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Anamaria Vranceanu - One of the best experts on this subject based on the ideXlab platform.
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bidirectional mediation of depression and Pain Intensity on their associations with upper extremity physical function
Journal of Behavioral Medicine, 2018Co-Authors: Mojtaba Talaeikhoei, David Ring, Neal C Chen, Stefan Fischerauer, Ragini Jha, Anamaria VranceanuAbstract:Pain Intensity and symptoms of depression are correlated and individually associated with decreased physical function. We compared two explanatory mediation models; one with depression as mediator of the association of Pain Intensity with physical function and the other one with Pain Intensity as the mediator of the effect of depression on physical function. In a cross-sectional study, 102 patients with upper extremity musculoskeletal illness completed measures of Pain Intensity, PROMIS depression CAT, PROMIS physical function-upper extremity CAT and demographics. We determined that Pain Intensity and symptoms of depression were partial mediators of their respective and independent effects on physical function. While depression had a larger standardized mediation effect and a bigger kappa-squared (κ 2) effect size compared to Pain Intensity, the actual proportion of variance in physical function that could be explained by the mediated effects (i.e., R 2 mediation effect size) was equal in both models suggesting that the two mediation models have equal ability to explain variations in physical function. The bidirectional mediation effect suggests a reinforcement mechanism, in which, Pain Intensity and symptoms of depression reciprocally influence their negative impacts on physical function among patients with musculoskeletal illness.
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does mindfulness correlate with physical function and Pain Intensity in patients with upper extremity illness
Hand, 2018Co-Authors: Reinier B Beks, Mariano E Menendez, David Ring, Jos J Mellema, Neal C Chen, Anamaria VranceanuAbstract:BACKGROUND Mindfulness skills training interventions seem efficacious in increasing physical function and decreasing Pain Intensity in patients with chronic Pain. The relationship of mindfulness and upper extremity complaints in patients presenting to orthopedic surgical practices is not known. The aim of this study was to assess if mindfulness has a relationship to physical function and Pain Intensity in patients with upper extremity illness. METHODS In this cross-sectional study, a total of 126 patients with a nontraumatic upper extremity condition were asked to fill out questionnaires assessing the 5 facets of mindfulness, Pain Intensity, and upper extremity physical function, along with clinical and demographic variables prior to their visit with the surgeon. RESULTS Nonreactivity to inner experiences was the only facet of mindfulness that was correlated with upper extremity physical function and Pain Intensity. The overall mindfulness score was correlated with Pain Intensity only. In multivariable analyses, mindfulness was not associated with either physical function or with Pain Intensity. Pain interference was the most important predictor of both Pain Intensity and physical function. CONCLUSIONS Greater overall mindfulness was associated with lower Pain Intensity, and greater ability to be nonreactive to inner experiences was associated with both Pain Intensity and upper extremity physical function in bivariate but not multivariable analyses. Pain interference was the most important predictor of both Pain Intensity and upper extremity physical function. Psychosocial interventions focused on improving physical function and decreasing Pain Intensity in this population should focus primarily on reducing Pain interference, and secondarily on teaching patients mindfulness skills.
