram readings from lower paraspinal and trapezius muscles, systolic and diastolic blood pressures, and heart rate were collected during mental arithmetic (MA) and an anger recall interview. The moderator hypothesis was supported: Only lower paraspinal reactivity during MA was related significantly to PS, but only among patients with high levels of depression. Thus, a profile of lower paraspinal hyperreactivity plus depressed affect may aggravate CLBP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arousal of negative emotions and symptom-specific reactivity in chronic low back pain patients.

Anger may have greater effects on chronic pain severity than other negative emotions and may do so by increasing muscle tension near the site of injury (symptom-specific reactivity). For patients with chronic low back pain (CLBP), relevant muscles are lower paraspinals (LP). Ninety-four CLBP patients and 79 controls underwent anger and sadness recall interviews. EMG and cardiovascular activity were recorded. Patients exhibited greater LP tension increases during anger and slower recovery than controls. Only patients showed greater LP reactivity during anger than sadness. For both groups, trapezius reactivity during anger and sadness did not differ. LP reactivity to anger correlated with everyday pain severity for patients. Anger-induced symptom-specific LP reactivity may be linked to chronic pain aggravation among CLBP patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of compensation involvement on the reporting of pain and disability by patients referred for rehabilitation of chronic low back pain

STUDY DESIGN: In this prospective, observational, cohort study of 192 individuals with chronic low back pain, the group of individuals was divided based on compensation involvement, and their presentation pain and disability, treatment recommendations, and compliance were compared. For 85 of these individuals who completed a spine rehabilitation program, their pain and disability at 3 and 12 months were compared. OBJECTIVES: To test the theory that individuals with compensation involvement presented with greater pain and disability and would report less change of pain and disability after rehabilitation efforts. BACKGROUND: Previous studies have produced conflicting results concerning this issue. METHODS: Individuals were recruited as consecutive patients referred for consultation at a spine rehabilitation center. Pain, depression, and disability were assessed using self-report questionnaires at evaluation and at 3 and 12 months. Rehabilitation services consisted of aggressive, quota-based exercises aimed at correcting impairments in flexibility, strength, endurance, and lifting capacity, identified through quantification of back function. Multifactoral analysis of variance models were used to control for baseline differences between compensation and noncompensation patients during analysis of target variables. RESULTS: The compensation group included 96 patients; these patients reported more pain, depression, and disability than the 96 patients without compensation involvement. These differences persisted when baseline differences were controlled for with multifactoral analysis of variance models. Treatment recommendations and compliance were not affected by compensation. For patients completing the spine rehabilitation program, length of treatment, flexibility, strength, lifting ability, and lower extremity work performance before and after treatment and patient satisfaction ratings were similar for the compensation and noncompensation groups. At 3 and 12 months, improvements in depression and disability were noted for both groups, but were statistically and clinically less substantial for the compensation group. At the 12 month follow-up visit, pain scores improved for the noncompensation group, but not for the compensation group. CONCLUSIONS: In chronic low back pain, compensation involvement may have an adverse effect on self-reported pain, depression, and disability before and after rehabilitation interventions.     

Depression among chronic pain patients: Cognitive-behavioral analysis and effect on rehabilitation outcome.

This study addressed two issues concerning the theoretical and clinical relevance of depression to chronic pain: (a) whether reliable differences among depressed, mildly depressed, and nondepressed chronic pain patients could be identified and (b) whether depression influenced participation in or outcome following a rehabilitation program. To address the first issue, four theoretical constructs were measured by multiple scales. Multivariate analyses of each construct revealed significant differences between the three groups on instrumental activities and coping skills, with more depressed individuals reporting lower levels of functioning and less support. An analysis of the second issue revealed that depressed pain patients showed a greater tendency to drop out of treatment. Outcome did not vary with depression among treatment completers. The results reveal the need to consider a cognitive-behavioral model of depression secondary to chronic pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do changes in cognitive factors influence outcome following multidisciplinary treatment for chronic pain? A cross-lagged panel analysis.

Changes in maladaptive cognitions may constitute therapeutic processes of multidisciplinary pain programs. A cross-lagged panel design was used to determine whether (a) early-treatment cognitive change predicted late-treatment outcome index change, but not vice versa; and (b) these effects remained significant with depression change controlled. Ninety chronic pain patients, in a 4-week multidisciplinary program, completed measures of catastrophizing, pain helplessness, depression, pain, interference, and activity level at pre-, mid-, and posttreatment. With depression changes controlled, early-treatment catastrophizing and pain helplessness changes predicted late-treatment outcome index changes, but not vice versa; early-treatment depression changes predicted late-treatment activity changes, but not vice versa. Findings advance understanding of pain treatment process and suggest that negative cognition changes may indeed affect improvements in treatment outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anger expression in Mexican American and White non-Hispanic adolescents.

