Effects of pain and fatigue on physical functioning and depression in persons with muscular dystrophy.

BACKGROUND: Pain and fatigue are common symptoms experienced by persons with muscular dystrophy (MD). However, it is unclear from previous studies whether pain and fatigue have independent effects on physical functioning and depression, and whether age moderates the relationship of pain and fatigue with physical functioning and depression. OBJECTIVE: This cross-sectional study aimed to describe the relationship of pain and fatigue to physical functioning and depression in persons 20-89 years old with MD. METHOD: A convenience sample of 332 individuals with MD completed a questionnaire that included measures of physical functioning (PROMIS item bank items), depression (PHQ-9), pain intensity (0-10 NRS), and fatigue (0-10 NRS). RESULTS: Pain and fatigue were each independently associated with physical functioning and depression. Depressive symptoms were most severe among middle-aged participants (45-64 years old) relative to older and younger participants. Physical functioning had a negative relationship with chronological age. CONCLUSIONS: Symptoms of pain and fatigue are significantly and independently related to physical functioning and depression in persons with MD. Research is needed to determine if treatments that target both pain and fatigue in patients with MD have more beneficial effects than treatments that target only one of these symptoms.

Self-compassion in patients with persistent musculoskeletal pain: relationship of self-compassion to adjustment to persistent pain.

CONTEXT: Self-compassion entails qualities such as kindness and understanding toward oneself in difficult circumstances and may influence adjustment to persistent pain. Self-compassion may be a particularly influential factor in pain adjustment for obese individuals who suffer from persistent pain, as they often experience heightened levels of pain and lower levels of psychological functioning. OBJECTIVES: The purpose of the present study was to examine the relationship of self-compassion to pain, psychological functioning, pain coping, and disability among patients who have persistent musculoskeletal pain and who are obese. METHODS: Eighty-eight obese patients with persistent pain completed a paper-and-pencil self-report assessment measure before or after their appointment with their anesthesiologist. RESULTS: Hierarchical linear regression analyses demonstrated that even after controlling for important demographic variables, self-compassion was a significant predictor of negative affect (ß=-0.48, P<0.001), positive affect (ß=0.29, P=0.01), pain catastrophizing (ß=-0.32, P=0.003), and pain disability (ß=-0.24, P<0.05). CONCLUSION: The results of this study indicate that self-compassion may be important in explaining the variability in pain adjustment among patients who have persistent musculoskeletal pain and are obese.

Pain and fatigue in persons with postpolio syndrome: independent effects on functioning.

OBJECTIVES: To better understand the importance of pain and fatigue in relation to functioning, and to investigate the role that age plays in these relationships in individuals with postpolio syndrome (PPS). DESIGN: Cross-sectional survey. SETTING: Community-based survey. PARTICIPANTS: Convenience sample of 446 individuals with PPS. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Physical functioning (Patient Reported Outcomes Measurement Information System Physical Functioning item bank items), psychological functioning (Patient Health Questionnaire-9), pain intensity (0-10 numerical rating scale [NRS]), and fatigue (0-10 NRS). RESULTS: Pain and fatigue make independent contributions to the prediction of physical and psychological functioning. Depression was more severe in the middle-aged (≤64y) group than in the young-old (65-74y) or middle-old to oldest (≥75y) groups, although the associations between pain and fatigue and both physical and psychological functioning are similar across all age cohorts. CONCLUSIONS: Complaints of pain or fatigue in patients with PPS who are older or elderly should not be attributed "merely" to the process of aging. The findings also support the need for clinical trials to develop and evaluate interventions that may help patients with PPS function better by treating pain and fatigue, as well as the negative effects that these symptoms can have on functioning.

Pain acceptance, hope, and optimism: relationships to pain and adjustment in patients with chronic musculoskeletal pain.

UNLABELLED: There is growing interest in the role that positive aspects of psychological adjustment, such as pain acceptance, hope, and optimism, may play in explaining adjustment in persons suffering from persistent pain. This study conducted in obese patients with persistent musculoskeletal pain (N = 89) examined the degree to which pain acceptance and hope explained pain intensity, pain unpleasantness, psychological distress, and pain-related disability, after controlling for the effects of optimism. In correlational analyses, pain acceptance and optimism were associated with psychological distress and pain disability with hope being related to only psychological distress. Pain acceptance, optimism, and hope were not significantly associated with pain. Hierarchical linear regression (HLR) analyses found that pain acceptance remained a significant predictor of psychological distress and pain disability after controlling for optimism, demographic, and medical variables. HLR analyses found that hope was not a significant predictor of psychological distress after controlling for optimism, pain acceptance, and demographic and medical variables. The results of this study are important because they indicate that pain acceptance, hope, and optimism are all related to pain adjustment. They also highlight the importance of controlling for optimism when examining the effects of pain acceptance and hope on pain adjustment. PERSPECTIVE: In a sample of obese patients with persistent musculoskeletal pain, pain acceptance was a significant predictor of psychological distress and pain disability even after controlling for optimism, demographic, and medical variables. These results add to the growing literature on the importance of pain acceptance in understanding adjustment to persistent pain.

What's the use of being happy? Mood states, useful objects, and repetition priming effects.

Two experiments involving 99 undergraduate participants sought to examine the influence of mood states on encoding speed within lexical decision and pronunciation tasks. Mood states were measured naturalistically in Experiment 1 and manipulated in Experiment 2. Stimuli consisted of nouns representing useful (e.g., food) and nonuseful (e.g., lint) objects. Mood states had no implications for initial encoding speed. However, when the same words were presented a 2nd time (i.e., repeated), happy individuals displayed a tendency to encode useful words faster than nonuseful ones. Thus, mood states influenced repetition priming on the basis of stimulus valence. The authors propose that happiness sensitizes individuals to useful or rewarding objects, which in turn creates a stronger memory trace for such stimuli in the future.

Driven to tears or to joy: response dominance and trait-based predictions.

The present studies reinvigorate the construct of traitedness from a cognitive perspective. Tendencies toward habit (vs. flexibility) were assessed by examining response dominance performance within choice reaction time tasks. Consistent with the idea that response dominance reflects a tendency toward habitual modes of thought and action, three studies involving 428 undergraduates revealed that trait-outcome and test-retest correlations were higher among individuals higher in response dominance. In Studies 1 and 2, such trait-consistency effects took the form of stronger relations between extraversion and neuroticism, on one hand, and mood states and behavior, on the other. In Study 3, such tendencies took the form of higher test-retest correlations related to daily experiences of mood states, somatic symptoms, and life satisfaction. Together, the studies reveal a consistent effect of response dominance on trait-like consistency and raise some important issues for future studies of the traitedness construct.