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Keefe, Francis Joseph

Overview:

The primary aim of our research over the past year has been to evaluate the efficacy of cognitive-behavioral treatments for arthritis pain. We are conducting two treatment outcome studies supported by grants from the National Institute of Arthritis, Musculoskeletal, and Skin Diseases. The first project, conducted with osteoarthritis patients, seeks to determine whether aerobic exercise training can enhance the effects of a cognitive behavior therapy (CBT) intervention for managing pain and disability. The CBT intervention is innovative in that it systematically involves spouses in training in pain coping skills. The second project, tests the long-term effectiveness of a relapse prevention training intervention. This study will feature the use of newly developed daily study methods to analyze the long-term effects of pain coping skills training on daily pain.

In addition, in conjunction with Lara Schanberg of the Department of Medicine we are carrying out a study funded by the Arthritis Foundation that examines the effects of a pain coping skills training regimen for pediatric fibromyalgia patients.

Finally, we are currently gathering pilot data for two new research projects. One project seeks to evaluate the efficacy of a cognitive behavior theapy and education intervention for managing pain in patients having breast cancer and prostate cancer. The second project examines the efficacy of patient controlled compression protocol in the management of pain during mammography.

Positions:

Professor in Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Professor in Psychology andNeuroscience

Psychology and Neuroscience
Trinity College of Arts & Sciences

Professor in Medicine

Medicine, Rheumatology and Immunology
School of Medicine

Professor in Anesthesiology

Anesthesiology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.A. 1971

B.A. — Bowdoin College

M.S. 1973

M.S. — Ohio State University

Ph.D. 1975

Ph.D. — Ohio State University

Grants:

Improving Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
July 01, 2016
End Date
June 30, 2021

Optimizing Delivery of a Behavioral Cancer Pain Intervention Using a SMART

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
June 01, 2016
End Date
May 31, 2021

Meaning-centered Psychotherapy and Pain Coping Skills in Advanced Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
American Cancer Society, Inc.
Role
Principal Investigator
Start Date
July 01, 2017
End Date
June 30, 2020

A Self-Management Intervention for Women with Breast Cancer and Diabetes

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
American Cancer Society, Inc.
Role
Co Investigator
Start Date
July 01, 2016
End Date
June 30, 2020

Improving Veteran Access To Integrated Management of Chronic Back Pain

Administered By
Duke Clinical Research Institute
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 20, 2017
End Date
August 31, 2019

Development of a Virtual Reality Graded Exposure Intervention for Chronic Low Back Pain

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
The University of Texas at Dallas
Role
Principal Investigator
Start Date
September 15, 2016
End Date
August 31, 2018

Behavioral Weight and Symptom Management for Breast Cancer Survivors and Partners

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 01, 2015
End Date
August 31, 2018

Coping Skills for Colorectal Cancer Survivors with Pain and Distress

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
American Cancer Society, Inc.
Role
Principal Investigator
Start Date
July 01, 2015
End Date
June 30, 2018

Caregiver-Guided Pain Management Training in Palliative Care

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
September 26, 2014
End Date
June 30, 2018

An Accessible Mobile Health Behavioral Intervention for Cancer Pain (mPain)

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
American Cancer Society, Inc.
Role
Co Investigator
Start Date
July 01, 2014
End Date
June 30, 2018

Refinement and Expansion of the Palliative Care Research Cooperative Group

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Investigator
Start Date
September 28, 2013
End Date
June 30, 2018

Yoga-based Symptom Management for Metastatic Breast Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 01, 2013
End Date
May 31, 2018

Mechanisms of Psychosocial Chronic Pain Treatment

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
Rush University
Role
Principal Investigator
Start Date
September 25, 2013
End Date
April 30, 2018

Couple Communication in Cancer: A Multi-method Examination

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
Arizona State University
Role
Co Investigator
Start Date
September 20, 2016
End Date
August 31, 2017

Knee Arthroplasty Pain Coping Skills Training (KASTpain): A Randomized Trial

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
Virginia Commonwealth University
Role
Principal Investigator
Start Date
August 01, 2012
End Date
July 31, 2017

Everyday Quality of Life in Blacks and Whites with Osteoarthritis

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
University of Alabama
Role
Principal Investigator
Start Date
August 01, 2012
End Date
April 30, 2017

Home-Based Tablet Computer Pain Coping Skills Following Stem Cell Transplant

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 10, 2013
End Date
August 31, 2015

Improving Adherence to Recommended Surveillance in Breast Cancer Survivors

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Mentor
Start Date
September 01, 2010
End Date
August 31, 2015

Pain, Distress and Mammography Use in Breast Cancer Patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
January 01, 2009
End Date
December 31, 2014

Telephone-based coping skills training for COPD

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 30, 2000
End Date
April 30, 2014

Coping Skills Training for Spinal Cord Stimulator Patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 30, 2008
End Date
August 31, 2013

Understanding Patient Expectations of Treatment Outcomes

Administered By
Duke Clinical Research Institute
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
June 08, 2009
End Date
November 30, 2011

Stress and Behavior in Health and Disease

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
July 01, 1989
End Date
June 30, 2011

Training in Psychological Intervention Research

Administered By
Psychology and Neuroscience
AwardedBy
National Institutes of Health
Role
Training Faculty
Start Date
June 01, 2006
End Date
May 31, 2011

IPA - McKee

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
Veterans Administration Medical Center
Role
Principal Investigator
Start Date
April 01, 2010
End Date
March 31, 2011

Quit-smoking program for lung cancer patients' families

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
May 10, 2003
End Date
April 30, 2010

Mammography Pain in Breast Cancer Survivors

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 04, 2006
End Date
September 03, 2009

Biomechanics and Inflammation in Osteoarthritis

Administered By
Orthopaedics
AwardedBy
National Institutes of Health
Role
Consultant
Start Date
September 01, 2003
End Date
August 31, 2008

Caregiver-Assisting Coping Skills Training for Lung Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
June 06, 2002
End Date
May 31, 2008

Partner-Assisted Emotional Disclosure for GI Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
March 02, 2004
End Date
February 28, 2008

Prostate Cancer Recovery Enhancement (PROCARE) for African American Men

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 27, 2007
End Date
January 31, 2008

Coping Skills Training for Early Rheumatoid Arthritis

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 27, 2002
End Date
August 31, 2007

Behavior Analysis of Chronic Low Back Pain

Administered By
Psychiatry & Behavioral Sciences, General Psychiatry
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
July 01, 2005
End Date
June 30, 2007

Self System Therapy and Chronic Low Back Pain

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
June 15, 2003
End Date
May 31, 2007

Anxiety, Depression, and Non-Cardiac Chest Pain

Administered By
Duke Clinical Research Institute
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
April 01, 2001
End Date
March 31, 2007

Gender, Coping, and the Arthritis Pain Experience

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 01, 1999
End Date
June 30, 2004

Gender, Coping and the Arthritis Pain Experience

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 01, 1999
End Date
June 30, 2003

Spouse Guided Pain Management Training for Cancer Pain

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
February 22, 2000
End Date
January 31, 2003

Fluoxetine And Behavior Therapy In Social Phobia

Administered By
Psychiatry & Behavioral Sciences, General Psychiatry
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 30, 1994
End Date
November 30, 2002

Pain Threshold And Tolerance In Sickle Cell Disease

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
May 01, 1995
End Date
April 30, 1999

Fluoxetine And Behavior Therapy In Social Phobia

Administered By
Psychiatry & Behavioral Sciences
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
September 30, 1994
End Date
August 31, 1998

Fluoxetine And Behavior Therapy In Social Phobia

Administered By
Psychiatry & Behavioral Sciences
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
September 01, 1993
End Date
August 31, 1998

Cognitive Behavioral Treatments For Arthritis Pain

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
August 01, 1993
End Date
July 31, 1998

Cognitive Behavioral Treatments For Arthritis Pain

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
August 01, 1993
End Date
July 31, 1998

Behavioral Treatment Of Fibromyalgia

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
July 01, 1996
End Date
December 31, 1997

Cognitive Behavioral Treatment For Arthritis Pain

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
August 01, 1993
End Date
December 31, 1997

Cognitive Behavioral Teatments For Arthritis Pain

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
August 01, 1993
End Date
July 31, 1997

Coping With Osteoarthritic Knee Pain

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
April 01, 1991
End Date
March 31, 1997

Medical Psychologist Member Of Task Force

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
Department Of Labor
Role
Principal Investigator
Start Date
December 01, 1987
End Date
December 01, 1988

Medical Psychologist Member Of Task Force

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
Department Of Labor
Role
Principal Investigator
Start Date
September 01, 1987
End Date
December 01, 1988

Coping With Osteoarthritic Knee Pain

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
May 01, 1986
End Date
April 01, 1987
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Awards:

Wilbert E. Fordyce Clinical Investigator Award and Lecture. American Pain Society.

Type
National
Awarded By
American Pain Society
Date
January 01, 1999

Publications:

A randomized pilot trial of a videoconference couples communication intervention for advanced GI cancer.

This study aims to test the feasibility and preliminary efficacy of a couple-based communication intervention for advanced GI cancer delivered via videoconference.Thirty-two couples were randomly assigned to either couples communication skills training (CCST) or an education comparison intervention, both delivered via videoconference. Participation was limited to couples who reported communication difficulties at screening. Patients and partners completed measures of relationship functioning and individual functioning at baseline and post-intervention.Eighty-eight percent of randomized dyads completed all six sessions and reported high levels of satisfaction with the intervention. Between-group effect sizes suggested that the CCST intervention led to improvements in relationship satisfaction for patients and partners and to improvements in intimacy and communication for patients.A couples-based communication intervention delivered via videoconference is feasible and acceptable in the context of advanced cancer. Preliminary findings suggest that the intervention shows promise in contributing to enhanced relationship functioning. Copyright © 2016 John Wiley & Sons, Ltd.

Authors
Porter, LS; Keefe, FJ; Baucom, DH; Olsen, M; Zafar, SY; Uronis, H
MLA Citation
Porter, LS, Keefe, FJ, Baucom, DH, Olsen, M, Zafar, SY, and Uronis, H. "A randomized pilot trial of a videoconference couples communication intervention for advanced GI cancer." Psycho-oncology 26.7 (July 2017): 1027-1035.
PMID
28691761
Source
epmc
Published In
Psycho-Oncology
Volume
26
Issue
7
Publish Date
2017
Start Page
1027
End Page
1035
DOI
10.1002/pon.4121

Information without Implementation: A Practical Example for Developing a Best Practice Education Control Group.

This article considers methodology for developing an education-only control group and proposes a simple approach to designing rigorous and well-accepted control groups. This approach is demonstrated in a large randomized trial. The Lifestyles trial (n = 367) compared three group interventions: (a) cognitive-behavioral treatment (CBT) for osteoarthritis pain, (b) CBT for osteoarthritis pain and insomnia, and (c) education-only control (EOC). EOC emulated the interventions excluding hypothesized treatment components and controlling for nonspecific treatment effects. Results showed this approach resulted in a control group that was highly credible and acceptable to patients. This approach can be an effective and practical guide for developing high-quality control groups in trials of behavioral interventions.

Authors
Balderson, BH; McCurry, SM; Vitiello, MV; Shortreed, SM; Rybarczyk, BD; Keefe, FJ; Korff, MV
MLA Citation
Balderson, BH, McCurry, SM, Vitiello, MV, Shortreed, SM, Rybarczyk, BD, Keefe, FJ, and Korff, MV. "Information without Implementation: A Practical Example for Developing a Best Practice Education Control Group." Behavioral sleep medicine 14.5 (September 2016): 514-527.
PMID
26485203
Source
epmc
Published In
Behavioral Sleep Medicine
Volume
14
Issue
5
Publish Date
2016
Start Page
514
End Page
527
DOI
10.1080/15402002.2015.1036271

Exploratory secondary analyses of a cognitive-behavioral intervention for knee osteoarthritis demonstrate reduction in biomarkers of adipocyte inflammation.

To investigate the effects of pain coping skills training (PCST) and a lifestyle behavioral weight management (BWM) program on inflammatory markers and biomarker associations with pain and function in the OA LIFE study.Serum samples were available from a subset (N = 169) of the overweight or obese knee OA participants in the OA LIFE study that evaluated: PCST, BWM, combined PCST + BWM, or standard care (SC). Inflammatory markers (hsCRP, IL-1ra, IL-1β, IL-6, IL-8, TNF-α, TNFRI, TNFRII, and hyaluronic acid (HA)), and adipokines (leptin and adiponectin) were measured before and after the 24-week treatment period. Biomarkers were assessed for effects of treatment and for associations with change in weight, pain and disability (unadjusted and adjusted for age, race, sex, baseline body mass index (BMI), and baseline biomarker concentration).PCST + BWM was associated with significant reductions in hsCRP (P = 0.0014), IL-6 (P = 0.0075), and leptin (P = 0.0001). After adjustment, there was a significant effect of PCST + BWM on changes in leptin (b = -0.19, P = 0.01) and IL-6 (b = -0.25, P = 0.02) relative to SC. Reductions in leptin and IL-6 were significantly correlated with reductions in weight, BMI and Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain; reductions in IL-6 were correlated with improvements in WOMAC and Arthritis Impact Measurement Scales (AIMS) physical function. By mediation analyses, weight loss was responsible for 54% of the change in IL-6 and all of the change in leptin.OA-related inflammatory markers were reduced by a 24-week combined PCST + BWM intervention. This suggests that the inflammatory state can be successfully modified in the context of a readily instituted clinical intervention with a positive clinical outcome.

Authors
Huebner, JL; Landerman, LR; Somers, TJ; Keefe, FJ; Guilak, F; Blumenthal, JA; Caldwell, DS; Kraus, VB
MLA Citation
Huebner, JL, Landerman, LR, Somers, TJ, Keefe, FJ, Guilak, F, Blumenthal, JA, Caldwell, DS, and Kraus, VB. "Exploratory secondary analyses of a cognitive-behavioral intervention for knee osteoarthritis demonstrate reduction in biomarkers of adipocyte inflammation." Osteoarthritis and cartilage 24.9 (September 2016): 1528-1534.
PMID
27090577
Source
epmc
Published In
Osteoarthritis and Cartilage
Volume
24
Issue
9
Publish Date
2016
Start Page
1528
End Page
1534
DOI
10.1016/j.joca.2016.04.002

Cognitive behavioral therapy for chronic pain is effective, but for whom?

Moderator analyses are reported for posttreatment outcomes in a large, randomized, controlled effectiveness trial for chronic pain for hip and knee osteoarthritis (N = 256). Pain Coping Skills Training, a form of cognitive behavioral therapy, was compared to usual care. Treatment was delivered by nurse practitioners in patients' community doctors' offices. Consistent with meta-analyses of pain cognitive behavioral therapy efficacy, treatment effects in this trial were significant for several primary and secondary outcomes, but tended to be small. This study was designed to examine differential response to treatment for patient subgroups to guide clinical decision-making for treatment. Based on existing literature, demographic (age, sex, race/ethnicity, and education) and clinical variables (disease severity, body mass index, patient treatment expectations, depression, and patient pain coping style) were specified a priori as potential moderators. Trial outcome variables (N = 15) included pain, fatigue, self-efficacy, quality of life, catastrophizing, and use of pain medication. Results yielded 5 significant moderators for outcomes at posttreatment: pain coping style, patient expectation for treatment response, radiographically assessed disease severity, age, and education. Thus, sex, race/ethnicity, body mass index, and depression at baseline were not associated with level of treatment response. In contrast, patients with interpersonal problems associated with pain coping did not benefit much from the treatment. Although most patients projected positive expectations for the treatment prior to randomization, only those with moderate to high expectations benefited. Patients with moderate to high osteoarthritis disease severity showed stronger treatment effects. Finally, the oldest and most educated patients showed strong treatment effects, while younger and less educated did not.

Authors
Broderick, JE; Keefe, FJ; Schneider, S; Junghaenel, DU; Bruckenthal, P; Schwartz, JE; Kaell, AT; Caldwell, DS; McKee, D; Gould, E
MLA Citation
Broderick, JE, Keefe, FJ, Schneider, S, Junghaenel, DU, Bruckenthal, P, Schwartz, JE, Kaell, AT, Caldwell, DS, McKee, D, and Gould, E. "Cognitive behavioral therapy for chronic pain is effective, but for whom?." Pain 157.9 (September 2016): 2115-2123.
PMID
27227692
Source
epmc
Published In
PAIN
Volume
157
Issue
9
Publish Date
2016
Start Page
2115
End Page
2123
DOI
10.1097/j.pain.0000000000000626

Pain coping skills training for African Americans with osteoarthritis (STAART): study protocol of a randomized controlled trial.

African Americans bear a disproportionate burden of osteoarthritis (OA), with higher prevalence rates, more severe pain, and more functional limitations. One key barrier to addressing these disparities has been limited engagement of African Americans in the development and evaluation of behavioral interventions for management of OA. Pain Coping Skills Training (CST) is a cognitive-behavioral intervention with shown efficacy to improve OA-related pain and other outcomes. Emerging data indicate pain CST may be a promising intervention for reducing racial disparities in OA symptom severity. However, there are important gaps in this research, including incorporation of stakeholder perspectives (e.g. cultural appropriateness, strategies for implementation into clinical practice) and testing pain CST specifically among African Americans with OA. This study will evaluate the effectiveness of a culturally enhanced pain CST program among African Americans with OA.This is a randomized controlled trial among 248 participants with symptomatic hip or knee OA, with equal allocation to a pain CST group and a wait list (WL) control group. The pain CST program incorporated feedback from patients and other stakeholders and involves 11 weekly telephone-based sessions. Outcomes are assessed at baseline, 12 weeks (primary time point), and 36 weeks (to assess maintenance of treatment effects). The primary outcome is the Western Ontario and McMaster Universities Osteoarthritis Index, and secondary outcomes include self-efficacy, pain coping, pain interference, quality of life, depressive symptoms, and global assessment of change. Linear mixed models will be used to compare the pain CST group to the WL control group and explore whether participant characteristics are associated with differential improvement in the pain CST program. This research is in compliance with the Helsinki Declaration and was approved by the Institutional Review Boards of the University of North Carolina at Chapel Hill, Durham Veterans Affairs Medical Center, East Carolina University, and Duke University Health System.This culturally enhanced pain CST program could have a substantial impact on outcomes for African Americans with OA and may be a key strategy in the reduction of racial health disparities.ClinicalTrials.gov, NCT02560922 , registered 9/22/2015.

Authors
Schrubbe, LA; Ravyts, SG; Benas, BC; Campbell, LC; Cené, CW; Coffman, CJ; Gunn, AH; Keefe, FJ; Nagle, CT; Oddone, EZ; Somers, TJ; Stanwyck, CL; Taylor, SS; Allen, KD
MLA Citation
Schrubbe, LA, Ravyts, SG, Benas, BC, Campbell, LC, Cené, CW, Coffman, CJ, Gunn, AH, Keefe, FJ, Nagle, CT, Oddone, EZ, Somers, TJ, Stanwyck, CL, Taylor, SS, and Allen, KD. "Pain coping skills training for African Americans with osteoarthritis (STAART): study protocol of a randomized controlled trial." BMC musculoskeletal disorders 17.1 (August 23, 2016): 359-.
PMID
27553385
Source
epmc
Published In
BMC Musculoskeletal Disorders
Volume
17
Issue
1
Publish Date
2016
Start Page
359
DOI
10.1186/s12891-016-1217-2

Self-system therapy for distress associated with persistent low back pain: A randomized clinical trial.

Persistent low back pain (PLBP) is associated with vulnerability to depression. PLBP frequently requires major changes in occupation and lifestyle, which can lead to a sense of failing to attain one's personal goals (self-discrepancy).We conducted a clinical trial to examine the efficacy of self-system therapy (SST), a brief structured therapy for depression based on self-discrepancy theory. A total of 101 patients with PLBP and clinically significant depressive symptoms were randomized either to SST, pain education, or standard care.Patients receiving SST showed significantly greater improvement in depressive symptoms. Reduction in self-discrepancy predicted reduction in depressive symptoms only within the SST condition.Findings support the utility of SST for individuals facing persistent pain and associated depression.

Authors
Waters, SJ; Strauman, TJ; McKee, DC; Campbell, LC; Shelby, RA; Dixon, KE; Fras, AM; Keefe, FJ
MLA Citation
Waters, SJ, Strauman, TJ, McKee, DC, Campbell, LC, Shelby, RA, Dixon, KE, Fras, AM, and Keefe, FJ. "Self-system therapy for distress associated with persistent low back pain: A randomized clinical trial." Psychotherapy research : journal of the Society for Psychotherapy Research 26.4 (July 2016): 472-483.
Website
http://hdl.handle.net/10161/13839
PMID
26079438
Source
epmc
Published In
Psychotherapy Research
Volume
26
Issue
4
Publish Date
2016
Start Page
472
End Page
483
DOI
10.1080/10503307.2015.1040485

Physical Therapist-Delivered Pain Coping Skills Training and Exercise for Knee Osteoarthritis: Randomized Controlled Trial.

To investigate whether a 12-week physical therapist-delivered combined pain coping skills training (PCST) and exercise (PCST/exercise) is more efficacious and cost effective than either treatment alone for knee osteoarthritis (OA).This was an assessor-blinded, 3-arm randomized controlled trial in 222 people (73 PCST/exercise, 75 exercise, and 74 PCST) ages ≥50 years with knee OA. All participants received 10 treatments over 12 weeks plus a home program. PCST covered pain education and training in cognitive and behavioral pain coping skills, exercise comprised strengthening exercises, and PCST/exercise integrated both. Primary outcomes were self-reported average knee pain (visual analog scale, range 0-100 mm) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index, range 0-68) at week 12. Secondary outcomes included other pain measures, global change, physical performance, psychological health, physical activity, quality of life, and cost effectiveness. Analyses were by intent-to-treat methodology with multiple imputation for missing data.A total of 201 participants (91%), 181 participants (82%), and 186 participants (84%) completed week 12, 32, and 52 measurements, respectively. At week 12, there were no significant between-group differences for reductions in pain comparing PCST/exercise versus exercise (mean difference 5.8 mm [95% confidence interval (95% CI) -1.4, 13.0]) and PCST/exercise versus PCST (6.7 mm [95% CI -0.6, 14.1]). Significantly greater improvements in function were found for PCST/exercise versus exercise (3.7 units [95% CI 0.4, 7.0]) and PCST/exercise versus PCST (7.9 units [95% CI 4.7, 11.2]). These differences persisted at weeks 32 (both) and 52 (PCST). Benefits favoring PCST/exercise were seen on several secondary outcomes. Cost effectiveness of PCST/exercise was not demonstrated.This model of care could improve access to psychological treatment and augment patient outcomes from exercise in knee OA, although it did not appear to be cost effective.

Authors
Bennell, KL; Ahamed, Y; Jull, G; Bryant, C; Hunt, MA; Forbes, AB; Kasza, J; Akram, M; Metcalf, B; Harris, A; Egerton, T; Kenardy, JA; Nicholas, MK; Keefe, FJ
MLA Citation
Bennell, KL, Ahamed, Y, Jull, G, Bryant, C, Hunt, MA, Forbes, AB, Kasza, J, Akram, M, Metcalf, B, Harris, A, Egerton, T, Kenardy, JA, Nicholas, MK, and Keefe, FJ. "Physical Therapist-Delivered Pain Coping Skills Training and Exercise for Knee Osteoarthritis: Randomized Controlled Trial." Arthritis care & research 68.5 (May 2016): 590-602.
PMID
26417720
Source
epmc
Published In
Arthritis Care and Research
Volume
68
Issue
5
Publish Date
2016
Start Page
590
End Page
602
DOI
10.1002/acr.22744

Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue.

To evaluate the impact of guided meditation and music interventions on patient anxiety, pain, and fatigue during imaging-guided breast biopsy.After giving informed consent, 121 women needing percutaneous imaging-guided breast biopsy were randomized into three groups: (1) guided meditation; (2) music; (3) standard-care control group. During biopsy, the meditation and music groups listened to an audio-recorded, guided, loving-kindness meditation and relaxing music, respectively; the standard-care control group received supportive dialogue from the biopsy team. Immediately before and after biopsy, participants completed questionnaires measuring anxiety (State-Trait Anxiety Inventory Scale), biopsy pain (Brief Pain Inventory), and fatigue (modified Functional Assessment of Chronic Illness Therapy-Fatigue). After biopsy, participants completed questionnaires assessing radiologist-patient communication (modified Questionnaire on the Quality of Physician-Patient Interaction), demographics, and medical history.The meditation and music groups reported significantly greater anxiety reduction (P values < .05) and reduced fatigue after biopsy than the standard-care control group; the standard-care control group reported increased fatigue after biopsy. The meditation group additionally showed significantly lower pain during biopsy, compared with the music group (P = .03). No significant difference in patient-perceived quality of radiologist-patient communication was noted among groups.Listening to guided meditation significantly lowered biopsy pain during imaging-guided breast biopsy; meditation and music reduced patient anxiety and fatigue without compromising radiologist-patient communication. These simple, inexpensive interventions could improve women's experiences during core-needle breast biopsy.

Authors
Soo, MS; Jarosz, JA; Wren, AA; Soo, AE; Mowery, YM; Johnson, KS; Yoon, SC; Kim, C; Hwang, ES; Keefe, FJ; Shelby, RA
MLA Citation
Soo, MS, Jarosz, JA, Wren, AA, Soo, AE, Mowery, YM, Johnson, KS, Yoon, SC, Kim, C, Hwang, ES, Keefe, FJ, and Shelby, RA. "Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue." Journal of the American College of Radiology : JACR 13.5 (May 2016): 526-534.
PMID
26853501
Source
epmc
Published In
Journal of the American College of Radiology
Volume
13
Issue
5
Publish Date
2016
Start Page
526
End Page
534
DOI
10.1016/j.jacr.2015.12.004

Restricted activity and persistent pain following motor vehicle collision among older adults: a multicenter prospective cohort study.

Restricted physical activity commonly occurs following acute musculoskeletal pain in older adults and may influence long-term outcomes. We sought to examine the relationship between restricted physical activity after motor vehicle collision (MVC) and the development of persistent pain.We examined data from a prospective study of adults ≥65 years of age presenting to the emergency department (ED) after MVC without life-threatening injuries. Restricted physical activity 6 weeks after MVC was defined in three different ways: 1) by a ≥25 point decrease in Physical Activity Scale in the Elderly (PASE) score, 2) by the answer "yes" to the question, "during the past two weeks, have you stayed in bed for at least half a day?", and 3) by the answer "yes" to the question, "during the past two weeks, have you cut down on your usual activities as compared to before the accident?" We examined relationships between each definition of restricted activity and pain severity, pain interference, and functional capacity at 6 months with adjustment for confounders.Within the study sample (N = 164), adjusted average pain severity scores at 6 months did not differ between patients with and without restricted physical activity based on decreased PASE score (2.54 vs. 2.07, p = 0.32). In contrast, clinically and statistically important differences in adjusted average pain severity at 6 months were observed for patients who reported spending half a day in bed vs. those who did not (3.56 vs. 1.91, p < 0.01). In adjusted analyses, both decreased PASE score and cutting down on activity were associated with functional capacity at 6 months, but only decreased PASE score was associated with increased ADL difficulty at 6 months (0.70 vs. -0.01, p = 0.02).Among older adults experiencing MVC, those reporting bed rest or reduced activity 6 weeks after the collision reported higher pain and pain interference scores at 6 months. More research is needed to determine if interventions to promote activity can improve outcomes after MVC in older adults.

Authors
Platts-Mills, TF; Nicholson, RJ; Richmond, NL; Patel, KV; Simonsick, EM; Domeier, RM; Swor, RA; Hendry, PL; Peak, DA; Rathlev, NK; Jones, JS; Lee, DC; Weaver, MA; Keefe, FJ; McLean, SA
MLA Citation
Platts-Mills, TF, Nicholson, RJ, Richmond, NL, Patel, KV, Simonsick, EM, Domeier, RM, Swor, RA, Hendry, PL, Peak, DA, Rathlev, NK, Jones, JS, Lee, DC, Weaver, MA, Keefe, FJ, and McLean, SA. "Restricted activity and persistent pain following motor vehicle collision among older adults: a multicenter prospective cohort study." BMC geriatrics 16 (April 19, 2016): 86-.
PMID
27094038
Source
epmc
Published In
BMC Geriatrics
Volume
16
Publish Date
2016
Start Page
86
DOI
10.1186/s12877-016-0260-z

Persistent Pain Among Older Adults Discharged Home From the Emergency Department After Motor Vehicle Crash: A Prospective Cohort Study.

Motor vehicle crashes are the second most common form of trauma among older adults. We seek to describe the incidence, risk factors, and consequences of persistent pain among older adults evaluated in the emergency department (ED) after a motor vehicle crash.We conducted a prospective longitudinal study of patients aged 65 years or older who presented to one of 8 EDs after motor vehicle crash between June 2011 and June 2014 and were discharged home after evaluation. ED evaluation was done through in-person interview; follow-up data were obtained through mail-in survey or telephone call. Pain severity (0 to 10 scale) overall and for 15 parts of the body were assessed at each follow-up point. Principal component analysis was used to assess the dimensionality of the locations of pain data. Participants reporting pain severity greater than or equal to 4 attributed to the motor vehicle crash at 6 months were defined as having persistent pain.Of the 161 participants, 72% reported moderate to severe pain at the ED evaluation. At 6 months, 26% of participants reported moderate to severe motor vehicle crash-related pain. ED characteristics associated with persistent pain included acute pain severity; pain located in the head, neck, and jaw or lower back and legs; poor self-rated health; less formal education; pre-motor vehicle crash depressive symptoms; and patient's expected time to physical recovery more than 30 days. Compared with individuals without persistent pain, those with persistent pain were substantially more likely at 6-month follow-up to have also experienced a decline in their capacity for physical function (73% versus 36%; difference=37%; 95% confidence interval [CI] 19% to 52%), a new difficulty with activities of daily living (42% versus 17%; difference=26%; 95% CI 10% to 43%), a 1-point or more reduction in overall self-rated health on a 5-point scale (54% versus 30%; difference=24%; 95% CI 6% to 41%), and a change in their living situation to obtain additional help (23% versus 8%; difference=15%; 95% CI 2% to 31%).Among older adults discharged home from the ED post-evaluation after a motor vehicle crash, persistent pain is common and frequently associated with functional decline and disability.

Authors
Platts-Mills, TF; Flannigan, SA; Bortsov, AV; Smith, S; Domeier, RM; Swor, RA; Hendry, PL; Peak, DA; Rathlev, NK; Jones, JS; Lee, DC; Keefe, FJ; Sloane, PD; McLean, SA
MLA Citation
Platts-Mills, TF, Flannigan, SA, Bortsov, AV, Smith, S, Domeier, RM, Swor, RA, Hendry, PL, Peak, DA, Rathlev, NK, Jones, JS, Lee, DC, Keefe, FJ, Sloane, PD, and McLean, SA. "Persistent Pain Among Older Adults Discharged Home From the Emergency Department After Motor Vehicle Crash: A Prospective Cohort Study." Annals of emergency medicine 67.2 (February 2016): 166-176.e1.
PMID
26092559
Source
epmc
Published In
Annals of Emergency Medicine
Volume
67
Issue
2
Publish Date
2016
Start Page
166
End Page
176.e1
DOI
10.1016/j.annemergmed.2015.05.003

Anger arousal and behavioral anger regulation in everyday life among people with chronic low back pain: Relationships with spouse responses and negative affect.

To determine the degree to which anger arousal and anger regulation (expression, inhibition) in the daily lives of people with chronic pain were related to spouse support, criticism, and hostility as perceived by patients and as reported by spouses.Married couples (N = 105, 1 spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. On these diaries, patients completed items on their own anger arousal, anger expression, and inhibition, and on perceived spouse support, criticism, and hostility. Spouses reported on their responses toward patients and their negative affect. Hierarchical linear modeling tested concurrent and lagged relationships.Patient-reported increases in anger arousal and anger expression were predominantly related to concurrent decreases in patient-perceived and spouse-reported spouse support, concurrent increases in patient-perceived and spouse-reported spouse criticism and hostility, and increases in spouse-reported negative affect. Relationships for anger expression remained significant with anger arousal controlled. These effects were especially strong for male patients. Spouses reported greater negative affect when patients were present than when they were not.Social support may facilitate adjustment to chronic pain, with declining support and overt criticism and hostility possibly adversely impacting pain and function. Results suggest that patient anger arousal and expression may be related to a negative interpersonal environment for married couples coping with chronic low back pain.

Authors
Burns, JW; Gerhart, JI; Bruehl, S; Post, KM; Smith, DA; Porter, LS; Schuster, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Burns, JW, Gerhart, JI, Bruehl, S, Post, KM, Smith, DA, Porter, LS, Schuster, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "Anger arousal and behavioral anger regulation in everyday life among people with chronic low back pain: Relationships with spouse responses and negative affect." Health psychology : official journal of the Division of Health Psychology, American Psychological Association 35.1 (January 2016): 29-40.
PMID
26030307
Source
epmc
Published In
Health Psychology
Volume
35
Issue
1
Publish Date
2016
Start Page
29
End Page
40
DOI
10.1037/hea0000221

Effects of enhanced caregiver training program on cancer caregiver's self-efficacy, preparedness, and psychological well-being.

We examined the effects of an enhanced informal caregiver training (Enhanced-CT) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients.We recruited adult patients in oncology units and their informal caregivers. We utilized a two-armed, randomized controlled trial design with data collected at baseline, post-training, and at 2 and 4 weeks after hospital discharge. Primary outcomes were self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving. Secondary outcomes were caregiver depression, anxiety, and burden. The education comparison (EDUC) group received information about community resources. We used general linear models to test for differences in the Enhanced-CT relative to the EDUC group.We consented and randomized 138 dyads: Enhanced-CT = 68 and EDUC = 70. The Enhanced-CT group had a greater increase in caregiver self-efficacy for cancer symptom management and stress management and preparation for caregiving at the post-training assessment compared to the EDUC group but not at 2- and 4-week post-discharge assessments. There were no intervention group differences in depression, anxiety, and burden.An Enhanced-CT protocol resulted in short-term improvements in self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving but not in caregivers' psychological well-being. The lack of sustained effects may be related to the single-dose nature of our intervention and the changing needs of informal caregivers after hospital discharge.

Authors
Hendrix, CC; Bailey, DE; Steinhauser, KE; Olsen, MK; Stechuchak, KM; Lowman, SG; Schwartz, AJ; Riedel, RF; Keefe, FJ; Porter, LS; Tulsky, JA
MLA Citation
Hendrix, CC, Bailey, DE, Steinhauser, KE, Olsen, MK, Stechuchak, KM, Lowman, SG, Schwartz, AJ, Riedel, RF, Keefe, FJ, Porter, LS, and Tulsky, JA. "Effects of enhanced caregiver training program on cancer caregiver's self-efficacy, preparedness, and psychological well-being." Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 24.1 (January 2016): 327-336.
PMID
26062925
Source
epmc
Published In
Supportive Care in Cancer
Volume
24
Issue
1
Publish Date
2016
Start Page
327
End Page
336
DOI
10.1007/s00520-015-2797-3

Allopregnanolone Levels Are Inversely Associated with Self-Reported Pain Symptoms in U.S. Iraq and Afghanistan-Era Veterans: Implications for Biomarkers and Therapeutics.

Pain symptoms are common among Iraq/Afghanistan-era veterans, many of whom continue to experience persistent pain symptoms despite multiple pharmacological interventions. Preclinical data suggest that neurosteroids such as allopregnanolone demonstrate pronounced analgesic properties, and thus represent logical biomarker candidates and therapeutic targets for pain. Allopregnanolone is also a positive GABAA receptor modulator with anxiolytic, anticonvulsant, and neuroprotective actions in rodent models. We previously reported inverse associations between serum allopregnanolone levels and self-reported pain symptom severity in a pilot study of 82 male veterans.The current study investigates allopregnanolone levels in a larger cohort of 485 male Iraq/Afghanistan-era veterans to attempt to replicate these initial findings. Pain symptoms were assessed by items from the Symptom Checklist-90-R (SCL-90-R) querying headache, chest pain, muscle soreness, and low back pain over the past 7 days. Allopregnanolone levels were quantified by gas chromatography/mass spectrometry.Associations between pain ratings and allopregnanolone levels were examined with Poisson regression analyses, controlling for age and smoking. Bivariate nonparametric Mann–Whitney analyses examining allopregnanolone levels across high and low levels of pain were also conducted. Allopregnanolone levels were inversely associated with muscle soreness [P = 0.0028], chest pain [P = 0.032], and aggregate total pain (sum of all four pain items) [P = 0.0001]. In the bivariate analyses, allopregnanolone levels were lower in the group reporting high levels of muscle soreness [P = 0.001].These findings are generally consistent with our prior pilot study and suggest that allopregnanolone may function as an endogenous analgesic. Thus, exogenous supplementation with allopregnanolone could have therapeutic potential. The characterization of neurosteroid profiles may also have biomarker utility.

Authors
Naylor, JC; Kilts, JD; Szabo, ST; Dunn, CE; Keefe, FJ; Tupler, LA; Shampine, LJ; Morey, RA; Strauss, JL; Hamer, RM; Wagner, HR; MIRECC Workgroup, ; Marx, CE
MLA Citation
Naylor, JC, Kilts, JD, Szabo, ST, Dunn, CE, Keefe, FJ, Tupler, LA, Shampine, LJ, Morey, RA, Strauss, JL, Hamer, RM, Wagner, HR, MIRECC Workgroup, , and Marx, CE. "Allopregnanolone Levels Are Inversely Associated with Self-Reported Pain Symptoms in U.S. Iraq and Afghanistan-Era Veterans: Implications for Biomarkers and Therapeutics." Pain medicine (Malden, Mass.) 17.1 (January 2016): 25-32.
Website
http://hdl.handle.net/10161/10962
PMID
26176345
Source
epmc
Published In
Pain Medicine
Volume
17
Issue
1
Publish Date
2016
Start Page
25
End Page
32

Pain Phenotypes and Associated Clinical Risk Factors Following Traumatic Amputation: Results from Veterans Integrated Pain Evaluation Research (VIPER).

To define clinical phenotypes of postamputation pain and identify markers of risk for the development of chronic pain.Cross-sectional study of military service members enrolled 3-18 months after traumatic amputation injury.Military Medical Center.124 recent active duty military service members.Study subjects completed multiple pain and psychometric questionnaires to assess the qualities of phantom and residual limb pain. Medical records were reviewed to determine the presence/absence of a regional catheter near the time of injury. Subtypes of residual limb pain (somatic, neuroma, and complex regional pain syndrome) were additionally analyzed and associated with clinical risk factors.A majority of enrolled patients (64.5%) reported clinically significant pain (pain score ≥ 3 averaged over previous week). 61% experienced residual limb pain and 58% experienced phantom pain. When analysis of pain subtypes was performed in those with residual limb pain, we found evidence of a sensitized neuroma in 48.7%, somatic pain in 40.8%, and complex regional pain syndrome in 19.7% of individuals. The presence of clinically significant neuropathic residual limb pain was associated with symptoms of PTSD and depression. Neuropathic pain of any severity was associated with symptoms of all four assessed clinical risk factors: depression, PTSD, catastrophizing, and the absence of regional analgesia catheter.Most military service members in this cohort suffered both phantom and residual limb pain following amputation. Neuroma was a common cause of neuropathic pain in this group. Associated risk factors for significant neuropathic pain included PTSD and depression. PTSD, depression, catastrophizing, and the absence of a regional analgesia catheter were associated with neuropathic pain of any severity.

Authors
Buchheit, T; Van de Ven, T; Hsia, H-LJ; McDuffie, M; MacLeod, DB; White, W; Chamessian, A; Keefe, FJ; Buckenmaier, CT; Shaw, AD
MLA Citation
Buchheit, T, Van de Ven, T, Hsia, H-LJ, McDuffie, M, MacLeod, DB, White, W, Chamessian, A, Keefe, FJ, Buckenmaier, CT, and Shaw, AD. "Pain Phenotypes and Associated Clinical Risk Factors Following Traumatic Amputation: Results from Veterans Integrated Pain Evaluation Research (VIPER)." Pain medicine (Malden, Mass.) 17.1 (January 2016): 149-161.
PMID
26177330
Source
epmc
Published In
Pain Medicine
Volume
17
Issue
1
Publish Date
2016
Start Page
149
End Page
161

A Small Randomized Controlled Pilot Trial Comparing Mobile and Traditional Pain Coping Skills Training Protocols for Cancer Patients with Pain.

Psychosocial pain management interventions are efficacious for cancer pain but are underutilized. Recent advances in mobile health (mHealth) technologies provide new opportunities to decrease barriers to access psychosocial pain management interventions. The objective of this study was to gain information about the accessibility and efficacy of mobile pain coping skills training (mPCST) intervention delivered to cancer patients with pain compared to traditional in-person pain coping skills training intervention. This study randomly assigned participants (N = 30) to receive either mobile health pain coping skills training intervention delivered via Skype or traditional pain coping skills training delivered face-to-face (PCST-trad). This pilot trial suggests that mPCST is feasible, presents low burden to patients, may lead to high patient engagement, and appears to be acceptable to patients. Cancer patients with pain in the mPCST group reported decreases in pain severity and physical symptoms as well as increases in self-efficacy for pain management that were comparable to changes in the PCST-trad group (p's < 0.05). These findings suggest that mPCST, which is a highly accessible intervention, may provide benefits similar to an in-person intervention and shows promise for being feasible, acceptable, and engaging to cancer patients with pain.

Authors
Somers, TJ; Kelleher, SA; Westbrook, KW; Kimmick, GG; Shelby, RA; Abernethy, AP; Keefe, FJ
MLA Citation
Somers, TJ, Kelleher, SA, Westbrook, KW, Kimmick, GG, Shelby, RA, Abernethy, AP, and Keefe, FJ. "A Small Randomized Controlled Pilot Trial Comparing Mobile and Traditional Pain Coping Skills Training Protocols for Cancer Patients with Pain." Pain research and treatment 2016 (January 2016): 2473629-.
PMID
27891252
Source
epmc
Published In
Pain Research and Treatment
Volume
2016
Publish Date
2016
Start Page
2473629

Impact of Smoking Cessation on Subsequent Pain Intensity Among Chronically Ill Veterans Enrolled in a Smoking Cessation Trial.

Prior cross-sectional studies have reported greater pain intensity among persistent smokers compared with nonsmokers or former smokers; yet, few prospective studies have examined how smoking abstinence affects pain intensity.To determine the impact of smoking cessation on subsequent pain intensity in smokers with chronic illness enrolled in a smoking cessation trial.We recruited veteran smokers with chronic illness (heart disease, cancer, chronic obstructive pulmonary disease, diabetes, or hypertension) for a randomized controlled smoking cessation trial and prospectively examined pain intensity and smoking status. Participants (n = 380) were asked to rate their pain in the past week from 0 to 10 at baseline and the five-month follow-up. The primary outcome measure was self-reported pain intensity at the five-month follow-up survey. Self-reported smoking status was categorized as an abstainer if patients reported no cigarettes in the seven days before the follow-up survey.In unadjusted analyses, abstainers reported significantly lower pain levels at the five-month follow-up compared with patients who continued to smoke (parameter estimate = -1.07; 95% CI = -1.77, -0.36). In multivariable modeling, abstaining from cigarettes was not associated with subsequent pain intensity at five-month follow-up (parameter estimate = -0.27; 95% CI = -0.79, 0.25).Participants who were classified as abstainers did not report significantly different levels of pain intensity than patients who continued to smoke. Future studies should expand on our findings and monitor pain intensity in smoking cessation trials.ClinicalTrials.govNCT00448344.

Authors
Bastian, LA; Fish, LJ; Gierisch, JM; Stechuchak, KM; Grambow, SC; Keefe, FJ
MLA Citation
Bastian, LA, Fish, LJ, Gierisch, JM, Stechuchak, KM, Grambow, SC, and Keefe, FJ. "Impact of Smoking Cessation on Subsequent Pain Intensity Among Chronically Ill Veterans Enrolled in a Smoking Cessation Trial." Journal of pain and symptom management 50.6 (December 2015): 822-829.
PMID
26210348
Source
epmc
Published In
Journal of Pain and Symptom Management
Volume
50
Issue
6
Publish Date
2015
Start Page
822
End Page
829
DOI
10.1016/j.jpainsymman.2015.06.012

The Communal Coping Model of Pain Catastrophizing in Daily Life: A Within-Couples Daily Diary Study.