This study explored aggressive anger expression in adolescents. A 3-factor model proved best (i.e., Expression through Verbal Assault, Physical Assault Toward People, and Physical Assault Toward Objects). These factors correlated positively with each other and with anger, anxiety, and depression. Correlations of aggressive anger expression styles with anger were larger than their correlations with anxiety and depression. Gender, ethnicity, and developmental effects were found; males reported more physical assault on people than females, and White non-Hispanic and older youths reported more verbal assault than Mexican American and younger, students. Both middle and high school students reported greater verbal assault than physical assault on objects which, in turn, was higher than physical assault on people. These findings suggest that adolescent aggressive anger expression is not unidimensional, but is more differentiated and meaningfully related to gender, ethnicity, and developmental status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring treatment effects on repetitive lifting for patients with chronic low back pain: speed, style, and coordination

The purpose of this study was to determine changes in the amount of work performed and lifting speed, style, and coordination during a repetitive dynamic-lifting task for patients with chronic low back pain (CLBP) after an intensive 3 1/2-week pain rehabilitation program. Subjects included 57 CLBP patients and an age- and gender-matched control group (n = 57). Patients' work indices increased by 71%, but remained significantly less than those observed for controls. Similarly, their lifting speed also increased significantly after treatment, but remained slower than the lifting speed of controls. Patients' posttreatment coordination indices, however, were not significantly different from those of controls. This finding suggests that treatment effectively normalized the dynamic lifting motion used by the patients. These findings, along with the basic kinematic patterns developed in this study, have important implications for determining improvements in functional capacity in the treatment of patients with CLBP.     

Therapeutic Reactance as a Predictor of Outcome in the Treatment of Chronic Depression.

This study examined whether reactance would negatively influence treatment outcome in 347 patients diagnosed with chronic forms of depression and treated at 9 sites with either Nefazodone, cognitive-behavioral analysis system of psychotherapy (CBASP), or combination therapy. Contrary to our hypotheses, reactance positively predicted treatment outcome in CBASP on 2 of 4 scales. These effects were independent of the therapeutic alliance, which also positively predicted outcome. Reactance did not predict outcome in the groups receiving medication alone or in combination with CBASP. The findings suggest that reactance may be an asset in psychotherapy among chronically depressed individuals and that reactant patients can benefit from directive psychotherapy when therapists flexibly respond to perturbations in the therapeutic relationship. Results support the importance of Aptitude × Treatment interactions in psychotherapy outcome. The direction and significance of such interactions may vary with different forms of psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of delay, attack, and retaliation on state depression and hostility

43 male and 43 female undergraduates were placed in an arbitrary waiting situation, and then the E either verbally attacked or apologized to them. Half of the Ss in each group were given a chance to retaliate by negatively evaluating the E on a written form. State and trait hostility and depression measures (e.g., Costello and Comrey's Depression scale, Buss-Durkee Hostility Inventory, and the Depression Adjective Check List) were given before the anger manipulation and again after the manipulation and retaliation. Both males and females became angry and depressed following the attack, and females tended to become more depressed than males (though not more angry). Although males reported more outward hostility than did females after attack, females retaliated more. Retaliation did not, however, reduce either anger or depression, as had been expected. Implications for clinical depression are discussed. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of gender, sex role identity, and Type A behavior in anger expression and mental health functioning.

This study, including 407 female and 222 male college students, investigated the relationship of gender, sex role identity, and Type A behavior to multiple dimensions of anger expression and mental health functioning. Significant multivariate effects were found for sex role and behavior pattern type for anger expression. Significant gender differences were not observed. Univariate analyses revealed consistent relationships between sex role identity and anger proneness, suppression, and control and the tendency to express anger outwardly. Consistent relationships were found between behavior pattern type and both anger proneness and suppression. Significant multivariate effects were found for gender, sex role, and behavior pattern type for mental health functioning. Gender differences were not observed in depression. Women obtained higher scores on indirect hostility, irritability, and dependency, and men obtained higher scores on assault and aggressiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Calcium and signal transduction in granulocytes

The purpose of this study was to examine the relationships among negative affect (depression, anxiety, and anger), microstressors (hassles), temporomandibular disorder (TMD) pain severity, and life interference, using structural equations modeling. One hundred four subjects were recruited from the Parker Mahan Facial Pain Clinic at the University of Florida. Significant positive direct effects were found for paths between pain severity and life interference; pain severity and negative affect; and negative affect and life interference. These results are consistent with a learning or behavioral model of suffering and suggest that negative affect is an important mediating variable in the relationship between pain and life interference. Microstressors were not a significant predictor and may not be a relevant issue in the TMD population. The results suggest that the impact of chronic pain conditions is influenced by both pain and negative affect, and assessment and treatment of chronic TMD disorders may better benefit from a multidisciplinary approach.     