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satisfaction with life moderates the indirect effect of Pain Intensity on Pain interference through Pain catastrophizing
Journal of Consulting and Clinical Psychology, 2018Co-Authors: Mojtaba Talaeikhoei, David Ring, Neal C Chen, Anamaria VranceanuAbstract:Objective Satisfaction with life buffers the effect of stress on health, but its role in the mechanism through which Pain may impact engagement in activities of daily living is not known. We tested whether satisfaction with life protects against engaging in Pain catastrophizing and through this explains individual differences in the extent to which Pain interferes with activities of daily living. Method One-hundred and 42 patients with upper extremity musculoskeletal illness participated in this cross-sectional study and completed the PROMIS Pain Intensity, PROMIS Pain interference, Pain catastrophizing scale (PCS), satisfaction with life scale (SWLS), and demographic variables. Results A simple mediation model confirmed that the indirect effect of Pain Intensity on Pain interference through PCS was 35.9% of the total effect. A moderated mediation analysis showed that the indirect effect of Pain Intensity on Pain interference through PCS was differentially moderated by SWLS after controlling for relevant covariates. As satisfaction with life increased from low to moderate to high, a smaller proportion of the effect of Pain Intensity on Pain interference (41.6%, 26.1%, and 10.5%) was carried through PCS, such that at the highest satisfaction with life, the indirect effect becomes completely nonsignificant. Conclusions Satisfaction with life appears to buffer the effect of Pain in individuals with upper extremity musculoskeletal illness. If replicated through longitudinal designs, results suggest that clinical interventions focused on increasing satisfaction with life, such as acceptance and commitment therapy, mindfulness training, gratitude, and other positive psychology skills, may improve outcomes in this population. (PsycINFO Database Record
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Pain catastrophizing mediates the effect of psychological inflexibility on Pain Intensity and upper extremity physical function in patients with upper extremity illness
Pain Practice, 2017Co-Authors: Mojtaba Talaeikhoei, David Ring, Stefan Fischerauer, Sanggil Lee, Anamaria VranceanuAbstract:Background Psychological inflexibility—the inability to take value-based actions in the presence of unwanted thoughts, feelings, or bodily symptoms—is associated with negative health outcomes including depression and anxiety. Objective We aimed to determine the association between the general construct of psychological inflexibility and Pain Intensity, and upper extremity physical function in patients with musculoskeletal illness in an orthopedics practice. We also set out to test multiple-mediator models proposing that psychological inflexibility affects Pain Intensity and upper extremity physical function directly, as well as indirectly through depression, anxiety, and Pain catastrophizing. Methods One hundred and eight patients with upper extremity illness completed self-report measures of Pain Intensity, upper extremity physical function, psychological inflexibility, Pain catastrophizing, depression, and anxiety in this cross-sectional study. Results We found that psychological inflexibility affected Pain Intensity and upper extremity physical function directly and indirectly. Pain catastrophizing but not depression or anxiety mediated the association of psychological inflexibility to Pain Intensity and upper extremity physical function. Conclusions Psychological inflexibility plays an important role in understanding the increased Pain and decreased upper extremity physical function in patients with musculoskeletal Pain. It also suggests that the cognitive error of Pain catastrophizing is one of the mechanisms through which the general construct of psychological inflexibility may influence Pain Intensity and upper extremity physical function. Psychological treatments aimed at decreasing Pain and increasing upper extremity physical function should target both Pain catastrophizing and psychological inflexibility.
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the correlation of cognitive flexibility with Pain Intensity and magnitude of disability in upper extremity illness
Journal of Hand and Microsurgery, 2016Co-Authors: Michiel G J S Hageman, David Ring, Jan Paul Briet, Thijs C H Oosterhoff, Arjan G J Bot, Anamaria VranceanuAbstract:Cognitive flexibility – the ability to restructure one’s knowledge, incorporate new facts, widen perspective, and adapt to the demands of new and unexpected conditions - can help one adapt to illness. The aim of this study was to assess the relationship between cognitive flexibility and hand and upper extremity specific disability in patients presenting to a hand surgeon. Secondarily, we determined predictors of cognitive flexibility and Pain. Eighty-nine consecutive outpatients completed the Cognitive flexibility questionnaire (CFS), Short Health Anxiety Inventory-5 (SHAI-5), Pain Self-Efficacy Questionnaire (PSEQ), Disabilities of Arm, Shoulder and Hand, short form (QuickDASH), and Patient Health Questionnaire for Depression-2 (PHQ-2) in a cross-sectional study. CFS did not correlate with disability or Pain Intensity. Disability correlated with PSEQ (r = −0.66, p < 0.01), PHQ-2 (r = 0.38, p = <0.01), and SHAI-5 (r = 0.33, p < 0.01). Pain Intensity correlated with PSEQ (r = −0.51 p < 0.01) and PHQ-2 (r = 0.41 p < 0.01). There was a small correlation between the CFS and PSEQ (r = 0.25, p = 0.02). The best multivariable models for QuickDASH and Pain Intensity included PSEQ and PHQ and explained 35 % and 28 % of the variability respectively. Upper extremity specific disability and Pain Intensity are limited more by self-efficacy than cognitive flexibility. Interventions to improve self-efficacy might help patients with upper extremity illness.
David Ring - One of the best experts on this subject based on the ideXlab platform.