The Communal Coping Model characterizes pain catastrophizing as a coping tactic whereby pain expression elicits assistance and empathic responses from others. Married couples (N = 105 couples; 1 spouse with chronic low back pain) completed electronic daily diary assessments 5 times/day for 14 days. In these diaries, patients reported pain catastrophizing, pain, and function, and perceived spouse support, perceived criticism, and perceived hostility. Non-patient spouses reported on their support, criticism, and hostility directed toward patients, as well as their observations of patient pain and pain behaviors. Hierarchical linear modeling tested concurrent and lagged (3 hours later) relationships. Principal findings included the following: a) within-person increases in pain catastrophizing were positively associated with spouse reports of patient pain behavior in concurrent and lagged analyses; b) within-person increases in pain catastrophizing were positively associated with patient perceptions of spouse support, criticism, and hostility in concurrent analyses; c) within-person increases in pain catastrophizing were negatively associated with spouse reports of criticism and hostility in lagged analyses. Spouses reported patient behaviors that were tied to elevated pain catastrophizing, and spouses changed their behavior during and after elevated pain catastrophizing episodes. Pain catastrophizing may affect the interpersonal environment of patients and spouses in ways consistent with the Communal Coping Model.Pain catastrophizing may represent a coping response by which individuals' pain expression leads to assistance or empathic responses from others. Results of the present study support this Communal Coping Model, which emphasizes interpersonal processes by which pain catastrophizing, pain, pain behavior, and responses of significant others are intertwined.

Authors
Burns, JW; Gerhart, JI; Post, KM; Smith, DA; Porter, LS; Schuster, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Burns, JW, Gerhart, JI, Post, KM, Smith, DA, Porter, LS, Schuster, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "The Communal Coping Model of Pain Catastrophizing in Daily Life: A Within-Couples Daily Diary Study." The journal of pain : official journal of the American Pain Society 16.11 (November 2015): 1163-1175.
PMID
26320945
Source
epmc
Published In
The Journal of Pain
Volume
16
Issue
11
Publish Date
2015
Start Page
1163
End Page
1175
DOI
10.1016/j.jpain.2015.08.005

A Pilot Study of a Mobile Health Pain Coping Skills Training Protocol for Patients With Persistent Cancer Pain.

Pain coping skills training (PCST) interventions have shown efficacy for reducing pain and providing other benefits in patients with cancer. However, their reach is often limited because of a variety of barriers (e.g., travel, physical burden, cost, time).This study examined the feasibility and acceptability of a brief PCST intervention delivered to patients in their homes using mobile health (mHealth) technology. Pre-to-post intervention changes in pain, physical functioning, physical symptoms, psychological distress, self-efficacy for pain management, and pain catastrophizing also were examined.Patients with a diagnosis of breast, lung, prostate, or colorectal cancer who reported persistent pain (N = 25) participated in a four-session intervention delivered using mHealth technology (videoconferencing on a tablet computer). Participants completed measures of pain, physical functioning, physical symptoms, psychological distress, self-efficacy for pain management, and pain catastrophizing. We also assessed patient satisfaction.Participants completed an average of 3.36 (SD = 1.11) of the four intervention sessions for an overall session completion rate of 84%. Participants reported that the program was of excellent quality and met their needs. Significant preintervention to postintervention differences were found in pain, physical symptoms, psychological distress, and pain catastrophizing.The use of mHealth technology is a feasible and acceptable option for delivery of PCST for patients with cancer. This delivery mode is likely to dramatically increase intervention access for cancer patients with pain compared to traditional in-person delivery. Preliminary data also suggest that the program is likely to produce pretreatment to post-treatment decreases in pain and other important outcomes.

Authors
Somers, TJ; Abernethy, AP; Edmond, SN; Kelleher, SA; Wren, AA; Samsa, GP; Keefe, FJ
MLA Citation
Somers, TJ, Abernethy, AP, Edmond, SN, Kelleher, SA, Wren, AA, Samsa, GP, and Keefe, FJ. "A Pilot Study of a Mobile Health Pain Coping Skills Training Protocol for Patients With Persistent Cancer Pain." Journal of pain and symptom management 50.4 (October 2015): 553-558.
PMID
26025279
Source
epmc
Published In
Journal of Pain and Symptom Management
Volume
50
Issue
4
Publish Date
2015
Start Page
553
End Page
558
DOI
10.1016/j.jpainsymman.2015.04.013

Effects of Adding an Internet-Based Pain Coping Skills Training Protocol to a Standardized Education and Exercise Program for People With Persistent Hip Pain (HOPE Trial): Randomized Controlled Trial Protocol.

Persistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability, and psychological dysfunction.The purpose of this study is to evaluate whether adding an Internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist-instructed home exercise leads to greater reductions in pain and improvements in function.An assessor-, therapist-, and participant-blinded randomized controlled trial will be conducted.The study will be conducted in a community setting.The participants will be 142 people over 50 years of age with self-reported hip pain consistent with hip OA.Participants will be randomly allocated to: (1) a control group receiving a 24-week standardized intervention comprising an 8-week Internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or (2) a PCST group receiving an 8-week Internet-based PCST protocol in addition to the control intervention.Outcomes will be measured at baseline and 8, 24, and 52 weeks, with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant-perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing, and physical activity. Measurements of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost-effectiveness will be assessed at 52 weeks.A self-reported diagnosis of persistent hip pain will be used.The findings will help determine whether adding an Internet-based PCST protocol to standardized education and physical therapist-instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice toward innovative modes of psychosocial health care provision.

Authors
Bennell, KL; Rini, C; Keefe, F; French, S; Nelligan, R; Kasza, J; Forbes, A; Dobson, F; Abbott, JH; Dalwood, A; Vicenzino, B; Harris, A; Hinman, RS
MLA Citation
Bennell, KL, Rini, C, Keefe, F, French, S, Nelligan, R, Kasza, J, Forbes, A, Dobson, F, Abbott, JH, Dalwood, A, Vicenzino, B, Harris, A, and Hinman, RS. "Effects of Adding an Internet-Based Pain Coping Skills Training Protocol to a Standardized Education and Exercise Program for People With Persistent Hip Pain (HOPE Trial): Randomized Controlled Trial Protocol." Physical therapy 95.10 (October 2015): 1408-1422.
PMID
26023213
Source
epmc
Published In
Physical Therapy
Volume
95
Issue
10
Publish Date
2015
Start Page
1408
End Page
1422
DOI
10.2522/ptj.20150119

Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy.

To explore how symptoms and psychosocial factors are related to intentional and unintentional non-adherent medication taking behaviors.Included were postmenopausal women with hormone receptor positive, stage I-IIIA breast cancer, who had completed surgery, chemotherapy, and radiation, and were taking endocrine therapy. Self-administered, standardized measures were completed during a routine clinic visit: Brief Fatigue Inventory, Brief Pain Inventory, Menopause Specific Quality of Life Questionnaire, Functional Assessment of Cancer Therapy General and Neurotoxicity scales, and Self-Efficacy for Appropriate Medication Use Scale. Regression analyses were performed to determine the degree to which demographic, medical, symptom, and psychosocial variables, explain intentional, such as changing one's doses or stopping medication, and unintentional, such as forgetting to take one's medication, non-adherent behaviors.Participants were 112 women: mean age 64 (SD = 9) years; 81% white; mean time from surgery 40 (SD = 28) months; 49% received chemotherapy (39% including a taxane); mean time on endocrine therapy, 35 (SD = 29.6) months; 82% taking an aromatase inhibitor. Intentional and unintentional non-adherent behaviors were described in 33.9% and 58.9% of participants, respectively. Multivariate analysis showed that higher self-efficacy for taking medication was associated with lower levels of unintentional (p = 0.002) and intentional (p = 0.004) non-adherent behaviors. The presence of symptoms (p = 0.03) and lower self-efficacy for physician communication (p = 0.009) were associated with higher levels of intentional non-adherent behaviors.These results suggest that women who report greater symptoms, lower self-efficacy for communicating with their physician, and lower self-efficacy for taking their medication are more likely to engage in both intentional and unintentional non-adherent behaviors.

Authors
Kimmick, G; Edmond, SN; Bosworth, HB; Peppercorn, J; Marcom, PK; Blackwell, K; Keefe, FJ; Shelby, RA
MLA Citation
Kimmick, G, Edmond, SN, Bosworth, HB, Peppercorn, J, Marcom, PK, Blackwell, K, Keefe, FJ, and Shelby, RA. "Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy." Breast (Edinburgh, Scotland) 24.5 (October 2015): 630-636.
PMID
26189978
Source
epmc
Published In
The Breast
Volume
24
Issue
5
Publish Date
2015
Start Page
630
End Page
636
DOI
10.1016/j.breast.2015.06.010

Pain Intensity and Pain Interference in Patients With Lung Cancer: A Pilot Study of Biopsychosocial Predictors.

OBJECTIVE: To explore biopsychosocial factors (beliefs, depression, catastrophizing cytokines) in individuals newly diagnosed with lung cancer and no pain to determine their relationship at diagnosis and across time and to determine whether these factors contribute to pain intensity or pain interference with function at pain onset. MATERIALS AND METHODS: A longitudinal, exploratory, pilot study was implemented in a private medical center and a VA medical center in the southeast. Twelve subjects not experiencing pain related to cancer of the lung or its treatment were recruited. A Karnofsky status of 40% and hemoglobin of 8 g were required. Five questionnaires were completed and 10 mL of blood was drawn at baseline; 4 questionnaires and blood draws were repeated monthly for 5 months. One baseline questionnaire and a pain assessment were added at final. Demographic, clinical, and questionnaire data were summarized; standardized scale scores were calculated. RESULTS: Biopsychosocial scores that were low at baseline increased from T1-T4 but decreased slightly T5-T6. Individuals with higher pain intensity and higher pain interference at final had higher psychosocial scores at baseline than individuals with lower pain intensity and lower pain interference at final. CONCLUSIONS: Unrelated to disease stage, metastasis, or treatment, unique levels of biopsychosocial factors are observed in patients newly diagnosed with lung cancer who report higher levels of pain intensity and higher levels of pain interference at the time pain occurs. Replication studies are needed to validate this response pattern and determine the value of repeated individual assessments.

Authors
Dalton, JA; Higgins, MK; Miller, AH; Keefe, FJ; Khuri, FR
MLA Citation
Dalton, JA, Higgins, MK, Miller, AH, Keefe, FJ, and Khuri, FR. "Pain Intensity and Pain Interference in Patients With Lung Cancer: A Pilot Study of Biopsychosocial Predictors." Am J Clin Oncol 38.5 (October 2015): 457-464.
PMID
24064756
Source
pubmed
Published In
American Journal of Clinical Oncology: Cancer Clinical Trials
Volume
38
Issue
5
Publish Date
2015
Start Page
457
End Page
464
DOI
10.1097/COC.0b013e3182a79009

A supplemental report to a randomized cluster trial of a 20-week Sun-style Tai Chi for osteoarthritic knee pain in elders with cognitive impairment.

This was a secondary data analysis of a cluster-randomized clinical trial that tested the efficacy of a 20-week Sun-style Tai Chi (TC) program in reducing pain in community-dwelling elders with cognitive impairment and knee osteoarthritis (OA). The study also examined whether elders' level of cognitive function was related to the outcomes of the TC program.Elders (N=55) were recruited from 8 study sites. Each site was randomly assigned to participate in either a 20-week TC or an education program. Verbal report of pain was measured by a Verbal Descriptor Scale (VDS) at weeks 1, 5, 9, 13, 17 and 21 (designated as times 1-6). Pain behaviors and analgesic intake were also recorded at times 1-6.At post-test, scores on the VDS and observed pain behaviors were significantly better in the TC group than in the control group (p=0.008-0.048). The beneficial effects of TC were not associated with cognitive ability.These results suggest that TC can be used as an adjunct to pharmacological intervention to relieve OA pain in elders with cognitive impairment.Clinical Trial.gov NCT01528566.

Authors
Tsai, P-F; Chang, JY; Beck, C; Kuo, Y-F; Keefe, FJ; Rosengren, K
MLA Citation
Tsai, P-F, Chang, JY, Beck, C, Kuo, Y-F, Keefe, FJ, and Rosengren, K. "A supplemental report to a randomized cluster trial of a 20-week Sun-style Tai Chi for osteoarthritic knee pain in elders with cognitive impairment." Complementary therapies in medicine 23.4 (August 2015): 570-576.
PMID
26275650
Source
epmc
Published In
Complementary Therapies in Medicine
Volume
23
Issue
4
Publish Date
2015
Start Page
570
End Page
576
DOI
10.1016/j.ctim.2015.06.001

Relationship Intimacy and Quality of Life in Black Prostate Cancer Survivors and Partners

Authors
Campbell, L; Stalls-Jernigan, J; Thornton, S; Keefe, FJ; McKee, D
MLA Citation
Campbell, L, Stalls-Jernigan, J, Thornton, S, Keefe, FJ, and McKee, D. "Relationship Intimacy and Quality of Life in Black Prostate Cancer Survivors and Partners." PSYCHO-ONCOLOGY 24 (July 2015): 330-330.
Source
wos-lite
Published In
Psycho-Oncology
Volume
24
Publish Date
2015
Start Page
330
End Page
330

Anger Arousal and Behavioral Anger Regulation in Everyday Life Among People With Chronic Low Back Pain: Relationships With Spouse Responses and Negative Affect

© 2015 APA, all rights reserved).Objective: To determine the degree to which anger arousal and anger regulation (expression, inhibition) in the daily lives of people with chronic pain were related to spouse support, criticism, and hostility as perceived by patients and as reported by spouses. Method: Married couples (N = 105, 1 spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. On these diaries, patients completed items on their own anger arousal, anger expression, and inhibition, and on perceived spouse support, criticism, and hostility. Spouses reported on their responses toward patients and their negative affect. Hierarchical linear modeling tested concurrent and lagged relationships. Results: Patient-reported increases in anger arousal and anger expression were predominantly related to concurrent decreases in patient-perceived and spouse-reported spouse support, concurrent increases in patient-perceived and spouse-reported spouse criticism and hostility, and increases in spouse-reported negative affect. Relationships for anger expression remained significant with anger arousal controlled. These effects were especially strong for male patients. Spouses reported greater negative affect when patients were present than when they were not. Conclusions: Social support may facilitate adjustment to chronic pain, with declining support and overt criticism and hostility possibly adversely impacting pain and function. Results suggest that patient anger arousal and expression may be related to a negative interpersonal environment for married couples coping with chronic low back pain. (PsycINFO Database Record

Authors
Burns, JW; Gerhart, JI; Bruehl, S; Post, KM; Smith, DA; Porter, LS; Schuster, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Burns, JW, Gerhart, JI, Bruehl, S, Post, KM, Smith, DA, Porter, LS, Schuster, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "Anger Arousal and Behavioral Anger Regulation in Everyday Life Among People With Chronic Low Back Pain: Relationships With Spouse Responses and Negative Affect (Accepted)." Health Psychology (June 1, 2015).
Source
scopus
Published In
Health Psychology
Publish Date
2015
DOI
10.1037/hea0000221

Dealing with cancer pain: Coping, pain catastrophizing, and related outcomes

Authors
Somers, TJ; Keefe, FJ; Kothadia, S; Pandiani, A
MLA Citation
Somers, TJ, Keefe, FJ, Kothadia, S, and Pandiani, A. "Dealing with cancer pain: Coping, pain catastrophizing, and related outcomes." Cancer Pain: From Molecules to Suffering. June 1, 2015.
Source
scopus
Publish Date
2015

Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: Relationships to patient pain and function.

The objective of this study was to determine the degree to which patient anger arousal and behavioral anger regulation (expression, inhibition) occurring in the course of daily life was related to patient pain and function as rated by patients and their spouses.Married couples (N = 105) (one spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. Patients completed items on their own state anger, behavioral anger expression and inhibition, and pain-related factors. Spouses completed items on their observations of patient pain-related factors. Hierarchical linear modeling was used to test concurrent and lagged relationships.Patient-reported increases in state anger were related to their reports of concurrent increases in pain and pain interference and to spouse reports of patient pain and pain behavior. Patient-reported increases in behavioral anger expression were related to lagged increases in pain intensity and interference and decreases in function. Most of these relationships remained significant with state anger controlled. Patient-reported increases in behavioral anger inhibition were related to concurrent increases in pain interference and decreases in function, which also remained significant with state anger controlled. Patient-reported increases in state anger were related to lagged increases in spouse reports of patient pain intensity and pain behaviors.Results indicate that in patients with chronic pain, anger arousal and behavioral anger expression and inhibition in everyday life are related to elevated pain intensity and decreased function as reported by patients. Spouse ratings show some degree of concordance with patient reports.

Authors
Burns, JW; Gerhart, JI; Bruehl, S; Peterson, KM; Smith, DA; Porter, LS; Schuster, E; Kinner, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Burns, JW, Gerhart, JI, Bruehl, S, Peterson, KM, Smith, DA, Porter, LS, Schuster, E, Kinner, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: Relationships to patient pain and function." Health psychology : official journal of the Division of Health Psychology, American Psychological Association 34.5 (May 2015): 547-555.
PMID
25110843
Source
epmc
Published In
Health Psychology
Volume
34
Issue
5
Publish Date
2015
Start Page
547
End Page
555
DOI
10.1037/hea0000091

Automated Internet-based pain coping skills training to manage osteoarthritis pain: a randomized controlled trial.

Osteoarthritis (OA) places a significant burden on worldwide public health because of the large and growing number of people affected by OA and its associated pain and disability. Pain coping skills training (PCST) is an evidence-based intervention targeting OA pain and disability. To reduce barriers that currently limit access to PCST, we developed an 8-week, automated, Internet-based PCST program called PainCOACH and evaluated its potential efficacy and acceptability in a small-scale, 2-arm randomized controlled feasibility trial. Participants were 113 men and women with clinically confirmed hip or knee OA and associated pain. They were randomized to a group completing PainCOACH or an assessment-only control group. Osteoarthritis pain, pain-related interference with functioning, pain-related anxiety, self-efficacy for pain management, and positive and negative affect were measured before intervention, midway through the intervention, and after intervention. Findings indicated high acceptability and adherence: 91% of participants randomized to complete PainCOACH finished all 8 modules over 8 to 10 weeks. Linear mixed models showed that, after treatment, women who received the PainCOACH intervention reported significantly lower pain than that in women in the control group (Cohen d = 0.33). Intervention effects could not be tested in men because of their low pain and small sample size. Additionally, both men and women demonstrated increases in self-efficacy from baseline to after intervention compared with the control group (d = 0.43). Smaller effects were observed for pain-related anxiety (d = 0.20), pain-related interference with functioning (d = 0.13), negative affect (d = 0.10), and positive affect (d = 0.24). Findings underscore the value of continuing to develop an automated Internet-based approach to disseminate this empirically supported intervention.

Authors
Rini, C; Porter, LS; Somers, TJ; McKee, DC; DeVellis, RF; Smith, M; Winkel, G; Ahern, DK; Goldman, R; Stiller, JL; Mariani, C; Patterson, C; Jordan, JM; Caldwell, DS; Keefe, FJ
MLA Citation
Rini, C, Porter, LS, Somers, TJ, McKee, DC, DeVellis, RF, Smith, M, Winkel, G, Ahern, DK, Goldman, R, Stiller, JL, Mariani, C, Patterson, C, Jordan, JM, Caldwell, DS, and Keefe, FJ. "Automated Internet-based pain coping skills training to manage osteoarthritis pain: a randomized controlled trial." Pain 156.5 (May 2015): 837-848.
PMID
25734997
Source
epmc
Published In
PAIN
Volume
156
Issue
5
Publish Date
2015
Start Page
837
End Page
848
DOI
10.1097/j.pain.0000000000000121

OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of lifestyle diet and exercise interventions for osteoarthritis.

The objective was to develop a set of "best practices" for use as a primer for those interested in entering the clinical trials field for lifestyle diet and/or exercise interventions in osteoarthritis (OA), and as a set of recommendations for experienced clinical trials investigators. A subcommittee of the non-pharmacologic therapies committee of the OARSI Clinical Trials Working Group was selected by the Steering Committee to develop a set of recommended principles for non-pharmacologic diet/exercise OA randomized clinical trials. Topics were identified for inclusion by co-authors and reviewed by the subcommittee. Resources included authors' expert opinions, traditional search methods including MEDLINE (via PubMed), and previously published guidelines. Suggested steps and considerations for study methods (e.g., recruitment and enrollment of participants, study design, intervention and assessment methods) were recommended. The recommendations set forth in this paper provide a guide from which a research group can design a lifestyle diet/exercise randomized clinical trial in patients with OA.

Authors
Messier, SP; Callahan, LF; Golightly, YM; Keefe, FJ
MLA Citation
Messier, SP, Callahan, LF, Golightly, YM, and Keefe, FJ. "OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of lifestyle diet and exercise interventions for osteoarthritis." Osteoarthritis and cartilage 23.5 (May 2015): 787-797. (Review)
PMID
25952349
Source
epmc
Published In
Osteoarthritis and Cartilage
Volume
23
Issue
5
Publish Date
2015
Start Page
787
End Page
797
DOI
10.1016/j.joca.2015.03.008

An introduction to the biennial review of pain.

Authors
Raja, SN; Keefe, FJ
MLA Citation
Raja, SN, and Keefe, FJ. "An introduction to the biennial review of pain." Pain 156 Suppl 1 (April 2015): S1-.
PMID
25789425
Source
epmc
Published In
PAIN
Volume
156 Suppl 1
Publish Date
2015
Start Page
S1
DOI
10.1097/j.pain.0000000000000112

Associations of coping strategies with diary based pain variables among Caucasian and African American patients with osteoarthritis.

PURPOSE: The purposes of this study are to examine the associations between pain coping strategies and daily diary-based pain measures and to determine whether these associations differed by race (African American and Caucasian). METHODS: Primary care patients from the Durham Veterans Affairs and Duke University Medical Centers (N = 153) with hand, hip, or knee osteoarthritis (OA) completed electronic pain diaries on a one-weekend day and one weekday. The maximum, range (maximum minus minimum pain), and area under the curve (AUC) of joint pain ratings were calculated. Pain coping (Coping Strategies Questionnaire (CSQ) coping attempts, catastrophizing, and praying/hoping subscale scores) was assessed prior to diary entries and at the end of each diary day (total, problem-focused, and emotion-focused scores from Stone and Neale's Daily Coping Inventory). Pearson correlations between pain variables and coping measures were examined. Linear mixed models were fit including age, race, weekend/weekday, study enrollment site, education level, pain medication use, self-rated health, Arthritis Impact Measurement Scales affect and function subscales, and interactions of coping measures with race and weekend day/weekday status. RESULTS: Correlations between coping and pain measures were 0.12-0.45. In adjusted models, maximum pain and pain range were associated with all three diary-based coping measures; maximum pain was associated with CSQ coping attempts; and AUC was associated with CSQ praying/hoping. Interactions were not significant. CONCLUSIONS: Among participants with OA, pain coping strategies were related to important aspects of the pain experience, particularly pain range and maximum pain. However, race did not modify associations of pain coping strategy use and the pain experience.

Authors
Golightly, YM; Allen, KD; Stechuchak, KM; Coffman, CJ; Keefe, FJ
MLA Citation
Golightly, YM, Allen, KD, Stechuchak, KM, Coffman, CJ, and Keefe, FJ. "Associations of coping strategies with diary based pain variables among Caucasian and African American patients with osteoarthritis." International journal of behavioral medicine 22.1 (February 2015): 101-108.
PMID
24590828
Source
epmc
Published In
International Journal of Behavioral Medicine
Volume
22
Issue
1
Publish Date
2015
Start Page
101
End Page
108
DOI
10.1007/s12529-013-9365-3

Validating pain communication: current state of the science.

Authors
Edmond, SN; Keefe, FJ
MLA Citation
Edmond, SN, and Keefe, FJ. "Validating pain communication: current state of the science." Pain 156.2 (February 2015): 215-219. (Review)
PMID
25599441
Source
epmc
Published In
PAIN
Volume
156
Issue
2
Publish Date
2015
Start Page
215
End Page
219
DOI
10.1097/01.j.pain.0000460301.18207.c2

Quantitative sensory testing in predicting persistent pain after joint replacement surgery: promise and challenges.

Authors
Coghill, RC; Keefe, FJ
MLA Citation
Coghill, RC, and Keefe, FJ. "Quantitative sensory testing in predicting persistent pain after joint replacement surgery: promise and challenges." Pain 156.1 (January 2015): 4-5.
PMID
25599294
Source
epmc
Published In
PAIN
Volume
156
Issue
1
Publish Date
2015
Start Page
4
End Page
5
DOI
10.1016/j.pain.0000000000000025

PAIN®: our "new look".

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "PAIN®: our "new look"." Pain 156.1 (January 2015): 1-2.
PMID
25599292
Source
epmc
Published In
PAIN
Volume
156
Issue
1
Publish Date
2015
Start Page
1
End Page
2
DOI
10.1016/j.pain.0000000000000029

Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: Relationships to patient pain and function

© 2014 American Psychological Association.Objective: The objective of this study was to determine the degree to which patient anger arousal and behavioral anger regulation (expression, inhibition) occurring in the course of daily life was related to patient pain and function as rated by patients and their spouses. Method: Married couples (N = 105) (one spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. Patients completed items on their own state anger, behavioral anger expression and inhibition, and pain-related factors. Spouses completed items on their observations of patient pain-related factors. Hierarchical linear modeling was used to test concurrent and lagged relationships. Results: Patient-reported increases in state anger were related to their reports of concurrent increases in pain and pain interference and to spouse reports of patient pain and pain behavior. Patient-reported increases in behavioral anger expression were related to lagged increases in pain intensity and interference and decreases in function. Most of these relationships remained significant with state anger controlled. Patient-reported increases in behavioral anger inhibition were related to concurrent increases in pain interference and decreases in function, which also remained significant with state anger controlled. Patient-reported increases in state anger were related to lagged increases in spouse reports of patient pain intensity and pain behaviors. Conclusions: Results indicate that in patients with chronic pain, anger arousal and behavioral anger expression and inhibition in everyday life are related to elevated pain intensity and decreased function as reported by patients. Spouse ratings show some degree of concordance with patient reports.

Authors
Burns, JW; Gerhart, JI; Bruehl, S; Peterson, KM; Smith, DA; Porter, LS; Schuster, E; Kinner, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Burns, JW, Gerhart, JI, Bruehl, S, Peterson, KM, Smith, DA, Porter, LS, Schuster, E, Kinner, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: Relationships to patient pain and function." Health Psychology 34.5 (2015): 547-555.
Source
scival
Published In
Health Psychology
Volume
34
Issue
5
Publish Date
2015
Start Page
547
End Page
555
DOI
10.1037/hea0000091

Associations of coping strategies with diary based pain variables among Caucasian and African American patients with osteoarthritis

PURPOSE: The purposes of this study are to examine the associations between pain coping strategies and daily diary-based pain measures and to determine whether these associations differed by race (African American and Caucasian).METHODS: Primary care patients from the Durham Veterans Affairs and Duke University Medical Centers (N = 153) with hand, hip, or knee osteoarthritis (OA) completed electronic pain diaries on a one-weekend day and one weekday. The maximum, range (maximum minus minimum pain), and area under the curve (AUC) of joint pain ratings were calculated. Pain coping (Coping Strategies Questionnaire (CSQ) coping attempts, catastrophizing, and praying/hoping subscale scores) was assessed prior to diary entries and at the end of each diary day (total, problem-focused, and emotion-focused scores from Stone and Neale's Daily Coping Inventory). Pearson correlations between pain variables and coping measures were examined. Linear mixed models were fit including age, race, weekend/weekday, study enrollment site, education level, pain medication use, self-rated health, Arthritis Impact Measurement Scales affect and function subscales, and interactions of coping measures with race and weekend day/weekday status.RESULTS: Correlations between coping and pain measures were 0.12-0.45. In adjusted models, maximum pain and pain range were associated with all three diary-based coping measures; maximum pain was associated with CSQ coping attempts; and AUC was associated with CSQ praying/hoping. Interactions were not significant.CONCLUSIONS: Among participants with OA, pain coping strategies were related to important aspects of the pain experience, particularly pain range and maximum pain. However, race did not modify associations of pain coping strategy use and the pain experience.

Authors
Golightly, YM; Allen, KD; Stechuchak, KM; Coffman, CJ; Keefe, FJ
MLA Citation
Golightly, YM, Allen, KD, Stechuchak, KM, Coffman, CJ, and Keefe, FJ. "Associations of coping strategies with diary based pain variables among Caucasian and African American patients with osteoarthritis." International journal of behavioral medicine 22.1 (2015): 101-108.
Source
scival
Published In
International Journal of Behavioral Medicine
Volume
22
Issue
1
Publish Date
2015
Start Page
101
End Page
108
DOI
10.1007/s12529-013-9365-3

Pain intensity and pain interference in patients with lung cancer: A pilot study of biopsychosocial predictors

Copyright © 2013 Wolters Kluwer Health, Inc.Objective: To explore biopsychosocial factors (beliefs, depression, catastrophizing cytokines) in individuals newly diagnosed with lung cancer and no pain to determine their relationship at diagnosis and across time and to determine whether these factors contribute to pain intensity or pain interference with function at pain onset. Materials and Methods: A longitudinal, exploratory, pilot study was implemented in a private medical center and a VA medical center in the southeast. Twelve subjects not experiencing pain related to cancer of the lung or its treatment were recruited. A Karnofsky status of 40% and hemoglobin of 8 g were required. Five questionnaires were completed and 10mL of blood was drawn at baseline; 4 questionnaires and blood draws were repeated monthly for 5 months. One baseline questionnaire and a pain assessment were added at final. Demographic, clinical, and questionnaire data were summarized; standardized scale scores were calculated. Results: Biopsychosocial scores that were low at baseline increased from T1-T4 but decreased slightly T5-T6. Individuals with higher pain intensity and higher pain interference at final had higher psychosocial scores at baseline than individuals with lower pain intensity and lower pain interference at final. Conclusions: Unrelated to disease stage, metastasis, or treatment, unique levels of biopsychosocial factors are observed in patients newly diagnosed with lung cancer who report higher levels of pain intensity and higher levels of pain interference at the time pain occurs. Replication studies are needed to validate this response pattern and determine the value of repeated individual assessments.

Authors
Dalton, JA; Higgins, MK; Miller, AH; Keefe, FJ; Khuri, FR
MLA Citation
Dalton, JA, Higgins, MK, Miller, AH, Keefe, FJ, and Khuri, FR. "Pain intensity and pain interference in patients with lung cancer: A pilot study of biopsychosocial predictors." American Journal of Clinical Oncology: Cancer Clinical Trials 38.5 (2015): 457-464.
Source
scival
Published In
American Journal of Clinical Oncology: Cancer Clinical Trials
Volume
38
Issue
5
Publish Date
2015
Start Page
457
End Page
464
DOI
10.1097/COC.0b013e3182a79009

Spouse confidence in self-efficacy for arthritis management predicts improved patient health.

In addition to patient self-efficacy, spouse confidence in patient efficacy may also independently predict patient health outcomes. However, the potential influence of spouse confidence has received little research attention.The current study examined the influence of patient and spouse efficacy beliefs for arthritis management on patient health.Patient health (i.e., arthritis severity, perceived health, depressive symptoms, lower extremity function), patient self-efficacy, and spouse confidence in patients' efficacy were assessed in a sample of knee osteoarthritis patients (N = 152) and their spouses at three time points across an 18-month period. Data were analyzed using structural equation models.Consistent with predictions, spouse confidence in patient efficacy for arthritis management predicted improvements in patient depressive symptoms, perceived health, and lower extremity function over 6 months and in arthritis severity over 1 year.Our findings add to a growing literature that highlights the important role of spouse perceptions in patients' long-term health.

Authors
Gere, J; Martire, LM; Keefe, FJ; Stephens, MAP; Schulz, R
MLA Citation
Gere, J, Martire, LM, Keefe, FJ, Stephens, MAP, and Schulz, R. "Spouse confidence in self-efficacy for arthritis management predicts improved patient health." Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 48.3 (December 2014): 337-346.
PMID
24604529
Source
epmc
Published In
Annals of Behavioral Medicine
Volume
48
Issue
3
Publish Date
2014
Start Page
337
End Page
346
DOI
10.1007/s12160-014-9608-9

Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section.

Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender differences in the assessment and treatment of pain conditions in emergency care settings.

Authors
Musey, PI; Linnstaedt, SD; Platts-Mills, TF; Miner, JR; Bortsov, AV; Safdar, B; Bijur, P; Rosenau, A; Tsze, DS; Chang, AK; Dorai, S; Engel, KG; Feldman, JA; Fusaro, AM; Lee, DC; Rosenberg, M; Keefe, FJ; Peak, DA; Nam, CS; Patel, RG; Fillingim, RB; McLean, SA
MLA Citation
Musey, PI, Linnstaedt, SD, Platts-Mills, TF, Miner, JR, Bortsov, AV, Safdar, B, Bijur, P, Rosenau, A, Tsze, DS, Chang, AK, Dorai, S, Engel, KG, Feldman, JA, Fusaro, AM, Lee, DC, Rosenberg, M, Keefe, FJ, Peak, DA, Nam, CS, Patel, RG, Fillingim, RB, and McLean, SA. "Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section." December 2014.
PMID
25422152
Source
epmc
Published In
Academic Emergency Medicine
Volume
21
Issue
12
Publish Date
2014
Start Page
1421
End Page
1430
DOI
10.1111/acem.12529

The relationship between pain and eating among overweight and obese individuals with osteoarthritis: an ecological momentary study.

Osteoarthritis (OA) patients who are overweight or obese report higher levels of pain compared with their normal-weight OA counterparts. Evidence suggests that overweight or obese OA patients also experience pain relief from eating foods high in calories, fat or sugar. Eating to alleviate pain may be problematic because it can lead to additional weight gain, which may contribute to heightened pain.To investigate the relationship between pain and food intake using ecological momentary assessments in a sample of 71 overweight and obese OA patients.Participants completed two consecutive days of diary entries in which they recorded their levels of pain, mood and food intake throughout the day. Data were analyzed using generalized estimating equations that modelled pain as a predictor of calorie, fat and sugar intake. All models were adjusted for sex, body mass index, negative mood, time and treatment history.Pain significantly predicted calorie (Z=2.57; P=0.01) and fat intake (Z=1.99; P=0.05).Using ecological momentary assessments as a novel approach, the present study provides preliminary data supporting a relationship between pain and food intake among overweight and obese OA patients. Continued advances in our understanding of the relationship between pain and eating behaviour may help to optimize intervention strategies for these patients.

Authors
Choi, KW; Somers, TJ; Babyak, MA; Sikkema, KJ; Blumenthal, JA; Keefe, FJ
MLA Citation
Choi, KW, Somers, TJ, Babyak, MA, Sikkema, KJ, Blumenthal, JA, and Keefe, FJ. "The relationship between pain and eating among overweight and obese individuals with osteoarthritis: an ecological momentary study." Pain research & management 19.6 (November 2014): e159-e163.
PMID
24911176
Source
epmc
Published In
Pain research & management : the journal of the Canadian Pain Society = journal de la societe canadienne pour le traitement de la douleur
Volume
19
Issue
6
Publish Date
2014
Start Page
e159
End Page
e163
DOI
10.1155/2014/598382

Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy.

This study examined the relationships between physical symptoms, self-efficacy for coping with symptoms, and functional, emotional, and social well-being in women who were taking adjuvant endocrine therapy for breast cancer.One hundred and twelve women who were taking adjuvant endocrine therapy (tamoxifen or an aromatase inhibitor) for breast cancer completed measures of physical symptoms, self-efficacy for coping with symptoms, and functional, social, and emotional well-being at the time of routine medical follow-up (women were on average 3.4 years post-surgery; range 3 months to 11 years).Multiple linear regression analyses showed that higher self-efficacy for coping with symptoms was associated with greater functional, emotional, and social well-being after controlling for physical symptoms (p < 0.05). Self-efficacy for coping with symptoms moderated the relationship between physical symptoms and functional (B = 0.05, SE = 0.02, t = 2.67, p = 0.009) and emotional well-being (B = 0.03, SE = 0.01, t = 2.45, p = 0.02). As self-efficacy increased, the relationship between greater physical symptoms and lower well-being became weaker. Among women with high levels of self-efficacy, physical symptoms were not related to functional and emotional well-being.Self-efficacy for coping with symptoms may reduce the negative impact of physical symptoms and contribute to well-being in breast cancer survivors taking adjuvant endocrine therapy. Future studies could examine whether psychosocial interventions aimed at increasing self-efficacy for managing symptoms help women better cope with treatment side effects and improve quality of life.

Authors
Shelby, RA; Edmond, SN; Wren, AA; Keefe, FJ; Peppercorn, JM; Marcom, PK; Blackwell, KL; Kimmick, GG
MLA Citation
Shelby, RA, Edmond, SN, Wren, AA, Keefe, FJ, Peppercorn, JM, Marcom, PK, Blackwell, KL, and Kimmick, GG. "Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy." Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 22.10 (October 2014): 2851-2859.
PMID
24821365
Source
epmc
Published In
Supportive Care in Cancer
Volume
22
Issue
10
Publish Date
2014
Start Page
2851
End Page
2859
DOI
10.1007/s00520-014-2269-1

Can physical therapists deliver a pain coping skills program? An examination of training processes and outcomes.

BACKGROUND: Physical therapists are well established as providers of treatments for common, painful, and disabling conditions, such as knee osteoarthritis (OA). Thus, they are well placed to deliver treatments that integrate physical and psychosocial elements. Attention is usually given to outcomes of such programs, but few studies have examined the processes and outcomes of training physical therapists to deliver such treatments. OBJECTIVE: The aim of this study was to describe the processes in training physical therapists: (1) to deliver a standardized pain coping skills treatment and (2) to evaluate the effectiveness of that training. DESIGN: This study was an analysis of data relating to therapist performance in a randomized clinical trial. METHODS: Eleven physical therapists were trained to deliver a 10-session pain coping skills training program for people with knee OA as part of a randomized controlled trial (N=222). The initial training was provided in a workshop format and included extensive, ongoing supervision by a psychologist and rigorous use of well-defined performance criteria to assess competence. Adherence to the program, ratings of performance, and use of advanced skills were all measured against these criteria in a sample (n=74, 10%) of the audio recordings of the intervention sessions. RESULTS: Overall, the physical therapists achieved a very high standard of treatment delivery, with 96.6% adherence to the program and mean performance ratings all in the satisfactory range. These results were maintained throughout the intervention and across all sessions. LIMITATIONS: Only 10% of the delivered sessions were analyzed, and the physical therapists who took part in the study were a self-selected group. CONCLUSIONS: This study demonstrated that a systematic approach to training and accrediting physical therapists to deliver a standardized pain coping skills program can result in high and sustained levels of adherence to the program. Training fidelity was achieved in this group of motivated clinicians, but the supervision provided was time intensive. The data provide a promising indicator of greater potential for psychologically informed practice to be a feature of effective health care.

Authors
Bryant, C; Lewis, P; Bennell, KL; Ahamed, Y; Crough, D; Jull, GA; Kenardy, J; Nicholas, MK; Keefe, FJ
MLA Citation
Bryant, C, Lewis, P, Bennell, KL, Ahamed, Y, Crough, D, Jull, GA, Kenardy, J, Nicholas, MK, and Keefe, FJ. "Can physical therapists deliver a pain coping skills program? An examination of training processes and outcomes." Physical therapy 94.10 (October 2014): 1443-1454.
PMID
24903113
Source
epmc
Published In
Physical Therapy
Volume
94
Issue
10
Publish Date
2014
Start Page
1443
End Page
1454
DOI
10.2522/ptj.20130444

The effects of a telehealth coping skills intervention on outcomes in chronic obstructive pulmonary disease: primary results from the INSPIRE-II study.

Chronic obstructive pulmonary disease (COPD) is associated with increased morbidity and mortality and reduced quality of life (QoL). Novel interventions are needed to improve outcomes in COPD patients. The present study assessed the effects of a telephone-based coping skills intervention on psychological and somatic QoL and on the combined medical end point of COPD-related hospitalizations and all-cause mortality.We conducted a dual-site, randomized clinical trial with assessments at baseline and after 16 weeks of treatment. The study population comprised 326 outpatients with COPD aged 38 to 81 years, randomized to coping skills training (CST) or to COPD education (COPD-ED). Patients completed a battery of QoL instruments, pulmonary function tests, and functional measures and were followed up for up to 4.4 years to assess medical outcomes.The CST group exhibited greater improvements in psychological QoL compared with controls (p = .001), including less depression (Cohen d = 0.22 [95% confidence interval, or CI = 0.08-0.36]) and anxiety (d = 0.17 [95% CI = 0.02-0.33]), and better overall mental health (d = 0.17 [95% CI = 0.03-0.32]), emotional role functioning (d = 0.29 [95% CI = 0.10-0.48]), vitality (d = 0.27 [95% CI = 0.11, 0.42]), and social functioning (d = 0.21 [95% CI = 0.03-0.38]). A significant baseline psychological QoL by treatment group interaction revealed that CST with lower QoL at baseline achieved even greater improvements in psychological QoL compared with COPD-ED. CST participants also exhibited greater improvements in somatic QoL (p = .042), including greater improvements in pulmonary QoL (d = 0.13 [95% CI = 0.01-0.24]), less fatigue (d = 0.34 [95% CI = 0.18-0.50]), and less shortness of breath (d = 0.11 [95% CI = -0.01 to 0.23]) and greater improvement in distance walked on the Six-Minute Walk test (d = 0.09 [95% CI = 0.01-0.16]). However, there was no significant difference in risk of time to COPD-related hospitalization or all-cause mortality between CST (34 events) and COPD-ED (32 events; p = 0.430).A telehealth CST intervention produced clinically meaningful improvements in QoL and functional capacity, but no overall improvement in risk of COPD-related hospitalization and all-cause mortality.clinicaltrials.gov Identifier: NCT00736268.

Authors
Blumenthal, JA; Emery, CF; Smith, PJ; Keefe, FJ; Welty-Wolf, K; Mabe, S; Martinu, T; Johnson, JJ; Babyak, MA; O'Hayer, VF; Diaz, PT; Durheim, M; Baucom, D; Palmer, SM
MLA Citation
Blumenthal, JA, Emery, CF, Smith, PJ, Keefe, FJ, Welty-Wolf, K, Mabe, S, Martinu, T, Johnson, JJ, Babyak, MA, O'Hayer, VF, Diaz, PT, Durheim, M, Baucom, D, and Palmer, SM. "The effects of a telehealth coping skills intervention on outcomes in chronic obstructive pulmonary disease: primary results from the INSPIRE-II study." Psychosomatic medicine 76.8 (October 2014): 581-592.
PMID
25251888
Source
epmc
Published In
Psychosomatic Medicine
Volume
76
Issue
8
Publish Date
2014
Start Page
581
End Page
592
DOI
10.1097/psy.0000000000000101

Couples and breast cancer: women's mood and partners' marital satisfaction predicting support perception.

Women who are diagnosed with breast cancer can experience an array of psychosocial difficulties; however, social support, particularly from a spouse, has been shown to have a protective function during this time. This study examined the ways in which a woman's daily mood, pain, and fatigue, and her spouse's marital satisfaction predict the woman's report of partner support in the context of breast cancer. Pretest data from a larger intervention study and multilevel modeling were used to examine the effects of women's daily mood, pain, and fatigue and average levels of mood, pain, and fatigue on women's report of social support received from her partner, as well as how the effects of mood interacted with partners' marital satisfaction. Results show that on days in which women reported higher levels of negative or positive mood, as well as on days they reported more pain and fatigue, they reported receiving more support. Women who, on average, reported higher levels of positive mood tended to report receiving more support than those who, on average, reported lower positive mood. However, average levels of negative mood were not associated with support. Higher average levels of fatigue but not pain were associated with higher support. Finally, women whose husbands reported higher levels of marital satisfaction reported receiving more partner support, but husbands' marital satisfaction did not moderate the effect of women's mood on support. Implications of these findings are discussed relative to assisting couples during this difficult time in their lives.

Authors
Boeding, SE; Pukay-Martin, ND; Baucom, DH; Porter, LS; Kirby, JS; Gremore, TM; Keefe, FJ
MLA Citation
Boeding, SE, Pukay-Martin, ND, Baucom, DH, Porter, LS, Kirby, JS, Gremore, TM, and Keefe, FJ. "Couples and breast cancer: women's mood and partners' marital satisfaction predicting support perception." Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43) 28.5 (October 2014): 675-683.
PMID
25133643
Source
epmc
Published In
Journal of Family Psychology
Volume
28
Issue
5
Publish Date
2014
Start Page
675
End Page
683
DOI
10.1037/fam0000019

Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation.

CONTEXT: Holding back, or withholding discussion of disease-related thoughts and emotions, is associated with negative outcomes including lower quality of life, diminished well-being, and relational distress. For patients undergoing hematopoietic stem cell transplantation (HSCT), the degree to which one holds back from discussing illness-related concerns may be an important determinant of social well-being and health; however, this has not been systematically assessed in this population. OBJECTIVES: The purpose of the present study was to assess the moderating effects of holding back discussion of disease-related concerns on the relationship between health-related symptoms and social well-being in adult patients undergoing HSCT. METHODS: Seventy autologous (n = 55) and allogeneic (n = 15) HSCT patients completed measures of holding back, social well-being, and health symptoms (i.e., pain, fatigue, sleep problems, cognitive problems) both before and after transplantation (i.e., three months after transplantation and six months after transplantation). RESULTS: In patients with average to high levels of holding back, health symptoms were significantly related to lower levels of social well-being; however, for patients with low levels of holding back, the relationship between health symptoms and social well-being was not significant. CONCLUSION: The results of the present study suggest that the level of holding back may be important in understanding how health-related symptoms relate to social well-being in patients undergoing HSCT. These findings underscore the importance of addressing how patients undergoing HSCT communicate about their disease with others as this may be related to their adjustment to illness and treatment.

