Lessons in Affect Regulation to Keep Stress and Pain UndeR control (LARKSPUR): Design of a randomized controlled trial to increase positive affect in middle-aged and older adults with fibromyalgia.

BACKGROUND: Fibromyalgia syndrome (FMS) is a leading cause of functional limitations and disability for which there is no cure. Positive psychological interventions for improving health have received increasing attention, but evidence of the feasibility, acceptability, and impact of such interventions in adult populations with FMS is limited. OBJECTIVES: To describe the rationale and design of a 5-week, online positive affect skills intervention, LARKSPUR: Lessons in Affect Regulation to Keep Stress and Pain UndeR control. METHODS: FMS participants (N = 90) will be randomized to one of two conditions: (1) LARKSPUR or (2) emotion reporting/attention control. LARKSPUR is an online multicomponent intervention that targets eight skills to help foster positive affect: (1) noticing positive events, (2) savoring positive events, (3) identifying personal strengths, (4) behavioral activation to set and work toward attainable goals, (5) mindfulness, (6) positive reappraisal, (7) gratitude, and (8) acts of kindness. The primary outcomes include feasibility (i.e., recruitment, retention, adherence) and acceptability (i.e., helpfulness, usability, satisfaction). Secondary outcomes include pain intensity and pain interference. SIGNIFICANCE: If feasibility and acceptability metrics are met and reductions in pain outcomes are achieved, we will undertake future efficacy and effectiveness trials of LARKSPUR among older adults with FMS. TRIAL REGISTRATION: NCT04869345.

Piloting the “Anti-Oppressive Practice & Research with Diverse Older Adults” Training Program during COVID-19

There is a critical need to develop our gerontological-sensitive workforce. Social workers (SW) frequently provide services to older adults yet there are few opportunities for them to train as gerontological clinicians and/or researchers. To provide an opportunity for SW students to gain gerontological knowledge, clinical practice, and research skills, we developed, and pilot tested the “Anti-Oppressive Practice and Research with Diverse Older Adults” virtual training program at a major medical facility in Manhattan, NY. We explored the feasibility, implementation, and impact of this novel program. The 21-hour weekly MSW field placement program followed an anti-oppressive framework and included: 1) supervision and training sessions;and 2) direct clinical and research practice (e.g., theory, funding, assessment, data collection etc.) and aging topical seminars (e.g., depression, loneliness, pain etc.). Racially diverse supervisors and graduate SW students engaged in reflective writing exercises, iterative discussions (recorded & transcribed) and a thematic analysis of data. All interns successfully completed the program and reported enhanced skills related to SW core competencies and research (e.g., standardized assessments), research and practice gap awareness (e.g., minority aging) and plans to pursue advanced research training and/or gerontological clinical work. Intern challenges included: 1) disconnect between MSW curricula and research placements;and 2) managing minority and contextual stressors (e.g., imposter syndrome, covid-19, civil unrest). Supervisory challenges included: 1) humanizing sensitive discussions via virtual communication and 2) resource constraints. Future research should systematically assess program effects (e.g., SW core competencies) and how to facilitate interprofessional collaborations to develop diverse gerontological SWs and researchers.

The Relationship Between Pain and Psychological Distress During the COVID-19 Pandemic: Is Social Technology Use Protective?

OBJECTIVES: The COVID-19 pandemic and resulting shelter-in-place orders have profoundly changed the everyday social environment. This study examines the relationship between pain and psychological distress (depression, anxiety, and loneliness) among U.S. adults ages 54 and older during the pandemic. We also test whether use of technology for social purposes moderates the association between pain severity and psychological distress. METHODS: Using cross-sectional data on 1,014 adults ages 54 and older (pain free, n = 637; mild pain, n = 106; moderate pain, n = 227; and severe pain, n = 64) from the 2020 Health and Retirement Study COVID-19 Project (Early, Version 1.0), we conducted regression analyses to test the association between pain severity and psychological outcomes and to assess social technology use frequency as a moderator. RESULTS: Compared with their pain-free peers, participants with mild-to-moderate pain reported more depressive symptoms and greater loneliness; those with severe pain reported higher levels of depression, anxiety, and loneliness. Social technology use was associated with lower levels of depression and loneliness. However, interaction analyses show that social technology use predicted an increase in depression for individuals with pain but a decrease in depression among pain-free individuals. For anxiety and loneliness, no significant effects of social technology use were observed. CONCLUSION: Older adults with pain are at high risk of depression, anxiety, and loneliness during the pandemic. Although social technologies have become a common alternative to face-to-face interactions during the COVID-19 crisis, and overall they can provide mental health benefits, our results suggest that social technologies can be detrimental to psychological well-being among people with pain. These findings can inform technology-based interventions aiming to promote well-being among older adults with pain.