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bidirectional mediation of depression and Pain Intensity on their associations with upper extremity physical function
Journal of Behavioral Medicine, 2018Co-Authors: Mojtaba Talaeikhoei, David Ring, Neal C Chen, Stefan Fischerauer, Ragini Jha, Anamaria VranceanuAbstract:Pain Intensity and symptoms of depression are correlated and individually associated with decreased physical function. We compared two explanatory mediation models; one with depression as mediator of the association of Pain Intensity with physical function and the other one with Pain Intensity as the mediator of the effect of depression on physical function. In a cross-sectional study, 102 patients with upper extremity musculoskeletal illness completed measures of Pain Intensity, PROMIS depression CAT, PROMIS physical function-upper extremity CAT and demographics. We determined that Pain Intensity and symptoms of depression were partial mediators of their respective and independent effects on physical function. While depression had a larger standardized mediation effect and a bigger kappa-squared (κ 2) effect size compared to Pain Intensity, the actual proportion of variance in physical function that could be explained by the mediated effects (i.e., R 2 mediation effect size) was equal in both models suggesting that the two mediation models have equal ability to explain variations in physical function. The bidirectional mediation effect suggests a reinforcement mechanism, in which, Pain Intensity and symptoms of depression reciprocally influence their negative impacts on physical function among patients with musculoskeletal illness.
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does mindfulness correlate with physical function and Pain Intensity in patients with upper extremity illness
Hand, 2018Co-Authors: Reinier B Beks, Mariano E Menendez, David Ring, Jos J Mellema, Neal C Chen, Anamaria VranceanuAbstract:BACKGROUND Mindfulness skills training interventions seem efficacious in increasing physical function and decreasing Pain Intensity in patients with chronic Pain. The relationship of mindfulness and upper extremity complaints in patients presenting to orthopedic surgical practices is not known. The aim of this study was to assess if mindfulness has a relationship to physical function and Pain Intensity in patients with upper extremity illness. METHODS In this cross-sectional study, a total of 126 patients with a nontraumatic upper extremity condition were asked to fill out questionnaires assessing the 5 facets of mindfulness, Pain Intensity, and upper extremity physical function, along with clinical and demographic variables prior to their visit with the surgeon. RESULTS Nonreactivity to inner experiences was the only facet of mindfulness that was correlated with upper extremity physical function and Pain Intensity. The overall mindfulness score was correlated with Pain Intensity only. In multivariable analyses, mindfulness was not associated with either physical function or with Pain Intensity. Pain interference was the most important predictor of both Pain Intensity and physical function. CONCLUSIONS Greater overall mindfulness was associated with lower Pain Intensity, and greater ability to be nonreactive to inner experiences was associated with both Pain Intensity and upper extremity physical function in bivariate but not multivariable analyses. Pain interference was the most important predictor of both Pain Intensity and upper extremity physical function. Psychosocial interventions focused on improving physical function and decreasing Pain Intensity in this population should focus primarily on reducing Pain interference, and secondarily on teaching patients mindfulness skills.