Authors
Bartley, EJ; Edmond, SN; Wren, AA; Somers, TJ; Teo, I; Zhou, S; Rowe, KA; Abernethy, AP; Keefe, FJ; Shelby, RA
MLA Citation
Bartley, EJ, Edmond, SN, Wren, AA, Somers, TJ, Teo, I, Zhou, S, Rowe, KA, Abernethy, AP, Keefe, FJ, and Shelby, RA. "Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation." Journal of pain and symptom management 48.3 (September 2014): 374-384.
PMID
24529631
Source
epmc
Published In
Journal of Pain and Symptom Management
Volume
48
Issue
3
Publish Date
2014
Start Page
374
End Page
384
DOI
10.1016/j.jpainsymman.2013.09.019

A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer

Authors
Reese, JB; Porter, LS; Regan, KR; Keefe, FJ; Azad, NS; Diaz, LA; Herman, JM; Haythornthwaite, JA
MLA Citation
Reese, JB, Porter, LS, Regan, KR, Keefe, FJ, Azad, NS, Diaz, LA, Herman, JM, and Haythornthwaite, JA. "A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer." Psycho-Oncology 23.9 (September 2014): 1005-1013.
Source
crossref
Published In
Psycho-Oncology
Volume
23
Issue
9
Publish Date
2014
Start Page
1005
End Page
1013
DOI
10.1002/pon.3508

Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial.

A multisite, randomized, controlled clinical effectiveness trial was conducted for osteoarthritis patients with chronic pain of the knee or hip. Adult health nurse practitioners provided a 10-session intervention, pain coping skills training (PCST), in patients' doctors' offices (N=129 patients); the control group received usual care (N=127 patients). Primary outcomes assessed at baseline, posttreatment, 6-month follow-up, and 12-month follow-up were: pain intensity, physical functioning, psychological distress, self-efficacy, catastrophizing, use of coping strategies, and quality of life. Secondary measures included fatigue, social functioning, health satisfaction, and use of pain medication. Methods favoring external validity, consistent with pragmatic, effectiveness research, were utilized. Primary ITT and secondary per-protocol analyses were conducted. Attrition was within the expected range: 11% at posttreatment and 29% at 12-month follow-up; rates did not differ between groups. Omnibus ITT analyses across all assessment points indicated significant improvement for the PCST group compared with the control group for pain intensity, physical functioning, psychological distress, use of pain coping strategies, and self-efficacy, as well as fatigue, satisfaction with health, and reduced use of pain medication. Treatment effects were robust to covariates (demographics and clinical sites). Trends in the outcomes across the assessments were examined. All outcomes, except for self-efficacy, were maintained through the 12-month follow-up; effects for self-efficacy degraded over time. Per-protocol analyses did not yield greater effect sizes. Comparisons of PCST patients who were more vs less treatment adherent suggested greater effectiveness for patients with high adherence. Results support the effectiveness of nurse practitioner delivery of PCST for chronic osteoarthritis pain.

Authors
Broderick, JE; Keefe, FJ; Bruckenthal, P; Junghaenel, DU; Schneider, S; Schwartz, JE; Kaell, AT; Caldwell, DS; McKee, D; Reed, S; Gould, E
MLA Citation
Broderick, JE, Keefe, FJ, Bruckenthal, P, Junghaenel, DU, Schneider, S, Schwartz, JE, Kaell, AT, Caldwell, DS, McKee, D, Reed, S, and Gould, E. "Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial." Pain 155.9 (September 2014): 1743-1754.
PMID
24865795
Source
epmc
Published In
PAIN
Volume
155
Issue
9
Publish Date
2014
Start Page
1743
End Page
1754
DOI
10.1016/j.pain.2014.05.024

A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer.

We previously developed and piloted a telephone-based intimacy enhancement (IE) intervention addressing sexual concerns of colorectal cancer patients and their partners in an uncontrolled study. The current study tested the feasibility, acceptability, and preliminary efficacy of the IE intervention in a randomized, controlled trial.Twenty-three couples were randomized to either the four-session IE condition or to a wait list control condition and completed sexual and relationship outcomes measures. The IE intervention teaches skills for coping with sexual concerns and improving intimacy. Feasibility and acceptability were assessed through enrollment and post-treatment program evaluations, respectively. Effect sizes were calculated by comparing differences in average pre/post change scores across completers in the two groups (n = 18 couples).Recruitment and attrition data supported feasibility. Program evaluations for process (e.g., ease of participation) and content (e.g., relevance) demonstrated acceptability. Engaging in intimacy-building activities and communication were the skills rated as most commonly practiced and most helpful. For patients, positive effects of the IE intervention were found for female and male sexual function, medical impact on sexual function, and self-efficacy for enjoying intimacy (≥.58); no effects were found on sexual distress or intimacy and small negative effects for sexual communication, and two self-efficacy items. For partners, positive IE effects were found for all outcomes; the largest were for sexual distress (.69), male sexual function (1.76), communication (.97), and two self-efficacy items (≥.87).The telephone-based IE intervention shows promise for couples facing colorectal cancer. Larger multi-site intervention studies are necessary to replicate findings.

Authors
Barsky Reese, J; Porter, LS; Regan, KR; Keefe, FJ; Azad, NS; Diaz, LA; Herman, JM; Haythornthwaite, JA
MLA Citation
Barsky Reese, J, Porter, LS, Regan, KR, Keefe, FJ, Azad, NS, Diaz, LA, Herman, JM, and Haythornthwaite, JA. "A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer." Psycho-oncology 23.9 (September 2014): 1005-1013.
PMID
24615831
Source
epmc
Published In
Psycho-Oncology
Volume
23
Issue
9
Publish Date
2014
Start Page
1005
End Page
1013
DOI
10.1002/pon.3508

Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia.

In a primary care population of 367 older adults (aged ⩾60 years) with osteoarthritis (OA) pain and insomnia, we examined the relationship between short-term improvement in sleep and long-term sleep, pain, and fatigue outcomes through secondary analyses of randomized controlled trial data. Study participants, regardless of experimental treatment received, were classified either as improvers (⩾30% baseline to 2-month reduction on the Insomnia Severity Index [ISI]) or as nonimprovers. After controlling for treatment arm and potential confounders, improvers showed significant, sustained improvements across 18 months compared with nonimprovers in pain severity (P<0.001, adjusted mean difference=-0.51 [95% CI: -0.80, -0.21), arthritis symptoms (P<0.001, 0.63 [0.26, 1.00]), and fear avoidance (P=0.009, -2.27 [-3.95, -0.58]) but not in catastrophizing or depression. Improvers also showed significant, sustained improvements in ISI (P<0.001, -3.03 [-3.74, -2.32]), Pittsburgh Sleep Quality Index Total (P<0.001, -1.45 [-1.97, -0.93]) and general sleep quality (P<0.001, -0.28 [-0.39, -0.16]) scores, Flinders Fatigue Scale (P<0.001, -1.99 [-3.01, -0.98]), and Dysfunctional Beliefs About Sleep Scale (P=0.037, -2.44 [-4.74, -0.15]), but no improvements on the Functional Outcomes of Sleep Questionnaire or the Epworth Sleepiness Scale. We conclude that short-term (2-month) improvements in sleep predicted long-term (9- and 18-month) improvements for multiple measures of sleep, chronic pain, and fatigue. These improvements were not attributable to nonspecific benefits for psychological well-being, such as reduced depression. These findings are consistent with benefits of improved sleep for chronic pain and fatigue among older persons with osteoarthritis pain and comorbid insomnia if robust improvements in sleep are achieved and sustained.ClinicalTrials.gov Identifier: NCT01142349.

Authors
Vitiello, MV; McCurry, SM; Shortreed, SM; Baker, LD; Rybarczyk, BD; Keefe, FJ; Von Korff, M
MLA Citation
Vitiello, MV, McCurry, SM, Shortreed, SM, Baker, LD, Rybarczyk, BD, Keefe, FJ, and Von Korff, M. "Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia." Pain 155.8 (August 2014): 1547-1554.
PMID
24793909
Source
epmc
Published In
PAIN
Volume
155
Issue
8
Publish Date
2014
Start Page
1547
End Page
1554
DOI
10.1016/j.pain.2014.04.032

Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function.

There is a significant gap in research regarding the readability and comprehension of existing sexual function measures. Patient-reported outcome measures may use terms not well understood by respondents with low literacy.This study aims to test comprehension of words and phrases typically used in sexual function measures to improve validity for all individuals, including those with low literacy.We recruited 20 men and 28 women for cognitive interviews on version 2.0 of the Patient-Reported Outcome Measurement Information System(®) (PROMIS(®) ) Sexual Function and Satisfaction measures. We assessed participants' reading level using the word reading subtest of the Wide Range Achievement Test. Sixteen participants were classified as having low literacy.In the first round of cognitive interviews, each survey item was reviewed by five or more people, at least two of whom had lower than a ninth-grade reading level (low literacy). Patient feedback was incorporated into a revised version of the items. In the second round of interviews, an additional three or more people (at least one with low literacy) reviewed each revised item.Participants with low literacy had difficulty comprehending terms such as aroused, orgasm, erection, ejaculation, incontinence, and vaginal penetration. Women across a range of literacy levels had difficulty with clinical terms like labia and clitoris. We modified unclear terms to include parenthetical descriptors or slang equivalents, which generally improved comprehension.Common words and phrases used across measures of self-reported sexual function are not universally understood. Researchers should appreciate these misunderstandings as a potential source of error in studies using self-reported measures of sexual function. This study also provides evidence for the importance of including individuals with low literacy in cognitive pretesting during the measure development.

Authors
Alexander, AM; Flynn, KE; Hahn, EA; Jeffery, DD; Keefe, FJ; Reeve, BB; Schultz, W; Reese, JB; Shelby, RA; Weinfurt, KP
MLA Citation
Alexander, AM, Flynn, KE, Hahn, EA, Jeffery, DD, Keefe, FJ, Reeve, BB, Schultz, W, Reese, JB, Shelby, RA, and Weinfurt, KP. "Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function." The journal of sexual medicine 11.8 (August 2014): 1991-1998.
PMID
24902984
Source
epmc
Published In
The Journal of Sexual Medicine
Volume
11
Issue
8
Publish Date
2014
Start Page
1991
End Page
1998
DOI
10.1111/jsm.12599

Pain, physical functioning, and overeating in obese rheumatoid arthritis patients: do thoughts about pain and eating matter?

BACKGROUND: Obese rheumatoid arthritis (RA) patients have higher levels of pain, disability, and disease activity than do nonobese patients with RA. Patients' health-related thoughts about arthritis and weight may be important to consider in obese patients with RA who face the dual challenge of managing RA and weight. OBJECTIVES: The objective of this study was to examine the relationships of pain catastrophizing, self-efficacy (ie, confidence) for arthritis management and self-efficacy for weight management to important outcomes in obese patients with RA. We expected that after controlling for demographic and medical variables, higher levels of pain catastrophizing and lower levels of confidence would account for significant and unique variance in pain, physical functioning, and overeating. METHODS: Participants had a diagnosis of RA and a body mass index of 28 kg/m or greater and completed self-report questionnaires assessing pain, physical functioning, overeating, pain catastrophizing, self-efficacy for arthritis management, self-efficacy for weight management, and a 6-minute walk test. RESULTS: Pain catastrophizing, self-efficacy for arthritis, and self-efficacy for weight management were significantly and uniquely related to RA-related outcomes. Pain catastrophizing was a significant independent predictor of pain severity (β = 0.38); self-efficacy for arthritis was a significant independent predictor of self-report physical functioning (β = -0.37) and the 6-minute walk performance (β = 0.44), and self-efficacy for weight management was a significant independent predictor of overeating (β = -0.58). CONCLUSIONS: Pain catastrophizing, self-efficacy for arthritis, and self-efficacy for weight management each contributed uniquely to relate to key outcomes in obese patients with RA. Clinicians should consider assessment of thought processes when assessing and intervening with patients who face dual health challenges; unique intervention approaches may be needed for addressing the challenges of arthritis and weight.

Authors
Somers, TJ; Wren, AA; Blumenthal, JA; Caldwell, D; Huffman, KM; Keefe, FJ
MLA Citation
Somers, TJ, Wren, AA, Blumenthal, JA, Caldwell, D, Huffman, KM, and Keefe, FJ. "Pain, physical functioning, and overeating in obese rheumatoid arthritis patients: do thoughts about pain and eating matter?." Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases 20.5 (August 2014): 244-250.
PMID
25036564
Source
epmc
Published In
Journal of Clinical Rheumatology
Volume
20
Issue
5
Publish Date
2014
Start Page
244
End Page
250
DOI
10.1097/rhu.0000000000000124

The effects of written emotional disclosure and coping skills training in rheumatoid arthritis: a randomized clinical trial.

Two psychological interventions for rheumatoid arthritis (RA) are cognitive-behavioral coping skills training (CST) and written emotional disclosure (WED). These approaches have developed independently, and their combination may be more effective than either one alone. Furthermore, most studies of each intervention have methodological limitations, and each needs further testing.We randomized 264 adults with RA in a 2 × 2 factorial design to 1 of 2 writing conditions (WED vs. control writing) followed by 1 of 2 training conditions (CST vs. arthritis education control training). Patient-reported pain and functioning, blinded evaluations of disease activity and walking speed, and an inflammatory marker (C-reactive protein) were assessed at baseline and 1-, 4-, and 12-month follow-ups.Completion of each intervention was high (>90% of patients), and attrition was low (10.2% at 12-month follow-up). Hierarchical linear modeling of treatment effects over the follow-up period, and analyses of covariance at each assessment point, revealed no interactions between writing and training; however, both interventions had main effects on outcomes, with small effect sizes. Compared with control training, CST decreased pain and psychological symptoms through 12 months. The effects of WED were mixed: Compared with control writing, WED reduced disease activity and physical disability at 1 month only, but WED had more pain than control writing on 1 of 2 measures at 4 and 12 months.The combination of WED and CST does not improve outcomes, perhaps because each intervention has unique effects at different time points. CST improves health status in RA and is recommended for patients, whereas WED has limited benefits and needs strengthening or better targeting to appropriate patients.

Authors
Lumley, MA; Keefe, FJ; Mosley-Williams, A; Rice, JR; McKee, D; Waters, SJ; Partridge, RT; Carty, JN; Coltri, AM; Kalaj, A; Cohen, JL; Neely, LC; Pahssen, JK; Connelly, MA; Bouaziz, YB; Riordan, PA
MLA Citation
Lumley, MA, Keefe, FJ, Mosley-Williams, A, Rice, JR, McKee, D, Waters, SJ, Partridge, RT, Carty, JN, Coltri, AM, Kalaj, A, Cohen, JL, Neely, LC, Pahssen, JK, Connelly, MA, Bouaziz, YB, and Riordan, PA. "The effects of written emotional disclosure and coping skills training in rheumatoid arthritis: a randomized clinical trial." Journal of consulting and clinical psychology 82.4 (August 2014): 644-658.
PMID
24865870
Source
epmc
Published In
Journal of Consulting and Clinical Psychology
Volume
82
Issue
4
Publish Date
2014
Start Page
644
End Page
658
DOI
10.1037/a0036958

Predictors of pain experienced by women during percutaneous imaging-guided breast biopsies.

PURPOSE: The purpose of this study was to evaluate pain experienced during imaging-guided core-needle breast biopsies and to identify factors that predict increased pain perception during procedures. METHODS: In this institutional review board-approved, HIPAA-compliant protocol, 136 women undergoing stereotactically or ultrasound-guided breast biopsy or cyst aspiration were recruited and provided written informed consent. Participants filled out questionnaires assessing anticipated biopsy pain, ongoing breast pain, pain experienced during biopsy, catastrophic thoughts about pain during biopsy, anxiety, perceived communication with the radiologist, chronic life stress, and demographic and medical information. Procedure type, experience level of the radiologist performing the biopsy, number of biopsies, breast density, histology, and tumor size were recorded for each patient. Data were analyzed using Spearman's ρ correlations and a probit regression model. RESULTS: No pain (0 out of 10) was reported by 39.7% of women, mild pain (1-3 out of 10) by 48.5%, and moderate to severe pain (≥4 out of 10) by 11.8% (n = 16). Significant (P < .05) predictors of greater biopsy pain in the probit regression model included younger age, greater prebiopsy breast pain, higher anticipated biopsy pain, and undergoing a stereotactic procedure. Anticipated biopsy pain correlated most strongly with biopsy pain (β = .27, P = .004). CONCLUSIONS: Most patients report minimal pain during imaging-guided biopsy procedures. Women experiencing greater pain levels tended to report higher anticipated pain before the procedure. Communication with patients before biopsy regarding minimal average pain reported during biopsy and encouragement to make use of coping strategies may reduce patient anxiety and anticipated pain.

Authors
Soo, AE; Shelby, RA; Miller, LS; Balmadrid, MH; Johnson, KS; Wren, AA; Yoon, SC; Keefe, FJ; Soo, MS
MLA Citation
Soo, AE, Shelby, RA, Miller, LS, Balmadrid, MH, Johnson, KS, Wren, AA, Yoon, SC, Keefe, FJ, and Soo, MS. "Predictors of pain experienced by women during percutaneous imaging-guided breast biopsies." Journal of the American College of Radiology : JACR 11.7 (July 2014): 709-716.
PMID
24993536
Source
epmc
Published In
Journal of the American College of Radiology
Volume
11
Issue
7
Publish Date
2014
Start Page
709
End Page
716
DOI
10.1016/j.jacr.2014.01.013

Energy recovery in individuals with knee osteoarthritis.

Pathological gaits have been shown to limit transfer between potential (PE) and kinetic (KE) energy during walking, which can increase locomotor costs. The purpose of this study was to examine whether energy exchange would be limited in people with knee osteoarthritis (OA).Ground reaction forces during walking were collected from 93 subjects with symptomatic knee OA (self-selected and fast speeds) and 13 healthy controls (self-selected speed) and used to calculate their center of mass (COM) movements, PE and KE relationships, and energy recovery during a stride. Correlations and linear regressions examined the impact of energy fluctuation phase and amplitude, walking velocity, body mass, self-reported pain, and radiographic severity on recovery. Paired t-tests were run to compare energy recovery between cohorts.Symptomatic knee OA subjects displayed lower energetic recovery during self-selected walking speeds than healthy controls (P = 0.0018). PE and KE phase relationships explained the majority (66%) of variance in recovery. Recovery had a complex relationship with velocity and its change across speeds was significantly influenced by the self-selected walking speed of each subject. Neither radiographic OA scores nor subject self-reported measures demonstrated any relationship with energy recovery.Knee OA reduces effective exchange of PE and KE, potentially increasing the muscular work required to control movements of the COM. Gait retraining may return subjects to more normal patterns of energy exchange and allow them to reduce fatigue.

Authors
Sparling, TL; Schmitt, D; Miller, CE; Guilak, F; Somers, TJ; Keefe, FJ; Queen, RM
MLA Citation
Sparling, TL, Schmitt, D, Miller, CE, Guilak, F, Somers, TJ, Keefe, FJ, and Queen, RM. "Energy recovery in individuals with knee osteoarthritis." Osteoarthritis and cartilage 22.6 (June 2014): 747-755.
Website
http://hdl.handle.net/10161/8901
PMID
24752039
Source
epmc
Published In
Osteoarthritis and Cartilage
Volume
22
Issue
6
Publish Date
2014
Start Page
747
End Page
755
DOI
10.1016/j.joca.2014.04.004

Psychological and behavioral approaches to cancer pain management.

This review examines evidence for psychological factors that affect pain across the cancer continuum from diagnosis through treatment and long-term survivorship or end of life. Evidence is convincing that emotional distress, depression, anxiety, uncertainty, and hopelessness interact with pain. Unrelieved pain can increase a desire for hastened death. Patients with cancer use many strategies to manage pain, with catastrophizing associated with increased pain and self-efficacy associated with lower pain reports. A variety of psychological and cognitive behavioral treatments can reduce pain severity and interference with function, as indicated in multiple meta-analyses and high-quality randomized controlled trials. Effective methods include education (with coping skills training), hypnosis, cognitive behavioral approaches, and relaxation with imagery. Exercise has been tested extensively in patients with cancer and long-term survivors, but few exercise studies have evaluated pain outcomes. In survivors post-treatment, yoga and hypnosis as well as exercise show promise for controlling pain. Although some of these treatments effectively reduce pain for patients with advanced disease, few have been tested in patients at the end of life. Given the clear indicators that psychological factors affect cancer pain and that psychological and behavioral treatments are effective in reducing varying types of pain for patients with active disease, these methods need further testing in cancer survivors post-treatment and in patients with end-stage disease. Multidisciplinary teams are essential in oncology settings to integrate analgesic care and expertise in psychological and behavioral interventions in standard care for symptom management, including pain.

Authors
Syrjala, KL; Jensen, MP; Mendoza, ME; Yi, JC; Fisher, HM; Keefe, FJ
MLA Citation
Syrjala, KL, Jensen, MP, Mendoza, ME, Yi, JC, Fisher, HM, and Keefe, FJ. "Psychological and behavioral approaches to cancer pain management." Journal of clinical oncology : official journal of the American Society of Clinical Oncology 32.16 (June 2014): 1703-1711. (Review)
PMID
24799497
Source
epmc
Published In
Journal of Clinical Oncology
Volume
32
Issue
16
Publish Date
2014
Start Page
1703
End Page
1711
DOI
10.1200/jco.2013.54.4825

The changing face of PAIN: New opportunities and new directions.

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "The changing face of PAIN: New opportunities and new directions." Pain 155.5 (May 2014): 839-840.
PMID
24534268
Source
epmc
Published In
PAIN
Volume
155
Issue
5
Publish Date
2014
Start Page
839
End Page
840
DOI
10.1016/j.pain.2014.02.010

Exploratory and confirmatory factor analysis of the PROMIS pain quality item bank

Purpose: The assessment of pain sensation and quality is a key component in understanding the experience of individuals with chronic pain. This study evaluated the factor structure of the patient-reported outcome measurement information system (PROMIS) pain quality item bank. Methods: As part of the PROMIS project, we developed a pool of 37 pain quality items, based on a review of existing pain questionnaires and development of new items. A web-based survey was designed and completed by 845 members of the general population and 967 individuals with different types of chronic pain. Exploratory factor analysis (EFA) was conducted on a random split-half sample of the data to examine the factor structure of the 37 PROMIS pain quality items in the general population and in a chronic pain sample. A confirmatory factor analysis was conducted in the holdout sample. Results: The EFA of the pain quality items resulted in comparable six-factor solutions for the general and chronic pain samples: (1) pulling/tugging pain; (2) tingling/numbness pain; (3) sharp/stabbing pain; (4) dull/aching pain; (5) pounding/pulsing pain; and (6) affective pain. The confirmatory factor analysis in the holdout sample supported this factor structure. Conclusions: Further research is needed to evaluate the psychometric characteristics of the derived scales based on their factor scores. © 2013 Springer Science+Business Media Dordrecht.

Authors
Revicki, DA; Cook, KF; Amtmann, D; Harnam, N; Chen, WH; Keefe, FJ
MLA Citation
Revicki, DA, Cook, KF, Amtmann, D, Harnam, N, Chen, WH, and Keefe, FJ. "Exploratory and confirmatory factor analysis of the PROMIS pain quality item bank." Quality of Life Research 23.1 (February 1, 2014): 245-255.
Source
scopus
Published In
Quality of Life Research
Volume
23
Issue
1
Publish Date
2014
Start Page
245
End Page
255
DOI
10.1007/s11136-013-0467-9

Introducing Pain Classics: a special review series for PAIN®.

Authors
Keefe, FJ; Mogil, JS
MLA Citation
Keefe, FJ, and Mogil, JS. "Introducing Pain Classics: a special review series for PAIN®." Pain 155.2 (February 2014): 207-.
PMID
24342466
Source
pubmed
Published In
Pain
Volume
155
Issue
2
Publish Date
2014
Start Page
207
DOI
10.1016/j.pain.2013.12.019

Physical therapist-delivered cognitive-behavioral therapy: a qualitative study of physical therapists' perceptions and experiences.

BACKGROUND: The importance of the biopsychosocial model in assessment and management of chronic musculoskeletal conditions is recognized. Physical therapists have been encouraged to develop psychologically informed practice. Little is known about the process of physical therapists' learning and delivering of psychological interventions within the practice context. OBJECTIVE: The aim of this study was to investigate physical therapists' experiences and perspectives of a cognitive-behavioral-informed training and intervention process as part of a randomized controlled trial (RCT) involving adults with painful knee osteoarthritis. DESIGN: A qualitative design was used. Participants were physical therapists trained to deliver pain coping skills training (PCST). METHODS: Eight physical therapists trained to deliver PCST were interviewed by telephone at 4 time points during the 12-month RCT period. Interviews were audiorecorded, transcribed verbatim into computer-readable files, and analyzed using Framework Analysis. RESULTS: Thematic categories identified were: training, experience delivering PCST, impact on general clinical practice, and perspectives on PCST and physical therapist practice. Physical therapists reported positive experiences with PCST and program delivery. They thought that their participation in the RCT had enhanced their general practice. Although some components of the PCST program were familiar, the therapists found delivering the program was quite different from regular practice. Physical therapists believed the PCST program, a 3- to 4-day workshop followed by formal mentoring and performance feedback from a psychologist for 3 to 6 months and during the RCT, was critical to their ability to effectively deliver the PCST intervention. They identified a number of challenges in delivering PCST in their normal practice. CONCLUSION: Physical therapists can be trained to confidently deliver a PCST program. The physical therapists in this study believed that training enhanced their clinical practice. Comprehensive training and mentoring by psychologists was crucial to ensure treatment fidelity.

Authors
Nielsen, M; Keefe, FJ; Bennell, K; Jull, GA
MLA Citation
Nielsen, M, Keefe, FJ, Bennell, K, and Jull, GA. "Physical therapist-delivered cognitive-behavioral therapy: a qualitative study of physical therapists' perceptions and experiences." Physical therapy 94.2 (February 2014): 197-209.
PMID
24029300
Source
epmc
Published In
Physical Therapy
Volume
94
Issue
2
Publish Date
2014
Start Page
197
End Page
209
DOI
10.2522/ptj.20130047

Introducing Bridging the Gaps: A new form of special commentary for PAIN®

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Introducing Bridging the Gaps: A new form of special commentary for PAIN®." Pain 155.1 (January 1, 2014): 1-.
Source
scopus
Published In
PAIN
Volume
155
Issue
1
Publish Date
2014
Start Page
1
DOI
10.1016/j.pain.2013.10.019

Introducing Pain Classics: A special review series for PAIN®

Authors
Keefe, FJ; Mogil, JS
MLA Citation
Keefe, FJ, and Mogil, JS. "Introducing Pain Classics: A special review series for PAIN®." Pain 155.2 (January 1, 2014): 207-.
Source
scopus
Published In
PAIN
Volume
155
Issue
2
Publish Date
2014
Start Page
207
DOI
10.1016/j.pain.2013.12.019

Energy recovery in individuals with knee osteoarthritis

Objective: Pathological gaits have been shown to limit transfer between potential (PE) and kinetic (KE) energy during walking, which can increase locomotor costs. The purpose of this study was to examine whether energy exchange would be limited in people with knee osteoarthritis (OA). Methods: Ground reaction forces during walking were collected from 93 subjects with symptomatic knee OA (self-selected and fast speeds) and 13 healthy controls (self-selected speed) and used to calculate their center of mass (COM) movements, PE and KE relationships, and energy recovery during a stride. Correlations and linear regressions examined the impact of energy fluctuation phase and amplitude, walking velocity, body mass, self-reported pain, and radiographic severity on recovery. Paired t-tests were run to compare energy recovery between cohorts. Results: Symptomatic knee OA subjects displayed lower energetic recovery during self-selected walking speeds than healthy controls (P=0.0018). PE and KE phase relationships explained the majority (66%) of variance in recovery. Recovery had a complex relationship with velocity and its change across speeds was significantly influ enced by the self-selected walking speed of each subject. Neither radiographic OA scores nor subject self-reported measures demonstrated any relationship with energy recovery. Conclusions: Knee OA reduces effective exchange of PE and KE, potentially increasing the muscular work required to control movements of the COM. Gait retraining may return subjects to more normal patterns of energy exchange and allow them to reduce fatigue. © 2014 Osteoarthritis Research Society International.

Authors
Sparling, TL; Schmitt, D; Miller, CE; Guilak, F; Somers, TJ; Keefe, FJ; Queen, RM
MLA Citation
Sparling, TL, Schmitt, D, Miller, CE, Guilak, F, Somers, TJ, Keefe, FJ, and Queen, RM. "Energy recovery in individuals with knee osteoarthritis." Osteoarthritis and Cartilage 22.6 (January 1, 2014): 747-755.
Source
scopus
Published In
Osteoarthritis and Cartilage
Volume
22
Issue
6
Publish Date
2014
Start Page
747
End Page
755
DOI
10.1016/j.joca.2014.04.004

Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia

In a primary care population of 367 older adults (aged ≥60 years) with osteoarthritis (OA) pain and insomnia, we examined the relationship between short-term improvement in sleep and long-term sleep, pain, and fatigue outcomes through secondary analyses of randomized controlled trial data. Study participants, regardless of experimental treatment received, were classified either as improvers (≥30% baseline to 2-month reduction on the Insomnia Severity Index [ISI]) or as nonimprovers. After controlling for treatment arm and potential confounders, improvers showed significant, sustained improvements across 18 months compared with nonimprovers in pain severity (P < 0.001, adjusted mean difference = -0.51 [95% CI: -0.80, -0.21), arthritis symptoms ( P < 0.001, 0.63 [0.26, 1.00]), and fear avoidance (P = 0.009, -2.27 [-3.95, -0.58] ) but not in catastrophizing or depression. Improvers also showed significant, sustained improvements in ISI (P < 0.001, -3.03 [-3.74, -2.32]), Pittsburgh Sleep Quality Index Total (P < 0.001, -1.45 [-1.97, -0.93]) and general sleep quality (P < 0.001, -0.28 [-0.39, -0.16]) scores, Flinders Fatigue Scale (P < 0.001, -1.99 [-3.01, -0.98]), and Dysfunctional Beliefs About Sleep Scale (P = 0.037, -2.44 [-4.74, -0.15] ), but no improvements on the Functional Outcomes of Sleep Questionnaire or the Epworth Sleepiness Scale. We conclude that short-term (2-month) improvements in sleep predicted long-term (9- and 18-month) improvements for multiple measures of sleep, chronic pain, and fatigue. These improvements were not attributable to nonspecific benefits for psychological well-being, such as reduced depression. These findings are consistent with benefits of improved sleep for chronic pain and fatigue among older persons with osteoarthritis pain and comorbid insomnia if robust improvements in sleep are achieved and sustained. Trial Registration: ClinicalTrials.gov Identifier: NCT01142349. © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Authors
Vitiello, MV; McCurry, SM; Shortreed, SM; Baker, LD; Rybarczyk, BD; Keefe, FJ; Von Korff, M
MLA Citation
Vitiello, MV, McCurry, SM, Shortreed, SM, Baker, LD, Rybarczyk, BD, Keefe, FJ, and Von Korff, M. "Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia." Pain 155.8 (January 1, 2014): 1547-1554.
Source
scopus
Published In
PAIN
Volume
155
Issue
8
Publish Date
2014
Start Page
1547
End Page
1554
DOI
10.1016/j.pain.2014.04.032

Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function

Introduction: There is a significant gap in research regarding the readability and comprehension of existing sexual function measures. Patient-reported outcome measures may use terms not well understood by respondents with low literacy. Aim: This study aims to test comprehension of words and phrases typically used in sexual function measures to improve validity for all individuals, including those with low literacy. Methods: We recruited 20 men and 28 women for cognitive interviews on version 2.0 of the Patient-Reported Outcome Measurement Information System ® (PROMIS ® ) Sexual Function and Satisfaction measures. We assessed participants' reading level using the word reading subtest of the Wide Range Achievement Test. Sixteen participants were classified as having low literacy. Main Outcome Measures: In the first round of cognitive interviews, each survey item was reviewed by five or more people, at least two of whom had lower than a ninth-grade reading level (low literacy). Patient feedback was incorporated into a revised version of the items. In the second round of interviews, an additional three or more people (at least one with low literacy) reviewed each revised item. Results: Participants with low literacy had difficulty comprehending terms such as aroused, orgasm, erection, ejaculation, incontinence, and vaginal penetration. Women across a range of literacy levels had difficulty with clinical terms like labia and clitoris. We modified unclear terms to include parenthetical descriptors or slang equivalents, which generally improved comprehension. Conclusions: Common words and phrases used across measures of self-reported sexual function are not universally understood. Researchers should appreciate these misunderstandings as a potential source of error in studies using self-reported measures of sexual function. This study also provides evidence for the importance of including individuals with low literacy in cognitive pretesting during the measure development. Alexander AM, Flynn KE, Hahn EA, Jeffery DD, Keefe FJ, Reeve BB, Schultz W, Reese JB, Shelby RA, and Weinfurt KP. Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function. J Sex Med 2014;11:1991-1998. © 2014 International Society for Sexual Medicine.

Authors
Alexander, AM; Flynn, KE; Hahn, EA; Jeffery, DD; Keefe, FJ; Reeve, BB; Schultz, W; Reese, JB; Shelby, RA; Weinfurt, KP
MLA Citation
Alexander, AM, Flynn, KE, Hahn, EA, Jeffery, DD, Keefe, FJ, Reeve, BB, Schultz, W, Reese, JB, Shelby, RA, and Weinfurt, KP. "Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function." Journal of Sexual Medicine 11.8 (January 1, 2014): 1991-1998.
Source
scopus
Published In
The Journal of Sexual Medicine
Volume
11
Issue
8
Publish Date
2014
Start Page
1991
End Page
1998
DOI
10.1111/jsm.12599

Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation

© 2014 American Academy of Hospice and Palliative Medicine. Context. Holding back, or withholding discussion of disease-related thoughts and emotions, is associated with negative outcomes including lower quality of life, diminished well-being, and relational distress. For patients undergoing hematopoietic stem cell transplantation (HSCT), the degree to which one holds back from discussing illness-related concerns may be an important determinant of social well-being and health; however, this has not been systematically assessed in this population. Objectives. The purpose of the present study was to assess the moderating effects of holding back discussion of disease-related concerns on the relationship between health-related symptoms and social well-being in adult patients undergoing HSCT. Methods. Seventy autologous (n = 55) and allogeneic (n = 15) HSCT patients completed measures of holding back, social well-being, and health symptoms (i.e., pain, fatigue, sleep problems, cognitive problems) both before and after transplantation (i.e., three months after transplantation and six months after transplantation). Results. In patients with average to high levels of holding back, health symptoms were significantly related to lower levels of social well-being; however, for patients with low levels of holding back, the relationship between health symptoms and social well-being was not significant. Conclusion. The results of the present study suggest that the level of holding back may be important in understanding how health-related symptoms relate to social well-being in patients undergoing HSCT. These findings underscore the importance of addressing how patients undergoing HSCT communicate about their disease with others as this may be related to their adjustment to illness and treatment.

Authors
Bartley, EJ; Edmond, SN; Wren, AA; Somers, TJ; Teo, I; Zhou, S; Rowe, KA; Abernethy, AP; Keefe, FJ; Shelby, RA
MLA Citation
Bartley, EJ, Edmond, SN, Wren, AA, Somers, TJ, Teo, I, Zhou, S, Rowe, KA, Abernethy, AP, Keefe, FJ, and Shelby, RA. "Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation." Journal of Pain and Symptom Management 48.3 (January 1, 2014): 374-384.
Source
scopus
Published In
Journal of Pain and Symptom Management
Volume
48
Issue
3
Publish Date
2014
Start Page
374
End Page
384
DOI
10.1016/j.jpainsymman.2013.09.019

Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial

A multisite, randomized, controlled clinical effectiveness trial was conducted for osteoarthritis patients with chronic pain of the knee or hip. Adult health nurse practitioners provided a 10-session intervention, pain coping skills training (PCST), in patients' doctors' offices (N = 129 patients); the control group received usual care (N = 127 patients). Primary outcomes assessed at baseline, posttreatment, 6-month follow-up, and 12-month follow-up were: pain intensity, physical functioning, psychological distress, self-efficacy, catastrophizing, use of coping strategies, and quality of life. Secondary measures included fatigue, social functioning, health satisfaction, and use of pain medication. Methods favoring external validity, consistent with pragmatic, effectiveness research, were utilized. Primary ITT and secondary per-protocol analyses were conducted. Attrition was within the expected range: 11% at posttreatment and 29% at 12-month follow-up; rates did not differ between groups. Omnibus ITT analyses across all assessment points indicated significant improvement for the PCST group compared with the control group for pain intensity, physical functioning, psychological distress, use of pain coping strategies, and self-efficacy, as well as fatigue, satisfaction with health, and reduced use of pain medication. Treatment effects were robust to covariates (demographics and clinical sites). Trends in the outcomes across the assessments were examined. All outcomes, except for self-efficacy, were maintained through the 12-month follow-up; effects for self-efficacy degraded over time. Per-protocol analyses did not yield greater effect sizes. Comparisons of PCST patients who were more vs less treatment adherent suggested greater effectiveness for patients with high adherence. Results support the effectiveness of nurse practitioner delivery of PCST for chronic osteoarthritis pain.

Authors
Broderick, JE; Keefe, FJ; Bruckenthal, P; Junghaenel, DU; Schneider, S; Schwartz, JE; Kaell, AT; Caldwell, DS; McKee, D; Reed, S; Gould, E
MLA Citation
Broderick, JE, Keefe, FJ, Bruckenthal, P, Junghaenel, DU, Schneider, S, Schwartz, JE, Kaell, AT, Caldwell, DS, McKee, D, Reed, S, and Gould, E. "Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial." Pain 155.9 (January 1, 2014): 1743-1754.
Source
scopus
Published In
PAIN
Volume
155
Issue
9
Publish Date
2014
Start Page
1743
End Page
1754
DOI
10.1016/j.pain.2014.05.024

Unlearning chronic pain: A randomized controlled trial to investigate changes in intrinsic brain connectivity following Cognitive Behavioral Therapy.

Chronic pain is a complex physiological and psychological phenomenon. Implicit learning mechanisms contribute to the development of chronic pain and to persistent changes in the central nervous system. We hypothesized that these central abnormalities can be remedied with Cognitive Behavioral Therapy (CBT). Specifically, since regions of the anterior Default Mode Network (DMN) are centrally involved in emotional regulation via connections with limbic regions, such as the amygdala, remediation of maladaptive behavioral and cognitive patterns as a result of CBT for chronic pain would manifest itself as a change in the intrinsic functional connectivity (iFC) between these prefrontal and limbic regions. Resting-state functional neuroimaging was performed in patients with chronic pain before and after 11-week CBT (n = 19), as well as a matched (ages 19-59, both sexes) active control group of patients who received educational materials (n = 19). Participants were randomized prior to the intervention. To investigate the differential impact of treatment on intrinsic functional connectivity (iFC), we compared pre-post differences in iFC between groups. In addition, we performed exploratory whole brain analyses of changes in fractional amplitude of low frequency fluctuations (fALFF). The course of CBT led to significant improvements in clinical measures of pain and self-efficacy for coping with chronic pain. Significant group differences in pre-post changes in both iFC and fALFF were correlated with clinical outcomes. Compared to control patients, iFC between the anterior DMN and the amygdala/periaqueductal gray decreased following CBT, whereas iFC between the basal ganglia network and the right secondary somatosensory cortex increased following CBT. CBT patients also had increased post-therapy fALFF in the bilateral posterior cingulate and the cerebellum. By delineating neuroplasticity associated with CBT-related improvements, these results add to mounting evidence that CBT is a valuable treatment option for chronic pain.

Authors
Shpaner, M; Kelly, C; Lieberman, G; Perelman, H; Davis, M; Keefe, FJ; Naylor, MR
MLA Citation
Shpaner, M, Kelly, C, Lieberman, G, Perelman, H, Davis, M, Keefe, FJ, and Naylor, MR. "Unlearning chronic pain: A randomized controlled trial to investigate changes in intrinsic brain connectivity following Cognitive Behavioral Therapy." NeuroImage. Clinical 5 (January 2014): 365-376.
PMID
26958466
Source
epmc
Published In
NeuroImage: Clinical
Volume
5
Publish Date
2014
Start Page
365
End Page
376
DOI
10.1016/j.nicl.2014.07.008

Internet-mediated physiotherapy and pain coping skills training for people with persistent knee pain (IMPACT - knee pain): a randomised controlled trial protocol.

BACKGROUND: Persistent knee pain in people over 50 years of age is often attributable to knee osteoarthritis (OA), a common joint condition that causes physical and psychological dysfunction. Exercise and pain coping skills training (PCST) can help reduce the impact of persistent knee pain, however, access to health professionals who deliver these services can be challenging. With increasing access to the Internet, remotely delivered Internet-based treatment approaches may provide alternatives for healthcare delivery. This pragmatic randomised controlled trial will investigate whether an Internet-delivered intervention that combines PCST and physiotherapist-guided exercise (PCST + Ex) is more effective than online educational material (educational control) in people with persistent knee pain. METHODS/DESIGN: We will recruit 148 people over 50 years of age with self-reported persistent knee pain consistent with knee OA from the Australian community. Following completion of baseline questionnaires, participants will be randomly allocated to access a 3-month intervention of either (i) online educational material, or (ii) the same online material plus an 8-module (once per week) Internet-based PCST program and seven Internet-delivered physiotherapy sessions with a home exercise programs to be performed 3 times per week. Outcomes will be measured at baseline, 3 months and 9 months with the primary time point at 3 months. Primary outcomes are average knee pain on walking (11-point numeric rating scale) and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index subscale). Secondary outcomes include additional measures of knee pain, health-related quality-of-life, perceived global change in symptoms, and potential moderators and mediators of outcomes including self-efficacy for pain management and function, pain coping attempts and pain catastrophising. Other measures of adherence, adverse events, harms, use of health services/co-interventions, and process measures including appropriateness and satisfaction of the intervention, will be collected at 3, 6 and 9 months. DISCUSSION: The findings will help determine the effectiveness and acceptability of Internet access to a combination of interventions that are known to be beneficial to people with persistent knee pain. This study has the potential to guide clinical practice towards innovative modes of healthcare provision. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry reference: ACTRN12614000243617.

Authors
Dobson, F; Hinman, RS; French, S; Rini, C; Keefe, F; Nelligan, R; Abbott, JH; Bryant, C; Staples, MP; Dalwood, A; Bennell, KL
MLA Citation
Dobson, F, Hinman, RS, French, S, Rini, C, Keefe, F, Nelligan, R, Abbott, JH, Bryant, C, Staples, MP, Dalwood, A, and Bennell, KL. "Internet-mediated physiotherapy and pain coping skills training for people with persistent knee pain (IMPACT - knee pain): a randomised controlled trial protocol." BMC musculoskeletal disorders 15 (January 2014): 279-.
PMID
25125068
Source
epmc
Published In
BMC Musculoskeletal Disorders
Volume
15
Publish Date
2014
Start Page
279
DOI
10.1186/1471-2474-15-279

Introducing Bridging the Gaps: a new form of special commentary for PAIN®.

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Introducing Bridging the Gaps: a new form of special commentary for PAIN®." Pain 155.1 (January 2014): 1-.
PMID
24157893
Source
pubmed
Published In
Pain
Volume
155
Issue
1
Publish Date
2014
Start Page
1
DOI
10.1016/j.pain.2013.10.019

The changing face of PAIN: New opportunities and new directions

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "The changing face of PAIN: New opportunities and new directions." Pain 155.5 (2014): 839-840.
Source
scival
Published In
PAIN
Volume
155
Issue
5
Publish Date
2014
Start Page
839
End Page
840
DOI
10.1016/j.pain.2014.02.010

Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy

© 2014, Springer-Verlag Berlin Heidelberg.Purpose: This study examined the relationships between physical symptoms, self-efficacy for coping with symptoms, and functional, emotional, and social well-being in women who were taking adjuvant endocrine therapy for breast cancer.Methods: One hundred and twelve women who were taking adjuvant endocrine therapy (tamoxifen or an aromatase inhibitor) for breast cancer completed measures of physical symptoms, self-efficacy for coping with symptoms, and functional, social, and emotional well-being at the time of routine medical follow-up (women were on average 3.4 years post-surgery; range 3 months to 11 years).Results: Multiple linear regression analyses showed that higher self-efficacy for coping with symptoms was associated with greater functional, emotional, and social well-being after controlling for physical symptoms (p < 0.05). Self-efficacy for coping with symptoms moderated the relationship between physical symptoms and functional (B = 0.05, SE = 0.02, t = 2.67, p = 0.009) and emotional well-being (B = 0.03, SE = 0.01, t = 2.45, p = 0.02). As self-efficacy increased, the relationship between greater physical symptoms and lower well-being became weaker. Among women with high levels of self-efficacy, physical symptoms were not related to functional and emotional well-being.Conclusions: Self-efficacy for coping with symptoms may reduce the negative impact of physical symptoms and contribute to well-being in breast cancer survivors taking adjuvant endocrine therapy. Future studies could examine whether psychosocial interventions aimed at increasing self-efficacy for managing symptoms help women better cope with treatment side effects and improve quality of life.