Chronic pain and depression: role of perceived impact and perceived control in different age cohorts

Chronic pain adversely affects individuals' physical as well as emotional well-being. A cognitive-behavioral model has been proposed to explain the role of cognitive appraisal variables in mediating the development of emotional distress following pain of long duration. There is little evidence linking the prevalence of depression in chronic pain patients to life stage, but there are suggestions in the literature that the link between medical illness and depression may be stronger in elderly patients. One purpose of this study was to replicate the efficacy of a previous study of the cognitive-behavioral mediation model in explaining the association between pain and depressed affect. A second purpose of this study was to extend the cognitive-behavioral model to evaluate relationships among pain, cognitive appraisal variables, and depressive affect in the elderly chronic pain population. One hundred chronic pain patients were divided into two age groups (< or = 69 years and > or = 70 years). A path analysis conducted for the total sample supported the cognitive-behavioral mediation model of depression in chronic pain, in which cognitive appraisal variables mediate the pain-depression relationship. Correlations among variables in each of the two age groups, however, revealed different patterns of association. Consistent with the cognitive-behavioral model, the younger patients demonstrated a low and non-significant correlation between pain severity and depression (r = 0.01). Conversely, a strong direct association was observed in the older patients between these variables (r = 0.51). These results suggest that the relationship between pain and depression varies substantially depending upon age cohort.     

Chronic pain and depression: Does the evidence support a relationship?

Examines the extent to which chronic pain and depression coexist by summarizing relevant literature and highlights common conceptual and methodological problems in this literature. The extent to which depression and chronic pain are associated remains a controversial issue that empirical studies have failed to resolve completely. An evaluation of relevant literature provides support for an association between the 2 syndromes and suggests that coexisting pain and depression may be a final common presentation reached by a number of potential pathways. Current biological, psychodynamic, and behavioral cognitive models of the mechanisms by which chronic pain and depression may interact are summarized. The literature suggests that a research approach is required to investigate the variety of paths by which individuals arrive at both chronic pain and depression. The usefulness of this strategy would be demonstrated if factors discriminating among subgroups of patients with both chronic pain and depression, and optimal intervention strategies for each, were determined. (2? p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How loss affects anger and alienates potential supporters.

The effects of loss of resources and illness symptoms on experienced anger, anger expression, and supporter's anger was studied among patients with severe chronic breathing disorder. Both illness symptoms and resource loss were related to greater anger. Angry feelings, in turn, led to more angry behavior. This angry behavior, in turn, resulted in increased anger of supporters. This process illustrates how chronic stress depletes both personal resources and social resources, making the individual increasingly vulnerable to further stressful experiences, inevitably to be confronted in chronic stress sequences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations between anger expression and cardiovascular reactivity: Reconciling inconsistent findings through a matching hypothesis.

Previous psychophysiological research (e.g., E. L. Diamond; see record 1983-01361-001) has demonstrated that both anger expression and anger suppression are related to cardiovascular responses, but in an inconsistent fashion. The present study tested the following hypotheses: (a) that the influence of anger expression style on psychophysiological responses would be limited to Ss exposed to an anger instigation, and (b) that the specific pattern of psychophysiological responses would vary as a function of whether Ss were induced to use their preferred vs. nonpreferred mode of anger expression style in response to the instigation. 78 male college undergraduates were randomly assigned to work on a task with either an annoying or a pleasant confederate and subsequently to write either a negative or a positive evaluation of the confederate. Blood pressure was measured intermittently and heart rate continuously throughout task performance and a subsequent 15-min rest period. Ss' preferred method of anger expression had been previously assessed by a self-report questionnaire. Systolic blood pressure results generally were consistent with the hypotheses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of functional impairment and social support on depressive symptoms in persons with diabetes.

Tested the hypothesis that, among patients with higher levels of illness-related impairment, adequate social support would act as a buffer against depression. 158 Ss (aged 17–78 yrs) with insulin-dependent diabetes mellitus completed the Beck Depression Inventory, a health status measure, and 2 measures of social support. Depressive symptoms correlated positively with functional impairment and negatively with adequacy of social support. In addition, social support moderated depression in the face of greater impairment such that, among Ss who reported the most illness-related functional disabilities, adequate support provided a relative protection from depression. Individuals with inadequate support seem to be most at risk for depression when disability related to illness increases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)