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satisfaction with life moderates the indirect effect of Pain Intensity on Pain interference through Pain catastrophizing
Journal of Consulting and Clinical Psychology, 2018Co-Authors: Mojtaba Talaeikhoei, David Ring, Neal C Chen, Anamaria VranceanuAbstract:Objective Satisfaction with life buffers the effect of stress on health, but its role in the mechanism through which Pain may impact engagement in activities of daily living is not known. We tested whether satisfaction with life protects against engaging in Pain catastrophizing and through this explains individual differences in the extent to which Pain interferes with activities of daily living. Method One-hundred and 42 patients with upper extremity musculoskeletal illness participated in this cross-sectional study and completed the PROMIS Pain Intensity, PROMIS Pain interference, Pain catastrophizing scale (PCS), satisfaction with life scale (SWLS), and demographic variables. Results A simple mediation model confirmed that the indirect effect of Pain Intensity on Pain interference through PCS was 35.9% of the total effect. A moderated mediation analysis showed that the indirect effect of Pain Intensity on Pain interference through PCS was differentially moderated by SWLS after controlling for relevant covariates. As satisfaction with life increased from low to moderate to high, a smaller proportion of the effect of Pain Intensity on Pain interference (41.6%, 26.1%, and 10.5%) was carried through PCS, such that at the highest satisfaction with life, the indirect effect becomes completely nonsignificant. Conclusions Satisfaction with life appears to buffer the effect of Pain in individuals with upper extremity musculoskeletal illness. If replicated through longitudinal designs, results suggest that clinical interventions focused on increasing satisfaction with life, such as acceptance and commitment therapy, mindfulness training, gratitude, and other positive psychology skills, may improve outcomes in this population. (PsycINFO Database Record
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Pain catastrophizing mediates the effect of psychological inflexibility on Pain Intensity and upper extremity physical function in patients with upper extremity illness
Pain Practice, 2017Co-Authors: Mojtaba Talaeikhoei, David Ring, Stefan Fischerauer, Sanggil Lee, Anamaria VranceanuAbstract:Background Psychological inflexibility—the inability to take value-based actions in the presence of unwanted thoughts, feelings, or bodily symptoms—is associated with negative health outcomes including depression and anxiety. Objective We aimed to determine the association between the general construct of psychological inflexibility and Pain Intensity, and upper extremity physical function in patients with musculoskeletal illness in an orthopedics practice. We also set out to test multiple-mediator models proposing that psychological inflexibility affects Pain Intensity and upper extremity physical function directly, as well as indirectly through depression, anxiety, and Pain catastrophizing. Methods One hundred and eight patients with upper extremity illness completed self-report measures of Pain Intensity, upper extremity physical function, psychological inflexibility, Pain catastrophizing, depression, and anxiety in this cross-sectional study. Results We found that psychological inflexibility affected Pain Intensity and upper extremity physical function directly and indirectly. Pain catastrophizing but not depression or anxiety mediated the association of psychological inflexibility to Pain Intensity and upper extremity physical function. Conclusions Psychological inflexibility plays an important role in understanding the increased Pain and decreased upper extremity physical function in patients with musculoskeletal Pain. It also suggests that the cognitive error of Pain catastrophizing is one of the mechanisms through which the general construct of psychological inflexibility may influence Pain Intensity and upper extremity physical function. Psychological treatments aimed at decreasing Pain and increasing upper extremity physical function should target both Pain catastrophizing and psychological inflexibility.
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factors associated with Pain Intensity and physical limitations after lateral ankle sprains
Injury-international Journal of The Care of The Injured, 2016Co-Authors: Jan Paul Briet, David Ring, Roderick M Houwert, Michiel G J S Hageman, Falco Hietbrink, Egbert J J M VerleisdonkAbstract:Abstract Background Swelling, tenderness, and ecchymosis don’t correlate with time to functional recovery in patients with a lateral ankle sprain. It is established that psychosocial factors such as symptoms of depression and low Pain self-efficacy correlate with Pain Intensity and magnitude of limitations in patients with musculoskeletal disorders. Objective We studied the correlation between Pain self-efficacy or symptoms of depression and (1) ankle specific limitations and (2) Pain Intensity in patients with a lateral ankle sprain. Further we explored the correlation between estimation of sprain severity (grade) and (3) Pain Intensity or magnitude of ankle specific limitations. Design Eighty-four patients with a lateral ankle sprain prospectively completed the Pain Self Efficacy Questionnaire, the Olerud Molander Ankle Score, Ordinal scale of Pain and the Patient Health Questionnaire-2 at enrollment and the Olerud Molander Ankle Score and the Ordinal scale of Pain three weeks after the injury. Factors associated with higher ankle specific limitations and symptoms were investigated in bivariable and multivariable analysis. Results When accounting for confounding factors, greater self-efficacy (p = 0.01) and older age (p Conclusions Psychosocial factors (adaptiveness in response to Pain in particular) explain more of the variation in symptoms and limitations after ankle sprain than the degree of pathophysiology. The influence of adaptive illness descriptions and recovery strategies based on methods for improving self-efficacy (i.e. cognitive behavioral therapy) might enhance and speed recovery from ankle injuries and merit additional investigation. Level of evidence Level 2 prospective cohort study.
Mojtaba Talaeikhoei - One of the best experts on this subject based on the ideXlab platform.