Authors
Shelby, RA; Edmond, SN; Wren, AA; Keefe, FJ; Peppercorn, JM; Marcom, PK; Blackwell, KL; Kimmick, GG
MLA Citation
Shelby, RA, Edmond, SN, Wren, AA, Keefe, FJ, Peppercorn, JM, Marcom, PK, Blackwell, KL, and Kimmick, GG. "Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy." Supportive Care in Cancer 22.10 (2014): 2851-2859.
Source
scival
Published In
Supportive Care in Cancer
Volume
22
Issue
10
Publish Date
2014
Start Page
2851
End Page
2859
DOI
10.1007/s00520-014-2269-1

Couples and breast cancer: Women's mood and partners' marital satisfaction predicting support perception

© 2014 American Psychological Association.Women who are diagnosed with breast cancer can experience an array of psychosocial difficulties; however, social support, particularly from a spouse, has been shown to have a protective function during this time. This study examined the ways in which a woman's daily mood, pain, and fatigue, and her spouse's marital satisfaction predict the woman's report of partner support in the context of breast cancer. Pretest data from a larger intervention study and multilevel modeling were used to examine the effects of women's daily mood, pain, and fatigue and average levels of mood, pain, and fatigue on women's report of social support received from her partner, as well as how the effects of mood interacted with partners' marital satisfaction. Results show that on days in which women reported higher levels of negative or positive mood, as well as on days they reported more pain and fatigue, they reported receiving more support. Women who, on average, reported higher levels of positive mood tended to report receiving more support than those who, on average, reported lower positive mood. However, average levels of negative mood were not associated with support. Higher average levels of fatigue but not pain were associated with higher support. Finally, women whose husbands reported higher levels of marital satisfaction reported receiving more partner support, but husbands' marital satisfaction did not moderate the effect of women's mood on support. Implications of these findings are discussed relative to assisting couples during this difficult time in their lives.

Authors
Boeding, SE; Pukay-Martin, ND; Baucom, DH; Porter, LS; Kirby, JS; Gremore, TM; Keefe, FJ
MLA Citation
Boeding, SE, Pukay-Martin, ND, Baucom, DH, Porter, LS, Kirby, JS, Gremore, TM, and Keefe, FJ. "Couples and breast cancer: Women's mood and partners' marital satisfaction predicting support perception." Journal of Family Psychology 28.5 (2014): 675-683.
Source
scival
Published In
Journal of Family Psychology
Volume
28
Issue
5
Publish Date
2014
Start Page
675
End Page
683
DOI
10.1037/fam0000019

Cognitive-behavioral therapy increases prefrontal cortex gray matter in patients with chronic pain

Several studies have reported reduced cerebral gray matter (GM) volume or density in chronic pain conditions, but there is limited research on the plasticity of the human cortex in response to psychological interventions. We investigated GM changes after cognitive-behavioral therapy (CBT) in patients with chronic pain. We used voxel-based morphometry to compare anatomic magnetic resonance imaging scans of 13 patients with mixed chronic pain types before and after an 11-week CBT treatment and to 13 healthy control participants. CBT led to significant improvements in clinical measures. Patients did not differ from healthy controls in GM anywhere in the brain. After treatment, patients had increased GM in the bilateral dorsolateral prefrontal, posterior parietal, subgenual anterior cingulate/orbitofrontal, and sensorimotor cortices, as well as hippocampus, and reduced GM in supplementary motor area. In most of these areas showing GM increases, GM became significantly higher than in controls. Decreased pain catastrophizing was associated with increased GM in the left dorsolateral prefrontal and ventrolateral prefrontal cortices, right posterior parietal cortex, somatosensory cortex, and pregenual anterior cingulate cortex. Although future studies with additional control groups will be needed to determine the specific roles of CBT on GM and brain function, we propose that increased GM in the prefrontal and posterior parietal cortices reflects greater top-down control over pain and cognitive reappraisal of pain, and that changes in somatosensory cortices reflect alterations in the perception of noxious signals. Perspective An 11-week CBT intervention for coping with chronic pain resulted in increased GM volume in prefrontal and somatosensory brain regions, as well as increased dorsolateral prefrontal volume associated with reduced pain catastrophizing. These results add to mounting evidence that CBT can be a valuable treatment option for chronic pain. © 2013 by the American Pain Society.

Authors
Seminowicz, DA; Shpaner, M; Keaser, ML; Krauthamer, GM; Mantegna, J; Dumas, JA; Newhouse, PA; Filippi, CG; Keefe, FJ; Naylor, MR
MLA Citation
Seminowicz, DA, Shpaner, M, Keaser, ML, Krauthamer, GM, Mantegna, J, Dumas, JA, Newhouse, PA, Filippi, CG, Keefe, FJ, and Naylor, MR. "Cognitive-behavioral therapy increases prefrontal cortex gray matter in patients with chronic pain." Journal of Pain 14.12 (December 1, 2013): 1573-1584.
Source
scopus
Published In
The Journal of Pain
Volume
14
Issue
12
Publish Date
2013
Start Page
1573
End Page
1584
DOI
10.1016/j.jpain.2013.07.020

The impact of daily arthritis pain on spouse sleep

Authors
Martire, LM; Keefe, FJ; Schulz, R; Stephens, MAP; Mogle, JA
MLA Citation
Martire, LM, Keefe, FJ, Schulz, R, Stephens, MAP, and Mogle, JA. "The impact of daily arthritis pain on spouse sleep." PAIN 154.9 (September 2013): 1725-1731.
PMID
23953126
Source
wos-lite
Published In
PAIN
Volume
154
Issue
9
Publish Date
2013
Start Page
1725
End Page
1731
DOI
10.1016/j.pain.2013.05.020

Psychosocial interventions for managing pain in older adults: outcomes and clinical implications.

Interest in the use of psychosocial interventions to help older adults manage pain is growing. In this article, we review this approach. The first section reviews the conceptual background for psychosocial interventions with a special emphasis on the biopsychosocial model of pain. The second section highlights three psychosocial interventions used with older adults: cognitive behavioural therapy, emotional disclosure, and mind-body interventions (specifically mindfulness-based stress reduction and yoga). The final section of the paper highlights important future directions for work in this area.

Authors
Keefe, FJ; Porter, L; Somers, T; Shelby, R; Wren, AV
MLA Citation
Keefe, FJ, Porter, L, Somers, T, Shelby, R, and Wren, AV. "Psychosocial interventions for managing pain in older adults: outcomes and clinical implications." Br J Anaesth 111.1 (July 2013): 89-94. (Review)
PMID
23794650
Source
pubmed
Published In
BJA: British Journal of Anaesthesia
Volume
111
Issue
1
Publish Date
2013
Start Page
89
End Page
94
DOI
10.1093/bja/aet129

Reply: To PMID 22505314.

Authors
Somers, TJ; Kurakula, PC; Criscione-Schreiber, L; Keefe, FJ; Clowse, MEB
MLA Citation
Somers, TJ, Kurakula, PC, Criscione-Schreiber, L, Keefe, FJ, and Clowse, MEB. "Reply: To PMID 22505314." Arthritis Care Res (Hoboken) 65.7 (July 2013): 1205-. (Letter)
PMID
23371927
Source
pubmed
Published In
Arthritis Care and Research
Volume
65
Issue
7
Publish Date
2013
Start Page
1205
DOI
10.1002/acr.21960

Chronic Hepatitis C and Antiviral Treatment Regimens: Where Can Psychology Contribute?

Authors
Evon, DM; Golin, CE; Fried, MW; Keefe, FJ
MLA Citation
Evon, DM, Golin, CE, Fried, MW, and Keefe, FJ. "Chronic Hepatitis C and Antiviral Treatment Regimens: Where Can Psychology Contribute?." JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY 81.2 (April 2013): 361-374.
PMID
22730952
Source
wos-lite
Published In
Journal of Consulting and Clinical Psychology
Volume
81
Issue
2
Publish Date
2013
Start Page
361
End Page
374
DOI
10.1037/a0029030

Development of the NIH PROMIS ® Sexual Function and Satisfaction measures in patients with cancer.

INTRODUCTION: We describe the development and validation of the Patient-Reported Outcomes Measurement Information System(®) Sexual Function and Satisfaction (PROMIS(®) SexFS; National Institutes of Health) measures, version 1.0, for cancer populations. AIM: To develop a customizable self-report measure of sexual function and satisfaction as part of the U.S. National Institutes of Health PROMIS Network. METHODS: Our multidisciplinary working group followed a comprehensive protocol for developing psychometrically robust patient-reported outcome measures including qualitative (scale development) and quantitative (psychometric evaluation) development. We performed an extensive literature review, conducted 16 focus groups with cancer patients and multiple discussions with clinicians, and evaluated candidate items in cognitive testing with patients. We administered items to 819 cancer patients. Items were calibrated using item-response theory and evaluated for reliability and validity. MAIN OUTCOME MEASURES: The PROMIS SexFS measures, version 1.0, include 81 items in 11 domains: Interest in Sexual Activity, Lubrication, Vaginal Discomfort, Erectile Function, Global Satisfaction with Sex Life, Orgasm, Anal Discomfort, Therapeutic Aids, Sexual Activities, Interfering Factors, and Screener Questions. RESULTS: In addition to content validity (patients indicate that items cover important aspects of their experiences) and face validity (patients indicate that items measure sexual function and satisfaction), the measure shows evidence for discriminant validity (domains discriminate between groups expected to be different) and convergent validity (strong correlations between scores on PROMIS and scores on conceptually similar older measures of sexual function), as well as favorable test-retest reliability among people not expected to change (interclass correlations from two administrations of the instrument, 1 month apart). CONCLUSIONS: The PROMIS SexFS offers researchers a reliable and valid set of tools to measure self-reported sexual function and satisfaction among diverse men and women. The measures are customizable; researchers can select the relevant domains and items comprising those domains for their study.

Authors
Flynn, KE; Lin, L; Cyranowski, JM; Reeve, BB; Reese, JB; Jeffery, DD; Smith, AW; Porter, LS; Dombeck, CB; Bruner, DW; Keefe, FJ; Weinfurt, KP
MLA Citation
Flynn, KE, Lin, L, Cyranowski, JM, Reeve, BB, Reese, JB, Jeffery, DD, Smith, AW, Porter, LS, Dombeck, CB, Bruner, DW, Keefe, FJ, and Weinfurt, KP. "Development of the NIH PROMIS ® Sexual Function and Satisfaction measures in patients with cancer." J Sex Med 10 Suppl 1 (February 2013): 43-52.
PMID
23387911
Source
pubmed
Published In
The Journal of Sexual Medicine
Volume
10 Suppl 1
Publish Date
2013
Start Page
43
End Page
52
DOI
10.1111/j.1743-6109.2012.02995.x

Validity of an observation method for assessing pain behavior in individuals with multiple sclerosis

Context. Pain is a common and complex experience for individuals who live with multiple sclerosis (MS) and it interferes with physical, psychological, and social function. A valid and reliable tool for quantifying observed pain behaviors in MS is critical to understand how pain behaviors contribute to pain-related disability in this clinical population. Objectives. To evaluate the reliability and validity of a pain behavioral observation protocol in individuals who have MS. Methods. Community-dwelling volunteers with MS (N = 30), back pain (N = 5), or arthritis (N = 8) were recruited based on clinician referrals, advertisements, fliers, web postings, and participation in previous research. Participants completed the measures of pain severity, pain interference, and self-reported pain behaviors and were videotaped doing typical activities (e.g., walking and sitting). Two coders independently recorded frequencies of pain behaviors by category (e.g., guarding and bracing) and interrater reliability statistics were calculated. Naýve observers reviewed videotapes of individuals with MS and rated their pain. The Spearman's correlations were calculated between pain behavior frequencies and self-reported pain and pain ratings by naýve observers. Results. Interrater reliability estimates indicated the reliability of pain codes in the MS sample. Kappa coefficients ranged from moderate (sighing = 0.40) to substantial agreements (guarding = 0.83). These values were comparable with those obtained in the combined back pain and arthritis sample. Concurrent validity was supported by correlations with self-reported pain (0.46e0.53) and with self-reports of pain behaviors (0.58). Construct validity was supported by a finding of 0.87 correlation between total pain behaviors observed by coders and mean pain ratings by naýve observers. Conclusion. Results support the use of the pain behavior observation protocol for assessing pain behaviors of individuals with MS. Valid assessments of pain behaviors of individuals with MS could lead to creative interventions in the management of chronic pain in this population. J Pain Symptom Manage 2013;46:413e421. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Authors
Cook, KF; Roddey, TS; Bamer, AM; Amtmann, D; Keefe, FJ
MLA Citation
Cook, KF, Roddey, TS, Bamer, AM, Amtmann, D, and Keefe, FJ. "Validity of an observation method for assessing pain behavior in individuals with multiple sclerosis." Journal of Pain and Symptom Management 46.3 (January 1, 2013): 413-421.
Source
scopus
Published In
Journal of Pain and Symptom Management
Volume
46
Issue
3
Publish Date
2013
Start Page
413
End Page
421
DOI
10.1016/j.jpainsymman.2012.08.006

Temporal associations between spouse criticism/hostility and pain among patients with chronic pain: A within-couple daily diary study

Chronic musculoskeletal pain can strain marriages, perhaps even to the point of engendering spouse criticism and hostility directed toward patients. Such negative spouse responses may have detrimental effects on patient well-being. While results of cross-sectional studies support this notion, we extended these efforts by introducing expressed emotion (EE) and interpersonal theoretical perspectives, and by using electronic diary methods to capture both patient and spouse reports in a prospective design. Patients with chronic low back pain (CLBP) and their spouses (N = 105 couples) reported on perceived spouse behavior and patient pain 5 times/day for 14 days using Personal Data Assistants (PDAs). Concurrent and lagged within-couple associations between patient's perceptions of spouse criticism/hostility and patient self-reported pain and spouses' observations of patient pain behaviors revealed that (1) patient perceived spouse criticism and hostility were correlated significantly with pain intensity, and spouse observed patient pain behavior was related significantly with patient perceived hostility at the same time point; (2) patient perceived spouse hostility significantly predicted patient pain intensity 3 hours later, and spouse observed pain behaviors significantly predicted patient perceived spouse hostility 3 hours later. Results support both EE and interpersonal models, and imply that a comprehensive model would combine these conceptualizations to fully illustrate how spouse criticism/hostility and patient pain interact to produce a negative spiral. Given that marital interactions are amenable to clinical intervention, improved insight into how spouse behavior and patient pain are tightly linked will encourage productive translational efforts to target this neglected area.

Authors
Burns, JW; Peterson, KM; Smith, DA; Keefe, FJ; Porter, LS; Schuster, E; Kinner, E
MLA Citation
Burns, JW, Peterson, KM, Smith, DA, Keefe, FJ, Porter, LS, Schuster, E, and Kinner, E. "Temporal associations between spouse criticism/hostility and pain among patients with chronic pain: A within-couple daily diary study." Pain 154.12 (January 1, 2013): 2715-2721.
Source
scopus
Published In
PAIN
Volume
154
Issue
12
Publish Date
2013
Start Page
2715
End Page
2721
DOI
10.1016/j.pain.2013.07.053

Pain imaging

Authors
Naylor, MR; Seminowicz, DA; Somers, TJ; Keefe, FJ
MLA Citation
Naylor, MR, Seminowicz, DA, Somers, TJ, and Keefe, FJ. "Pain imaging." Handbook of Pain and Palliative Care: Biobehavioral Approaches for the Life Course. January 1, 2013. 439-467.
Source
scopus
Publish Date
2013
Start Page
439
End Page
467
DOI
10.1007/978-1-4419-1651-8_27

Optimism and pain: a positive move forward.

Authors
Keefe, FJ; Wren, AA
MLA Citation
Keefe, FJ, and Wren, AA. "Optimism and pain: a positive move forward." Pain 154.1 (January 2013): 7-8.
PMID
23159574
Source
pubmed
Published In
Pain
Volume
154
Issue
1
Publish Date
2013
Start Page
7
End Page
8
DOI
10.1016/j.pain.2012.10.005

Introducing the Biennial Review of Pain

Authors
Tracey, I; Keefe, F
MLA Citation
Tracey, I, and Keefe, F. "Introducing the Biennial Review of Pain." Pain (2013).
PMID
24148359
Source
scival
Published In
PAIN
Publish Date
2013
DOI
10.1016/j.pain.2013.10.017

Development and validation of a new self-report measure of pain behaviors

Pain behaviors that are maintained beyond the acute stage after injury can contribute to subsequent psychosocial and physical disability. Critical to the study of pain behaviors is the availability of psychometrically sound pain behavior measures. In this study we developed a self-report measure of pain behaviors, the Pain Behaviors Self Report (PaB-SR). PaB-SR scores were developed using item response theory and evaluated using a rigorous, multiple-witness approach to validity testing. Participants included 661 survey participants with chronic pain and with multiple sclerosis, back pain, or arthritis; 618 survey participants who were significant others of a chronic pain participant; and 86 participants in a videotaped pain behavior observation protocol. Scores on the PaB-SR were found to be measurement invariant with respect to clinical condition. PaB-SR scores, observer reports, and the videotaped protocol yielded distinct, but convergent views of pain behavior, supporting the validity of the new measure. The PaB-SR is expected to be of substantial utility to researchers wishing to explore the relationship between pain behaviors and constructs such as pain intensity, pain interference, and disability.

Authors
Cook, KF; Keefe, F; Jensen, MP; Roddey, TS; Callahan, LF; Revicki, D; Bamer, AM; Kim, J; Chung, H; Salem, R; al, E
MLA Citation
Cook, KF, Keefe, F, Jensen, MP, Roddey, TS, Callahan, LF, Revicki, D, Bamer, AM, Kim, J, Chung, H, Salem, R, and al, E. "Development and validation of a new self-report measure of pain behaviors." Pain 154.12 (2013): 2867-2876.
Source
scival
Published In
PAIN
Volume
154
Issue
12
Publish Date
2013
Start Page
2867
End Page
2876
DOI
10.1016/j.pain.2013.08.024

Introducing the biennial review of pain

Authors
Tracey, I; Keefe, F
MLA Citation
Tracey, I, and Keefe, F. "Introducing the biennial review of pain." Pain 154.SUPPL. 1 (2013): S1-.
Source
scival
Published In
PAIN
Volume
154
Issue
SUPPL. 1
Publish Date
2013
Start Page
S1
DOI
10.1016/j.pain.2013.10.017

Assessment of the Impact of Adjunctive Proactive Telephone Counseling to Promote Smoking Cessation Among Lung Cancer Patients' Social Networks

Authors
Bastian, LA; Fish, LJ; Peterson, BL; Biddle, AK; Garst, J; Lyna, P; Molner, S; Bepler, G; Kelley, M; Keefe, FJ; McBride, CM
MLA Citation
Bastian, LA, Fish, LJ, Peterson, BL, Biddle, AK, Garst, J, Lyna, P, Molner, S, Bepler, G, Kelley, M, Keefe, FJ, and McBride, CM. "Assessment of the Impact of Adjunctive Proactive Telephone Counseling to Promote Smoking Cessation Among Lung Cancer Patients' Social Networks." AMERICAN JOURNAL OF HEALTH PROMOTION 27.3 (2013): 181-190.
PMID
23286595
Source
wos-lite
Published In
American journal of health promotion : AJHP
Volume
27
Issue
3
Publish Date
2013
Start Page
181
End Page
190
DOI
10.4278/ajhp.101122-QUAN-387

A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis: A pilot study

Background: Osteoarthritis (OA) of the knee is associated with a number of physical and psychological impairments. Unfortunately, very few treatment strategies are capable of addressing both types of impairments concurrently. We performed a pilot, randomized controlled, proof of principle trial investigating the feasibility and effects of an intervention combining physical exercise and pain coping skills training (PCST). Methods: Twenty patients with a clinical and radiographical diagnosis of tibiofemoral OA were randomized to receive either 10. weeks of physiotherapist supervised exercises (lower limb strengthening and walking) combined with non-directive counseling (NDC) or the same exercise program delivered concurrently with PCST. Primary outcomes included self-reported pain and pain coping, while secondary outcomes included self efficacy and self-reported physical function. Results: Ten participants were randomized to each group and both groups exhibited significant improvements in isometric knee strength, self-reported knee pain and physical function, self efficacy for control of pain management and other arthritis symptoms. Only those in the exercise. +. PCST group reported statistically significant improvements in pain control coping and rational thinking. No between-group differences existed in any outcome (0.07. <. p<. 0.98). Based on our findings, 63 participants per group would be needed for future large-scale studies using similar outcome measures and design. Conclusions: Our study showed that an intervention that combines exercise and PCST within the same treatment session and delivered by specially-trained physiotherapists is feasible and can improve both physical and psychological outcomes in individuals with knee OA. Level of evidence: Level II. Clinical Trials Registry number: ACTRN12609000623291. © 2012 Elsevier B.V.

Authors
Hunt, MA; Keefe, FJ; Bryant, C; Metcalf, BR; Ahamed, Y; Nicholas, MK; Bennell, KL
MLA Citation
Hunt, MA, Keefe, FJ, Bryant, C, Metcalf, BR, Ahamed, Y, Nicholas, MK, and Bennell, KL. "A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis: A pilot study." Knee 20.2 (2013): 106-112.
Source
scival
Published In
The Knee
Volume
20
Issue
2
Publish Date
2013
Start Page
106
End Page
112
DOI
10.1016/j.knee.2012.07.008

A pilot cluster-randomized trial of a 20-week tai chi program in elders with cognitive impairment and osteoarthritic knee: Effects on pain and other health outcomes

Context: Because Tai Chi (TC) is beneficial to elders without cognitive impairment (CI), it also may benefit elders with CI. But elders with CI have generally been excluded from TC studies because many measurement tools require verbal reports that some elders with CI are unable to provide. Objectives: To test the efficacy of a TC program in improving pain and other health outcomes in community-dwelling elders with knee osteoarthritis (OA) and CI. Methods: This pilot cluster-randomized trial was conducted between January 2008 and June 2010 (ClinicalTrials.gov Identifier: NCT01528566). The TC group attended Sun style TC classes, three sessions a week for 20 weeks; the control group attended classes providing health and cultural information for the same length of time. Measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, physical function and stiffness subscales; the Get Up and Go test; the Sit-to-Stand test; and the Mini-Mental State Examination (MMSE), administered at baseline, every four weeks during the intervention and at the end of the study (post-test). Results: Eight sites participated in either the TC group (four sites, 28 participants) or control group (four sites, 27 participants). The WOMAC pain (P = 0.006) and stiffness scores (P = 0.010) differed significantly between the two groups at post-test, whereas differences between the two groups in the WOMAC physical function score (P = 0.071) and the MMSE (P = 0.096) showed borderline significance at the post-test. WOMAC pain (P = 0.001), physical function (P = 0.021), and stiffness (P ≤ 0.001) scores improved significantly more over time in the TC group than in controls. No adverse events were found in either group. Conclusion: Practicing TC can be efficacious in reducing pain and stiffness in elders with knee OA and CI. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Authors
Tsai, P-F; Chang, JY; Beck, C; Kuo, Y-F; Keefe, FJ
MLA Citation
Tsai, P-F, Chang, JY, Beck, C, Kuo, Y-F, and Keefe, FJ. "A pilot cluster-randomized trial of a 20-week tai chi program in elders with cognitive impairment and osteoarthritic knee: Effects on pain and other health outcomes." Journal of Pain and Symptom Management 45.4 (2013): 660-669.
Source
scival
Published In
Journal of Pain and Symptom Management
Volume
45
Issue
4
Publish Date
2013
Start Page
660
End Page
669
DOI
10.1016/j.jpainsymman.2012.04.009

Creating Widely Accessible Spatial Interfaces Mobile VR for Managing Persistent Pain

Authors
Schroeder, D; Korsakov, F; Jolton, J; Keefe, FJ; Haley, A; Keefe, DF
MLA Citation
Schroeder, D, Korsakov, F, Jolton, J, Keefe, FJ, Haley, A, and Keefe, DF. "Creating Widely Accessible Spatial Interfaces Mobile VR for Managing Persistent Pain." IEEE COMPUTER GRAPHICS AND APPLICATIONS 33.3 (2013): 82-89.
PMID
24807994
Source
wos-lite
Published In
IEEE Computer Graphics and Applications
Volume
33
Issue
3
Publish Date
2013
Start Page
82
End Page
89

Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: The lifestyles randomized controlled trial

Objectives: To assess whether older persons with osteoarthritis (OA) pain and insomnia receiving cognitive-behavioral therapy for pain and insomnia (CBT-PI), a cognitive-behavioral pain coping skills intervention (CBT-P), and an education-only control (EOC) differed in sleep and pain outcomes. Design: Double-blind, cluster-randomized controlled trial with 9-month follow-up. Setting: Group Health and University of Washington, 2009 to 2011. Participants: Three hundred sixty-seven older adults with OA pain and insomnia. Interventions: Six weekly group sessions of CBT-PI, CBT-P, or EOC delivered in participants' primary care clinics. Measurements: Primary outcomes were insomnia severity and pain severity. Secondary outcomes were actigraphically measured sleep efficiency and arthritis symptoms. Results: CBT-PI reduced insomnia severity (score range 0-28) more than EOC (adjusted mean difference = -1.89, 95% confidence interval = -2.83 to -0.96; P < .001) and CBT-P (adjusted mean difference = -2.03, 95% CI = -3.01 to -1.04; P < .001) and improved sleep efficiency (score range 0-100) more than EOC (adjusted mean difference = 2.64, 95% CI = 0.44-4.84; P = .02). CBT-P did not improve insomnia severity more than EOC, but improved sleep efficiency (adjusted mean difference = 2.91, 95% CI = 0.85-4.97; P = .006). Pain severity and arthritis symptoms did not differ between the three arms. A planned analysis in participants with severe baseline pain revealed similar results. Conclusion: Over 9 months, CBT of insomnia was effective for older adults with OA pain and insomnia. The addition of CBT for insomnia to CBT for pain alone improved outcomes. © 2013, The American Geriatrics Society.

Authors
Vitiello, MV; Mccurry, SM; Shortreed, SM; Balderson, BH; Baker, LD; Keefe, FJ; Rybarczyk, BD; Korff, MV
MLA Citation
Vitiello, MV, Mccurry, SM, Shortreed, SM, Balderson, BH, Baker, LD, Keefe, FJ, Rybarczyk, BD, and Korff, MV. "Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: The lifestyles randomized controlled trial." Journal of the American Geriatrics Society (2013).
PMID
23711168
Source
scival
Published In
Journal of American Geriatrics Society
Publish Date
2013
DOI
10.1111/jgs.12275

The Effect of Neuroticism on the Recall of Persistent Low Back Pain and Perceived Activity Interference

The assessment of persistent pain often relies on recalling and then summarizing the entire pain experience using a single rating. Newer methodologies, such as the Original Pain Recall Assessment, ask people to recall the pain they experienced over a specific period of time by tracing a single line in a graph to represent their pain levels. One advantage of this approach is that one can compare recalled levels of pain with actual daily diary pain ratings. This methodology was used to investigate the effects of neuroticism on the recall of levels and patterns of persistent pain. The study involved 70 participants who completed a measure of neuroticism, depressive symptoms, and up to 15 daily diaries that asked for ratings of pain intensity, pain unpleasantness, and activity interference due to pain. Following completion of the daily diary period, the participants were asked to recall the entire diary period using the Original Pain Recall Assessment methodology. The analyses revealed that higher levels of neuroticism were related to significantly better recall of the variability of pain unpleasantness over time. Furthermore, individuals who reported higher levels of depressive symptoms were less accurate in the recall of pain in general. Perspective: Memory for pain is crucial in the assessment of pain, with little research devoted to the study of this topic. The current study demonstrates that people higher on neuroticism had better recall of pain unpleasantness, and people with higher levels of depressive symptoms had poorer recall of pain in general. © 2013 American Pain Society.

Authors
Lefebvre, JC; Keefe, FJ
MLA Citation
Lefebvre, JC, and Keefe, FJ. "The Effect of Neuroticism on the Recall of Persistent Low Back Pain and Perceived Activity Interference." Journal of Pain (2013).
PMID
23683583
Source
scival
Published In
The Journal of Pain
Publish Date
2013
DOI
10.1016/j.jpain.2013.03.006

Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: The lifestyles randomized controlled trial

Objectives To assess whether older persons with osteoarthritis (OA) pain and insomnia receiving cognitive-behavioral therapy for pain and insomnia (CBT-PI), a cognitive-behavioral pain coping skills intervention (CBT-P), and an education-only control (EOC) differed in sleep and pain outcomes. Design Double-blind, cluster-randomized controlled trial with 9-month follow-up. Setting Group Health and University of Washington, 2009 to 2011. Participants Three hundred sixty-seven older adults with OA pain and insomnia. Interventions Six weekly group sessions of CBT-PI, CBT-P, or EOC delivered in participants' primary care clinics. Measurements Primary outcomes were insomnia severity and pain severity. Secondary outcomes were actigraphically measured sleep efficiency and arthritis symptoms. Results CBT-PI reduced insomnia severity (score range 0-28) more than EOC (adjusted mean difference = -1.89, 95% confidence interval = -2.83 to -0.96; P <.001) and CBT-P (adjusted mean difference = -2.03, 95% CI = -3.01 to -1.04; P <.001) and improved sleep efficiency (score range 0-100) more than EOC (adjusted mean difference = 2.64, 95% CI = 0.44-4.84; P =.02). CBT-P did not improve insomnia severity more than EOC, but improved sleep efficiency (adjusted mean difference = 2.91, 95% CI = 0.85-4.97; P =.006). Pain severity and arthritis symptoms did not differ between the three arms. A planned analysis in participants with severe baseline pain revealed similar results. Conclusion Over 9 months, CBT of insomnia was effective for older adults with OA pain and insomnia. The addition of CBT for insomnia to CBT for pain alone improved outcomes. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Authors
Vitiello, MV; McCurry, SM; Shortreed, SM; Balderson, BH; Baker, LD; Keefe, FJ; Rybarczyk, BD; Korff, MV
MLA Citation
Vitiello, MV, McCurry, SM, Shortreed, SM, Balderson, BH, Baker, LD, Keefe, FJ, Rybarczyk, BD, and Korff, MV. "Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: The lifestyles randomized controlled trial." Journal of the American Geriatrics Society 61.6 (2013): 947-956.
Source
scival
Published In
Journal of American Geriatrics Society
Volume
61
Issue
6
Publish Date
2013
Start Page
947
End Page
956
DOI
10.1111/jgs.12275

Daily spousal influence on physical activity in knee osteoarthritis

Background: Physical activity is critical for the management of knee osteoarthritis, and the spouse may play a role in encouraging or discouraging physical activity. Purpose: The purpose of this study was to examine four types of spousal influence - spouses' daily activity, autonomy support, pressure, and persuasion - on the daily physical activity of adults living with knee osteoarthritis. Methods: A total of 141 couples reported their daily experiences for 22 days using a handheld computer and wore an accelerometer to measure moderate activity and steps. Results: Spouses' autonomy support for patient physical activity, as well as their own level of activity, was concurrently associated with patients' greater daily moderate activity and steps. In addition, on days when male patients perceived that spouses exerted more pressure to be active, they spent less time in moderate activity. Conclusions: Couple-oriented interventions for knee osteoarthritis should target physical activity in both partners and spousal strategies for helping patients stay active. © 2012 The Society of Behavioral Medicine.

Authors
Martire, LM; Stephens, MAP; Mogle, J; Schulz, R; Brach, J; Keefe, FJ
MLA Citation
Martire, LM, Stephens, MAP, Mogle, J, Schulz, R, Brach, J, and Keefe, FJ. "Daily spousal influence on physical activity in knee osteoarthritis." Annals of Behavioral Medicine 45.2 (2013): 213-223.
Source
scival
Published In
Annals of Behavioral Medicine
Volume
45
Issue
2
Publish Date
2013
Start Page
213
End Page
223
DOI
10.1007/s12160-012-9442-x

Exploratory and confirmatory factor analysis of the PROMIS pain quality item bank

Purpose: The assessment of pain sensation and quality is a key component in understanding the experience of individuals with chronic pain. This study evaluated the factor structure of the patient-reported outcome measurement information system (PROMIS) pain quality item bank. Methods: As part of the PROMIS project, we developed a pool of 37 pain quality items, based on a review of existing pain questionnaires and development of new items. A web-based survey was designed and completed by 845 members of the general population and 967 individuals with different types of chronic pain. Exploratory factor analysis (EFA) was conducted on a random split-half sample of the data to examine the factor structure of the 37 PROMIS pain quality items in the general population and in a chronic pain sample. A confirmatory factor analysis was conducted in the holdout sample. Results: The EFA of the pain quality items resulted in comparable six-factor solutions for the general and chronic pain samples: (1) pulling/tugging pain; (2) tingling/numbness pain; (3) sharp/stabbing pain; (4) dull/aching pain; (5) pounding/pulsing pain; and (6) affective pain. The confirmatory factor analysis in the holdout sample supported this factor structure. Conclusions: Further research is needed to evaluate the psychometric characteristics of the derived scales based on their factor scores. © 2013 Springer Science+Business Media Dordrecht.

Authors
Revicki, DA; Cook, KF; Amtmann, D; Harnam, N; Chen, W-H; Keefe, FJ
MLA Citation
Revicki, DA, Cook, KF, Amtmann, D, Harnam, N, Chen, W-H, and Keefe, FJ. "Exploratory and confirmatory factor analysis of the PROMIS pain quality item bank." Quality of Life Research (2013): 1-11.
PMID
23836435
Source
scival
Published In
Quality of Life Research
Publish Date
2013
Start Page
1
End Page
11
DOI
10.1007/s11136-013-0467-9

Daily verbal and nonverbal expression of osteoarthritis pain and spouse responses

The current study applied a model of pain communication to examine the distinction between verbal and nonverbal pain expression in their prediction of punishing, empathic, and solicitous spouse responses to patient pain. It was hypothesized that on days when patients engaged in more nonverbal expression, spouses would respond more positively (ie, with less punishing and more solicitous and empathic behavior). The same pattern was predicted for verbal expression. In addition, it was expected that associations between patient nonverbal pain expression and positive spouse responses would be strengthened, and that the association with punishing responses would be weakened, on days when levels of verbal pain expression were higher than usual, regardless of daily pain severity. In a 22-day diary study, 144 individuals with knee osteoarthritis and their spouses completed daily measures of pain expression, spouse responses, health, and affect. The predicted positive main effect of nonverbal expression on empathic and solicitous responses was supported by the data, as was the positive main effect for verbal pain expression. Results from moderation analyses partially supported our hypothesis in that patients' nonverbal pain expression was even more strongly related to empathic and solicitous spouse responses on days of high verbal pain expression, and patients were buffered from spouse punishing responses on days when both nonverbal and verbal expression were high. These findings suggest that pain expression in both verbal and nonverbal modes of communication is important for positive and negative spousal responses. © 2013 International Association for the Study of Pain.

Authors
Wilson, SJ; Martire, LM; Keefe, FJ; Mogle, JA; Stephens, MAP; Schulz, R
MLA Citation
Wilson, SJ, Martire, LM, Keefe, FJ, Mogle, JA, Stephens, MAP, and Schulz, R. "Daily verbal and nonverbal expression of osteoarthritis pain and spouse responses." Pain (2013).
PMID
23791895
Source
scival
Published In
PAIN
Publish Date
2013
DOI
10.1016/j.pain.2013.06.023

Symptom communication in breast cancer: relationships of holding back and self-efficacy for communication to symptoms and adjustment.

Adjuvant endocrine therapy improves overall survival for women with breast cancer. However, side effects may compromise patients' quality of life (QOL). This study examined how two communication variables (self-efficacy for symptom communication [SE] and holding back from discussing cancer-related concerns [HB]) relate to QOL, pain and menopausal symptoms. Participants with breast cancer (N = 61) completed questionnaires regarding symptoms, communication, and QOL. SE was positively related to QOL and negatively related to pain interference. HB from discussing cancer-related concerns was related negatively to QOL and positively to pain interference. HB mediated the relationship between SE and QOL as well as between SE and pain interference. Increased SE is beneficial among women on endocrine therapy for breast cancer. Future research should determine if interventions to improve SE are feasible and can improve QOL and symptom tolerability.

Authors
Edmond, SN; Shelby, RA; Kimmick, GG; Marcom, PK; Peppercorn, JM; Keefe, FJ
MLA Citation
Edmond, SN, Shelby, RA, Kimmick, GG, Marcom, PK, Peppercorn, JM, and Keefe, FJ. "Symptom communication in breast cancer: relationships of holding back and self-efficacy for communication to symptoms and adjustment." J Psychosoc Oncol 31.6 (2013): 698-711.
PMID
24175903
Source
pubmed
Published In
Journal of Psychosocial Oncology
Volume
31
Issue
6
Publish Date
2013
Start Page
698
End Page
711
DOI
10.1080/07347332.2013.835023

Daily verbal and nonverbal expression of osteoarthritis pain and spouse responses

The current study applied a model of pain communication to examine the distinction between verbal and nonverbal pain expression in their prediction of punishing, empathic, and solicitous spouse responses to patient pain. It was hypothesized that on days when patients engaged in more nonverbal expression, spouses would respond more positively (ie, with less punishing and more solicitous and empathic behavior). The same pattern was predicted for verbal expression. In addition, it was expected that associations between patient nonverbal pain expression and positive spouse responses would be strengthened, and that the association with punishing responses would be weakened, on days when levels of verbal pain expression were higher than usual, regardless of daily pain severity. In a 22-day diary study, 144 individuals with knee osteoarthritis and their spouses completed daily measures of pain expression, spouse responses, health, and affect. The predicted positive main effect of nonverbal expression on empathic and solicitous responses was supported by the data, as was the positive main effect for verbal pain expression. Results from moderation analyses partially supported our hypothesis in that patients' nonverbal pain expression was even more strongly related to empathic and solicitous spouse responses on days of high verbal pain expression, and patients were buffered from spouse punishing responses on days when both nonverbal and verbal expression were high. These findings suggest that pain expression in both verbal and nonverbal modes of communication is important for positive and negative spousal responses. © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Authors
Wilson, SJ; Martire, LM; Keefe, FJ; Mogle, JA; Stephens, MAP; Schulz, R
MLA Citation
Wilson, SJ, Martire, LM, Keefe, FJ, Mogle, JA, Stephens, MAP, and Schulz, R. "Daily verbal and nonverbal expression of osteoarthritis pain and spouse responses." Pain 154.10 (2013): 2045-2053.
Source
scival
Published In
PAIN
Volume
154
Issue
10
Publish Date
2013
Start Page
2045
End Page
2053
DOI
10.1016/j.pain.2013.06.023

The effect of neuroticism on the recall of persistent low-back pain and perceived activity interference

The assessment of persistent pain often relies on recalling and then summarizing the entire pain experience using a single rating. Newer methodologies, such as the Original Pain Recall Assessment, ask people to recall the pain they experienced over a specific period of time by tracing a single line in a graph to represent their pain levels. One advantage of this approach is that one can compare recalled levels of pain with actual daily diary pain ratings. This methodology was used to investigate the effects of neuroticism on the recall of levels and patterns of persistent pain. The study involved 70 participants who completed a measure of neuroticism, depressive symptoms, and up to 15 daily diaries that asked for ratings of pain intensity, pain unpleasantness, and activity interference due to pain. Following completion of the daily diary period, the participants were asked to recall the entire diary period using the Original Pain Recall Assessment methodology. The analyses revealed that higher levels of neuroticism were related to significantly better recall of the variability of pain unpleasantness over time. Furthermore, individuals who reported higher levels of depressive symptoms were less accurate in the recall of pain in general. Perspective: Memory for pain is crucial in the assessment of pain, with little research devoted to the study of this topic. The current study demonstrates that people higher on neuroticism had better recall of pain unpleasantness, and people with higher levels of depressive symptoms had poorer recall of pain in general. © 2013 by the American Pain Society.

Authors
Lefebvre, JC; Keefe, FJ
MLA Citation
Lefebvre, JC, and Keefe, FJ. "The effect of neuroticism on the recall of persistent low-back pain and perceived activity interference." Journal of Pain 14.9 (2013): 948-956.
Source
scival
Published In
The Journal of Pain
Volume
14
Issue
9
Publish Date
2013
Start Page
948
End Page
956
DOI
10.1016/j.jpain.2013.03.006

Development and validation of a new self-report measure of pain behaviors

Pain behaviors that are maintained beyond the acute stage after injury can contribute to subsequent psychosocial and physical disability. Critical to the study of pain behaviors is the availability of psychometrically sound pain behavior measures. In this study we developed a self-report measure of pain behaviors, the Pain Behaviors Self Report (PaB-SR). PaB-SR scores were developed using item response theory and evaluated using a rigorous, multiple-witness approach to validity testing. Participants included 661 survey participants with chronic pain and with multiple sclerosis, back pain, or arthritis; 618 survey participants who were significant others of a chronic pain participant; and 86 participants in a videotaped pain behavior observation protocol. Scores on the PaB-SR were found to be measurement invariant with respect to clinical condition. PaB-SR scores, observer reports, and the videotaped protocol yielded distinct, but convergent views of pain behavior, supporting the validity of the new measure. The PaB-SR is expected to be of substantial utility to researchers wishing to explore the relationship between pain behaviors and constructs such as pain intensity, pain interference, and disability. © 2013 International Association for the Study of Pain.

Authors
Cook, KF; Keefe, F; Jensen, MP; Roddey, TS; Callahan, LF; Revicki, D; Bamer, AM; Kim, J; Chung, H; Salem, R; al, E
MLA Citation
Cook, KF, Keefe, F, Jensen, MP, Roddey, TS, Callahan, LF, Revicki, D, Bamer, AM, Kim, J, Chung, H, Salem, R, and al, E. "Development and validation of a new self-report measure of pain behaviors." Pain (2013).
PMID
23994451
Source
scival
Published In
PAIN
Publish Date
2013
DOI
10.1016/j.pain.2013.08.024

Temporal associations between spouse criticism/hostility and pain among patients with chronic pain: A within-couple daily diary study

Chronic musculoskeletal pain can strain marriages, perhaps even to the point of engendering spouse criticism and hostility directed toward patients. Such negative spouse responses may have detrimental effects on patient well-being. While results of cross-sectional studies support this notion, we extended these efforts by introducing expressed emotion (EE) and interpersonal theoretical perspectives, and by using electronic diary methods to capture both patient and spouse reports in a prospective design. Patients with chronic low back pain (CLBP) and their spouses (N = 105 couples) reported on perceived spouse behavior and patient pain 5 times/day for 14 days using Personal Data Assistants (PDAs). Concurrent and lagged within-couple associations between patient's perceptions of spouse criticism/hostility and patient self-reported pain and spouses' observations of patient pain behaviors revealed that (1) patient perceived spouse criticism and hostility were correlated significantly with pain intensity, and spouse observed patient pain behavior was related significantly with patient perceived hostility at the same time point; (2) patient perceived spouse hostility significantly predicted patient pain intensity 3 hours later, and spouse observed pain behaviors significantly predicted patient perceived spouse hostility 3 hours later. Results support both EE and interpersonal models, and imply that a comprehensive model would combine these conceptualizations to fully illustrate how spouse criticism/hostility and patient pain interact to produce a negative spiral. Given that marital interactions are amenable to clinical intervention, improved insight into how spouse behavior and patient pain are tightly linked will encourage productive translational efforts to target this neglected area. © 2013 International Association for the Study of Pain.

Authors
Burns, JW; Peterson, KM; Smith, DA; Keefe, FJ; Porter, LS; Schuster, E; Kinner, E
MLA Citation
Burns, JW, Peterson, KM, Smith, DA, Keefe, FJ, Porter, LS, Schuster, E, and Kinner, E. "Temporal associations between spouse criticism/hostility and pain among patients with chronic pain: A within-couple daily diary study." Pain (2013).
PMID
23932908
Source
scival
Published In
PAIN
Publish Date
2013
DOI
10.1016/j.pain.2013.07.053

Cognitive-Behavioral Therapy Increases Prefrontal Cortex Gray Matter in Patients With Chronic Pain

Authors
Seminowicz, DA; Shpaner, M; Keaser, ML; Krauthamer, GM; Mantegna, J; Dumas, JA; Newhouse, PA; Filippi, C; Keefe, FJ; Naylor, MR
MLA Citation
Seminowicz, DA, Shpaner, M, Keaser, ML, Krauthamer, GM, Mantegna, J, Dumas, JA, Newhouse, PA, Filippi, C, Keefe, FJ, and Naylor, MR. "Cognitive-Behavioral Therapy Increases Prefrontal Cortex Gray Matter in Patients With Chronic Pain." Journal of Pain (2013).
PMID
24135432
Source
scopus
Published In
The Journal of Pain
Publish Date
2013

Virtual reality for persistent pain: a new direction for behavioral pain management.

Authors
Keefe, FJ; Huling, DA; Coggins, MJ; Keefe, DF; Zachary Rosenthal, M; Herr, NR; Hoffman, HG
MLA Citation
Keefe, FJ, Huling, DA, Coggins, MJ, Keefe, DF, Zachary Rosenthal, M, Herr, NR, and Hoffman, HG. "Virtual reality for persistent pain: a new direction for behavioral pain management." Pain 153.11 (November 2012): 2163-2166. (Review)
PMID
22770840
Source
pubmed
Published In
Pain
Volume
153
Issue
11
Publish Date
2012
Start Page
2163
End Page
2166
DOI
10.1016/j.pain.2012.05.030

Attachment styles in patients with lung cancer and their spouses: associations with patient and spouse adjustment.

PURPOSE: This study examined attachment styles in patients with lung cancer and their spouses and associations between attachment styles and patient and spouse adjustment. METHODS: One hundred twenty-seven patients with early stage lung cancer completed measures of attachment style, marital quality, self-efficacy, pain, depression, anxiety, and quality of life. Their spouses completed measures of attachment style, marital quality, self-efficacy, caregiver strain, and mood. RESULTS: Analyses indicated that, among patients, those high in either attachment anxiety or avoidance had significantly higher levels of anxiety and poorer social well-being. Attachment avoidance was also significantly associated with higher levels of depression and poorer marital quality and functional well-being. Spouse avoidant attachment was significantly associated with patient reports of increased pain and poorer functional well-being, and spouse anxious attachment was associated with poorer patient marital quality. Among spouses, those high in attachment avoidance reported significantly higher levels of caregiver strain, anger, depressed mood, and poorer marital quality; those high in attachment anxiety reported higher anxious mood. Dyads in which both partners were insecurely attached had significantly poorer adjustment compared to dyads in which both partners reported secure attachment. CONCLUSIONS: These preliminary findings raise the possibility that attachment styles of cancer patients and their spouses as individuals and as a dyad may be important factors affecting adjustment in multiple domains.

Authors
Porter, LS; Keefe, FJ; Davis, D; Rumble, M; Scipio, C; Garst, J
MLA Citation
Porter, LS, Keefe, FJ, Davis, D, Rumble, M, Scipio, C, and Garst, J. "Attachment styles in patients with lung cancer and their spouses: associations with patient and spouse adjustment." Support Care Cancer 20.10 (October 2012): 2459-2466.
PMID
22246596
Source
pubmed
Published In
Supportive Care in Cancer
Volume
20
Issue
10
Publish Date
2012
Start Page
2459
End Page
2466
DOI
10.1007/s00520-011-1367-6

Self-efficacy and pain catastrophizing in systemic lupus erythematosus: relationship to pain, stiffness, fatigue, and psychological distress.

OBJECTIVE: To determine how self-efficacy for pain control and pain catastrophizing, both potentially modifiable pain coping cognitions, are related to pain, stiffness, fatigue, and psychological distress in patients with systemic lupus erythematosus (SLE). METHODS: We conducted a cross-sectional study of patients with SLE who completed measures of pain coping cognitions (i.e., self-efficacy for pain control, pain catastrophizing), symptom ratings (i.e., pain, stiffness, fatigue), and psychological distress. RESULTS: Correlational analyses revealed that self-efficacy for pain control and pain catastrophizing were associated with the patients' physical symptom reports and psychological distress. After controlling for age, race, and disease activity, patients with lower levels of self-efficacy for pain control reported much higher levels of pain, stiffness, and fatigue. Patients with higher levels of pain catastrophizing reported much lower positive mood. SLE activity as assessed by the rheumatologist was not associated with physical symptoms, psychological distress, self-efficacy for pain control, or pain catastrophizing. CONCLUSION: These results suggest that pain coping cognitions (i.e., either self-efficacy for pain control or pain catastrophizing) are significantly related to physical symptoms and psychological distress in patients with SLE. This finding is important because the results of studies from other samples of patients with persistent pain conditions have shown that these pain coping variables can be modified using psychological interventions, and that such treatment-related changes in pain cognitions are related to improved patient outcomes.

Authors
Somers, TJ; Kurakula, PC; Criscione-Schreiber, L; Keefe, FJ; Clowse, MEB
MLA Citation
Somers, TJ, Kurakula, PC, Criscione-Schreiber, L, Keefe, FJ, and Clowse, MEB. "Self-efficacy and pain catastrophizing in systemic lupus erythematosus: relationship to pain, stiffness, fatigue, and psychological distress." Arthritis Care Res (Hoboken) 64.9 (September 2012): 1334-1340.
PMID
22505314
Source
pubmed
Published In
Arthritis Care and Research
Volume
64
Issue
9
Publish Date
2012
Start Page
1334
End Page
1340
DOI
10.1002/acr.21686

Masculinity beliefs predict psychosocial functioning in African American prostate cancer survivors.

Research examining psychosocial functioning in African American prostate cancer survivors has been limited, in spite of documented higher mortality from prostate cancer and worse long-term physical and emotional outcomes from prostate cancer treatment reported by this group of survivors. In addition, the role of masculinity in psychosocial adjustment among prostate cancer survivors is not well understood. In this study, 59 African American prostate cancer survivors completed a questionnaire assessing masculinity beliefs related to self-reliance, emotional control, and dominance, as well as measures of psychosocial functioning (i.e., symptom distress, negative mood, and functional and social well-being). Results of regression analyses indicated that masculinity beliefs predicted negative mood, functional well-being, and social well-being, controlling for age, income, and medical comorbidities. The findings reported here, although preliminary, suggest that masculinity beliefs could be important therapeutic targets for improving the efficacy of cognitive-behavioral interventions for men adjusting to prostate cancer survivorship.

Authors
Campbell, LC; Keefe, FJ; McKee, DC; Waters, SJ; Moul, JW
MLA Citation
Campbell, LC, Keefe, FJ, McKee, DC, Waters, SJ, and Moul, JW. "Masculinity beliefs predict psychosocial functioning in African American prostate cancer survivors." Am J Mens Health 6.5 (September 2012): 400-408.
PMID
22691305
Source
pubmed
Published In
American Journal of Men's Health
Volume
6
Issue
5
Publish Date
2012
Start Page
400
End Page
408
DOI
10.1177/1557988312450185

Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers.

PURPOSE: Survivors of acute lung injury (ALI) and their informal caregivers have difficulty coping with the physical and emotional challenges of recovery from critical illness. We aimed to develop and pilot test a telephone-based coping skills training intervention for this population. METHODS: Fifty-eight participants were enrolled overall. A total of 21 patients and 23 caregivers participated in a cross-sectional study to assess coping and its association with psychological distress. This also informed the development of an ALI coping skills training intervention in an iterative process involving content and methodological experts. The intervention was then evaluated in seven patients and seven caregivers in an uncontrolled, prospective, pre-post study. Outcomes included acceptability, feasibility, and symptoms of psychological distress measured with the Hospital Anxiety and Depression Scale (HADS) and Post-Traumatic Symptom Scale (PTSS). RESULTS: Survivors and their caregivers used adaptive coping infrequently, a pattern that was strongly associated with psychological distress. These findings informed the development of a 12-session intervention for acquiring, applying, and maintaining coping skills. In the evaluation phase, participants completed 77 (92 %) of a possible 84 telephone sessions and all (100 %) reported the intervention's usefulness in their daily routine. Mean change scores reflecting improvements in the HADS (7.8 U) and PTSS (10.3 U) were associated with adaptive coping (r = 0.50-0.70) and high self-efficacy (r = 0.67-0.79). CONCLUSIONS: A novel telephone-based coping skills training intervention was acceptable, feasible, and may have been associated with a reduction in psychological distress among survivors of ALI and their informal caregivers. A randomized trial is needed to evaluate the intervention.

Authors
Cox, CE; Porter, LS; Hough, CL; White, DB; Kahn, JM; Carson, SS; Tulsky, JA; Keefe, FJ
MLA Citation
Cox, CE, Porter, LS, Hough, CL, White, DB, Kahn, JM, Carson, SS, Tulsky, JA, and Keefe, FJ. "Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers." Intensive Care Med 38.8 (August 2012): 1289-1297.
PMID
22527082
Source
pubmed
Published In
Intensive Care Medicine
Volume
38
Issue
8
Publish Date
2012
Start Page
1289
End Page
1297
DOI
10.1007/s00134-012-2567-3

Partner-assisted emotional disclosure for patients with GI cancer: 8-week follow-up and processes associated with change.

PURPOSE: We recently reported that a partner-assisted emotional disclosure intervention for gastrointestinal cancer led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns. The purposes of the present study were to examine outcomes at 8-week follow-up and process variables that may influence treatment effects. METHODS: One hundred thirty couples were randomly assigned to either partner-assisted emotional disclosure or an education/support control condition. Participants completed measures of relationship quality, intimacy, and psychological distress before randomization, post-treatment, and 8 weeks later. Patients in the disclosure intervention completed measures of negative affect immediately following each treatment session, and their level of expressiveness during the sessions was rated by trained observers. Data were analyzed using multilevel modeling. RESULTS: Among couples in which the patient initially reported higher levels of holding back, the disclosure intervention led to improvements in relationship quality and intimacy that were maintained at 8-weeks follow-up. High levels of patient expressiveness during the disclosure sessions were associated with improvements in relationship quality and intimacy, and high levels of patient negative affect immediately following the sessions were associated with reductions in psychological distress at the post-test assessment. CONCLUSIONS: For couples in which the patient tends to hold back from discussing concerns, partner-assisted emotional disclosure is a beneficial intervention leading to improvements in relationship functioning that maintain over time. Future research is needed to examine methods of enhancing intervention effects, including encouraging patient expressiveness and negative affect during the sessions.

Authors
Porter, LS; Keefe, FJ; Baucom, DH; Hurwitz, H; Moser, B; Patterson, E; Kim, HJ
MLA Citation
Porter, LS, Keefe, FJ, Baucom, DH, Hurwitz, H, Moser, B, Patterson, E, and Kim, HJ. "Partner-assisted emotional disclosure for patients with GI cancer: 8-week follow-up and processes associated with change." Support Care Cancer 20.8 (August 2012): 1755-1762.
PMID
21947440
Source
pubmed
Published In
Supportive Care in Cancer
Volume
20
Issue
8
Publish Date
2012
Start Page
1755
End Page
1762
DOI
10.1007/s00520-011-1272-z

Spouse-assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: A 1-year randomized controlled trial

Authors
Abbasi, M; Dehghani, M; Keefe, FJ; Jafari, H; Behtash, H; Shams, J
MLA Citation
Abbasi, M, Dehghani, M, Keefe, FJ, Jafari, H, Behtash, H, and Shams, J. "Spouse-assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: A 1-year randomized controlled trial." EUROPEAN JOURNAL OF PAIN 16.7 (August 2012): 1033-1043.
PMID
22337646
Source
wos-lite
Published In
European Journal of Pain
Volume
16
Issue
7
Publish Date
2012
Start Page
1033
End Page
1043
DOI
10.1002/j.1532-2149.2011.00097.x

Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study.

Overweight and obese patients with osteoarthritis (OA) experience more OA pain and disability than patients who are not overweight. This study examined the long-term efficacy of a combined pain coping skills training (PCST) and lifestyle behavioral weight management (BWM) intervention in overweight and obese OA patients. Patients (n=232) were randomized to a 6-month program of: 1) PCST+BWM; 2) PCST-only; 3) BWM-only; or 4) standard care control. Assessments of pain, physical disability (Arthritis Impact Measurement Scales [AIMS] physical disability, stiffness, activity, and gait), psychological disability (AIMS psychological disability, pain catastrophizing, arthritis self-efficacy, weight self-efficacy), and body weight were collected at 4 time points (pretreatment, posttreatment, and 6 months and 12 months after the completion of treatment). Patients randomized to PCST+BWM demonstrated significantly better treatment outcomes (average of all 3 posttreatment values) in terms of pain, physical disability, stiffness, activity, weight self-efficacy, and weight when compared to the other 3 conditions (Ps<0.05). PCST+BWM also did significantly better than at least one of the other conditions (ie, PCST-only, BWM-only, or standard care) in terms of psychological disability, pain catastrophizing, and arthritis self-efficacy. Interventions teaching overweight and obese OA patients pain coping skills and weight management simultaneously may provide the more comprehensive long-term benefits.

Authors
Somers, TJ; Blumenthal, JA; Guilak, F; Kraus, VB; Schmitt, DO; Babyak, MA; Craighead, LW; Caldwell, DS; Rice, JR; McKee, DC; Shelby, RA; Campbell, LC; Pells, JJ; Sims, EL; Queen, R; Carson, JW; Connelly, M; Dixon, KE; Lacaille, LJ; Huebner, JL; Rejeski, WJ; Keefe, FJ
MLA Citation
Somers, TJ, Blumenthal, JA, Guilak, F, Kraus, VB, Schmitt, DO, Babyak, MA, Craighead, LW, Caldwell, DS, Rice, JR, McKee, DC, Shelby, RA, Campbell, LC, Pells, JJ, Sims, EL, Queen, R, Carson, JW, Connelly, M, Dixon, KE, Lacaille, LJ, Huebner, JL, Rejeski, WJ, and Keefe, FJ. "Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study." Pain 153.6 (June 2012): 1199-1209.
PMID
22503223
Source
pubmed
Published In
Pain
Volume
153
Issue
6
Publish Date
2012
Start Page
1199
End Page
1209
DOI
10.1016/j.pain.2012.02.023

Brief Fear of Movement Scale for osteoarthritis.

OBJECTIVE: Fear of movement has important clinical implications for individuals with osteoarthritis (OA). This study aimed to establish a brief fear of movement scale for use in OA. Items from the Tampa Scale for Kinesiophobia (TSK) were examined. METHODS: The English version of the TSK was examined in a community-based sample (n = 1,136) of individuals with OA of the hip or knee. Exploratory and confirmatory factor analyses were used to determine the number and content of the dimensions of fear of movement. Factorial invariance was tested across subgroups of sex, race, education, and OA severity. Convergent validity with measures of pain, physical functioning, and psychological functioning was examined. RESULTS: Factor analyses identified a single-factor 6-item scale that measures activity avoidance due to pain-related fear of movement (confirmatory factor analysis indices of model fit: root mean square error of approximation = 0.04, standardized root mean square residual = 0.01, comparative fit index = 0.99, and Tucker-Lewis Index = 0.99). The 6-item scale demonstrated factorial invariance across sex, race, levels of education, and OA severity, suggesting that this scale performs consistently across diverse groups of individuals with OA. Convergent validity with measures of pain (β = 0.30-0.41), physical functioning (β = 0.44-0.48), and psychological functioning (β = 0.36-0.37) was also demonstrated. CONCLUSION: The Brief Fear of Movement Scale identified in this study provides a promising and valid approach for assessing fear of movement in individuals with OA. This brief scale demonstrated several important strengths, including a small number of items, sound psychometric properties, and consistent performance across diverse groups of individuals with OA.

Authors
Shelby, RA; Somers, TJ; Keefe, FJ; DeVellis, BM; Patterson, C; Renner, JB; Jordan, JM
MLA Citation
Shelby, RA, Somers, TJ, Keefe, FJ, DeVellis, BM, Patterson, C, Renner, JB, and Jordan, JM. "Brief Fear of Movement Scale for osteoarthritis." Arthritis Care Res (Hoboken) 64.6 (June 2012): 862-871.
PMID
22290689
Source
pubmed
Published In
Arthritis Care and Research
Volume
64
Issue
6
Publish Date
2012
Start Page
862
End Page
871
DOI
10.1002/acr.21626

Reactions to a partner-assisted emotional disclosure intervention: direct observation and self-report of patient and partner communication.

Partner-assisted emotional disclosure is a couple-based intervention designed to help patients disclose cancer-related concerns to their spouses-partners. We previously found that, compared with an education/support control condition, partner-assisted emotional disclosure led to significant improvements in relationship quality and intimacy for couples in which the patient initially reported holding back from discussing cancer-related concerns (Porter et al., 2009, Cancer, 115, 4326-4338). The purpose of this study was to examine the process data from couples who participated in the disclosure sessions including (a) observational ratings of couples' communication during the sessions; (b) couples' ratings of their communication during the sessions; and (c) associations between participants' observed communication and their baseline psychological/relationship functioning. As rated by trained observers, couples' communication was in the moderate range of adaptive skills. Self-report data indicated that participants had positive perceptions of their communication. Observational and self-report ratings were weakly associated. Patients reporting lower levels of relationship quality, higher levels of holding back, and higher partner avoidance at baseline were rated by observers as more expressive during the sessions. Overall, these findings suggest that the intervention was acceptable to couples and was particularly helpful for patients who had difficulty talking with their partners on their own without skills training.

Authors
Porter, LS; Baucom, DH; Keefe, FJ; Patterson, ES
MLA Citation
Porter, LS, Baucom, DH, Keefe, FJ, and Patterson, ES. "Reactions to a partner-assisted emotional disclosure intervention: direct observation and self-report of patient and partner communication." J Marital Fam Ther 38 Suppl 1 (June 2012): 284-295.
PMID
22765340
Source
pubmed
Published In
Journal of Marital and Family Therapy
Volume
38 Suppl 1
Publish Date
2012
Start Page
284
End Page
295
DOI
10.1111/j.1752-0606.2011.00278.x

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 (β=-0.48, P<0.001), positive affect (β=0.29, P=0.01), pain catastrophizing (β=-0.32, P=0.003), and pain disability (β=-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.

Authors
Wren, AA; Somers, TJ; Wright, MA; Goetz, MC; Leary, MR; Fras, AM; Huh, BK; Rogers, LL; Keefe, FJ
MLA Citation
Wren, AA, Somers, TJ, Wright, MA, Goetz, MC, Leary, MR, Fras, AM, Huh, BK, Rogers, LL, and Keefe, FJ. "Self-compassion in patients with persistent musculoskeletal pain: relationship of self-compassion to adjustment to persistent pain." J Pain Symptom Manage 43.4 (April 2012): 759-770.
PMID
22071165
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
43
Issue
4
Publish Date
2012
Start Page
759
End Page
770
DOI
10.1016/j.jpainsymman.2011.04.014

Prospective study of factors predicting adherence to surveillance mammography in women treated for breast cancer.

PURPOSE: This prospective study examined the factors that predicted sustained adherence to surveillance mammography in women treated for breast cancer. METHODS: Breast cancer survivors (N = 204) who were undergoing surveillance mammography completed questionnaires assessing mammography-related anticipatory anxiety, persistent breast pain, mammography pain, and catastrophic thoughts about mammography pain. Adherence to mammography in the following year was assessed. RESULTS: In the year after study entry, 84.8% of women (n = 173) returned for a subsequent mammogram. Unadjusted associations showed that younger age, shorter period of time since surgery, and having upper extremity lymphedema were associated with lower mammography adherence. Forty percent of women reported moderate to high levels of mammography pain (score of ≥ 5 on a 0 to 10 scale). Although mammography pain was not associated with adherence, higher levels of mammography-related anxiety and pain catastrophizing were associated with not returning for a mammogram (P < .05). The impact of anxiety on mammography use was mediated by pain catastrophizing (indirect effect, P < .05). CONCLUSION: Findings suggest that women who are younger, closer to the time of surgery, or have upper extremity lymphedema may be less likely to undergo repeated mammograms. It may be important for health professionals to remind selected patients directly that some women avoid repeat mammography and to re-emphasize the value of mammography for women with a history of breast cancer. Teaching women behavioral techniques (eg, redirecting attention) or providing medication for reducing anxiety could be considered for women with high levels of anxiety or catastrophic thoughts related to mammography.

Authors
Shelby, RA; Scipio, CD; Somers, TJ; Soo, MS; Weinfurt, KP; Keefe, FJ
MLA Citation
Shelby, RA, Scipio, CD, Somers, TJ, Soo, MS, Weinfurt, KP, and Keefe, FJ. "Prospective study of factors predicting adherence to surveillance mammography in women treated for breast cancer." J Clin Oncol 30.8 (March 10, 2012): 813-819.
PMID
22331949
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
30
Issue
8
Publish Date
2012
Start Page
813
End Page
819
DOI
10.1200/JCO.2010.34.4333

Meeting them where they are: Using the Internet to deliver behavioral medicine interventions for pain.

Pharmacological and interventional pain medicine treatments are emphasized in the routine treatment of chronic pain despite strong evidence for the efficacy and safety of behavioral approaches. Most medical professionals have not incorporated behavioral pain treatments into their practices. Internet-based interventions have the potential to increase clinical use of these treatments. We discuss the strengths and weaknesses of current Internet-based behavioral pain management interventions, focusing on three broad intervention categories: therapist-guided interventions, unguided (automated) interventions, and pain-relevant applications for mobile platforms. Examples of each category are discussed, revealing a high degree of variation in approaches, user interfaces, and components as well as variability in the degree to which these interventions have been subjected to empirical testing. Finally, we highlight key issues for research and clinical implementation, with the goal of advancing this field so that it can meet its potential to increase access to evidence-based behavioral medicine treatments for chronic pain.

Authors
Rini, C; Williams, DA; Broderick, JE; Keefe, FJ
MLA Citation
Rini, C, Williams, DA, Broderick, JE, and Keefe, FJ. "Meeting them where they are: Using the Internet to deliver behavioral medicine interventions for pain." Translational behavioral medicine 2.1 (March 2012): 82-92. (Review)
PMID
22924084
Source
epmc
Published In
Translational Behavioral Medicine
Volume
2
Issue
1
Publish Date
2012
Start Page
82
End Page
92
DOI
10.1007/s13142-011-0107-2

A phase III randomized three-arm trial of physical therapist delivered pain coping skills training for patients with total knee arthroplasty: The KASTPain protocol

Abstract. Background: Approximately 20% of patients report persistent and disabling pain following total knee arthroplasty (TKA) despite an apparently normally functioning prosthesis. One potential risk factor for unexplained persistent pain is high levels of pain catastrophizing. We designed a three-arm trial to determine if a pain coping skills training program, delivered prior to TKA, effectively reduces function-limiting pain following the procedure in patients with high levels of pain catastrophizing. Methods/design. The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. Discussion. The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. Trial Registration. NCT01620983. © 2012 Riddle et al.; licensee BioMed Central Ltd.

Authors
Riddle, DL; Keefe, FJ; Ang, D; Khaled, J; Dumenci, L; Jensen, MP; Bair, MJ; Reed, SD; Kroenke, K
MLA Citation
Riddle, DL, Keefe, FJ, Ang, D, Khaled, J, Dumenci, L, Jensen, MP, Bair, MJ, Reed, SD, and Kroenke, K. "A phase III randomized three-arm trial of physical therapist delivered pain coping skills training for patients with total knee arthroplasty: The KASTPain protocol." BMC Musculoskeletal Disorders 13 (2012).
PMID
22906061
Source
scival
Published In
BMC Musculoskeletal Disorders
Volume
13
Publish Date
2012
DOI
10.1186/1471-2474-13-149

Pilot feasibility study of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer

No studies have tested interventions addressing the sexual concerns of colorectal cancer patients and their partners. The authors reported findings from a pilot feasibility study of a novel telephone-based intimacy enhancement protocol that addresses the intimacy and sexual concerns of couples facing colorectal cancer. On the basis of a flexible coping model, the intervention was designed to help couples make cognitive and behavioral shifts in their intimate relationships. Participants were 18 individuals (9 dyads) who completed the intervention and measures of feasibility (frequency, ease of use, helpfulness of skills, ratings of rapport), program evaluations, and measures of sexual and relationship functioning. Most participants reported that the intervention was quite a bit or extremely helpful and that they had used the skills taught within the past week. The skills most commonly practiced and perceived as most helpful tended to be behavioral (e.g., trying a new sexual activity). The authors found the largest effect sizes (.60) for sexual distress, sexual function (female), and sexual communication. Findings from this pilot study suggest that the intimacy enhancement protocol is feasible and holds promise for improving sexual and intimacy outcomes in colorectal cancer patients and their partners. The authors discuss the research and clinical implications. © 2012 Copyright Taylor and Francis Group, LLC.

Authors
Reese, JB; Porter, LS; Somers, TJ; Keefe, FJ
MLA Citation
Reese, JB, Porter, LS, Somers, TJ, and Keefe, FJ. "Pilot feasibility study of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer." Journal of Sex and Marital Therapy 38.5 (2012): 402-417.
PMID
22900623
Source
scival
Published In
Journal of Sex & Marital Therapy
Volume
38
Issue
5
Publish Date
2012
Start Page
402
End Page
417
DOI
10.1080/0092623X.2011.606886

Group interventions for co-morbid insomnia and osteoarthritis pain in primary care: The lifestyles cluster randomized trial design

Six weekly sessions of group cognitive-behavioral therapy for insomnia and osteoarthritis pain (CBT-PI), and for osteoarthritis pain alone (CBT-P) were compared to an education only control (EOC). Basic education about pain and sleep was comparable, so EOC controlled for information and group participation. Active interventions differed from EOC in training pain coping skills (CBT-P and CBT-PI) and sleep enhancement techniques (CBT-PI). Persons with osteoarthritis age 60 or older were screened for osteoarthritis pain and insomnia severity via mailed survey. Primary outcomes were pain severity (pain intensity and interference ratings from the Graded Chronic Pain Scale) and insomnia severity (Insomnia Severity Index). Secondary outcomes were arthritis pain (AIMS-2 symptom scale) and sleep efficiency assessed by wrist actigraphy. Ancillary outcomes included: cognitive function, depression, and health care use. A clustered randomized design provided adequate power to identify moderate effects on primary outcomes (effect size > 0.35). Modified intent to treat analyses, including all participants who attended the first session, assessed effects across CBT-PI, CBT-P, and EOC groups. Treatment effects were assessed post-intervention (2. months) and at 9. months, with durability of intervention effects evaluated at 18. months. The trial was executed in 6 primary clinics, randomizing 367 participants, with 93.2% of randomized patients attending at least 4 group sessions. Response rates for post-intervention and 9. month assessments were 96.7% and 92.9% respectively. This hybrid efficacy-effectiveness trial design evaluates whether interventions yield specific benefits for clinical and behavioral outcomes relative to an education only control when implemented in a primary care setting. © 2012 Elsevier Inc.

Authors
Korff, MV; Vitiello, MV; McCurry, SM; Balderson, BH; Moore, AL; Baker, LD; Yarbro, P; Saunders, K; Keefe, FJ; Rybarczyk, BD
MLA Citation
Korff, MV, Vitiello, MV, McCurry, SM, Balderson, BH, Moore, AL, Baker, LD, Yarbro, P, Saunders, K, Keefe, FJ, and Rybarczyk, BD. "Group interventions for co-morbid insomnia and osteoarthritis pain in primary care: The lifestyles cluster randomized trial design." Contemporary Clinical Trials 33.4 (2012): 759-768.
PMID
22484341
Source
scival
Published In
Contemporary Clinical Trials
Volume
33
Issue
4
Publish Date
2012
Start Page
759
End Page
768
DOI
10.1016/j.cct.2012.03.010

Men's psychological functioning in the context of women's breast cancer

Previous research indicates that men are affected when their female partners have breast cancer. However, little is known about what predicts men's psychological well-being in this context. The current investigation involved couples in which the woman had early stage breast cancer and explored the degree to which men's positive and negative well-being was related to women's well-being, women's physical symptoms, relationship functioning, and relationship duration. The findings indicate that all of these factors play a role and interact in predicting men's well-being. In particular, when women have a high level of physical symptoms, the typical associations between men's well-being with women's well-being and relationship adjustment no longer persist. Implications for working with couples addressing health problems are provided. © 2010 American Association for Marriage and Family Therapy.

Authors
Baucom, DH; Kirby, JS; Pukay-Martin, ND; Porter, LS; Fredman, SJ; Gremore, TM; Keefe, FJ; Atkins, D
MLA Citation
Baucom, DH, Kirby, JS, Pukay-Martin, ND, Porter, LS, Fredman, SJ, Gremore, TM, Keefe, FJ, and Atkins, D. "Men's psychological functioning in the context of women's breast cancer." Journal of Marital and Family Therapy 38.2 (2012): 317-329.
PMID
22512294
Source
scival
Published In
Journal of Marital and Family Therapy
Volume
38
Issue
2
Publish Date
2012
Start Page
317
End Page
329
DOI
10.1111/j.1752-0606.2009.00133.x

Individual differences in the day-to-day variability of pain, fatigue, and well-being in patients with rheumatic disease: Associations with psychological variables

This report examines day-to-day variability in rheumatology patients' ratings of pain and related quality-of-life variables as well as predictors of that variability. Data from 2 studies were used. The hypothesis was that greater psychological distress (i.e., depression and anxiety) and poorer coping appraisals (i.e., higher pain catastrophizing and lower self-efficacy) are associated with more variability. Electronic daily diary ratings were collected from 106 patients from a community rheumatology practice across 28 days (study 1) and from 194 osteoarthritis patients across 7 days (study 2). In multilevel modeling analyses, substantial day-to-day variability was evident for all variables in both studies, and individual patients differed considerably and somewhat reliably in the magnitude of their variability. Higher levels of depression significantly predicted greater variability in pain, as well as in happiness and frustration (study 1). Lower self-efficacy was associated with more variability in patients' daily satisfaction with accomplishments and in the quality of their day (study 2). Greater pain catastrophizing and higher depression predicted more variability in interference with social relationships (study 2). Anxiety was not significantly associated with day-to-day variability. The results of these studies suggest that individual differences in the magnitude of symptom fluctuation may play a vital role in understanding patients' adjustment to pain. Future research will be needed to examine the clinical utility of measuring variability in patients' pain and well-being, and to understand whether reducing variability may be an important treatment target. © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Authors
Schneider, S; Junghaenel, DU; Keefe, FJ; Schwartz, JE; Stone, AA; Broderick, JE
MLA Citation
Schneider, S, Junghaenel, DU, Keefe, FJ, Schwartz, JE, Stone, AA, and Broderick, JE. "Individual differences in the day-to-day variability of pain, fatigue, and well-being in patients with rheumatic disease: Associations with psychological variables." Pain 153.4 (2012): 813-822.
PMID
22349917
Source
scival
Published In
PAIN
Volume
153
Issue
4
Publish Date
2012
Start Page
813
End Page
822
DOI
10.1016/j.pain.2012.01.001

Translational behavioral pain management: New directions and new opportunities

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Translational behavioral pain management: New directions and new opportunities." Translational Behavioral Medicine 2.1 (2012): 19-21.
PMID
24073094
Source
scival
Published In
Translational Behavioral Medicine
Volume
2
Issue
1
Publish Date
2012
Start Page
19
End Page
21
DOI
10.1007/s13142-012-0117-8

A primary care-based interdisciplinary team approach to the treatment of chronic pain utilizing a pragmatic clinical trials framework

Chronic pain affects at least 116 million adults in the USA and exacts a tremendous cost in suffering and lost productivity. While health systems offer specialized pain services, the primary care setting is where most patients seek and receive care for pain. Primary care-based treatment of chronic pain by interdisciplinary teams (including behavioral specialists, nurse case managers, physical therapists, and pharmacists) is one of the most effective approaches for improving outcomes and managing costs. To ensure robust integration of such services into sustainable health-care programs, evaluations must be conducted by researchers well versed in the methodologies of clinical trials, mixed methods and implementation research, bioinformatics, health services, and cost-effectiveness. Recent national health policy changes, in addition to the increasing recognition of the high prevalence and cost of chronic pain conditions, present a unique opportunity to shift the care paradigm for patients with chronic pain. © 2012 Society of Behavioral Medicine.

Authors
DeBar, LL; Kindler, L; Keefe, FJ; Green, CA; Smith, DH; Deyo, RA; Ames, K; Feldstein, A
MLA Citation
DeBar, LL, Kindler, L, Keefe, FJ, Green, CA, Smith, DH, Deyo, RA, Ames, K, and Feldstein, A. "A primary care-based interdisciplinary team approach to the treatment of chronic pain utilizing a pragmatic clinical trials framework." Translational Behavioral Medicine 2.4 (2012): 523-530.
PMID
23440672
Source
scival
Published In
Translational Behavioral Medicine
Volume
2
Issue
4
Publish Date
2012
Start Page
523
End Page
530
DOI
10.1007/s13142-012-0163-2

A physiotherapist-delivered integrated exercise and pain coping skills training intervention for individuals with knee osteoarthritis: A randomised controlled trial protocol

Background: Knee osteoarthritis (OA) is a prevalent chronic musculoskeletal condition with no cure. Pain is the primary symptom and results from a complex interaction between structural changes, physical impairments and psychological factors. Much evidence supports the use of strengthening exercises to improve pain and physical function in this patient population. There is also a growing body of research examining the effects of psychologist-delivered pain coping skills training (PCST) particularly in other chronic pain conditions. Though typically provided separately, there are symptom, resource and personnel advantages of exercise and PCST being delivered together by a single healthcare professional. Physiotherapists are a logical choice to be trained to deliver a PCST intervention as they already have expertise in administering exercise for knee OA and are cognisant of the need for a biopsychosocial approach to management. No studies to date have examined the effects of an integrated exercise and PCST program delivered solely by physiotherapists in this population. The primary aim of this multisite randomised controlled trial is to investigate whether an integrated 12-week PCST and exercise treatment program delivered by physiotherapists is more efficacious than either program alone in treating pain and physical function in individuals with knee OA. Methods/design. This will be an assessor-blinded, 3-arm randomised controlled trial of a 12-week intervention involving 10 physiotherapy visits together with home practice. Participants with symptomatic and radiographic knee OA will be recruited from the community in two cities in Australia and randomized into one of three groups: exercise alone, PCST alone, or integrated PCST and exercise. Randomisation will be stratified by city (Melbourne or Brisbane) and gender. Primary outcomes are overall average pain in the past week measured by a Visual Analogue Scale and physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index subscale. Secondary outcomes include global rating of change, muscle strength, functional performance, physical activity levels, health related quality of life and psychological factors. Measurements will be taken at baseline and immediately following the intervention (12 weeks) as well as at 32 weeks and 52 weeks to examine maintenance of any intervention effects. Specific assessment of adherence to the treatment program will also be made at weeks 22 and 42. Relative cost-effectiveness will be determined from health service usage and outcome data. Discussion. The findings from this randomised controlled trial will provide evidence for the efficacy of an integrated PCST and exercise program delivered by physiotherapists in the management of painful and functionally limiting knee OA compared to either program alone. Trial registration. Australian New Zealand Clinical Trials Registry reference number: ACTRN12610000533099. © 2012 Bennell et al.; licensee BioMed Central Ltd.

Authors
Bennell, KL; Ahamed, Y; Bryant, C; Jull, G; Hunt, MA; Kenardy, J; Forbes, A; Harris, A; Nicholas, M; Metcalf, B; Egerton, T; Keefe, FJ
MLA Citation
Bennell, KL, Ahamed, Y, Bryant, C, Jull, G, Hunt, MA, Kenardy, J, Forbes, A, Harris, A, Nicholas, M, Metcalf, B, Egerton, T, and Keefe, FJ. "A physiotherapist-delivered integrated exercise and pain coping skills training intervention for individuals with knee osteoarthritis: A randomised controlled trial protocol." BMC Musculoskeletal Disorders 13 (2012).
PMID
22828288
Source
scival
Published In
BMC Musculoskeletal Disorders
Volume
13
Publish Date
2012
DOI
10.1186/1471-2474-13-129

Daily Spousal Influence on Physical Activity in Knee Osteoarthritis

Background: Physical activity is critical for the management of knee osteoarthritis, and the spouse may play a role in encouraging or discouraging physical activity. Purpose: The purpose of this study was to examine four types of spousal influence-spouses' daily activity, autonomy support, pressure, and persuasion-on the daily physical activity of adults living with knee osteoarthritis. Methods: A total of 141 couples reported their daily experiences for 22 days using a handheld computer and wore an accelerometer to measure moderate activity and steps. Results: Spouses' autonomy support for patient physical activity, as well as their own level of activity, was concurrently associated with patients' greater daily moderate activity and steps. In addition, on days when male patients perceived that spouses exerted more pressure to be active, they spent less time in moderate activity. Conclusions: Couple-oriented interventions for knee osteoarthritis should target physical activity in both partners and spousal strategies for helping patients stay active. © 2012 The Society of Behavioral Medicine.

Authors
Martire, LM; Stephens, MAP; Mogle, J; Schulz, R; Brach, J; Keefe, FJ
MLA Citation
Martire, LM, Stephens, MAP, Mogle, J, Schulz, R, Brach, J, and Keefe, FJ. "Daily Spousal Influence on Physical Activity in Knee Osteoarthritis." Annals of Behavioral Medicine (2012): 1-11.
PMID
23161472
Source
scival
Published In
Annals of Behavioral Medicine
Publish Date
2012
Start Page
1
End Page
11
DOI
10.1007/s12160-012-9442-x

A Pilot Cluster-Randomized Trial of a 20-Week Tai Chi Program in Elders With Cognitive Impairment and Osteoarthritic Knee: Effects on Pain and Other Health Outcomes

Context: Because Tai Chi (TC) is beneficial to elders without cognitive impairment (CI), it also may benefit elders with CI. But elders with CI have generally been excluded from TC studies because many measurement tools require verbal reports and some elders with CI are unable to provide. Objectives: To test the efficacy of a TC program in improving pain and other health outcomes in community-dwelling elders with knee osteoarthritis (OA) and CI. Methods: This pilot cluster-randomized trial was conducted between January 2008 and June 2010 (ClinicalTrials.gov Identifier: NCT01528566). The TC group attended Sun style TC classes, three sessions a week for 20 weeks; the control group attended classes providing health and cultural information for the same length of time. Measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, physical function and stiffness subscales; the Get Up and Go test; the Sit-to-Stand test; and the Mini-Mental State Examination (MMSE), administered at baseline, every four weeks during the intervention and at the end of the study (posttest). Results: Eight sites participated in either the TC group (four sites, 28 participants) or control group (four sites, 27 participants). The WOMAC pain (P = 0.006) and stiffness scores (P = 0.010) differed significantly between the two groups at posttest, whereas differences between the two groups in the WOMAC physical function score (P = 0.071) and the MMSE (P = 0.096) showed borderline significance at the posttest. WOMAC pain (P = 0.001), physical function (P = 0.021), and stiffness (P ≤ 0.001) scores improved significantly more over time in the TC group than in controls. No adverse events were found in either group. Conclusion: Practicing TC can be efficacious in reducing pain and stiffness in elders with knee OA and CI. © 2012 U.S. Cancer Pain Relief Committee.

Authors
Tsai, P-F; Chang, JY; Beck, C; Kuo, Y-F; Keefe, FJ
MLA Citation
Tsai, P-F, Chang, JY, Beck, C, Kuo, Y-F, and Keefe, FJ. "A Pilot Cluster-Randomized Trial of a 20-Week Tai Chi Program in Elders With Cognitive Impairment and Osteoarthritic Knee: Effects on Pain and Other Health Outcomes." Journal of Pain and Symptom Management (2012).
PMID
23017610
Source
scival
Published In
Journal of Pain and Symptom Management
Publish Date
2012
DOI
10.1016/j.jpainsymman.2012.04.009

Validity of an Observation Method for Assessing Pain Behavior in Individuals With Multiple Sclerosis

Context: Pain is a common and complex experience for individuals who live with multiple sclerosis (MS) and it interferes with physical, psychological, and social function. A valid and reliable tool for quantifying observed pain behaviors in MS is critical to understand how pain behaviors contribute to pain-related disability in this clinical population. Objectives: To evaluate the reliability and validity of a pain behavioral observation protocol in individuals who have MS. Methods: Community-dwelling volunteers with MS (N = 30), back pain (N = 5), or arthritis (N = 8) were recruited based on clinician referrals, advertisements, fliers, web postings, and participation in previous research. Participants completed the measures of pain severity, pain interference, and self-reported pain behaviors and were videotaped doing typical activities (e.g., walking and sitting). Two coders independently recorded frequencies of pain behaviors by category (e.g., guarding and bracing) and interrater reliability statistics were calculated. Naïve observers reviewed videotapes of individuals with MS and rated their pain. The Spearman's correlations were calculated between pain behavior frequencies and self-reported pain and pain ratings by naïve observers. Results: Interrater reliability estimates indicated the reliability of pain codes in the MS sample. Kappa coefficients ranged from moderate (sighing = 0.40) to substantial agreements (guarding = 0.83). These values were comparable with those obtained in the combined back pain and arthritis sample. Concurrent validity was supported by correlations with self-reported pain (0.46-0.53) and with self-reports of pain behaviors (0.58). Construct validity was supported by finding of 0.87 correlation between total pain behaviors observed by coders and mean pain ratings by naïve observers. Conclusion: Results support the use of the pain behavior observation protocol for assessing pain behaviors of individuals with MS. Valid assessments of pain behaviors of individuals with MS could lead to creative interventions in the management of chronic pain in this population. © 2012 U.S. Cancer Pain Relief Committee.

Authors
Cook, KF; Roddey, TS; Bamer, AM; Amtmann, D; Keefe, FJ
MLA Citation
Cook, KF, Roddey, TS, Bamer, AM, Amtmann, D, and Keefe, FJ. "Validity of an Observation Method for Assessing Pain Behavior in Individuals With Multiple Sclerosis." Journal of Pain and Symptom Management (2012).
PMID
23159684
Source
scival
Published In
Journal of Pain and Symptom Management
Publish Date
2012
DOI
10.1016/j.jpainsymman.2012.08.006

A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis: A pilot study

Background: Osteoarthritis (OA) of the knee is associated with a number of physical and psychological impairments. Unfortunately, very few treatment strategies are capable of addressing both types of impairments concurrently. We performed a pilot, randomized controlled, proof of principle trial investigating the feasibility and effects of an intervention combining physical exercise and pain coping skills training (PCST). Methods: Twenty patients with a clinical and radiographical diagnosis of tibiofemoral OA were randomized to receive either 10 weeks of physiotherapist supervised exercises (lower limb strengthening and walking) combined with non-directive counseling (NDC) or the same exercise program delivered concurrently with PCST. Primary outcomes included self-reported pain and pain coping, while secondary outcomes included self efficacy and self-reported physical function. Results: Ten participants were randomized to each group and both groups exhibited significant improvements in isometric knee strength, self-reported knee pain and physical function, self efficacy for control of pain management and other arthritis symptoms. Only those in the exercise + PCST group reported statistically significant improvements in pain control coping and rational thinking. No between-group differences existed in any outcome (0.07 < p < 0.98). Based on our findings, 63 participants per group would be needed for future large-scale studies using similar outcome measures and design. Conclusions: Our study showed that an intervention that combines exercise and PCST within the same treatment session and delivered by specially-trained physiotherapists is feasible and can improve both physical and psychological outcomes in individuals with knee OA. Level of evidence: Level II. Clinical Trials Registry number: ACTRN12609000623291. © 2012 Elsevier B.V. All rights reserved.

Authors
Hunt, MA; Keefe, FJ; Bryant, C; Metcalf, BR; Ahamed, Y; Nicholas, MK; Bennell, KL
MLA Citation
Hunt, MA, Keefe, FJ, Bryant, C, Metcalf, BR, Ahamed, Y, Nicholas, MK, and Bennell, KL. "A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis: A pilot study." Knee (2012).
PMID
22921688
Source
scival
Published In
The Knee
Publish Date
2012
DOI
10.1016/j.knee.2012.07.008

Neuroimaging of pain: A psychosocial perspective

The past 60 years has witnessed major changes in the way that pain is conceptualized and treated. In the 1950s, pain was generally conceptualized using a sensory model that maintained that pain is a simple sensory event that warned of tissue damage. Treatments for pain were biomedical and consisted mainly of attempts to identify underlying tissue damage and treat it medically or surgically. In the 1960s, clinicians and researchers expressed growing dissatisfaction with the sensory model of pain. In particular, it became increasingly clear that the sensory model failed to explain phenomena often seen in patients experiencing chronic pain: pain persisting despite multiple medical and surgical treatments aimed at correcting underlying tissue damage, reports of pain showing poor correlation with underlying evidence of tissue damage, pain being modified by psychosocial factors such as anxiety, social support, or expectations. Melzack and Wall's gate control theory was one of the first to maintain that pain was complex in that it not only had a sensory component but also affective,-cognitive, and behavioral components (Science 150(699):971-979, 1965). A key tenet of the gate control theory was that the brain could play a major role in modulating nociceptive signals at the spinal cord, through descending pathways from brain areas thought to be involved in affect, cognition, and behavior. The gate control theory also led to renewed interest in expanding pain treatments beyond traditional medical and surgical approaches to a wide array of-interventions that could alter pain by modifying sensation (e.g.,-transcutaneous nerve stimulation, massage), or affective (e.g., antianxiety and antidepressant medications), cognitive (e.g., cognitive therapy, distraction techniques), and behavioral processes (e.g., exercise, graded activation). © 2011 Springer Science+Business Media, LLC.