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bidirectional mediation of depression and Pain Intensity on their associations with upper extremity physical function
Journal of Behavioral Medicine, 2018Co-Authors: Mojtaba Talaeikhoei, David Ring, Neal C Chen, Stefan Fischerauer, Ragini Jha, Anamaria VranceanuAbstract:Pain Intensity and symptoms of depression are correlated and individually associated with decreased physical function. We compared two explanatory mediation models; one with depression as mediator of the association of Pain Intensity with physical function and the other one with Pain Intensity as the mediator of the effect of depression on physical function. In a cross-sectional study, 102 patients with upper extremity musculoskeletal illness completed measures of Pain Intensity, PROMIS depression CAT, PROMIS physical function-upper extremity CAT and demographics. We determined that Pain Intensity and symptoms of depression were partial mediators of their respective and independent effects on physical function. While depression had a larger standardized mediation effect and a bigger kappa-squared (κ 2) effect size compared to Pain Intensity, the actual proportion of variance in physical function that could be explained by the mediated effects (i.e., R 2 mediation effect size) was equal in both models suggesting that the two mediation models have equal ability to explain variations in physical function. The bidirectional mediation effect suggests a reinforcement mechanism, in which, Pain Intensity and symptoms of depression reciprocally influence their negative impacts on physical function among patients with musculoskeletal illness.
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satisfaction with life moderates the indirect effect of Pain Intensity on Pain interference through Pain catastrophizing
Journal of Consulting and Clinical Psychology, 2018Co-Authors: Mojtaba Talaeikhoei, David Ring, Neal C Chen, Anamaria VranceanuAbstract:Objective Satisfaction with life buffers the effect of stress on health, but its role in the mechanism through which Pain may impact engagement in activities of daily living is not known. We tested whether satisfaction with life protects against engaging in Pain catastrophizing and through this explains individual differences in the extent to which Pain interferes with activities of daily living. Method One-hundred and 42 patients with upper extremity musculoskeletal illness participated in this cross-sectional study and completed the PROMIS Pain Intensity, PROMIS Pain interference, Pain catastrophizing scale (PCS), satisfaction with life scale (SWLS), and demographic variables. Results A simple mediation model confirmed that the indirect effect of Pain Intensity on Pain interference through PCS was 35.9% of the total effect. A moderated mediation analysis showed that the indirect effect of Pain Intensity on Pain interference through PCS was differentially moderated by SWLS after controlling for relevant covariates. As satisfaction with life increased from low to moderate to high, a smaller proportion of the effect of Pain Intensity on Pain interference (41.6%, 26.1%, and 10.5%) was carried through PCS, such that at the highest satisfaction with life, the indirect effect becomes completely nonsignificant. Conclusions Satisfaction with life appears to buffer the effect of Pain in individuals with upper extremity musculoskeletal illness. If replicated through longitudinal designs, results suggest that clinical interventions focused on increasing satisfaction with life, such as acceptance and commitment therapy, mindfulness training, gratitude, and other positive psychology skills, may improve outcomes in this population. (PsycINFO Database Record
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Pain catastrophizing mediates the effect of psychological inflexibility on Pain Intensity and upper extremity physical function in patients with upper extremity illness
Pain Practice, 2017Co-Authors: Mojtaba Talaeikhoei, David Ring, Stefan Fischerauer, Sanggil Lee, Anamaria VranceanuAbstract:Background Psychological inflexibility—the inability to take value-based actions in the presence of unwanted thoughts, feelings, or bodily symptoms—is associated with negative health outcomes including depression and anxiety. Objective We aimed to determine the association between the general construct of psychological inflexibility and Pain Intensity, and upper extremity physical function in patients with musculoskeletal illness in an orthopedics practice. We also set out to test multiple-mediator models proposing that psychological inflexibility affects Pain Intensity and upper extremity physical function directly, as well as indirectly through depression, anxiety, and Pain catastrophizing. Methods One hundred and eight patients with upper extremity illness completed self-report measures of Pain Intensity, upper extremity physical function, psychological inflexibility, Pain catastrophizing, depression, and anxiety in this cross-sectional study. Results We found that psychological inflexibility affected Pain Intensity and upper extremity physical function directly and indirectly. Pain catastrophizing but not depression or anxiety mediated the association of psychological inflexibility to Pain Intensity and upper extremity physical function. Conclusions Psychological inflexibility plays an important role in understanding the increased Pain and decreased upper extremity physical function in patients with musculoskeletal Pain. It also suggests that the cognitive error of Pain catastrophizing is one of the mechanisms through which the general construct of psychological inflexibility may influence Pain Intensity and upper extremity physical function. Psychological treatments aimed at decreasing Pain and increasing upper extremity physical function should target both Pain catastrophizing and psychological inflexibility.
Stefan Fischerauer - One of the best experts on this subject based on the ideXlab platform.
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bidirectional mediation of depression and Pain Intensity on their associations with upper extremity physical function
Journal of Behavioral Medicine, 2018Co-Authors: Mojtaba Talaeikhoei, David Ring, Neal C Chen, Stefan Fischerauer, Ragini Jha, Anamaria VranceanuAbstract:Pain Intensity and symptoms of depression are correlated and individually associated with decreased physical function. We compared two explanatory mediation models; one with depression as mediator of the association of Pain Intensity with physical function and the other one with Pain Intensity as the mediator of the effect of depression on physical function. In a cross-sectional study, 102 patients with upper extremity musculoskeletal illness completed measures of Pain Intensity, PROMIS depression CAT, PROMIS physical function-upper extremity CAT and demographics. We determined that Pain Intensity and symptoms of depression were partial mediators of their respective and independent effects on physical function. While depression had a larger standardized mediation effect and a bigger kappa-squared (κ 2) effect size compared to Pain Intensity, the actual proportion of variance in physical function that could be explained by the mediated effects (i.e., R 2 mediation effect size) was equal in both models suggesting that the two mediation models have equal ability to explain variations in physical function. The bidirectional mediation effect suggests a reinforcement mechanism, in which, Pain Intensity and symptoms of depression reciprocally influence their negative impacts on physical function among patients with musculoskeletal illness.
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Pain catastrophizing mediates the effect of psychological inflexibility on Pain Intensity and upper extremity physical function in patients with upper extremity illness
Pain Practice, 2017Co-Authors: Mojtaba Talaeikhoei, David Ring, Stefan Fischerauer, Sanggil Lee, Anamaria VranceanuAbstract:Background Psychological inflexibility—the inability to take value-based actions in the presence of unwanted thoughts, feelings, or bodily symptoms—is associated with negative health outcomes including depression and anxiety. Objective We aimed to determine the association between the general construct of psychological inflexibility and Pain Intensity, and upper extremity physical function in patients with musculoskeletal illness in an orthopedics practice. We also set out to test multiple-mediator models proposing that psychological inflexibility affects Pain Intensity and upper extremity physical function directly, as well as indirectly through depression, anxiety, and Pain catastrophizing. Methods One hundred and eight patients with upper extremity illness completed self-report measures of Pain Intensity, upper extremity physical function, psychological inflexibility, Pain catastrophizing, depression, and anxiety in this cross-sectional study. Results We found that psychological inflexibility affected Pain Intensity and upper extremity physical function directly and indirectly. Pain catastrophizing but not depression or anxiety mediated the association of psychological inflexibility to Pain Intensity and upper extremity physical function. Conclusions Psychological inflexibility plays an important role in understanding the increased Pain and decreased upper extremity physical function in patients with musculoskeletal Pain. It also suggests that the cognitive error of Pain catastrophizing is one of the mechanisms through which the general construct of psychological inflexibility may influence Pain Intensity and upper extremity physical function. Psychological treatments aimed at decreasing Pain and increasing upper extremity physical function should target both Pain catastrophizing and psychological inflexibility.
Neal C Chen - One of the best experts on this subject based on the ideXlab platform.