Authors
Somers, TJ; Moseley, GL; Keefe, FJ; Kothadia, SM
MLA Citation
Somers, TJ, Moseley, GL, Keefe, FJ, and Kothadia, SM. "Neuroimaging of pain: A psychosocial perspective." (December 1, 2011): 275-292. (Chapter)
Source
scopus
Publish Date
2011
Start Page
275
End Page
292
DOI
10.1007/978-1-4419-6373-4_17

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.

Authors
Wright, MA; Wren, AA; Somers, TJ; Goetz, MC; Fras, AM; Huh, BK; Rogers, LL; Keefe, FJ
MLA Citation
Wright, MA, Wren, AA, Somers, TJ, Goetz, MC, Fras, AM, Huh, BK, Rogers, LL, and Keefe, FJ. "Pain acceptance, hope, and optimism: relationships to pain and adjustment in patients with chronic musculoskeletal pain." J Pain 12.11 (November 2011): 1155-1162.
PMID
21820969
Source
pubmed
Published In
Journal of Pain
Volume
12
Issue
11
Publish Date
2011
Start Page
1155
End Page
1162
DOI
10.1016/j.jpain.2011.06.002

Psychosocial issues in cancer pain.

Cancer pain is a complex and multidimensional experience that affects and is affected by psychological and social factors. This article reviews recent research that points to a number of key psychosocial factors associated with pain, including psychological distress, coping, and social support, as well as the impact of socioeconomic factors on barriers to pain management. We also review recent research suggesting that psychosocial interventions, including education, coping-skills training, and hypnosis, may be useful adjuncts to medical management of pain. Clinical implications and recommendations for future research are discussed.

Authors
Porter, LS; Keefe, FJ
MLA Citation
Porter, LS, and Keefe, FJ. "Psychosocial issues in cancer pain." Curr Pain Headache Rep 15.4 (August 2011): 263-270. (Review)
PMID
21400251
Source
pubmed
Published In
Current Pain and Headache Reports
Volume
15
Issue
4
Publish Date
2011
Start Page
263
End Page
270
DOI
10.1007/s11916-011-0190-6

Proactive recruitment of cancer patients' social networks into a smoking cessation trial.

BACKGROUND: This report describes the characteristics associated with successful enrollment of smokers in the social networks (i.e., family and close friends) of patients with lung cancer into a smoking cessation intervention. METHODS: Lung cancer patients from four clinical sites were asked to complete a survey enumerating their family members and close friends who smoke, and provide permission to contact these potential participants. Family members and close friends identified as smokers were interviewed and offered participation in a smoking cessation intervention. Repeated measures logistic regression model examined characteristics associated with enrollment. RESULTS: A total of 1062 eligible lung cancer patients were identified and 516 patients consented and completed the survey. These patients identified 1325 potentially eligible family and close friends. Of these, 496 consented and enrolled in the smoking cessation program. Network enrollment was highest among patients who were white and had late-stage disease. Social network members enrolled were most likely to be female, a birth family, immediate family, or close friend, and live in close geographic proximity to the patient. CONCLUSIONS: Proactive recruitment of smokers in the social networks of lung cancer patients is challenging. In this study, the majority of family members and friends declined to participate. Enlisting immediate female family members and friends, who live close to the patient as agents to proactively recruit other network members into smoking cessation trials could be used to extend reach of cessation interventions to patients' social networks. Moreover, further consideration should be given to the appropriate timing of approaching network smokers to consider cessation.

Authors
Bastian, LA; Fish, LJ; Peterson, BL; Biddle, AK; Garst, J; Lyna, P; Molner, S; Bepler, G; Kelley, M; Keefe, FJ; McBride, CM
MLA Citation
Bastian, LA, Fish, LJ, Peterson, BL, Biddle, AK, Garst, J, Lyna, P, Molner, S, Bepler, G, Kelley, M, Keefe, FJ, and McBride, CM. "Proactive recruitment of cancer patients' social networks into a smoking cessation trial." Contemporary clinical trials 32.4 (July 2011): 498-504. (Academic Article)
PMID
21382509
Source
manual
Published In
Contemporary Clinical Trials
Volume
32
Issue
4
Publish Date
2011
Start Page
498
End Page
504
DOI
10.1016/j.cct.2011.03.006

Pain coping skills training for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty: a quasi-experimental study.

OBJECTIVES: To (1) describe a behavioral intervention designed for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty, and (2) use a quasi-experimental design to evaluate the potential efficacy of the intervention on pain severity, catastrophizing cognitions, and disability. DESIGN: Quasi-experimental nonequivalent control group design with a 2-month follow-up. SETTING: Two university-based orthopedic surgery departments. PARTICIPANTS: Adults (N=63) scheduled for knee replacement surgery who reported elevated levels of pain catastrophizing. Patients were recruited from 2 clinics and were assessed prior to surgery and 2 months after surgery. INTERVENTIONS: A group of 18 patients received a psychologist-directed pain coping skills training intervention comprising 8 sessions. The other group, a historical cohort of 45 patients, received usual care. MAIN OUTCOME MEASURES: Western Ontario and McMaster Universities Arthritis Index Pain and Disability scores, as well as scores on the Pain Catastrophizing Scale. RESULTS: Two months after surgery, the patients who received pain coping skills training reported significantly greater reductions in pain severity and catastrophizing, and greater improvements in function as compared to the usual care cohort. CONCLUSIONS: Pain catastrophizing is known to increase risk of poor outcome after knee arthroplasty. The findings provide preliminary evidence that the treatment may be highly efficacious for reducing pain, catastrophizing, and disability, in patients reporting elevated catastrophizing prior to knee arthroplasty. A randomized controlled trial is warranted to confirm these effects.

Authors
Riddle, DL; Keefe, FJ; Nay, WT; McKee, D; Attarian, DE; Jensen, MP
MLA Citation
Riddle, DL, Keefe, FJ, Nay, WT, McKee, D, Attarian, DE, and Jensen, MP. "Pain coping skills training for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty: a quasi-experimental study." Arch Phys Med Rehabil 92.6 (June 2011): 859-865.
PMID
21530943
Source
pubmed
Published In
Archives of Physical Medicine and Rehabilitation
Volume
92
Issue
6
Publish Date
2011
Start Page
859
End Page
865
DOI
10.1016/j.apmr.2011.01.003

Effects of coping skills training and sertraline in patients with non-cardiac chest pain: a randomized controlled study.

Non-cardiac chest pain (NCCP) is a common and distressing condition. Prior studies suggest that psychotropic medication or pain coping skills training (CST) may benefit NCCP patients. To our knowledge, no clinical trials have examined the separate and combined effects of CST and psychotropic medication in the management of NCCP. This randomized clinical trial examined the separate and combined effects of CST and antidepressant medication (sertraline) in participants with non-cardiac chest pain. A sample of individuals diagnosed with NCCP was randomly assigned to one of four treatments: (1) CST plus sertraline (CST+sertraline), (2) CST plus placebo (CST+placebo), (3) sertraline alone, or (4) placebo alone. Assessments of pain intensity, pain unpleasantness, anxiety, pain catastrophizing, depression, and physical disability were collected prior to treatment, and at 10- and 34-weeks following randomization. Data analyses revealed that CST and sertraline either alone or in combination significantly reduced pain intensity and pain unpleasantness. The combination of CST plus sertraline may have the greatest promise in that, when compared to placebo alone, it not only significantly reduced pain but also pain catastrophizing and anxiety. Overall, these findings support the importance of further research on the effects of CST and sertraline for non-cardiac chest pain.

Authors
Keefe, FJ; Shelby, RA; Somers, TJ; Varia, I; Blazing, M; Waters, SJ; McKee, D; Silva, S; She, L; Blumenthal, JA; O'Connor, J; Knowles, V; Johnson, P; Bradley, L
MLA Citation
Keefe, FJ, Shelby, RA, Somers, TJ, Varia, I, Blazing, M, Waters, SJ, McKee, D, Silva, S, She, L, Blumenthal, JA, O'Connor, J, Knowles, V, Johnson, P, and Bradley, L. "Effects of coping skills training and sertraline in patients with non-cardiac chest pain: a randomized controlled study." Pain 152.4 (April 2011): 730-741.
PMID
21324590
Source
pubmed
Published In
Pain
Volume
152
Issue
4
Publish Date
2011
Start Page
730
End Page
741
DOI
10.1016/j.pain.2010.08.040

Sexual functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS®).

OBJECTIVE: Cancer and treatments for cancer affect specific aspects of sexual functioning and intimacy; however, limited qualitative work has been done in diverse cancer populations. As part of an effort to improve measurement of self-reported sexual functioning, we explored the scope and importance of sexual functioning and intimacy to patients across cancer sites and along the continuum of care. METHODS: We conducted 16 diagnosis- and sex-specific focus groups with patients recruited from the Duke University tumor registry and oncology/hematology clinics (N=109). A trained note taker produced field notes summarizing the discussions. An independent auditor verified field notes against written transcripts. The content of the discussions was analyzed for major themes by two independent coders. RESULTS: Across all cancers, the most commonly discussed cancer- or treatment-related effects on sexual functioning and intimacy were fatigue, treatment-related hair loss, weight gain and organ loss or scarring. Additional barriers were unique to particular diagnoses, such as shortness of breath in lung cancer, gastrointestinal problems in colorectal cancers and incontinence in prostate cancer. Sexual functioning and intimacy were considered important to quality of life. While most effects of cancer were considered negative, many participants identified improvements to intimacy after cancer. CONCLUSION: Overall evaluations of satisfaction with sex life did not always correspond to specific aspects of functioning (e.g. erectile dysfunction), presenting a challenge to researchers aiming to measure sexual functioning as an outcome. Health-care providers should not assume that level of sexual impairment determines sexual satisfaction and should explore cancer patients' sexual concerns directly.

Authors
Flynn, KE; Jeffery, DD; Keefe, FJ; Porter, LS; Shelby, RA; Fawzy, MR; Gosselin, TK; Reeve, BB; Weinfurt, KP
MLA Citation
Flynn, KE, Jeffery, DD, Keefe, FJ, Porter, LS, Shelby, RA, Fawzy, MR, Gosselin, TK, Reeve, BB, and Weinfurt, KP. "Sexual functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS®)." Psychooncology 20.4 (April 2011): 378-386.
PMID
20878833
Source
pubmed
Published In
Psycho-Oncology
Volume
20
Issue
4
Publish Date
2011
Start Page
378
End Page
386
DOI
10.1002/pon.1738

Behavioral medicine: a voyage to the future.

This paper discusses trends and future directions in behavioral medicine. It is divided into three sections. The first briefly reviews key developments in the history of behavioral medicine. The second section highlights trends and future directions in pain research and practice as a way of illustrating future directions for behavioral medicine. Consistent with the biopsychosocial model of pain, this section focuses on trends and future directions in three key areas: biological, psychological, and social. The third section describes recent Society of Behavioral Medicine initiatives designed to address some of the key challenges facing our field as we prepare for the future.

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Behavioral medicine: a voyage to the future." Ann Behav Med 41.2 (April 2011): 141-151.
PMID
21264691
Source
pubmed
Published In
Annals of Behavioral Medicine
Volume
41
Issue
2
Publish Date
2011
Start Page
141
End Page
151
DOI
10.1007/s12160-010-9239-8

Yoga for persistent pain: new findings and directions for an ancient practice.

Authors
Wren, AA; Wright, MA; Carson, JW; Keefe, FJ
MLA Citation
Wren, AA, Wright, MA, Carson, JW, and Keefe, FJ. "Yoga for persistent pain: new findings and directions for an ancient practice." Pain 152.3 (March 2011): 477-480. (Review)
PMID
21247696
Source
pubmed
Published In
Pain
Volume
152
Issue
3
Publish Date
2011
Start Page
477
End Page
480
DOI
10.1016/j.pain.2010.11.017

Caregiver-assisted coping skills training for lung cancer: results of a randomized clinical trial.

CONTEXT: Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms, including pain, fatigue, shortness of breath, and psychological distress. Caregivers and patients are adversely affected. However, previous studies of coping skills training (CST) interventions have not been tested in patients with lung cancer nor have systematically included caregivers. OBJECTIVES: This study tested the efficacy of a caregiver-assisted CST protocol in a sample of patients with lung cancer. METHODS: Two hundred thirty-three lung cancer patients and their caregivers were randomly assigned to receive 14 telephone-based sessions of either caregiver-assisted CST or education/support involving the caregiver. Patients completed measures assessing pain, psychological distress, quality of life (QOL), and self-efficacy for symptom management; caregivers completed measures assessing psychological distress, caregiver strain, and self-efficacy for helping the patient manage symptoms. RESULTS: Patients in both treatment conditions showed improvements in pain, depression, QOL, and self-efficacy, and caregivers in both conditions showed improvements in anxiety and self-efficacy from baseline to four-month follow-up. Results of exploratory analyses suggested that the CST intervention was more beneficial to patients/caregivers with Stage II and III cancers, whereas the education/support intervention was more beneficial to patients/caregivers with Stage I cancer. CONCLUSION: Taken together with the broader literature in this area, results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients. Suggestions for future studies include the use of three-group designs (e.g., comparing two active interventions with a standard-care control) and examining mechanisms of change.

Authors
Porter, LS; Keefe, FJ; Garst, J; Baucom, DH; McBride, CM; McKee, DC; Sutton, L; Carson, K; Knowles, V; Rumble, M; Scipio, C
MLA Citation
Porter, LS, Keefe, FJ, Garst, J, Baucom, DH, McBride, CM, McKee, DC, Sutton, L, Carson, K, Knowles, V, Rumble, M, and Scipio, C. "Caregiver-assisted coping skills training for lung cancer: results of a randomized clinical trial." J Pain Symptom Manage 41.1 (January 2011): 1-13.
PMID
20832982
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
41
Issue
1
Publish Date
2011
Start Page
1
End Page
13
DOI
10.1016/j.jpainsymman.2010.04.014

Understanding chronic pain in older adults: abdominal fat is where it is at.

Authors
Somers, TJ; Wren, AA; Keefe, FJ
MLA Citation
Somers, TJ, Wren, AA, and Keefe, FJ. "Understanding chronic pain in older adults: abdominal fat is where it is at." Pain 152.1 (January 2011): 8-9.
PMID
20952130
Source
pubmed
Published In
Pain
Volume
152
Issue
1
Publish Date
2011
Start Page
8
End Page
9
DOI
10.1016/j.pain.2010.09.022

Supporting implementation of evidence-based behavioral interventions: The role of data liquidity in facilitating translational behavioral medicine

The advancement of translational behavioral medicine will require that we discover new methods of managing large volumes of data from disparate sources such as disease surveillance systems, public health systems, and health information systems containing patient-centered data informed by behavioral and social sciences. The term "liquidity," when applied to data, refers to its availability and free flow throughout human/computer interactions. In seeking to achieve liquidity, the focus is not on creating a single, comprehensive database or set of coordinated datasets, nor is it solely on developing the electronic health record as the "one-stop shopping" source of health-related data. Rather, attention is on ensuring the availability of secure data through the various methods of collecting and storing data currently existent or under development-so that these components of the health information infrastructure together support a liquid data system. The value of accessible, interoperable, high-volume, reliable, secure, and contextually appropriate data is becoming apparent in many areas of the healthcare system, and health information liquidity is currently viewed as an important component of a patient-centered healthcare system. The translation from research interventions to behavioral and psychosocial indicators challenges the designers of healthcare systems to include this new set of data in the correct context. With the intention of advancing translational behavioral medicine at the local level, "on the ground" in the clinical office and research institution, this commentary discusses data liquidity from the patient's and clinician's perspective, requirements for a liquid healthcare data system, and the ways in which data liquidity can support translational behavioral medicine. © 2011 Society of Behavioral Medicine.

Authors
Abernethy, AP; Wheeler, JL; Courtney, PK; Keefe, FJ
MLA Citation
Abernethy, AP, Wheeler, JL, Courtney, PK, and Keefe, FJ. "Supporting implementation of evidence-based behavioral interventions: The role of data liquidity in facilitating translational behavioral medicine." Translational Behavioral Medicine 1.1 (2011): 45-52.
PMID
24073032
Source
scival
Published In
Translational Behavioral Medicine
Volume
1
Issue
1
Publish Date
2011
Start Page
45
End Page
52
DOI
10.1007/s13142-011-0024-4

Predictive relationships between chronic pain and negative emotions: A 4-month daily process study using Therapeutic Interactive Voice Response (TIVR)

This article examines temporal relationships between negative emotions and pain in a cohort of 33 patients with chronic musculoskeletal pain enrolled in a telephone-based relapse prevention program (Therapeutic Interactive Voice Response [TIVR]), after 11 weeks of group cognitive behavioral therapy (CBT). Patients were asked to make daily reports to the TIVR system for 4 months after CBT. Patients' daily reports were analyzed with path analysis to examine temporal relationships between 3 emotion variables (anger, sadness, and stress) and 2 pain variables (pain and pain control). As expected, same-day correlations were significant between emotion variables and both pain and pain control. The lagged associations revealed unidirectional relationships between pain and next-day emotions: increased pain predicted higher reports of sadness the following day (P <.05). Conversely, increased pain control predicted decreased sadness and anger the following day (P <.05). Unlike some previous studies, this study did not reveal that an increase of negative emotions predicted increased next-day pain. We speculate that CBT treatment followed by the relapse prevention program teaches patients how to modulate negative emotions such that they no longer have a negative impact on next-day pain perception. The clinical implications of our findings are discussed. © 2011 Elsevier Inc.

Authors
Naylor, MR; Krauthamer, GM; Naud, S; Keefe, FJ; Helzer, JE
MLA Citation
Naylor, MR, Krauthamer, GM, Naud, S, Keefe, FJ, and Helzer, JE. "Predictive relationships between chronic pain and negative emotions: A 4-month daily process study using Therapeutic Interactive Voice Response (TIVR)." Comprehensive Psychiatry 52.6 (2011): 731-736.
PMID
21349510
Source
scival
Published In
Comprehensive Psychiatry
Volume
52
Issue
6
Publish Date
2011
Start Page
731
End Page
736
DOI
10.1016/j.comppsych.2010.11.008

Pain and emotion: A biopsychosocial review of recent research

Objective and Method: Research on emotion and pain has burgeoned. We review the last decade's literature, focusing on links between emotional processes and persistent pain. Results: Neurobiological research documents the neural processes that distinguish affective from sensory pain dimensions, link emotion and pain, and generate central nervous system pain sensitization. Psychological research demonstrates that greater pain is related to emotional stress and limited emotional awareness, expression, and processing. Social research shows the potential importance of emotional communication, empathy, attachment, and rejection. Conclusions: Emotions are integral to the conceptualization, assessment, and treatment of persistent pain. Research should clarify when to eliminate or attenuate negative emotions, and when to access, experience, and express them. Theory and practice should integrate emotion into cognitive-behavioral models of persistent pain. © 2011 Wiley Periodicals, Inc.

Authors
Lumley, MA; Cohen, JL; Borszcz, GS; Cano, A; Radcliffe, AM; Porter, LS; Schubiner, H; Keefe, FJ
MLA Citation
Lumley, MA, Cohen, JL, Borszcz, GS, Cano, A, Radcliffe, AM, Porter, LS, Schubiner, H, and Keefe, FJ. "Pain and emotion: A biopsychosocial review of recent research." Journal of Clinical Psychology 67.9 (2011): 942-968.
PMID
21647882
Source
scival
Published In
Journal of Clinical Psychology
Volume
67
Issue
9
Publish Date
2011
Start Page
942
End Page
968
DOI
10.1002/jclp.20816

Treatment expectation for pain coping skills training: Relationship to osteoarthritis patients baseline psychosocial characteristics

Objectives: This study examined predictors of treatment expectation among osteoarthritis (OA) patients in a multisite clinical trial of pain coping skills training (CST). Methods: Patients (N=171) completed a pretreatment assessment battery that asked questions about treatment expectations, pain coping variables, pain, physical function, psychological distress, quality of life, and depression as well as background demographic and medical variables. Results: Regression analyses indicated that several variables accounted for 21% of the variance in treatment expectations (P<0.0001). Patients who were classified as adaptive copers, reported higher self-efficacy and social interaction, had higher quality of life, and who had lower levels of affective distress and depression had more positive expectations about engaging in pain CST. Variables that were not associated with treatment expectation were level of pain and physical dysfunction, duration of disease, and disability status as well as demographic variables. Discussion: Although many OA patients will approach pain CST with positive expectations, others have lower expectations. This study suggests that a multidimensional assessment of OA patients with chronic pain can identify those who have higher expectations versus lower expectations. The results suggest that patients who are psychologically distressed are less optimistic about engaging in treatment and that these patients, in particular, may benefit from and need pretreatment motivational interviewing to enhance their uptake of pain coping skills. Copyright © 2011 by Lippincott Williams & Wilkins.

Authors
Broderick, JE; Junghaenel, DU; Schneider, S; Bruckenthal, P; Keefe, FJ
MLA Citation
Broderick, JE, Junghaenel, DU, Schneider, S, Bruckenthal, P, and Keefe, FJ. "Treatment expectation for pain coping skills training: Relationship to osteoarthritis patients baseline psychosocial characteristics." Clinical Journal of Pain 27.4 (2011): 315-322.
PMID
21178591
Source
scival
Published In
Clinical Journal of Pain
Volume
27
Issue
4
Publish Date
2011
Start Page
315
End Page
322
DOI
10.1097/AJP.0b013e3182048549

Non-verbal cues to osteoarthritic knee and/or hip pain in elders

Behavioral cues are believed to be useful to identify pain among elders who may be experiencing pain but unable to express it. To examine this assumption, we recruited 192 elders who could verbally express pain to determine whether regression models combining behavioral cues (motor and gait patterns) predicted verbal pain reports. In the best model, age (p<.01) and subscales that measured guarding (p<.001) and joint flexion (p<.01) motor patterns were significant predictors of verbal pain reports. The receiver operating characteristic curve indicated that the best cutoff for predictive probability was 40-44%, with a fair to good C statistic of .78 (SD=.04). With a 40% cutoff, sensitivity and specificity were 71.6% and 71.0%, respectively. The investigators concluded that the final model could serve as a building block for the development of a tool using behavioral cues to identify elders' pain. © 2011 Wiley Periodicals, Inc.

Authors
Tsai, P-F; Kuo, Y-F; Beck, C; Richards, K; Means, KM; Pate, BL; Keefe, FJ
MLA Citation
Tsai, P-F, Kuo, Y-F, Beck, C, Richards, K, Means, KM, Pate, BL, and Keefe, FJ. "Non-verbal cues to osteoarthritic knee and/or hip pain in elders." Research in Nursing and Health 34.3 (2011): 218-227.
PMID
21425277
Source
scival
Published In
Research in Nursing & Health
Volume
34
Issue
3
Publish Date
2011
Start Page
218
End Page
227
DOI
10.1002/nur.20432

Repressive coping style: Relationships with depression, pain, and pain coping strategies in lung cancer out patients

Researchers have shown that coping style is related to pain and adjustment in people with chronic illness. This study was the first to examine how coping style related to pain, pain coping strategies, and depression in lung cancer outpatients. We conducted a comparative, secondary data analysis of 107 lung cancer patients (73% male, mean age 61.4 ± 10.43 years, 88% Caucasian). As in prior studies, we classified patients into four coping style groups based on Marlowe-Crowne Social Desirability Scale and trait anxiety scores. The coping style groups were low-anxious (n = 25); high-anxious (n = 31); defensive high-anxious (n = 21); and repressive (n = 30). Compared to other coping style groups, the repressive group reported statistically significant lower mean scores for pain quality, pain catastrophizing, and depression. Assessing coping style by measuring personal characteristics such as social desirability and trait anxiety may help clinicians to identify vulnerable individuals with lung cancer who may be candidates for early and timely intervention efforts to enhance adjustment to pain. © 2010 Elsevier Ireland Ltd.

Authors
Prasertsri, N; Holden, J; Keefe, FJ; Wilkie, DJ
MLA Citation
Prasertsri, N, Holden, J, Keefe, FJ, and Wilkie, DJ. "Repressive coping style: Relationships with depression, pain, and pain coping strategies in lung cancer out patients." Lung Cancer 71.2 (2011): 235-240.
PMID
20557973
Source
scival
Published In
Lung Cancer
Volume
71
Issue
2
Publish Date
2011
Start Page
235
End Page
240
DOI
10.1016/j.lungcan.2010.05.009

Stress Buffering Effects of Daily Spousal Support on Women's Daily Emotional and Physical Experiences in the Context of Breast Cancer Concerns

Objective: This study examined whether the relationship between daily spousal support and daily psychological and physical outcomes varied as a function of level of breast cancer related concern (stress buffering model). Design: Ninety-five women with early stage breast cancer completed daily reports of emotional and physical experiences and satisfaction with spousal support for 30 days. Women also rated problems dealing with three types of cancer specific concerns: emotional, physical, and social. Main outcome measures: Women's positive and negative affect and cancer related pain and fatigue. Results: Multilevel analyses supported a stress buffering effect for social concerns and a reverse stress buffering effect for emotional and physical concerns. Conclusion: Daily spousal support appears to be an important contributor to the daily emotional and physical wellbeing of women with breast cancer. Contrary to the tenets of the stress buffering model, these data suggest that the buffering effect of spousal support is attenuated when breast cancer related emotional and physical concerns reach high levels. © 2011 American Psychological Association.

Authors
Gremore, TM; Baucom, DH; Porter, LS; Kirby, JS; Atkins, DC; Keefe, FJ
MLA Citation
Gremore, TM, Baucom, DH, Porter, LS, Kirby, JS, Atkins, DC, and Keefe, FJ. "Stress Buffering Effects of Daily Spousal Support on Women's Daily Emotional and Physical Experiences in the Context of Breast Cancer Concerns." Health Psychology 30.1 (2011): 20-30.
PMID
21299291
Source
scival
Published In
Health Psychology
Volume
30
Issue
1
Publish Date
2011
Start Page
20
End Page
30
DOI
10.1037/a0021798

Chronic pain and adherence

Chronic pain of non-malignant etiology is a significant problem. Chronic non-malignant pain is typically defined as pain that persists for 3 months or longer and that is non-life threatening [1, 2]. Among the most common chronic pain conditions are chronic back pain, migraine headaches, and tension headaches. Chronic pain is very common. In the United States, 17% of patients seen in primary care report chronic pain [3] , and chronic pain accounts for almost 80% of all physician visits [4]. A review of 15 epidemiologic studies found that the prevalence of chronic pain ranges from 2 to 40% in the adult population, with a median point prevalence of 15% [5] . The personal and economic costs of chronic pain are substantial. A study of primary care patients found that 13% of headache patients and 18% of back pain patients were unable to maintain full-time work over a 3-year period due to pain [6]. Chronic pain is often accompanied by substantial decreases in physical functioning, disruption of social and family roles, and psychological distress [4] . © 2010 Springer Science+Business Media, LLC.

Authors
Shelby, RA; Keefe, FJ
MLA Citation
Shelby, RA, and Keefe, FJ. "Chronic pain and adherence." (December 1, 2010): 179-214. (Chapter)
Source
scopus
Publish Date
2010
Start Page
179
End Page
214
DOI
10.1007/978-1-4419-5866-2_8

Sleep-wake functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS(®)).

OBJECTIVE: Cancer and its treatments disturb sleep-wake functioning; however, there is little information available on the characteristics and consequences of sleep problems associated with cancer. As part of an effort to improve measurement of sleep-wake functioning, we explored the scope of difficulties with sleep in a diverse group of patients diagnosed with cancer. METHODS: We conducted 10 focus groups with patients recruited from the Duke University tumor registry and oncology/hematology clinics. Separate groups were held with patients scheduled to begin or currently undergoing treatment for breast, prostate, lung, colorectal, hematological, and other cancer types and with patients who were in posttreatment follow-up. The content of the focus group discussions was transcribed and analyzed for major themes by independent coders. RESULTS: Participants not only reported causes of sleep disturbance common in other populations, such as pain and restless legs, but they also reported causes that may be unique to cancer populations, including abnormal dreams, anxiety about cancer diagnosis and recurrence, night sweats, and problems with sleep positioning. Many participants felt that sleep problems reduced their productivity, concentration, social interactions, and overall quality of life. Many also shared beliefs about the increased importance of sleep when fighting cancer. CONCLUSIONS: The findings underscore the need for interventions that minimize the negative impact of cancer and its treatments on sleep. This study will inform efforts now underway to develop a patient-reported measure of sleep-wake functioning that reflects the breadth of concepts considered important by patients with cancer.

Authors
Flynn, KE; Shelby, RA; Mitchell, SA; Fawzy, MR; Hardy, NC; Husain, AM; Keefe, FJ; Krystal, AD; Porter, LS; Reeve, BB; Weinfurt, KP
MLA Citation
Flynn, KE, Shelby, RA, Mitchell, SA, Fawzy, MR, Hardy, NC, Husain, AM, Keefe, FJ, Krystal, AD, Porter, LS, Reeve, BB, and Weinfurt, KP. "Sleep-wake functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS(®))." Psychooncology 19.10 (October 2010): 1086-1093.
PMID
20013938
Source
pubmed
Published In
Psycho-Oncology
Volume
19
Issue
10
Publish Date
2010
Start Page
1086
End Page
1093
DOI
10.1002/pon.1664

Neurosteroids and self-reported pain in veterans who served in the U.S. Military after September 11, 2001.

OBJECTIVE: Nearly half of Operation Enduring Freedom/Operation Iraqi Freedom veterans experience continued pain post-deployment. Several investigations report analgesic effects of allopregnanolone and other neurosteroids in animal models, but few data are currently available focusing on neurosteroids in clinical populations. Allopregnanolone positively modulates GABA(A) receptors and demonstrates pronounced analgesic and anxiolytic effects in rodents, yet studies examining the relationship between pain and allopregnanolone in humans are limited. We thus hypothesized that endogenous allopregnanolone and other neurosteroid levels may be negatively correlated with self-reported pain symptoms in humans. DESIGN: We determined serum neurosteroid levels by gas chromatography/mass spectrometry (allopregnanolone, pregnenolone) or radioimmunoassay (dehydroepiandrosterone [DHEA], progesterone, DHEA sulfate [DHEAS]) in 90 male veterans who served in the U.S. military after September 11, 2001. Self-reported pain symptoms were assessed in four areas (low back pain, chest pain, muscle soreness, headache). Stepwise linear regression analyses were conducted to investigate the relationship between pain assessments and neurosteroids, with the inclusion of smoking, alcohol use, age, and history of traumatic brain injury as covariates. SETTING: Durham VA Medical Center. RESULTS: Allopregnanolone levels were inversely associated with low back pain (P=0.044) and chest pain (P=0.013), and DHEA levels were inversely associated with muscle soreness (P=0.024). DHEAS levels were positively associated with chest pain (P=0.001). Additionally, there was a positive association between traumatic brain injury and muscle soreness (P=0.002). CONCLUSIONS: Neurosteroids may be relevant to the pathophysiology of self-reported pain symptoms in this veteran cohort, and could represent future pharmacological targets for pain disorders.

Authors
Kilts, JD; Tupler, LA; Keefe, FJ; Payne, VM; Hamer, RM; Naylor, JC; Calnaido, RP; Morey, RA; Strauss, JL; Parke, G; Massing, MW; Youssef, NA; Shampine, LJ; tVeterans Affairs Mid-Atlantic Mental Illness, Research, Education and Clinical Center Workgroup, ; Marx, CE
MLA Citation
Kilts, JD, Tupler, LA, Keefe, FJ, Payne, VM, Hamer, RM, Naylor, JC, Calnaido, RP, Morey, RA, Strauss, JL, Parke, G, Massing, MW, Youssef, NA, Shampine, LJ, tVeterans Affairs Mid-Atlantic Mental Illness, Research, Education and Clinical Center Workgroup, , and Marx, CE. "Neurosteroids and self-reported pain in veterans who served in the U.S. Military after September 11, 2001." Pain Med 11.10 (October 2010): 1469-1476.
PMID
20735755
Source
pubmed
Published In
Pain Medicine
Volume
11
Issue
10
Publish Date
2010
Start Page
1469
End Page
1476
DOI
10.1111/j.1526-4637.2010.00927.x

Sexual concerns in cancer patients: a comparison of GI and breast cancer patients.

PURPOSE: Although sexual concerns have been examined in breast cancer (BC), these concerns remain understudied and undertreated for patients with gastrointestinal (GI) cancer. Objectives were to: (1) assess sexual concerns in GI cancer patients compared with breast cancer patients; (2) examine whether sexual concerns are stable over time in GI and breast cancer patients; and (3) evaluate whether sexual concerns in GI and breast cancer are significantly associated with quality of life, symptom severity, and disease interference, and whether these associations change over time. METHODS: Data were collected from GI and breast cancer patients during four outpatient clinic visits over 6 months. Measures included sexual concerns (reduced sexual enjoyment, interest, or performance), quality of life (FACT-G), symptom severity, disease interference (MD Anderson Symptom Inventory), and disease-related distress (NCCN Distress Scale). Linear mixed model analyses were conducted. RESULTS: Sexual concerns were common in both samples, with 57% of GI cancer patients and 53% of breast cancer patients reporting at least mild sexual concerns. Sexual concerns were stable over time and were significantly associated with lower levels of functioning in multiple domains (e.g., quality of life, symptom severity, disease interference, and disease-related distress), irrespective of length of time since diagnosis. Cancer type (GI/breast cancer) was not a moderator of this relationship. CONCLUSIONS: Self-reported sexual concerns were common, stable, and related significantly to quality of life, symptom severity, disease interference, and disease-related distress for both GI and breast cancer patients. Limitations and implications for future research are discussed.

Authors
Reese, JB; Shelby, RA; Keefe, FJ; Porter, LS; Abernethy, AP
MLA Citation
Reese, JB, Shelby, RA, Keefe, FJ, Porter, LS, and Abernethy, AP. "Sexual concerns in cancer patients: a comparison of GI and breast cancer patients." Support Care Cancer 18.9 (September 2010): 1179-1189.
PMID
19777269
Source
pubmed
Published In
Supportive Care in Cancer
Volume
18
Issue
9
Publish Date
2010
Start Page
1179
End Page
1189
DOI
10.1007/s00520-009-0738-8

Hope in the context of lung cancer: relationships of hope to symptoms and psychological distress.

CONTEXT: Hope may be important in explaining the variability in how patients adjust to lung cancer. OBJECTIVES: The aim of this study was to examine how hope, as conceptualized by Snyder et al., is associated with multiple indices of adjustment to lung cancer. This theoretical model of hope suggests that people with high levels of hope are able to think about the pathways to goals (pathways) and feel confident that they can pursue those pathways to reach their goals (agency). METHODS: We hypothesized that higher levels of hope, as measured by Snyder et al.'s hope scale, would be related to lower levels of pain and other lung cancer symptoms (i.e., fatigue and cough) and lower psychological distress (i.e., depression). Participants in this study included patients with a diagnosis of lung cancer (n=51). All participants provided demographic and medical information and completed measures of hope, lung cancer symptoms, and psychological distress. RESULTS: Data analyses found that hope was inversely associated with major symptoms of cancer (i.e., pain, fatigue, and cough) and psychological distress (i.e., depression), even after accounting for important demographic and medical variables (i.e., age and cancer stage). CONCLUSION: The findings of this cross-sectional study highlight the potential importance of hope in understanding adjustment to lung cancer. Future longitudinal research could help reveal how hope and adjustment interact over the course of cancer survivorship.

Authors
Berendes, D; Keefe, FJ; Somers, TJ; Kothadia, SM; Porter, LS; Cheavens, JS
MLA Citation
Berendes, D, Keefe, FJ, Somers, TJ, Kothadia, SM, Porter, LS, and Cheavens, JS. "Hope in the context of lung cancer: relationships of hope to symptoms and psychological distress." J Pain Symptom Manage 40.2 (August 2010): 174-182.
PMID
20579840
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
40
Issue
2
Publish Date
2010
Start Page
174
End Page
182
DOI
10.1016/j.jpainsymman.2010.01.014

Coping with sexual concerns after cancer: the use of flexible coping.

INTRODUCTION: Although cancer treatment commonly has a negative impact on sexual functioning, sexual concerns are still largely undertreated in routine cancer care. The medical model that guides current approaches to sexual care in cancer does not adequately address key patient needs. METHODS: In this paper, we describe a broader approach to understanding and treating sexual concerns in cancer that focuses on the construct of flexibility in behavioral and cognitive coping strategies. We previously presented this model in the context of general medical conditions. We now adapt this model to the context of cancer, focusing on issues related to the benefits of flexible coping, interventions that shift perspectives following cancer, and on coping as a couple. RESULTS: We argue that coping flexibly with sexual concerns is likely to lead to improvements in mood and sexual and relationship satisfaction. We present clinical applications of the flexible coping model, including suggestions for assessment and sexual concerns and methods of introducing flexible coping into both the content and process of clinical interactions with patients. DISCUSSION: Finally, we discuss areas for future research, including the development of a validated instrument, the use of electronic methods of assessment, and intervention trials directly addressing flexibility in coping.

Authors
Reese, JB; Keefe, FJ; Somers, TJ; Abernethy, AP
MLA Citation
Reese, JB, Keefe, FJ, Somers, TJ, and Abernethy, AP. "Coping with sexual concerns after cancer: the use of flexible coping." Support Care Cancer 18.7 (July 2010): 785-800. (Review)
PMID
20165890
Source
pubmed
Published In
Supportive Care in Cancer
Volume
18
Issue
7
Publish Date
2010
Start Page
785
End Page
800
DOI
10.1007/s00520-010-0819-8

Comparison of pain measures among patients with osteoarthritis.

UNLABELLED: This study compared recalled average pain, assessed at the end of the day, with the average of real-time pain ratings recorded throughout the day among patients with osteoarthritis (OA). Participants (N = 157) with hand, hip, or knee OA completed electronic pain diaries on 1 weekend day and 1 weekday. Diaries included at least 7 pain ratings per day, immediately after waking and every 2 hours following, using a visual analog scale (VAS) scored as 1 to 100 (scores not seen by participants). At the end of each diary day, participants rated their average pain that day on the same VAS. Pearson correlations examined associations between recalled average pain and the average of real-time pain ratings that day. Mixed models, including interaction terms, examined whether associations between recalled and actual average pain ratings differed according to the following patient characteristics: joint site, age, race, gender, study enrollment site, and pain catastrophizing. Correlations between recalled and actual average pain ratings were r = .88 for weekdays and r = .86 for weekends (P < .0001). In mixed models, there were no significant interaction terms for any patient characteristics. In summary, patients with OA accurately recalled their average pain over a 1-day period, and this did not differ according to any patient characteristics examined. PERSPECTIVE: This study showed that patients with OA accurately recalled their average pain over a single-day period, and this did not differ according to patient characteristics. Results of this study indicate that end-of-day recall is a practical and valid method for assessing patients' average pain during a day.

Authors
Allen, KD; Coffman, CJ; Golightly, YM; Stechuchak, KM; Voils, CI; Keefe, FJ
MLA Citation
Allen, KD, Coffman, CJ, Golightly, YM, Stechuchak, KM, Voils, CI, and Keefe, FJ. "Comparison of pain measures among patients with osteoarthritis." J Pain 11.6 (June 2010): 522-527.
PMID
20096640
Source
pubmed
Published In
Journal of Pain
Volume
11
Issue
6
Publish Date
2010
Start Page
522
End Page
527
DOI
10.1016/j.jpain.2009.09.007

Disease severity and domain-specific arthritis self-efficacy: relationships to pain and functioning in patients with rheumatoid arthritis.

OBJECTIVE: To examine the degree to which disease severity and domains of self-efficacy (pain, function, and other symptoms) explain pain and functioning in rheumatoid arthritis (RA) patients. METHODS: Patients (n = 263) completed the Arthritis Impact Measurement Scales 2 to assess pain and functioning (physical, affective, and social), the Arthritis Self-Efficacy Scale to assess 3 self-efficacy domains (pain, physical function, and other). Disease severity was assessed with C-reactive protein level, physician's rating, and abnormal joint count. Structural equation modeling was used to examine 3 hypotheses: does disease severity have a direct relationship with pain and each area of functioning, does disease severity have a direct relationship with each arthritis self-efficacy domain, and do the self-efficacy domains mediate the relationship between disease severity and RA pain and each area of functioning. RESULTS: Disease severity was related to pain, physical functioning, and each self-efficacy domain (beta = 0.28-0.56, P < 0.001). Each self-efficacy domain was related to its respective domain of functioning (e.g., self-efficacy for pain was related to pain; beta = 0.36-0.54, P < 0.001). Self-efficacy mediated the relationship between disease severity and pain and functioning (beta = 0.12-0.19, P < 0.001). Self-efficacy for pain control and to perform functional tasks accounted for 32-42% of disease severity's total effect on their respective outcomes (e.g., self-efficacy for pain control accounted for 32% of disease severity's total effect on pain). Variance accounted for by the total model was 52% for pain, 53% for physical functioning, and 44% for affective and social functioning. CONCLUSION: Disease severity and self-efficacy both impact RA functioning, and intervening in these areas may lead to better outcomes.

Authors
Somers, TJ; Shelby, RA; Keefe, FJ; Godiwala, N; Lumley, MA; Mosley-Williams, A; Rice, JR; Caldwell, D
MLA Citation
Somers, TJ, Shelby, RA, Keefe, FJ, Godiwala, N, Lumley, MA, Mosley-Williams, A, Rice, JR, and Caldwell, D. "Disease severity and domain-specific arthritis self-efficacy: relationships to pain and functioning in patients with rheumatoid arthritis." Arthritis Care Res (Hoboken) 62.6 (June 2010): 848-856.
PMID
20535796
Source
pubmed
Published In
Arthritis Care and Research
Volume
62
Issue
6
Publish Date
2010
Start Page
848
End Page
856
DOI
10.1002/acr.20127

Catastrophizing and pain coping: moving forward.

Authors
Keefe, FJ; Shelby, RA; Somers, TJ
MLA Citation
Keefe, FJ, Shelby, RA, and Somers, TJ. "Catastrophizing and pain coping: moving forward." Pain 149.2 (May 2010): 165-166.
PMID
20211526
Source
pubmed
Published In
Pain
Volume
149
Issue
2
Publish Date
2010
Start Page
165
End Page
166
DOI
10.1016/j.pain.2010.02.030

Psychologic Interventions for Cancer Pain

Authors
Keefe, FJ; Somers, TJ; Abernethy, A
MLA Citation
Keefe, FJ, Somers, TJ, and Abernethy, A. "Psychologic Interventions for Cancer Pain." (April 14, 2010): 337-347. (Chapter)
Source
scopus
Publish Date
2010
Start Page
337
End Page
347
DOI
10.1002/9781444314380.ch26

Psychological approaches to understanding and treating arthritis pain.

Arthritis pain has traditionally been evaluated from a biomedical perspective, but there is increasing evidence that psychological factors have an important role in patients' adjustment to arthritis pain. The evolution of pain theories has led to the development of models, such as the cognitive-behavioral model, which recognize the potential involvement of psychological factors in pain. Emotional, cognitive, behavioral and social context variables are useful in understanding pain in patients with arthritis, and have led to the development of psychological approaches for treating arthritis pain. These include pain coping skills training, interventions that include patients' partners, and emotional disclosure strategies.

Authors
Keefe, FJ; Somers, TJ
MLA Citation
Keefe, FJ, and Somers, TJ. "Psychological approaches to understanding and treating arthritis pain." Nat Rev Rheumatol 6.4 (April 2010): 210-216. (Review)
PMID
20357790
Source
pubmed
Published In
Nature Reviews Rheumatology
Volume
6
Issue
4
Publish Date
2010
Start Page
210
End Page
216
DOI
10.1038/nrrheum.2010.22

Racial differences in osteoarthritis pain and function: potential explanatory factors.

OBJECTIVE: This study examined factors underlying racial differences in pain and function among patients with hip and/or knee osteoarthritis (OA). METHODS: Participants were n=491 African Americans and Caucasians enrolled in a clinical trial of telephone-based OA self-management. Arthritis Impact Measurement Scales-2 (AIMS2) pain and function subscales were obtained at baseline. Potential explanatory variables included arthritis self-efficacy, AIMS2 affect subscale, problem- and emotion-focused pain coping, demographic characteristics, body mass index, self-reported health, joint(s) with OA, symptom duration, pain medication use, current exercise, and AIMS2 pain subscale (in models of function). Variables associated with both race and pain or function, and which reduced the association of race with pain or function by >or=10%, were included in final multivariable models. RESULTS: In simple linear regression models, African Americans had worse scores than Caucasians on AIMS2 pain (B=0.65, P=0.001) and function (B=0.59, P<0.001) subscales. In multivariable models race was no longer associated with pain (B=0.03, P=0.874) or function (B=0.07, P=0.509), indicating these associations were accounted for by other covariates. Variables associated with worse AIMS2 pain and function were: worse AIMS2 affect scores, greater emotion-focused coping, lower arthritis self-efficacy, and fair or poor self-reported health. AIMS2 pain scores were also significantly associated with AIMS2 function. CONCLUSION: Factors explaining racial differences in pain and function were largely psychological, including arthritis self-efficacy, affect, and use of emotion-focused coping. Self-management and psychological interventions can influence these factors, and greater dissemination among African Americans may be a key step toward reducing racial disparities in pain and function.

Authors
Allen, KD; Oddone, EZ; Coffman, CJ; Keefe, FJ; Lindquist, JH; Bosworth, HB
MLA Citation
Allen, KD, Oddone, EZ, Coffman, CJ, Keefe, FJ, Lindquist, JH, and Bosworth, HB. "Racial differences in osteoarthritis pain and function: potential explanatory factors." Osteoarthritis Cartilage 18.2 (February 2010): 160-167.
PMID
19825498
Source
pubmed
Published In
Osteoarthritis and Cartilage
Volume
18
Issue
2
Publish Date
2010
Start Page
160
End Page
167
DOI
10.1016/j.joca.2009.09.010

Contribution of cancer symptoms, dysfunctional sleep related thoughts, and sleep inhibitory behaviors to the insomnia process in breast cancer survivors: A daily process analysis

Study Objectives: Using a comprehensive cognitive-behavioral model of insomnia and a daily process approach, this study was conducted to examine the contribution of cancer symptoms and dysfunctional sleep related thoughts and behaviors to the process of insomnia in breast cancer survivors. Design: Within-group longitudinal research design. Setting: An academic medical center. Participants: 41 women with breast cancer who had completed their primary cancer treatment and met Research Diagnostic Criteria for primary insomnia or insomnia comorbid with breast cancer. Interventions: NA Measurements and Results: For 28 days, participants completed morning diaries assessing sleep, nighttime pain and hot flashes, and dysfunctional sleep related thoughts and behaviors during the day and night, and evening diaries assessing daytime pain, fatigue, hot flashes, and mood. All diaries were collected using an automated telephone-based system. Results revealed that poorer sleep was related to nighttime pain and hot flashes in breast cancer patients. Time-lagged effects were also found. The current study identified higher levels of dysfunctional sleep related thoughts and sleep inhibitory behaviors during the day and night as antecedents of insomnia, and higher levels of pain, fatigue, and hot flashes and lower levels of positive mood and dysfunctional sleep related thoughts as consequences of insomnia in this population. Conclusions: The current study found support for a comprehensive cognitive-behavioral model of insomnia, which has several theoretical, practice, and research implications.

Authors
Rumble, ME; Keefe, FJ; Edinger, JD; Affleck, G; Marcom, PK; Shaw, HS
MLA Citation
Rumble, ME, Keefe, FJ, Edinger, JD, Affleck, G, Marcom, PK, and Shaw, HS. "Contribution of cancer symptoms, dysfunctional sleep related thoughts, and sleep inhibitory behaviors to the insomnia process in breast cancer survivors: A daily process analysis." Sleep 33.11 (2010): 1501-1509.
PMID
21102992
Source
scival
Published In
Sleep
Volume
33
Issue
11
Publish Date
2010
Start Page
1501
End Page
1509

Therapeutic interactive voice response (TIVR) to reduce analgesic medication use for chronic pain management

This paper examines whether a telephone-based, automated maintenance enhancement program can help to reduce opioid and nonsteroidal anti-inflamatory drugs (NSAID) analgesic use in patients with chronic pain. Following 11 weeks of group cognitive-behavioral therapy (CBT), 51 subjects with chronic musculoskeletal pain were randomized to 1 of 2 study groups. Twenty-six subjects participated in 4 months of a Therapeutic Interactive Voice Response (TIVR) program in addition to standard follow-up care, while a control group of 25 subjects received standard follow-up care only. TIVR is an automated, telephone-based tool developed for the maintenance and enhancement of CBT skills. Opioid analgesic use decreased in the experimental group in both follow-ups: 4 and 8 months postCBT. In addition, at 8-month follow-up, 21% of the TIVR subjects had discontinued the use of opioid analgesics, 23% had discontinued NSAIDS, and 10% had discontinued antidepressant medications. In contrast, the control group showed increases in opioid and NSAIDS use. Analysis of covariance (ANCOVA) revealed significant between-group differences in opioid analgesic use at 8-month follow up (P = .004). We have previously demonstrated the efficacy of TIVR to decrease pain and improve coping; this analysis demonstrates that the use of TIVR may also result in concurrent reductions in opioid analgesic and NSAID medications use. Perspective: This article demonstrates that the Therapeutic Interactive Voice Response maintenance enhancement program can help to reduce opioid analgesic use in patients with chronic pain. This automated maintenance enhancement program could potentially assist patients not only to decrease pain and improve coping, but also to diminish the likelihood of opioid dependence. © 2010 by the American Pain Society.

Authors
Naylor, MR; Naud, S; Keefe, FJ; Helzer, JE
MLA Citation
Naylor, MR, Naud, S, Keefe, FJ, and Helzer, JE. "Therapeutic interactive voice response (TIVR) to reduce analgesic medication use for chronic pain management." Journal of Pain 11.12 (2010): 1410-1419.
PMID
20620119
Source
scival
Published In
The Journal of Pain
Volume
11
Issue
12
Publish Date
2010
Start Page
1410
End Page
1419
DOI
10.1016/j.jpain.2010.03.019

The pragmatic-explanatory continuum indicator summary (PRECIS) instrument was useful for refining a randomized trial design: Experiences from an investigative team

Objective: A recently published instrument (PRECIS) was designed to assist investigative teams in understanding the various design decisions that need to be made regarding pragmatic vs. explanatory trials. Our team used this instrument during an investigators' meeting to organize our discussion regarding the design of a planned trial and to determine the extent of consensus among the study investigators. Study Design and Setting: The study was descriptive in nature and occurred during an investigator meeting. After reading and reviewing the 10 PRECIS criteria, the team made quantitative judgments of the planned study regarding each PRECIS criteria to reflect initial, ideal, and final study design perceptions. Results: Data indicated that the final study design was more explanatory in nature than the preliminary plan. Evidence of consensus was obtained. Conclusion: The investigative team found that applying PRECIS principles were useful for (1) detailing points of discussion related to trial design, (2) making revisions to the design to be consistent with the project goals, and (3) achieving consensus. We believe our experiences with PRECIS may prove valuable for trial researchers in much the same way that case reports can provide valuable insights for clinicians. © 2010 Elsevier Inc. All rights reserved.

Authors
Riddle, DL; Johnson, RE; Jensen, MP; Keefe, FJ; Kroenke, K; Bair, MJ; Ang, DC
MLA Citation
Riddle, DL, Johnson, RE, Jensen, MP, Keefe, FJ, Kroenke, K, Bair, MJ, and Ang, DC. "The pragmatic-explanatory continuum indicator summary (PRECIS) instrument was useful for refining a randomized trial design: Experiences from an investigative team." Journal of Clinical Epidemiology 63.11 (2010): 1271-1275.
PMID
20670911
Source
scival
Published In
Journal of Clinical Epidemiology
Volume
63
Issue
11
Publish Date
2010
Start Page
1271
End Page
1275
DOI
10.1016/j.jclinepi.2010.03.006

Pain and functioning of rheumatoid arthritis patients based on marital status: Is a distressed marriage preferable to no marriage?

Relationships may influence adjustment to chronic pain conditions such as rheumatoid arthritis (RA). We examined how both marital status and marital adjustment were related to pain, physical disability, and psychological disability in 255 adults with RA. Among married participants (n = 158), better marital adjustment (assessed using the Locke-Wallace Marital Adjustment Scale) was correlated with less pain and physical and psychological disability (all P values < .05). Married participants were divided into distressed (n = 44) and nondistressed (n = 114) subgroups and compared with unmarried participants (n = 97). Controlling for demographics and disease severity, unmarried participants had higher affective pain (P = .009) and higher psychological disability (P = .02) than only the nondistressed married participants, but unmarried participants did not differ from distressed married participants. These findings suggest that being married in itself is not associated with better health in RA but that being in a well-adjusted or nondistressed marriage is linked with less pain and better functioning. Perspective: This study examined relationships of marital status and marital adjustment to pain and physical and psychological disability in RA. Findings underscore the importance of considering not only marital status but also degree of marital adjustment in RA and may inform clinical interventions in this population. © 2010 by the American Pain Society.

Authors
Reese, JB; Somers, TJ; Keefe, FJ; Mosley-Williams, A; Lumley, MA
MLA Citation
Reese, JB, Somers, TJ, Keefe, FJ, Mosley-Williams, A, and Lumley, MA. "Pain and functioning of rheumatoid arthritis patients based on marital status: Is a distressed marriage preferable to no marriage?." Journal of Pain 11.10 (2010): 958-964.
PMID
20418185
Source
scival
Published In
The Journal of Pain
Volume
11
Issue
10
Publish Date
2010
Start Page
958
End Page
964
DOI
10.1016/j.jpain.2010.01.003

Development of a PROMIS item bank to measure pain interference

This paper describes the psychometric properties of the PROMIS-pain interference (PROMIS-PI) bank. An initial candidate item pool (n = 644) was developed and evaluated based on the review of existing instruments, interviews with patients, and consultation with pain experts. From this pool, a candidate item bank of 56 items was selected and responses to the items were collected from large community and clinical samples. A total of 14,848 participants responded to all or a subset of candidate items. The responses were calibrated using an item response theory (IRT) model. A final 41-item bank was evaluated with respect to IRT assumptions, model fit, differential item function (DIF), precision, and construct and concurrent validity. Items of the revised bank had good fit to the IRT model (CFI and NNFI/TLI ranged from 0.974 to 0.997), and the data were strongly unidimensional (e.g., ratio of first and second eigenvalue = 35). Nine items exhibited statistically significant DIF. However, adjusting for DIF had little practical impact on score estimates and the items were retained without modifying scoring. Scores provided substantial information across levels of pain; for scores in the T-score range 50-80, the reliability was equivalent to 0.96-0.99. Patterns of correlations with other health outcomes supported the construct validity of the item bank. The scores discriminated among persons with different numbers of chronic conditions, disabling conditions, levels of self-reported health, and pain intensity (p < 0.0001). The results indicated that the PROMIS-PI items constitute a psychometrically sound bank. Computerized adaptive testing and short forms are available. © 2010 International Association for the Study of Pain.

Authors
Amtmann, D; Cook, KF; Jensen, MP; Chen, W-H; Choi, S; Revicki, D; Cella, D; Rothrock, N; Keefe, F; Callahan, L; Lai, J-S
MLA Citation
Amtmann, D, Cook, KF, Jensen, MP, Chen, W-H, Choi, S, Revicki, D, Cella, D, Rothrock, N, Keefe, F, Callahan, L, and Lai, J-S. "Development of a PROMIS item bank to measure pain interference." Pain 150.1 (2010): 173-182.
PMID
20554116
Source
scival
Published In
PAIN
Volume
150
Issue
1
Publish Date
2010
Start Page
173
End Page
182
DOI
10.1016/j.pain.2010.04.025

Integrative and behavioral approaches to the treatment of cancer-related neuropathic pain.

Integrative oncology is the synthesis of mainstream cancer care and evidence-based complementary therapies. Complementary strategies include massage therapies, acupuncture, fitness, and mind-body techniques, which take advantage of the reciprocal relationship between the mind and body. Neuropathic pain--and pain more generally--is part of a complex process involving the whole physical and psychosocial being, therefore requiring an integrative management approach. Several studies have demonstrated, for example, that social context plays an important role in the perception of pain and that a patient's coping strategies can influence the persistence of pain. In this article, we briefly describe research illustrating the promise of integrative approaches for the treatment of cancer-related neuropathic pain.

Authors
Cassileth, BR; Keefe, FJ
MLA Citation
Cassileth, BR, and Keefe, FJ. "Integrative and behavioral approaches to the treatment of cancer-related neuropathic pain." The oncologist 15 Suppl 2 (2010): 19-23.
PMID
20489193
Source
scival
Published In
The oncologist
Volume
15 Suppl 2
Publish Date
2010
Start Page
19
End Page
23
DOI
10.1634/theoncologist.2009-S504

Multi-Modal Examination of Psychological and Interpersonal Distinctions Among MPI Coping Clusters: A Preliminary Study

The Multidimensional Pain Inventory (MPI) is a widely used instrument to characterize distinct psychosocial subgroups of patients with chronic pain: Adaptive (AC), Dysfunctional (DYS), and Interpersonally Distressed (ID). To date, several questions remain about the validity and distinctiveness of the patient clusters, and continued scientific attention has strongly been recommended. It is unclear if AC patients experience better adjustment or merely present themselves favorably. Moreover, differences in psychological distress and interpersonal relations between DYS and ID patients are equivocal. The present study is the first to utilize comprehensive informant ratings to extend prior validity research on the MPI. We employed a multimodal methodology consisting of patient self-report, parallel informant ratings, and behavioral measures. Ninety-nine patients with chronic pain, their partners, and providers participated. They completed measures of patients' psychological distress and social relations. We also systematically observed patients' pain behavior. Results provided strong support for the validity of the AC cluster in that patients' positive adaptation was reliably corroborated by informants. The differentiating characteristics between the 2 maladaptive clusters, however, remain elusive. We found evidence that DYS patients' distress appeared to be illness specific rather than generalized; however, both clusters were equally associated with social distress and partner/caregiver burden. Perspective: An adaptive style of coping with chronic pain is reliably recognized by patients' partners and healthcare providers. Differences between a dysfunctional and an interpersonally distressed coping style, however, remain unclear. Patients with a dysfunctional style appear more distressed by their illness but both styles are characterized by social difficulties. © 2010 American Pain Society.

Authors
Junghaenel, DU; Keefe, FJ; Broderick, JE
MLA Citation
Junghaenel, DU, Keefe, FJ, and Broderick, JE. "Multi-Modal Examination of Psychological and Interpersonal Distinctions Among MPI Coping Clusters: A Preliminary Study." Journal of Pain 11.1 (2010): 87-96.
PMID
19783221
Source
scival
Published In
The Journal of Pain
Volume
11
Issue
1
Publish Date
2010
Start Page
87
End Page
96
DOI
10.1016/j.jpain.2009.06.006

Understanding and enhancing patient and partner adjustment to disease-related pain: A biopsychosocial perspective

Persistent, disease-related pain is a challenge not only for patients who experience it, but also for their loved ones. There is growing interest in involving partners and caregivers in pain management efforts. The purpose of this chapter is to discuss factors that influence patient and partner adjustment to diseaserelated pain within a biopsychosocial framework and provide an overview of biopsychosocial approaches involving partners in pain management. The chapter is divided into three sections. In the first section, we present a biopsychosocial model that can be used to understand how patients and their partners adjust to disease-related pain. In the second section, we discuss factors that influence patient and partner adjustment to both arthritis pain and cancer pain and how these factors are influenced by patient and partner pain management interventions. Finally, we highlight important future directions for clinical and research efforts in this area.

Authors
Somers, TJ; Keefe, FJ; Porter, L
MLA Citation
Somers, TJ, Keefe, FJ, and Porter, L. "Understanding and enhancing patient and partner adjustment to disease-related pain: A biopsychosocial perspective." (December 1, 2009): 95-124. (Chapter)
Source
scopus
Publish Date
2009
Start Page
95
End Page
124
DOI
10.1007/978-0-387-78323-9_6

Racial differences in gait mechanics associated with knee osteoarthritis.

BACKGROUND AND AIMS: This study examines racial differences in gait mechanics in persons with knee osteoarthritis and the influence of anthropometrics, educational level, radiographic disease severity (rOA), and self-report measures of pain and disability on racial differences in gait. METHODS: One hundred seventy five (64 black and 111 white) adults with radiographic knee OA were tested. 3-D kinematic and kinetic data were collected while subjects walked at two self-selected speeds (normal and fast). Anthropometric data, radiographic level of OA, and self-report measures of pain and disability were also collected. Gait patterns were compared across groups and within groups. RESULTS: Black and white subjects did not differ significantly in radiographic OA. However, blacks walked significantly more slowly when asked to walk fast. At the normal speed, blacks had a smaller knee range of motion and loading rate than whites. Blacks also took longer to reach their peak maximum ground reaction force than whites. Within black subjects variations in gait mechanics were primarily explained by BMI, rOA, selfreported psychological disability, and pain self-efficacy. In white subjects, variations in gait mechanics were primarily explained by weight, age, velocity, psychological disability, and self-efficacy. CONCLUSIONS: Blacks in this study had a pattern of gait mechanics generally associated with high levels of osteoarthritis, though they did not differ significantly in rOA from whites. The variability in gait patterns exhibited by blacks was most strongly related to variance in walking speed, anthropometrics, and perceived physical ability. Taken together, these results suggest that race is an important factor that must be considered in the treatment and study of osteoarthritis.

Authors
Sims, EL; Keefe, FJ; Kraus, VB; Guilak, F; Queen, RM; Schmitt, D
MLA Citation
Sims, EL, Keefe, FJ, Kraus, VB, Guilak, F, Queen, RM, and Schmitt, D. "Racial differences in gait mechanics associated with knee osteoarthritis." Aging Clin Exp Res 21.6 (December 2009): 463-469.
PMID
20154517
Source
pubmed
Published In
Aging clinical and experimental research
Volume
21
Issue
6
Publish Date
2009
Start Page
463
End Page
469

The relationship of self-reported pain and functional impairment to gait mechanics in overweight and obese persons with knee osteoarthritis.

OBJECTIVE: To examine the degree to which 2 commonly used measures of pain and disability, the Arthritis Impact Measurement Scales (AIMS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), relate to objective gait measurements. DESIGN: A descriptive study of the influence of self-reported pain and perceived functional impairment on gait mechanics in osteoarthritic adults. SETTING: A university clinical research laboratory. PARTICIPANTS: Overweight/obese adults with radiographic knee osteoarthritis (OA) as well as pain and disability associated with the disease (N=179). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The AIMS and WOMAC were administered to determine self-report measures of pain and disability. Speed, stride length, support time, knee angle, and peak vertical force (PVF) were determined from 3-dimensional kinematic and kinetic data collected on subjects walking at self-selected normal and fast speeds. Anthropometric data and radiographic levels of OA were also collected. RESULTS: Pearson correlation analysis showed that the AIMS physical disability score was inversely correlated with speed, stride length, and knee range of motion at both speeds and PVF at the fast speed. The WOMAC function score was inversely correlated with speed and stride length at both speeds and with PVF at fast speed. The WOMAC pain score was inversely correlated with speed and PVF at the fast speed. Regression analysis revealed that the AIMS physical disability score and body mass index accounted for the greatest variation in speed at the normal speed. Overall, AIMS physical disability and WOMAC function explained a larger proportion of variance in gait mechanics than radiographic measures of OA disease severity. CONCLUSIONS: Taken together, the results suggest that the AIMS physical disability and WOMAC function scores are associated with some important measures of gait impairment.

Authors
Nebel, MB; Sims, EL; Keefe, FJ; Kraus, VB; Guilak, F; Caldwell, DS; Pells, JJ; Queen, R; Schmitt, D
MLA Citation
Nebel, MB, Sims, EL, Keefe, FJ, Kraus, VB, Guilak, F, Caldwell, DS, Pells, JJ, Queen, R, and Schmitt, D. "The relationship of self-reported pain and functional impairment to gait mechanics in overweight and obese persons with knee osteoarthritis." Arch Phys Med Rehabil 90.11 (November 2009): 1874-1879.
PMID
19887211
Source
pubmed
Published In
Archives of Physical Medicine and Rehabilitation
Volume
90
Issue
11
Publish Date
2009
Start Page
1874
End Page
1879
DOI
10.1016/j.apmr.2009.07.010

Daily pain variations among patients with hand, hip, and knee osteoarthritis.

OBJECTIVE: This study examined within-day osteoarthritis (OA)-related pain patterns and associated patient characteristics. METHODS: Participants with physician diagnoses and self-reported symptoms of hand (N=40), hip (N=32), and knee (N=85) OA recorded pain using a handheld computer on one weekday and one weekend day, with ratings beginning immediately after waking, then approximately every 2h following. Pain was rated on a sliding visual analog scale with hidden coding of 1-100. Multivariable linear mixed models examined associations of patient demographic characteristics, enrollment site (Durham VA Medical Center vs Duke University Medical Center), joint site, body mass index, and pain medication use with within-day pain range (maximum minus minimum pain rating) and area under the curve (AUC) of pain ratings, which incorporates the magnitude of all pain measurements. RESULTS: Pain patterns differed substantially across individuals. The sample means of the average, maximum, and minimum weekday pain scores were 35.3, 54.4, and 17.9, respectively. The mean pain range was 36.4, and the mean pain AUC was 564.3 (possible range: 16-1600). Pain scores were similar on weekends. In multivariable mixed models, both knee and hip OA were associated with a greater within-day pain range than hand OA. Only VA enrollment site was associated with a significantly greater pain AUC. CONCLUSION: There is substantial within-day range in OA-related pain. Both pain range and overall within-day magnitude vary according to patient characteristics. Patients' records of within-day pain patterns could be used in clinical encounters to tailor recommendations for the timing of medication use and behavioral strategies.

Authors
Allen, KD; Coffman, CJ; Golightly, YM; Stechuchak, KM; Keefe, FJ
MLA Citation
Allen, KD, Coffman, CJ, Golightly, YM, Stechuchak, KM, and Keefe, FJ. "Daily pain variations among patients with hand, hip, and knee osteoarthritis." Osteoarthritis Cartilage 17.10 (October 2009): 1275-1282.
PMID
19410670
Source
pubmed
Published In
Osteoarthritis and Cartilage
Volume
17
Issue
10
Publish Date
2009
Start Page
1275
End Page
1282
DOI
10.1016/j.joca.2009.03.021

Pain catastrophizing in patients with noncardiac chest pain: relationships with pain, anxiety, and disability.

OBJECTIVE: To examine the contributions of chest pain, anxiety, and pain catastrophizing to disability in 97 patients with noncardiac chest pain (NCCP) and to test whether chest pain and anxiety were related indirectly to greater disability via pain catastrophizing. METHODS: Participants completed daily diaries measuring chest pain for 7 days before completing measures of pain catastrophizing, trait anxiety, and disability. Linear path model analyses examined the contributions of chest pain, trait anxiety, and catastrophizing to physical disability, psychosocial disability, and disability in work, home, and recreational activities. RESULTS: Path models accounted for a significant amount of the variability in disability scales (R(2) = 0.35 to 0.52). Chest pain and anxiety accounted for 46% of the variance in pain catastrophizing. Both chest pain (beta = 0.18, Sobel test Z = 2.58, p < .01) and trait anxiety (beta = 0.14, Sobel test Z = 2.11, p < .05) demonstrated significant indirect relationships with physical disability via pain catastrophizing. Chest pain demonstrated a significant indirect relationship with psychosocial disability via pain catastrophizing (beta = 0.12, Sobel test Z = 1.96, p = .05). After controlling for the effects of chest pain and anxiety, pain catastrophizing was no longer related to disability in work, home, and recreational activities. CONCLUSIONS: Chest pain and anxiety were directly related to greater disability and indirectly related to physical and psychosocial disability via pain catastrophizing. Efforts to improve functioning in patients with NCCP should consider addressing pain catastrophizing.

Authors
Shelby, RA; Somers, TJ; Keefe, FJ; Silva, SG; McKee, DC; She, L; Waters, SJ; Varia, I; Riordan, YB; Knowles, VM; Blazing, M; Blumenthal, JA; Johnson, P
MLA Citation
Shelby, RA, Somers, TJ, Keefe, FJ, Silva, SG, McKee, DC, She, L, Waters, SJ, Varia, I, Riordan, YB, Knowles, VM, Blazing, M, Blumenthal, JA, and Johnson, P. "Pain catastrophizing in patients with noncardiac chest pain: relationships with pain, anxiety, and disability." Psychosom Med 71.8 (October 2009): 861-868.
PMID
19737857
Source
pubmed
Published In
Psychosomatic Medicine
Volume
71
Issue
8
Publish Date
2009
Start Page
861
End Page
868
DOI
10.1097/PSY.0b013e3181b49584

Using cognitive interviews to evaluate items for measuring sexual functioning across cancer populations: improvements and remaining challenges.

PURPOSE: One goal of the Patient-Reported Outcomes Measurement Information System (PROMIS) is to develop a measure of sexual functioning that broadens the definition of sexual activity and incorporates items that reflect constructs identified as important by patients with cancer. We describe how cognitive interviews improved the quality of the items and discuss remaining challenges to assessing sexual functioning in research with cancer populations. METHODS: We conducted 39 cognitive interviews of patients with cancer and survivors on the topic of sexual experience. Each of the 83 candidate items was seen by 5-24 participants. Participants included both men and women and varied by cancer type, treatment trajectory, race, and literacy level. Significantly revised items were retested in subsequent interviews. RESULTS: Cognitive interviews provided useful feedback about the relevance, sensitivity, appropriateness, and clarity of the items. Participants identified broad terms (e.g., "sex life") to assess sexual experience and exposed the challenges of measuring sexual functioning consistently, considering both adjusted and unadjusted sexual experiences. CONCLUSIONS: Cognitive interviews were critical for item refinement in the development of the PROMIS measure of sexual function. Efforts are underway to validate the measure in larger cancer populations.

Authors
Fortune-Greeley, AK; Flynn, KE; Jeffery, DD; Williams, MS; Keefe, FJ; Reeve, BB; Willis, GB; Weinfurt, KP; PROMIS Sexual Function Domain Committee,
MLA Citation
Fortune-Greeley, AK, Flynn, KE, Jeffery, DD, Williams, MS, Keefe, FJ, Reeve, BB, Willis, GB, Weinfurt, KP, and PROMIS Sexual Function Domain Committee, . "Using cognitive interviews to evaluate items for measuring sexual functioning across cancer populations: improvements and remaining challenges." Qual Life Res 18.8 (October 2009): 1085-1093.
PMID
19672697
Source
pubmed
Published In
Quality of Life Research
Volume
18
Issue
8
Publish Date
2009
Start Page
1085
End Page
1093
DOI
10.1007/s11136-009-9523-x

Pain coping in Latino populations.

UNLABELLED: Although there has been a rapid increase in Latino populations in the United States over the last 10 years, health research with Latino cultural groups is sorely lacking. In the area of pain-coping research, one consequence of the limited research is that very little is known about pain coping among Latinos. The purpose of this paper is to review the existing literature on pain coping in Latino populations, and to propose new directions for the future study of pain coping in Latino populations. This review is divided into 4 sections. In the first section, the challenges of defining Latino populations are discussed. In the second section, the current literature on pain coping in Latinos is reviewed. Third, we discuss the implications of existing findings for pain-coping assessment and pain treatment. Finally, we offer ideas for future research on pain coping in Latino populations. PERSPECTIVE: In this review article, we identify gaps in our current understanding of pain coping in Latino cultural groups, and associated implications for pain assessment and treatment. We also highlight potential directions for future pain-coping research with Latino populations.

Authors
Campbell, LC; Andrews, N; Scipio, C; Flores, B; Feliu, MH; Keefe, FJ
MLA Citation
Campbell, LC, Andrews, N, Scipio, C, Flores, B, Feliu, MH, and Keefe, FJ. "Pain coping in Latino populations." J Pain 10.10 (October 2009): 1012-1019. (Review)
PMID
19595635
Source
pubmed
Published In
Journal of Pain
Volume
10
Issue
10
Publish Date
2009
Start Page
1012
End Page
1019
DOI
10.1016/j.jpain.2009.03.004

Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial.

GOAL OF WORK: Breast cancer survivors have limited options for the treatment of hot flashes and related symptoms. Further, therapies widely used to prevent recurrence in survivors, such as tamoxifen, tend to induce or exacerbate menopausal symptoms. The aim of this preliminary, randomized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer (stages IA-IIB). MATERIALS AND METHODS: Thirty-seven disease-free women experiencing hot flashes were randomized to the 8-week Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) or to wait-list control. The primary outcome was daily reports of hot flashes collected at baseline, posttreatment, and 3 months after treatment via an interactive telephone system. Data were analyzed by intention to treat. MAIN RESULTS: At posttreatment, women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency, severity, and total scores and in levels of joint pain, fatigue, sleep disturbance, symptom-related bother, and vigor. At 3 months follow-up, patients maintained their treatment gains in hot flashes, joint pain, fatigue, symptom-related bother, and vigor and showed additional significant gains in negative mood, relaxation, and acceptance. CONCLUSIONS: This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors.

Authors
Carson, JW; Carson, KM; Porter, LS; Keefe, FJ; Seewaldt, VL
MLA Citation
Carson, JW, Carson, KM, Porter, LS, Keefe, FJ, and Seewaldt, VL. "Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial." Support Care Cancer 17.10 (October 2009): 1301-1309.
PMID
19214594
Source
pubmed
Published In
Supportive Care in Cancer
Volume
17
Issue
10
Publish Date
2009
Start Page
1301
End Page
1309
DOI
10.1007/s00520-009-0587-5

Partner-assisted emotional disclosure for patients with gastrointestinal cancer: results from a randomized controlled trial.

BACKGROUND: For patients with cancer who are married or in an intimate relationship, their relationships with their partners play a critical role in their adaptation to illness. However, cancer patients and their partners often have difficulty in talking with each other about their cancer-related concerns. Difficulties in communication ultimately may compromise both the patient-partner relationship and the patient's psychological adjustment. The current study tested the efficacy of a novel partner-assisted emotional disclosure intervention in a sample of patients with gastrointestinal (GI) cancer. METHODS: One hundred thirty patients with GI cancer and their partners were assigned randomly to receive 4 sessions of either partner-assisted emotional disclosure or a couples cancer education/support intervention. Patients and partners completed measures of relationship quality, intimacy with their partner, and psychological distress before randomization and at the end of the intervention sessions. Data were analyzed using multilevel modeling. RESULTS: Compared with an education/support condition, the partner-assisted emotional disclosure condition led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns. CONCLUSIONS: Partner-assisted emotional disclosure is a novel intervention that builds on both the private emotional disclosure and the cognitive-behavioral marital literature. The results of this study suggested that this intervention may be beneficial for couples in which the patient tends to hold back from discussing concerns. The authors concluded that future research on methods of enhancing the effects of partner-assisted emotional disclosure is warranted.

Authors
Porter, LS; Keefe, FJ; Baucom, DH; Hurwitz, H; Moser, B; Patterson, E; Kim, HJ
MLA Citation
Porter, LS, Keefe, FJ, Baucom, DH, Hurwitz, H, Moser, B, Patterson, E, and Kim, HJ. "Partner-assisted emotional disclosure for patients with gastrointestinal cancer: results from a randomized controlled trial." Cancer 115.18 Suppl (September 15, 2009): 4326-4338.
PMID
19731357
Source
pubmed
Published In
Cancer
Volume
115
Issue
18 Suppl
Publish Date
2009
Start Page
4326
End Page
4338
DOI
10.1002/cncr.24578

Psychosocial factors and the pain experience of osteoarthritis patients: new findings and new directions.

PURPOSE OF REVIEW: The present paper reviews recent psychosocial research in the area of osteoarthritis pain. First, the review highlights studies of psychosocial factors that can influence osteoarthritis pain. Next, research testing the efficacy of psychosocial treatments for osteoarthritis pain is summarized. RECENT FINDINGS: Recent studies suggest that asking osteoarthritis patients to recall pain experiences may not be as accurate as having them keep daily pain records. New studies also support the notion that fatigue and increased weight are linked to higher osteoarthritis pain. Osteoarthritis patients who report higher levels of depression are more prone to report increased osteoarthritis pain. New studies also indicate that social factors such as ethnic background, ability to communicate pain to others, and participation in social activities can influence osteoarthritis pain and disability. Cognitions about pain (i.e. pain catastrophizing, acceptance, self-efficacy for pain) also have been found to relate to pain in patients with osteoarthritis. Recent, randomized controlled studies suggest that psychosocial interventions (i.e. self-management programs, exercise) can decrease osteoarthritis pain and disability. SUMMARY: Several psychosocial variables have been suggested as influencing osteoarthritis pain and disability. There is evidence that psychosocial interventions may decrease osteoarthritis pain and disability.

Authors
Somers, TJ; Keefe, FJ; Godiwala, N; Hoyler, GH
MLA Citation
Somers, TJ, Keefe, FJ, Godiwala, N, and Hoyler, GH. "Psychosocial factors and the pain experience of osteoarthritis patients: new findings and new directions." Curr Opin Rheumatol 21.5 (September 2009): 501-506. (Review)
PMID
19617836
Source
pubmed
Published In
Current Opinion in Rheumatology
Volume
21
Issue
5
Publish Date
2009
Start Page
501
End Page
506
DOI
10.1097/BOR.0b013e32832ed704

Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability.

This study examined the degree to which pain catastrophizing and pain-related fear explain pain, psychological disability, physical disability, and walking speed in patients with osteoarthritis (OA) of the knee. Participants in this study were 106 individuals diagnosed as having OA of at least one knee, who reported knee pain persisting for six months or longer. Results suggest that pain catastrophizing explained a significant proportion (all Ps < or = 0.05) of variance in measures of pain (partial r(2) [pr(2)] = 0.10), psychological disability (pr(2) = 0.20), physical disability (pr(2) = 0.11), and gait velocity at normal (pr(2) = 0.04), fast (pr(2) = 0.04), and intermediate speeds (pr(2) = 0.04). Pain-related fear explained a significant proportion of the variance in measures of psychological disability (pr(2) = 0.07) and walking at a fast speed (pr(2) = 0.05). Pain cognitions, particularly pain catastrophizing, appear to be important variables in understanding pain, disability, and walking at normal, fast, and intermediate speeds in knee OA patients. Clinicians interested in understanding variations in pain and disability in this population may benefit by expanding the focus of their inquiries beyond traditional medical and demographic variables to include an assessment of pain catastrophizing and pain-related fear.

Authors
Somers, TJ; Keefe, FJ; Pells, JJ; Dixon, KE; Waters, SJ; Riordan, PA; Blumenthal, JA; McKee, DC; LaCaille, L; Tucker, JM; Schmitt, D; Caldwell, DS; Kraus, VB; Sims, EL; Shelby, RA; Rice, JR
MLA Citation
Somers, TJ, Keefe, FJ, Pells, JJ, Dixon, KE, Waters, SJ, Riordan, PA, Blumenthal, JA, McKee, DC, LaCaille, L, Tucker, JM, Schmitt, D, Caldwell, DS, Kraus, VB, Sims, EL, Shelby, RA, and Rice, JR. "Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability." J Pain Symptom Manage 37.5 (May 2009): 863-872.
PMID
19041218
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
37
Issue
5
Publish Date
2009
Start Page
863
End Page
872
DOI
10.1016/j.jpainsymman.2008.05.009

Caregiver-assisted coping skills training for patients with COPD: background, design, and methodological issues for the INSPIRE-II study.

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a progressive illness characterized by airflow obstruction and dyspnea that afflicts over 12 million people and represents a leading cause of death in the United States. Not surprisingly, COPD is often associated with emotional distress and reduced psychosocial adjustment, which can negatively impact physical functioning and impair quality of life. However, the psychosocial consequences of COPD remain largely untreated. A previous randomized trial from our research team demonstrated that coping skills training (CST) can improve pulmonary-specific quality of life among pulmonary patients awaiting lung transplant (the INSPIRE study). To date, however, no studies have examined the effects of a caregiver-assisted CST intervention in patients with COPD with less severe disease. PURPOSE: INSPIRE II is a randomized clinical trial (RCT) funded by the NHLBI to evaluate the effects of telephone-based enhanced CST for patients with COPD and their caregivers compared to standardized medical care (SMC) including COPD education and symptom monitoring on medical outcomes, physical functioning, and quality of life. METHODS: Six hundred COPD patients and their respective caregivers recruited from Duke University and Ohio State University will be evaluated and randomized (in a 1:1 ratio) to enhanced CST (including sessions promoting physical activity, relaxation, cognitive restructuring, communication skills, and problem solving) or to SMC. The primary outcomes include all-cause mortality, COPD-related hospitalizations/ physician visits, and quality of life. These endpoints will be measured through self-report questionnaires, behavioral measures of functional capacity (i.e., accelerometer and six minute walk test) and pulmonary function tests (e.g., FEV(1)). RESULTS: This article reviews prior studies in the area and describes the design of INSPIRE-II. Several key methodological issues are discussed including the delivery of CST over the telephone, encouraging physical activity, and inclusion of caregivers as patient coaches to enhance the effectiveness of the intervention. LIMITATIONS: We recognize that SMC does not adequately control for attention, support, and non-specific factors, and that, in theory, non-specific effects of the intervention could account for some, or all, of the observed benefits. However, our fundamental question is whether the telephone intervention produces benefits over-and-above the usual care that patients typically receive. The SMC condition will provide education and additional weekly telephone contact, albeit less than the attention received by the CST group. We recognize that this attention control condition may not provide equivalent patient contact, but it will minimize group differences due to attention. We considered several alternative designs including adding a third usual care only arm as well as an education only control arm. However, these alternatives would require more patients, reduce the power to detect significant effects of our primary medical endpoints, and add a significant additional expense to the cost of the study that would make such an undertaking neither scientifically or financially viable. CONCLUSIONS: We believe that this novel approach to patient care in which caregivers are used to assist in the delivery of coping skills training to patients with COPD has the potential to change the way in which COPD patients are routinely managed in order to reduce distress, enhance quality of life, and potentially improve medical outcomes.

Authors
Blumenthal, JA; Keefe, FJ; Babyak, MA; Fenwick, CV; Johnson, JM; Stott, K; Funk, RK; McAdams, MJ; Palmer, S; Martinu, T; Baucom, D; Diaz, PT; Emery, CF
MLA Citation
Blumenthal, JA, Keefe, FJ, Babyak, MA, Fenwick, CV, Johnson, JM, Stott, K, Funk, RK, McAdams, MJ, Palmer, S, Martinu, T, Baucom, D, Diaz, PT, and Emery, CF. "Caregiver-assisted coping skills training for patients with COPD: background, design, and methodological issues for the INSPIRE-II study." Clin Trials 6.2 (April 2009): 172-184.
PMID
19342470
Source
pubmed
Published In
Clinical Trials
Volume
6
Issue
2
Publish Date
2009
Start Page
172
End Page
184
DOI
10.1177/1740774509102565

Initial report of the cancer Patient-Reported Outcomes Measurement Information System (PROMIS) sexual function committee: review of sexual function measures and domains used in oncology.

For this report, the authors described the initial activities of the Cancer Patient-Reported Outcomes Measurement Information System (PROMIS)-Sexual Function domain group, which is part of the National Institutes of Health Roadmap Initiative to develop brief questionnaires or individually tailored assessments of quality-of-life domains. Presented are a literature review of sexual function measures used in cancer populations and descriptions of the domains found in those measures. By using a consensus-driven approach, an electronic bibliographic search was conducted for articles that were published from 1991 to 2007, and 486 articles were identified for in-depth review. In total, 257 articles reported the administration of a psychometrically evaluated sexual function measure to individuals who were diagnosed with cancer. Apart from the University of California-Los Angeles Prostate Cancer Index, the International Index of Erectile Function, and the Female Sexual Function Index, the 31 identified measures have not been tested widely in cancer populations. Most measures were multidimensional and included domains related to the sexual response cycle and to general sexual satisfaction. The current review supports the need for a flexible, psychometrically robust measure of sexual function for use in oncology settings and strongly justifies the development of the PROMIS-Sexual Function instrument. When the PROMIS-Sexual Function instrument is available publicly, cancer clinicians and researchers will have another measure with which to assess patient-reported sexual function outcomes in addition to the few legacy measures that were identified through this review.

Authors
Jeffery, DD; Tzeng, JP; Keefe, FJ; Porter, LS; Hahn, EA; Flynn, KE; Reeve, BB; Weinfurt, KP
MLA Citation
Jeffery, DD, Tzeng, JP, Keefe, FJ, Porter, LS, Hahn, EA, Flynn, KE, Reeve, BB, and Weinfurt, KP. "Initial report of the cancer Patient-Reported Outcomes Measurement Information System (PROMIS) sexual function committee: review of sexual function measures and domains used in oncology." Cancer 115.6 (March 15, 2009): 1142-1153. (Review)
PMID
19195044
Source
pubmed
Published In
Cancer
Volume
115
Issue
6
Publish Date
2009
Start Page
1142
End Page
1153
DOI
10.1002/cncr.24134

Psychological interventions for cancer pain

© Cambridge University Press 2010. Over the past 15 years, psychological interventions have emerged as a useful adjunct to medical approaches to cancer pain management. Psychological interventions offer several advantages in cancer pain management. First, they can enhance patients' sense of self-efficacy (i.e., confidence) in their own abilities to control pain. Increased self-efficacy for pain control has been linked to lower psychological distress, less interference of pain with daily activities, and improved quality of life. Second, psychological interventions teach patients skills that can be applied to many of the day-to-day challenges of living with persistent pain, such as coping with pain flares, managing emotional reactions to pain (e.g., anxiety, fear, depression), and maintaining an active and rewarding life despite having pain. Third, psychological interventions and pain medications may have synergistic effects for cancer patients and produce an array of benefits (e.g., decreased pain, improved mood, enhanced interpersonal interactions) that may not be achieved by alone. Finally, psychological interventions may offer a viable pain management option for patients who respond poorly or have difficulty tolerating pain medications. This chapter provides an introduction to psychological approaches to managing cancer pain. The chapter is divided into three sections. The first section highlights the challenges of cancer pain. This section emphasizes the fact that psychological interventions for pain are delivered in the context of multiple ongoing challenges faced by persons having cancer pain.

Authors
Keefe, FJ; Abernethy, AP; Wheeler, JL; Somers, TJ
MLA Citation
Keefe, FJ, Abernethy, AP, Wheeler, JL, and Somers, TJ. "Psychological interventions for cancer pain." Cancer Pain: Assessment and Management, Second Edition. January 1, 2009. 343-353.
Source
scopus
Publish Date
2009
Start Page
343
End Page
353
DOI
10.1017/CBO9780511642357.019

Acute pain: A psychosocial perspective

© Cambridge University Press, 2009 and Raymond S. Sinatra, Oscar A. de Leon-Casasola, Brian Ginsberg, Eugene R. Viscusi. Our understanding of the psychosocial aspects of pain has advanced considerably since the early 1980s. Much has been learned about psychosocial factors that influence pain and psychosocial interventions that can enhance pain control. Recently, there has been growing interest in applying the psychosocial perspective to enhance our understanding and ability to treat acute pain. This chapter focuses specifically on psychosocial aspects of acute pain. The chapter is divided into four sections. The first section provides a conceptual background on psychosocial aspects of acute pain. The second section highlights research on the role of psychosocial factors in acute pain. The third summarizes the results of recent studies testing the efficacy of psychosocial interventions for acute pain. The chapter concludes with a discussion of future directions for work in this important area. Conceptual Background: Traditionally, acute pain has been understood using a biomedical model. According to this model, acute pain is a warning signal that results from nociceptive input as a result of tissue damage or injury. In the biomedical approach, careful assessments are conducted to identify sources of tissue damage or injury that are causing pain. Medical and/or surgical interventions designed to correct or ameliorate underlying tissue damage or injury are then carried out to eliminate or reduce pain. In the biomedical model, psychosocial factors play a secondary role in that they are viewed simply as responses to pain itself.

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Acute pain: A psychosocial perspective." Acute Pain Management. January 1, 2009. 41-52.
Source
scopus
Publish Date
2009
Start Page
41
End Page
52
DOI
10.1017/CBO9780511576706.005

Sex differences in biomechanics associated with knee osteoarthritis.

Osteoarthritis of the knee is seen more frequently in females than males. However, few studies have examined the interplay of gender, gait mechanics, pain, and disability in persons with osteoarthritis. This study examines the influence of anthropometrics, radiographic disease severity, pain, and disability on gender differences in gait mechanics in patients with knee osteoarthritis. Gait mechanics for 26 men and 30 women were collected using 3-D kinematics and kinetics. Women had a significantly lower knee adduction moment than men and a significantly higher stride frequency. Within female subjects, variations in gait mechanics were primarily explained by weight, BMI, pain, and disability. In males, variations in gait mechanics were primarily explained by age and disability.