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bidirectional mediation of depression and Pain Intensity on their associations with upper extremity physical function
Journal of Behavioral Medicine, 2018Co-Authors: Mojtaba Talaeikhoei, David Ring, Neal C Chen, Stefan Fischerauer, Ragini Jha, Anamaria VranceanuAbstract:Pain Intensity and symptoms of depression are correlated and individually associated with decreased physical function. We compared two explanatory mediation models; one with depression as mediator of the association of Pain Intensity with physical function and the other one with Pain Intensity as the mediator of the effect of depression on physical function. In a cross-sectional study, 102 patients with upper extremity musculoskeletal illness completed measures of Pain Intensity, PROMIS depression CAT, PROMIS physical function-upper extremity CAT and demographics. We determined that Pain Intensity and symptoms of depression were partial mediators of their respective and independent effects on physical function. While depression had a larger standardized mediation effect and a bigger kappa-squared (κ 2) effect size compared to Pain Intensity, the actual proportion of variance in physical function that could be explained by the mediated effects (i.e., R 2 mediation effect size) was equal in both models suggesting that the two mediation models have equal ability to explain variations in physical function. The bidirectional mediation effect suggests a reinforcement mechanism, in which, Pain Intensity and symptoms of depression reciprocally influence their negative impacts on physical function among patients with musculoskeletal illness.
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does mindfulness correlate with physical function and Pain Intensity in patients with upper extremity illness
Hand, 2018Co-Authors: Reinier B Beks, Mariano E Menendez, David Ring, Jos J Mellema, Neal C Chen, Anamaria VranceanuAbstract:BACKGROUND Mindfulness skills training interventions seem efficacious in increasing physical function and decreasing Pain Intensity in patients with chronic Pain. The relationship of mindfulness and upper extremity complaints in patients presenting to orthopedic surgical practices is not known. The aim of this study was to assess if mindfulness has a relationship to physical function and Pain Intensity in patients with upper extremity illness. METHODS In this cross-sectional study, a total of 126 patients with a nontraumatic upper extremity condition were asked to fill out questionnaires assessing the 5 facets of mindfulness, Pain Intensity, and upper extremity physical function, along with clinical and demographic variables prior to their visit with the surgeon. RESULTS Nonreactivity to inner experiences was the only facet of mindfulness that was correlated with upper extremity physical function and Pain Intensity. The overall mindfulness score was correlated with Pain Intensity only. In multivariable analyses, mindfulness was not associated with either physical function or with Pain Intensity. Pain interference was the most important predictor of both Pain Intensity and physical function. CONCLUSIONS Greater overall mindfulness was associated with lower Pain Intensity, and greater ability to be nonreactive to inner experiences was associated with both Pain Intensity and upper extremity physical function in bivariate but not multivariable analyses. Pain interference was the most important predictor of both Pain Intensity and upper extremity physical function. Psychosocial interventions focused on improving physical function and decreasing Pain Intensity in this population should focus primarily on reducing Pain interference, and secondarily on teaching patients mindfulness skills.
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satisfaction with life moderates the indirect effect of Pain Intensity on Pain interference through Pain catastrophizing
Journal of Consulting and Clinical Psychology, 2018Co-Authors: Mojtaba Talaeikhoei, David Ring, Neal C Chen, Anamaria VranceanuAbstract:Objective Satisfaction with life buffers the effect of stress on health, but its role in the mechanism through which Pain may impact engagement in activities of daily living is not known. We tested whether satisfaction with life protects against engaging in Pain catastrophizing and through this explains individual differences in the extent to which Pain interferes with activities of daily living. Method One-hundred and 42 patients with upper extremity musculoskeletal illness participated in this cross-sectional study and completed the PROMIS Pain Intensity, PROMIS Pain interference, Pain catastrophizing scale (PCS), satisfaction with life scale (SWLS), and demographic variables. Results A simple mediation model confirmed that the indirect effect of Pain Intensity on Pain interference through PCS was 35.9% of the total effect. A moderated mediation analysis showed that the indirect effect of Pain Intensity on Pain interference through PCS was differentially moderated by SWLS after controlling for relevant covariates. As satisfaction with life increased from low to moderate to high, a smaller proportion of the effect of Pain Intensity on Pain interference (41.6%, 26.1%, and 10.5%) was carried through PCS, such that at the highest satisfaction with life, the indirect effect becomes completely nonsignificant. Conclusions Satisfaction with life appears to buffer the effect of Pain in individuals with upper extremity musculoskeletal illness. If replicated through longitudinal designs, results suggest that clinical interventions focused on increasing satisfaction with life, such as acceptance and commitment therapy, mindfulness training, gratitude, and other positive psychology skills, may improve outcomes in this population. (PsycINFO Database Record