Authors
Sims, EL; Carland, JM; Keefe, FJ; Kraus, VB; Guilak, F; Schmitt, D
MLA Citation
Sims, EL, Carland, JM, Keefe, FJ, Kraus, VB, Guilak, F, and Schmitt, D. "Sex differences in biomechanics associated with knee osteoarthritis." J Women Aging 21.3 (2009): 159-170.
PMID
20183142
Source
pubmed
Published In
Journal of Women & Aging
Volume
21
Issue
3
Publish Date
2009
Start Page
159
End Page
170
DOI
10.1080/08952840903054856

Response to Knittle

Authors
Dixon, KE; Keefe, FJ; Scipio, CD; Perri, LM; Abernethy, AP
MLA Citation
Dixon, KE, Keefe, FJ, Scipio, CD, Perri, LM, and Abernethy, AP. "Response to Knittle." Health Psychology 28.5 (2009): 647-648.
Source
scival
Published In
Health Psychology
Volume
28
Issue
5
Publish Date
2009
Start Page
647
End Page
648
DOI
10.1037/a0017217

Multidimensional Pain Inventory-Screening Chinese version (MPI-sC): Psychometric testing in terminal cancer patients in Taiwan

Introduction: Cancer pain is identified as a multidimensional experience, but relatively few brief instruments are available for assessing the complex pain-related experiences of terminal cancer patients in Taiwan. The purposes of this study were to (1) translate and examine the feasibility and psychometric characteristics of the eight-item Multidimensional Pain Inventory-Screening Chinese (MPI-sC) when used with patients having terminal cancer and (2) apply the MPI-sC to examine multidimensional pain-related experiences of terminal cancer patients in Taiwan. Materials and methods: The MPI-sC was tested in 106 terminal cancer inpatients at a hospice setting in Taipei. Results: The results showed that the MPI-sC has satisfactory face and content validity, feasibility, acceptable internal consistency reliability (overall Cronbach's alpha of 0.75), and overall support of theoretical assumptions. However, instead of the four-factor structure of the original instrument, we found a three-factor structure (with pain intensity and pain interference merged into one factor) that explained 76.73% of the variance. Close to half the patients (48.1%) had considerable levels of pain interference, and a majority (72.6%) reported not having control in life based on the cut-point of MPI-sC categorization. Conclusion: Our results support the brief MPI-sC as a feasible and valid tool for assessing and representing multidimensional pain experiences in terminal cancer patients. The MPI-sC could help clinicians and researchers assess the complex multidimensional pain experiences of terminal cancer patients, including Chinese-speaking cancer populations. © 2009 Springer-Verlag.

Authors
Lai, Y-H; Guo, S-L; Keefe, FJ; Tsai, L-Y; Shun, S-C; Liao, Y-C; Li, I-F; Liu, C-P; Lee, Y-H
MLA Citation
Lai, Y-H, Guo, S-L, Keefe, FJ, Tsai, L-Y, Shun, S-C, Liao, Y-C, Li, I-F, Liu, C-P, and Lee, Y-H. "Multidimensional Pain Inventory-Screening Chinese version (MPI-sC): Psychometric testing in terminal cancer patients in Taiwan." Supportive Care in Cancer 17.12 (2009): 1445-1453.
PMID
19242731
Source
scival
Published In
Supportive Care in Cancer
Volume
17
Issue
12
Publish Date
2009
Start Page
1445
End Page
1453
DOI
10.1007/s00520-009-0597-3

Does classification of persons with fibromyalgia into multidimensional pain inventory subgroups detect differences in outcome after a standard chronic pain management program?

INTRODUCTION: The present study aimed to replicate and validate the empirically derived subgroup classification based on the Multidimensional Pain Inventory (MPI) in a sample of highly disabled fibromyalgia (FM) patients. Second, it examined how the identified subgroups differed in their response to an intensive, interdisciplinary inpatient pain management program. METHODS: Participants were 118 persons with FM who experienced persistent pain and were disabled. Subgroup classification was conducted by cluster analysis using MPI subscale scores at entry to the program. At program entry and discharge, participants completed the MPI, Medical Outcomes Study Short Form-36, Hospital Anxiety and Depression Scale and Coping Strategies Questionnaire. RESULTS: Cluster analysis identified three subgroups in the highly disabled sample that were similar to those described by other studies using less disabled samples of FM. The dysfunctional subgroup (DYS; 36% of the sample) showed the highest level of depression, the interpersonally distressed subgroup (ID; 24%) showed a modest level of depression and the adaptive copers subgroup (AC; 38%) showed the lowest depression scores in the MPI (negative mood), Medical Outcomes Study Short Form-36 (mental health), Hospital Anxiety and Depression Scale (depression) and Coping Strategies Questionnaire (catastrophizing). Significant differences in treatment outcome were observed among the three subgroups in terms of reduction of pain severity (as assessed using the MPI). The effect sizes were 1.42 for DYS, 1.32 for AC and 0.62 for ID (P=0.004 for pairwise comparison of ID-AC and P=0.018 for ID-DYS). DISCUSSION: These findings underscore the importance of assessing individuals' differences in how they adjust to FM. ©2009 Pulsus Group Inc. All rights reserved.

Authors
Verra, ML; Angst, F; Brioschi, R; Lehmann, S; Keefe, FJ; Staal, JB; Bie, RAD; Aeschlimann, A
MLA Citation
Verra, ML, Angst, F, Brioschi, R, Lehmann, S, Keefe, FJ, Staal, JB, Bie, RAD, and Aeschlimann, A. "Does classification of persons with fibromyalgia into multidimensional pain inventory subgroups detect differences in outcome after a standard chronic pain management program?." Pain Research and Management 14.6 (2009): 445-453.
PMID
20011715
Source
scival
Published In
Pain research & management : the journal of the Canadian Pain Society = journal de la societe canadienne pour le traitement de la douleur
Volume
14
Issue
6
Publish Date
2009
Start Page
445
End Page
453

Development and psychometric analysis of the PROMIS pain behavior item bank

The measurement of pain behavior is a key component of the assessment of persons with chronic pain; however, few self-reported pain behavior instruments have been developed. We developed a pain behavior item bank as part of the Patient-Reported Outcome Measurement Information System (PROMIS). For the Wave I testing, because of the large number of PROMIS items, a complex sampling approach was used where participants were randomly assigned to either respond to two full-item banks or to multiple 7-item blocks of items. A web-based survey was designed and completed by 15,528 members of the general population and 967 individuals with different types of chronic pain. Item response theory (IRT) analysis models were used to evaluate item characteristics and to scale both items and individuals on the pain behavior domain. The pain behavior item bank demonstrated good fit to a unidimensional model (Comparative Fit Index = 0.94). Several iterations of IRT analyses resulted in a final 39-item pain behavior bank, and different IRT models were fit to the total sample and to those participants who experienced some pain. The results indicated that these items demonstrated good coverage of the pain behavior construct. Pain behavior scores were strongly related to pain intensity and moderately related to self-reported general health status. Mean pain behavior scores varied significantly by groups based on pain severity and general health status. The PROMIS pain behavior item bank can be used to develop static short-form and dynamic measures of pain behavior for clinical studies. © 2009 International Association for the Study of Pain.

Authors
Revicki, DA; Chen, W-H; Harnam, N; Cook, KF; Amtmann, D; Callahan, LF; Jensen, MP; Keefe, FJ
MLA Citation
Revicki, DA, Chen, W-H, Harnam, N, Cook, KF, Amtmann, D, Callahan, LF, Jensen, MP, and Keefe, FJ. "Development and psychometric analysis of the PROMIS pain behavior item bank." Pain 146.1-2 (2009): 158-169.
PMID
19683873
Source
scival
Published In
PAIN
Volume
146
Issue
1-2
Publish Date
2009
Start Page
158
End Page
169
DOI
10.1016/j.pain.2009.07.029

The impact of cognitive behavioral group training on event-free survival in patients with myocardial infarction: The ENRICHD experience

Objective: Although the Enhancing Recovery in Coronary Heart Disease (ENRICHD) treatment was designed to include individual therapy and cognitive behavioral group training for patients with depression and/or low perceived social support, only 31% of treated participants received group training. Secondary analyses classified intervention participants into two subgroups, (1) individual therapy only or (2) group training (i.e., coping skills training) plus individual therapy, to determine whether medical outcomes differed in participants who received the combination of group training and individual therapy compared to participants who received individual therapy only or usual care. Methods: Secondary analyses of 1243 usual care, 781 individual therapy only, and 356 group plus individual therapy myocardial infarction (MI) patients were performed. Depression was diagnosed using modified Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria; low perceived social support was determined by the ENRICHD Social Support Instrument. Psychosocial treatment followed MI, and for participants with severe or unremitting depression, was supplemented with a selective serotonin reuptake inhibitor. Cox proportional hazards regression was used to estimate intervention effects on time to first occurrence of the composite end point of death plus nonfatal MI. To control for confounding of group participation with survival (because individual sessions preceded group), we used risk set sampling to match minimal survival time of those receiving or not receiving group training. Results: Analyses correcting for differential survival among comparison groups showed that group plus individual therapy was associated with a 33% reduction (hazard ratio=0.67; 95% confidence interval, 0.49-0.92, P=.01) in medical outcome compared to usual care. No significant effect on event-free survival was associated with individual therapy alone. The group training benefit was reduced to 23% (hazard ratio=0.77; 95% confidence interval: 0.56-1.07, P=.11) in the multivariate-adjusted model. Conclusions: Findings suggest that adding group training to individual therapy may be associated with reduction in the composite end point. A randomized controlled trial is warranted to definitively resolve this issue. © 2009 Elsevier Inc. All rights reserved.

Authors
Saab, PG; Bang, H; Williams, RB; Powell, LH; Schneiderman, N; Thoresen, C; Burg, M; Keefe, F
MLA Citation
Saab, PG, Bang, H, Williams, RB, Powell, LH, Schneiderman, N, Thoresen, C, Burg, M, and Keefe, F. "The impact of cognitive behavioral group training on event-free survival in patients with myocardial infarction: The ENRICHD experience." Journal of Psychosomatic Research 67.1 (2009): 45-56.
PMID
19539818
Source
scival
Published In
Journal of Psychosomatic Research
Volume
67
Issue
1
Publish Date
2009
Start Page
45
End Page
56
DOI
10.1016/j.jpsychores.2009.01.015

Psychological determinants of problematic outcomes following Total Knee Arthroplasty

The primary objective of the present study was to examine the role of pain-related psychological factors in predicting pain and disability following Total Knee Arthroplasty (TKA). The study sample consisted of 75 (46 women, 29 men) individuals with osteoarthritis of the knee who were scheduled for TKA. Measures of pain severity, pain catastrophizing, depression, and pain-related fears of movement were completed prior to surgery. Participants completed measures of pain severity and self-reported disability 6 weeks following surgery. Consistent with previous research, cross-sectional analyses revealed significant correlations among measures of pre-surgical pain severity, pain catastrophizing, depression and pain-related fears of movement. Prospective analyses revealed that pre-surgical pain severity and pain catastrophizing were unique predictors of post-surgical pain severity (6-week follow-up). Pain-related fears of movement were predictors of post-surgical functional difficulties in univariate analyses, but not when controlling for pre-surgical co-morbidities (e.g. back pain). The results of this study add to a growing literature highlighting the prognostic value of psychological variables in the prediction of post-surgical health outcomes. The results support the view that the psychological determinants of post-surgical pain severity differ from the psychological determinants of post-surgical disability. The results suggest that interventions designed to specifically target pain-related psychological risk factors might improve post-surgical outcomes. © 2009 International Association for the Study of Pain.

Authors
Sullivan, M; Tanzer, M; Stanish, W; Fallaha, M; Keefe, FJ; Simmonds, M; Dunbar, M
MLA Citation
Sullivan, M, Tanzer, M, Stanish, W, Fallaha, M, Keefe, FJ, Simmonds, M, and Dunbar, M. "Psychological determinants of problematic outcomes following Total Knee Arthroplasty." Pain 143.1-2 (2009): 123-129.
PMID
19304392
Source
scival
Published In
PAIN
Volume
143
Issue
1-2
Publish Date
2009
Start Page
123
End Page
129
DOI
10.1016/j.pain.2009.02.011

A couple-based intervention for female breast cancer

Objective: Although women's breast cancer affects both women and their male partners, as well as their relationships, few interventions have been developed to work with couples confronting breast cancer. The current investigation presents the pilot results from a new couple-based intervention program for breast cancer that teaches couples how to minimize negative effects and maximize positive functioning during this diffcult time. Method: In this pilot study, 14 couples in which the wife had early stage breast cancer were randomly assigned to one of the two treatment conditions: Couple-based relationship enhancement (RE) or treatment-as-usual (TAU). Results: The results from this study suggest that compared with couples receiving treatment-as-usual, both women and men in the RE condition experienced improved functioning on individual psychological variables as well as relationship functioning at posttest and 1-year follow-up. In addition, women in RE show fewer medical symptoms at both time periods. Conclusions: In this pilot study, the couple-based intervention, RE, has shown promise in improving individual, medical, and relationship functioning for couples in which the woman is facing breast cancer, and therefore merits further investigation on a larger scale. Copyright © 2008 John Wiley & Sons, Ltd.

Authors
Baucom, DH; Porter, LS; Kirby, JS; Gremore, TM; Wiesenthal, N; Aldridge, W; Fredman, SJ; Stanton, SE; Scott, JL; Halford, KW; Keefe, FJ
MLA Citation
Baucom, DH, Porter, LS, Kirby, JS, Gremore, TM, Wiesenthal, N, Aldridge, W, Fredman, SJ, Stanton, SE, Scott, JL, Halford, KW, and Keefe, FJ. "A couple-based intervention for female breast cancer." Psycho-Oncology 18.3 (2009): 276-283.
PMID
18702064
Source
scival
Published In
Psycho-Oncology
Volume
18
Issue
3
Publish Date
2009
Start Page
276
End Page
283
DOI
10.1002/pon.1395

Persistent Smoking After a Diagnosis of Lung Cancer Is Associated With Higher Reported Pain Levels

The purpose of this study was to evaluate the impact of smoking status after a diagnosis of lung cancer on reported pain levels. We conducted a telephone survey of patients with lung cancer identified from 4 participating sites between September 2004 and July 2006. Patients were asked to rate their usual pain level over the past week on a 0 to 10 rating scale on which 0 was "no pain" and 10 "pain as bad as you can imagine." We operationally defined persistent smokers as patients who reported continuing to smoke after their lung cancer diagnosis. A logistic regression analysis was used to test the hypothesis that persistent smokers report higher usual pain levels than nonsmokers. Overall, 893 patients completed the survey. The majority (76%) was found to have advanced cancer (stages IIIb and IV). The mean age was 63 years (SD = 10). Seventeen percent of the patients studied were categorized as persistent smokers. The mean pain score for the study sample was 3.1 (SD = 2.7) and 41% reported moderate (4 to 6) or severe pain (7 to 10). A greater proportion of persistent smokers reported moderate or severe pain than nonsmokers or former smokers (P < .001). Logistic regression analysis revealed that smoking status was associated with the usual pain even after adjusting for age, perceived health status, and other lung cancer symptoms such as dyspnea, fatigue, and trouble eating. In conclusion, patients who continue to smoke after a diagnosis of lung cancer report higher levels of usual pain than nonsmokers or former smokers. More research is needed to understand the mechanisms that relate nicotine intake to pain and disease progression in late-stage lung cancer. Perspective: This article examines the relationship between pain and persistent smoking in patients with lung cancer. Although more research is needed to understand the mechanisms that relate nicotine intake to pain and disease progression, physicians can promote smoking cessation in patients with lung cancer to improve health and quality of life. © 2009 American Pain Society.

Authors
Daniel, M; Keefe, FJ; Lyna, P; Peterson, B; Garst, J; Kelley, M; Bepler, G; Bastian, LA
MLA Citation
Daniel, M, Keefe, FJ, Lyna, P, Peterson, B, Garst, J, Kelley, M, Bepler, G, and Bastian, LA. "Persistent Smoking After a Diagnosis of Lung Cancer Is Associated With Higher Reported Pain Levels." Journal of Pain 10.3 (2009): 323-328.
PMID
19254679
Source
scival
Published In
The Journal of Pain
Volume
10
Issue
3
Publish Date
2009
Start Page
323
End Page
328
DOI
10.1016/j.jpain.2008.10.006

The Symptoms of Osteoarthritis and the Genesis of Pain

This article delineates the characteristic symptoms and signs associated with OA and how they can be used to make the clinical diagnosis. The predominant symptom in most patients is pain. The remainder of the article focuses on what we know causes pain in OA and contributes to its severity. Much has been learned over recent years; however, for the budding researcher much of this puzzle remains unexplored or inadequately understood. © 2008 Elsevier Inc. All rights reserved.

Authors
Hunter, DJ; McDougall, JJ; Keefe, FJ
MLA Citation
Hunter, DJ, McDougall, JJ, and Keefe, FJ. "The Symptoms of Osteoarthritis and the Genesis of Pain." Medical Clinics of North America 93.1 (2009): 83-100.
PMID
19059023
Source
scival
Published In
Medical Clinics of North America
Volume
93
Issue
1
Publish Date
2009
Start Page
83
End Page
100
DOI
10.1016/j.mcna.2008.08.008

Domain specific self-efficacy mediates the impact of pain catastrophizing on pain and disability in overweight and obese osteoarthritis patients.

UNLABELLED: This study examined whether self-efficacy mediated the relationship between pain catastrophizing and pain and disability. Participants were 192 individuals diagnosed with osteoarthritis (OA) of the knees who were overweight or obese. Multiple mediator analyses were conducted to simultaneously test self-efficacy for pain control, physical function, and emotional symptoms as mediators while controlling for demographic and medical status variables. Higher pain catastrophizing was associated with lower self-efficacy in all 3 domains (Ps < .05). Self-efficacy for pain control fully mediated the relationship between pain catastrophizing and pain (beta = .08, Sobel test Z = 1.97, P < .05). The relationship between pain catastrophizing and physical disability was fully mediated by self-efficacy for physical function (beta = .06, Sobel test Z = 1.95, P = .05). Self-efficacy for emotional symptoms partially mediated the relationship between pain catastrophizing and psychological disability (beta = .12, Sobel test Z = 2.92, P < .05). These results indicate that higher pain catastrophizing contributed to greater pain and disability via lower domain-specific self-efficacy. Efforts to reduce pain and improve functioning in OA patients should consider addressing pain catastrophizing and domain specific self-efficacy. Pain catastrophizing may be addressed through cognitive therapy techniques and self-efficacy may be enhanced through practice of relevant skills and personal accomplishments. PERSPECTIVE: This study found that higher pain catastrophizing contributed to greater pain and disability via domain specific self-efficacy. These results suggest that treatment efforts to reduce pain and improve functioning in OA patients who are overweight or obese should consider addressing both pain catastrophizing and self-efficacy.

Authors
Shelby, RA; Somers, TJ; Keefe, FJ; Pells, JJ; Dixon, KE; Blumenthal, JA
MLA Citation
Shelby, RA, Somers, TJ, Keefe, FJ, Pells, JJ, Dixon, KE, and Blumenthal, JA. "Domain specific self-efficacy mediates the impact of pain catastrophizing on pain and disability in overweight and obese osteoarthritis patients." J Pain 9.10 (October 2008): 912-919.
PMID
18602871
Source
pubmed
Published In
Journal of Pain
Volume
9
Issue
10
Publish Date
2008
Start Page
912
End Page
919
DOI
10.1016/j.jpain.2008.05.008

Pain communication in the context of osteoarthritis: patient and partner self-efficacy for pain communication and holding back from discussion of pain and arthritis-related concerns.

OBJECTIVES: This preliminary study examined aspects of pain communication (self-efficacy for pain communication and holding back from discussing pain and arthritis-related concerns) among patients with osteoarthritis (OA) and their partners, and associations between patient and partner pain communication and measures of patient and partner adjustment. METHODS: A sample of 38 patients with OA and their partners completed measures of self-efficacy for pain communication and holding back from discussion of pain and arthritis-related concerns. Patients completed measures of pain, physical and psychologic disability, and pain catastrophizing, and partners completed measures of caregiver strain and positive and negative affect. RESULTS: Correlation analyses indicated that, among patients, higher levels of self-efficacy for pain communication were associated with significantly lower levels of pain, physical and psychologic disability, and pain catastrophizing, and with lower levels of partner negative affect. Among partners, high self-efficacy for pain communication was associated with higher levels of positive affect. Among patients, higher levels of holding back were significantly correlated with higher levels of psychologic disability and catastrophizing. Higher levels of partner holding back were associated with significantly higher levels of caregiver strain, and with higher levels of patient psychologic disability and catastrophizing. DISCUSSION: Taken together, results from this preliminary study suggest that self-efficacy for pain communication and holding back from discussions of pain and arthritis-related concerns may be important in understanding how patients with OA and their partners adjust to the demands of the patient's disease.

Authors
Porter, LS; Keefe, FJ; Wellington, C; de Williams, A
MLA Citation
Porter, LS, Keefe, FJ, Wellington, C, and de Williams, A. "Pain communication in the context of osteoarthritis: patient and partner self-efficacy for pain communication and holding back from discussion of pain and arthritis-related concerns." Clin J Pain 24.8 (October 2008): 662-668.
PMID
18806530
Source
pubmed
Published In
Clinical Journal of Pain
Volume
24
Issue
8
Publish Date
2008
Start Page
662
End Page
668
DOI
10.1097/AJP.0b013e31816ed964

Pain catastrophizing in borderline morbidly obese and morbidly obese individuals with osteoarthritic knee pain.

OBJECTIVE: There is limited information about how morbidly obese osteoarthritis (OA) patients cope with the pain they experience. Pain catastrophizing is an important predictor of pain and adjustment in persons with persistent pain. This may be particularly relevant in the morbidly obese (body mass index [BMI] of 40 kg/m(2) or greater) OA population at risk for increased pain. The present study first examined whether borderline morbidly obese and morbidly obese OA patients report higher levels of pain catastrophizing than a sample of OA patients in the overweight and obese category (BMI between 25 kg/m(2) and 34 kg/m(2)). Next, it examined how pain catastrophizing is related to important indexes of pain and adjustment in borderline morbidly obese and morbidly obese OA patients. METHODS: Participants included 43 individuals with knee OA who were borderline morbidly obese or morbidly obese (BMI of 38 kg/m(2) or greater). Participants completed self-report measures of pain catastrophizing, pain, psychological distress, quality of life, binge eating and eating self-efficacy. RESULTS: The sample of borderline morbidly obese and morbidly obese OA patients reported significantly higher levels of pain catastrophizing (P=0.007) than a comparison sample of overweight and obese OA patients. Results suggested that patients who engaged in a high level of pain catastrophizing reported having much more intense and unpleasant pain, higher levels of binge eating, lower self-efficacy for controlling their eating and lower weight-related quality of life (P<0.05 for all). CONCLUSIONS: Pain catastrophizing is related to pain and adjustment in borderline morbidly obese and morbidly obese OA patients. Clinicians working with this population should consider assessing pain catastrophizing in the patients they treat.

Authors
Somers, TJ; Keefe, FJ; Carson, JW; Pells, JJ; Lacaille, L
MLA Citation
Somers, TJ, Keefe, FJ, Carson, JW, Pells, JJ, and Lacaille, L. "Pain catastrophizing in borderline morbidly obese and morbidly obese individuals with osteoarthritic knee pain." Pain Res Manag 13.5 (September 2008): 401-406.
PMID
18958312
Source
pubmed
Published In
Pain research & management : the journal of the Canadian Pain Society = journal de la societe canadienne pour le traitement de la douleur
Volume
13
Issue
5
Publish Date
2008
Start Page
401
End Page
406

Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: associations with symptoms and distress.

This study examined self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their caregivers, and associations between self-efficacy and patient and caregiver adjustment. One hundred and fifty-two patients with early stage lung cancer completed measures of self-efficacy, pain, fatigue, quality of life, depression, and anxiety. Their caregivers completed a measure assessing their self-efficacy for helping the patient manage symptoms and measures of psychological distress and caregiver strain. Analyses indicated that, overall, patients and caregivers were relatively low in self-efficacy for managing pain, symptoms, and function, and that there were significant associations between self-efficacy and adjustment. Patients low in self-efficacy reported significantly higher levels of pain, fatigue, lung cancer symptoms, depression, and anxiety, and significantly worse physical and functional well being, as did patients whose caregivers were low in self-efficacy. When patients and caregivers both had low self-efficacy, patients reported higher levels of anxiety and poorer quality of life than when both were high in self-efficacy. There were also significant associations between patient and caregiver self-efficacy and caregiver adjustment, with lower levels of self-efficacy associated with higher levels of caregiver strain and psychological distress. These preliminary findings raise the possibility that patient and caregiver self-efficacy for managing pain, symptoms, and function may be important factors affecting adjustment, and that interventions targeted at increasing self-efficacy may be useful in this population.

Authors
Porter, LS; Keefe, FJ; Garst, J; McBride, CM; Baucom, D
MLA Citation
Porter, LS, Keefe, FJ, Garst, J, McBride, CM, and Baucom, D. "Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: associations with symptoms and distress." Pain 137.2 (July 15, 2008): 306-315.
PMID
17942229
Source
pubmed
Published In
Pain
Volume
137
Issue
2
Publish Date
2008
Start Page
306
End Page
315
DOI
10.1016/j.pain.2007.09.010

Coping and quality of life in patients awaiting lung transplantation.

OBJECTIVE: Patients with end-stage lung disease (ESLD) experience significant decrements in quality of life (QOL). Although coping strategies are related to QOL in patients with ESLD, the extent to which specific native lung disease moderates this relationship is unknown. METHODS: We investigated the relationship between coping, native lung disease, and QOL among 187 patients awaiting lung transplantation, including 139 patients with chronic obstructive pulmonary disease (COPD) and 48 with cystic fibrosis (CF). Participants completed a psychosocial battery assessing psychological QOL, physical QOL, and coping strategies. RESULTS: For both COPD and CF patients, higher levels of Active Coping (P< .0001) and lower levels of Disengagement (P< .0001) were associated with better psychological QOL. For physical QOL, we observed a Native Disease x Coping interaction (P=.01) such that Active Coping was associated with better physical QOL in patients with COPD but not in patients with CF. CONCLUSIONS: The relationship between coping and QOL may vary as a function of native lung disease. Patients' native disease may need to be considered in order to develop effective interventions to help patients cope successfully with ESLD.

Authors
Taylor, JL; Smith, PJ; Babyak, MA; Barbour, KA; Hoffman, BM; Sebring, DL; Davis, RD; Palmer, SM; Keefe, FJ; Carney, RM; Csik, I; Freedland, KE; Blumenthal, JA
MLA Citation
Taylor, JL, Smith, PJ, Babyak, MA, Barbour, KA, Hoffman, BM, Sebring, DL, Davis, RD, Palmer, SM, Keefe, FJ, Carney, RM, Csik, I, Freedland, KE, and Blumenthal, JA. "Coping and quality of life in patients awaiting lung transplantation." J Psychosom Res 65.1 (July 2008): 71-79.
PMID
18582615
Source
pubmed
Published In
Journal of Psychosomatic Research
Volume
65
Issue
1
Publish Date
2008
Start Page
71
End Page
79
DOI
10.1016/j.jpsychores.2008.04.009

A randomized, controlled trial of emotional disclosure in rheumatoid arthritis: can clinician assistance enhance the effects?

Emotional disclosure by writing or talking about stressful life experiences improves health status in non-clinical populations, but its success in clinical populations, particularly rheumatoid arthritis (RA), has been mixed. In this randomized, controlled trial, we attempted to increase the efficacy of emotional disclosure by having a trained clinician help patients emotionally disclose and process stressful experiences. We randomized 98 adults with RA to one of four conditions: (a) private verbal emotional disclosure; (b) clinician-assisted verbal emotional disclosure; (c) arthritis information control (all of which engaged in four, 30-min laboratory sessions); or (d) no-treatment, standard care only control group. Outcome measures (pain, disability, affect, stress) were assessed at baseline, 2 months following treatment (2-month follow-up), and at 5-month, and 15-month follow-ups. A manipulation check demonstrated that, as expected, both types of emotional disclosure led to immediate (post-session) increases in negative affect compared with arthritis information. Outcome analyses at all three follow-ups revealed no clear pattern of effects for either clinician-assisted or private emotional disclosure compared with the two control groups. There were some benefits in terms of a reduction in pain behavior with private disclosure vs. clinician-assisted disclosure at the 2-month follow-up, but no other significant between group differences. We conclude that verbal emotional disclosure about stressful experiences, whether conducted privately or assisted by a clinician, has little or no benefit for people with RA.

Authors
Keefe, FJ; Anderson, T; Lumley, M; Caldwell, D; Stainbrook, D; McKee, D; Waters, SJ; Connelly, M; Affleck, G; Pope, MS; Weiss, M; Riordan, PA; Uhlin, BD
MLA Citation
Keefe, FJ, Anderson, T, Lumley, M, Caldwell, D, Stainbrook, D, McKee, D, Waters, SJ, Connelly, M, Affleck, G, Pope, MS, Weiss, M, Riordan, PA, and Uhlin, BD. "A randomized, controlled trial of emotional disclosure in rheumatoid arthritis: can clinician assistance enhance the effects?." Pain 137.1 (July 2008): 164-172.
PMID
17923329
Source
pubmed
Published In
Pain
Volume
137
Issue
1
Publish Date
2008
Start Page
164
End Page
172
DOI
10.1016/j.pain.2007.08.031

Pain behavior in rheumatoid arthritis patients: identification of pain behavior subgroups.

This study used Ward's minimum variance hierarchical cluster analysis to identify homogeneous subgroups of rheumatoid arthritis patients suffering from chronic pain who exhibited similar pain behavior patterns during a videotaped behavior sample. Ninety-two rheumatoid arthritis patients were divided into two samples. Six motor pain behaviors were examined: guarding, bracing, active rubbing, rigidity, grimacing, and sighing. The cluster analysis procedure identified four similar subgroups in Samples 1 and 2. The first subgroup exhibited low levels of all pain behaviors. The second subgroup exhibited a high level of guarding and low levels of other pain behaviors. The third subgroup exhibited high levels of guarding and rigidity and low levels of other pain behaviors. The fourth subgroup exhibited high levels of guarding and active rubbing and low levels of other pain behaviors. Sample 1 contained a fifth subgroup that exhibited a high level of active rubbing and low levels of other pain measures. The results of this study suggest that there are homogeneous subgroups within rheumatoid arthritis patient populations who differ in the motor pain behaviors they exhibit.

Authors
Waters, SJ; Riordan, PA; Keefe, FJ; Lefebvre, JC
MLA Citation
Waters, SJ, Riordan, PA, Keefe, FJ, and Lefebvre, JC. "Pain behavior in rheumatoid arthritis patients: identification of pain behavior subgroups." J Pain Symptom Manage 36.1 (July 2008): 69-78.
PMID
18358682
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
36
Issue
1
Publish Date
2008
Start Page
69
End Page
78
DOI
10.1016/j.jpainsymman.2007.08.015

Couple-Oriented Education and Support Intervention for Osteoarthritis: Effects on Spouses' Support and Responses to Patient Pain.

The purpose of this study was to determine whether a couple-oriented education and support intervention for osteoarthritis was more efficacious than a similar patient-oriented intervention in terms of enhancing spouses' support of patients and their positive and negative responses to patient pain. Repeated-measures analyses of covariance with the completers sample (N = 103 dyads) showed that at the postintervention assessment, patients in the couple-oriented intervention reported a greater decrease in their spouses' punishing responses (e.g., anger, irritation) than did patients in the patient-oriented intervention. In addition, a trend effect was observed in regard to the advantage of couple-oriented intervention for increasing spouses' attempts to distract patients from their pain. At the 6-month follow-up, patients in the couple-oriented intervention reported greater increased spouse support than those in the patient-oriented intervention. Findings illustrate the value of examining change in specific types of marital interactions targeted in a couples intervention, and the need to strengthen the impact of future couple-oriented interventions.

Authors
Martire, LM; Schulz, R; Keefe, FJ; Rudy, TE; Starz, TW
MLA Citation
Martire, LM, Schulz, R, Keefe, FJ, Rudy, TE, and Starz, TW. "Couple-Oriented Education and Support Intervention for Osteoarthritis: Effects on Spouses' Support and Responses to Patient Pain." Fam Syst Health 26.2 (June 1, 2008): 185-195.
PMID
19946460
Source
pubmed
Published In
Families, Systems, & Health
Volume
26
Issue
2
Publish Date
2008
Start Page
185
End Page
195
DOI
10.1037/1091-7527.26.2.185

Arthritis self-efficacy and self-efficacy for resisting eating: relationships to pain, disability, and eating behavior in overweight and obese individuals with osteoarthritic knee pain.

This study examined arthritis self-efficacy and self-efficacy for resisting eating as predictors of pain, disability, and eating behaviors in overweight or obese patients with osteoarthritis (OA) of the knee. Patients (N=174) with a body mass index between 25 and 42 completed measures of arthritis-related self-efficacy, weight-related self-efficacy, pain, physical disability, psychological disability, overeating, and demographic and medical information. Hierarchical linear regression analyses were conducted to examine whether arthritis self-efficacy (efficacy for pain control, physical function, and other symptoms) and self-efficacy for resisting eating accounted for significant variance in pain, disability, and eating behaviors after controlling for demographic and medical characteristics. Analyses also tested whether the contributions of self-efficacy were domain specific. Results showed that self-efficacy for pain accounted for 14% (p=.01) of the variance in pain, compared to only 3% accounted for by self-efficacy for physical function and other symptoms. Self-efficacy for physical function accounted for 10% (p=.001) of the variance in physical disability, while self-efficacy for pain and other symptoms accounted for 3%. Self-efficacy for other (emotional) symptoms and resisting eating accounted for 21% (p<.05) of the variance in psychological disability, while self-efficacy for pain control and physical function were not significant predictors. Self-efficacy for resisting eating accounted for 28% (p=.001) of the variance in eating behaviors. Findings indicate that self-efficacy is important in understanding pain and behavioral adjustment in overweight or obese OA patients. Moreover, the contributions of self-efficacy were domain specific. Interventions targeting both arthritis self-efficacy and self-efficacy for resisting eating may be helpful in this population.

Authors
Pells, JJ; Shelby, RA; Keefe, FJ; Dixon, KE; Blumenthal, JA; Lacaille, L; Tucker, JM; Schmitt, D; Caldwell, DS; Kraus, VB
MLA Citation
Pells, JJ, Shelby, RA, Keefe, FJ, Dixon, KE, Blumenthal, JA, Lacaille, L, Tucker, JM, Schmitt, D, Caldwell, DS, and Kraus, VB. "Arthritis self-efficacy and self-efficacy for resisting eating: relationships to pain, disability, and eating behavior in overweight and obese individuals with osteoarthritic knee pain." Pain 136.3 (June 2008): 340-347.
PMID
17764844
Source
pubmed
Published In
Pain
Volume
136
Issue
3
Publish Date
2008
Start Page
340
End Page
347
DOI
10.1016/j.pain.2007.07.012

Psychologic interventions and lifestyle modifications for arthritis pain management.

This article provides an overview of self-management interventions used to manage pain in patients who have arthritis. The article is divided in two major sections. The first section reviews psychologic interventions used to manage arthritis pain, including pain-coping skills training and cognitive behavioral therapy for pain management, emotional disclosure interventions, and partner-assisted interventions. The second section addresses lifestyle behavioral weight loss interventions used to reduce arthritis pain. In each section, the authors briefly describe the rationale and nature of the interventions, present data on their efficacy, and highlight potential future research directions.

Authors
Keefe, FJ; Somers, TJ; Martire, LM
MLA Citation
Keefe, FJ, Somers, TJ, and Martire, LM. "Psychologic interventions and lifestyle modifications for arthritis pain management." Rheum Dis Clin North Am 34.2 (May 2008): 351-368.
PMID
18638681
Source
pubmed
Published In
Rheumatic Disease Clinics of North America
Volume
34
Issue
2
Publish Date
2008
Start Page
351
End Page
368
DOI
10.1016/j.rdc.2008.03.001

Don't ask, don't tell? Revealing placebo responses to research participants and patients.

Authors
Keefe, F; Abernethy, AP; Wheeler, J; Affleck, G
MLA Citation
Keefe, F, Abernethy, AP, Wheeler, J, and Affleck, G. "Don't ask, don't tell? Revealing placebo responses to research participants and patients." Pain 135.3 (April 2008): 213-214.
PMID
18282661
Source
pubmed
Published In
Pain
Volume
135
Issue
3
Publish Date
2008
Start Page
213
End Page
214
DOI
10.1016/j.pain.2008.01.009

Applying centrality of event to persistent pain: a preliminary view.

UNLABELLED: Living with persistent pain is a complex experience. Based on clinical observations, persistent pain is often described as a stressful life event that has significantly altered how patients view themselves and the world around them. The Centrality of Event Scale (CES) assesses how much a stressful life event serves as a turning point in the individual's life, forms a reference point for personal identity, and affects the attribution of meaning to other life experiences. In this study, 47 patients with persistent pain were asked to complete the CES using "the experience of persistent pain" as the designated stressful life event. Data analyses revealed patients scoring high on the CES (ie, those who viewed persistent pain as a central life event) were significantly more likely to experience higher levels of pain intensity (r = .35, P = .02), life interference due to pain (r = .50, P = .002), and psychological distress (r = .46, P = .001). Additional analyses revealed that the CES was a significant predictor of life interference due to pain and psychological distress even after controlling for the effects of age, sex, education, and pain intensity. PERSPECTIVE: The experience of persistent pain can serve as a major turning point in patients' lives, affect patients' interpretations of other life events, and become a key component of patients' identities. The results of this study indicate that centrality of event, a relatively new construct, could improve our understanding of persistent pain.

Authors
Perri, LM; Keefe, FJ
MLA Citation
Perri, LM, and Keefe, FJ. "Applying centrality of event to persistent pain: a preliminary view." J Pain 9.3 (March 2008): 265-271.
PMID
18096438
Source
pubmed
Published In
The Journal of Pain
Volume
9
Issue
3
Publish Date
2008
Start Page
265
End Page
271
DOI
10.1016/j.jpain.2007.10.019

Genetic and environmental determinants of postthoracotomy pain syndrome.

PURPOSE OF REVIEW: Pain after thoracic surgery may persist for up to a year or longer in as many as 50% of patients undergoing lung resection. There is currently no specific therapy, and our ability to predict who will develop a persistent pain syndrome is poor at best. Persistent pain after thoracotomy is not an acute somatic pain, rather it is a complex syndrome with many of the characteristics of neuropathic, dysesthetic pain. RECENT FINDINGS: The pain genetics field has been dominated by reports of single variants leading to severe phenotypes. These (Mendelian) diseases are not representative of the more common, complex phenotype that is characterized by the lay term 'pain threshold'. Recently, work describing the association of genetic variants with idiopathic pain disorders has appeared in the literature, and here the authors suggest that these concepts are applicable to postthoracotomy pain syndrome. SUMMARY: Postthoracotomy pain syndrome likely arises as a direct result of an environmental stress (surgery) occurring on a landscape of susceptibility that is determined by an individual's behavioral, clinical and genetic characteristics.

Authors
Shaw, A; Keefe, FJ
MLA Citation
Shaw, A, and Keefe, FJ. "Genetic and environmental determinants of postthoracotomy pain syndrome." Curr Opin Anaesthesiol 21.1 (February 2008): 8-11. (Review)
PMID
18195602
Source
pubmed
Published In
Current Opinion in Anaesthesiology
Volume
21
Issue
1
Publish Date
2008
Start Page
8
End Page
11
DOI
10.1097/ACO.0b013e3282f2daa2

Pain in its environmental context: implications for designing environments to enhance pain control.

Authors
Malenbaum, S; Keefe, FJ; Williams, ACDC; Ulrich, R; Somers, TJ
MLA Citation
Malenbaum, S, Keefe, FJ, Williams, ACDC, Ulrich, R, and Somers, TJ. "Pain in its environmental context: implications for designing environments to enhance pain control." Pain 134.3 (February 2008): 241-244. (Review)
PMID
18178010
Source
pubmed
Published In
Pain
Volume
134
Issue
3
Publish Date
2008
Start Page
241
End Page
244
DOI
10.1016/j.pain.2007.12.002

Validity of pain behaviors in persons with mild to moderate cognitive impairment

OBJECTIVES: To evaluate the validity of traditional pain behaviors (guarding, bracing, rubbing, grimacing, and sighing) in persons with and without cognitive impairment and chronic low back pain (CLBP). DESIGN: Prospective observational study. SETTING: Outpatient clinics. PARTICIPANTS: Thirty-seven cognitively intact and 40 cognitively impaired participants with and without CLBP. MEASUREMENTS: Frequency of traditional pain behaviors. RESULTS: Forty-six of the participants were pain free, and 31 had CLBP. The internal consistency reliability coefficient of the five pain behaviors was 0.32, suggesting that a unidimensional scale did not exist. Multivariate analysis of variance analysis according to the independent variables pain status (pain free vs CLBP) and cognitive status (intact vs impaired) with the dependent variable frequency of pain behaviors found significant differences according to pain status (F[5,61]=3.06, P=.02) and cognitive status (F[5,61]=5.41, P<.001) but without evidence of an interaction (F[5,61]=1.14, P=.35). Participants with CLBP exhibited significantly higher levels of grimacing (P<.001) and guarding (P=.02) than pain-free participants. Intact subjects exhibited fewer guarding (P=.02) and rubbing behaviors (P<.001) but a higher number of bracing behaviors (P=.03) than cognitively impaired participants. CONCLUSION: These results support the utility of facial grimacing in assessing pain in patients with mild to moderate cognitive impairment and call into question the validity of guarding and rubbing in assessing pain in persons with mild to moderate cognitive impairment. © 2008, Copyright the Authors.

Authors
Shega, JW; Rudy, T; Keefe, FJ; Perri, LC; Mengin, OT; Weiner, DK
MLA Citation
Shega, JW, Rudy, T, Keefe, FJ, Perri, LC, Mengin, OT, and Weiner, DK. "Validity of pain behaviors in persons with mild to moderate cognitive impairment." Journal of the American Geriatrics Society 56.9 (2008): 1631-1637.
PMID
18662203
Source
scival
Published In
Journal of American Geriatrics Society
Volume
56
Issue
9
Publish Date
2008
Start Page
1631
End Page
1637
DOI
10.1111/j.1532-5415.2008.01831.x

The Symptoms of Osteoarthritis and the Genesis of Pain

Symptomatic osteoarthritis (OA) causes substantial physical and psychosocial disability. This article delineates the characteristic symptoms and signs associated with OA and how they can be used to make the clinical diagnosis. The predominant symptom in most patients is pain. The remainder of the article focuses on what is known about the causes of pain in OA and factors that contribute to its severity. Much has been learned during recent years, but much of this puzzle remains unexplored or inadequately understood. © 2008 Elsevier Inc. All rights reserved.

Authors
Hunter, DJ; McDougall, JJ; Keefe, FJ
MLA Citation
Hunter, DJ, McDougall, JJ, and Keefe, FJ. "The Symptoms of Osteoarthritis and the Genesis of Pain." Rheumatic Disease Clinics of North America 34.3 (2008): 623-643.
PMID
18687276
Source
scival
Published In
Rheumatic Disease Clinics of North America
Volume
34
Issue
3
Publish Date
2008
Start Page
623
End Page
643
DOI
10.1016/j.rdc.2008.05.004

Therapeutic Interactive Voice Response for chronic pain reduction and relapse prevention

We developed Therapeutic Interactive Voice Response (TIVR) as an automated, telephone-based tool for maintenance enhancement following group cognitive-behavioral therapy (CBT) for chronic pain. TIVR has four components: a daily self-monitoring questionnaire, a didactic review of coping skills, pre-recorded behavioral rehearsals of coping skills, and monthly personalized feedback messages from the CBT therapist based on a review of the patient's daily reports. The first three components are pre-recorded and all four can be accessed remotely by patients via touch-tone telephone on demand. Following 11 weeks of group CBT, 51 subjects with chronic musculoskeletal pain were randomized to one of two study groups. Twenty-six subjects participated in 4 months of TIVR, while a control group of 25 subjects received standard care only. The TIVR group showed maximum improvement over baseline at the 8-month follow-up for seven of the eight outcome measures; improvement was found to be significant for all outcomes (p ≤ .001). Between-group analysis of covariance (ANCOVA) revealed significantly greater improvement for the experimental group at both 4- and 8-month follow-ups for most of the outcomes. Results demonstrate that TIVR can be used to decrease pain, improve coping and decrease likelihood of relapse into pain behavior. Preliminary analysis of medication usage suggests that the superior outcome of the TIVR group was unlikely to be a consequence of differential medication use. © 2007 International Association for the Study of Pain.

Authors
Naylor, MR; Keefe, FJ; Brigidi, B; Naud, S; Helzer, JE
MLA Citation
Naylor, MR, Keefe, FJ, Brigidi, B, Naud, S, and Helzer, JE. "Therapeutic Interactive Voice Response for chronic pain reduction and relapse prevention." Pain 134.3 (2008): 335-345.
PMID
18178011
Source
scival
Published In
PAIN
Volume
134
Issue
3
Publish Date
2008
Start Page
335
End Page
345
DOI
10.1016/j.pain.2007.11.001

Spirituality, religion, and clinical outcomes in patients recovering from an acute myocardial infarction.

OBJECTIVE: To assess the prospective relationship between spiritual experiences and health in a sample of patients surviving an acute myocardial infarction (AMI) with depression or low social support. METHODS: A subset of 503 patients participating in the enhancing recovery in coronary heart disease (ENRICHD) trial completed a Daily Spiritual Experiences (DSE) questionnaire within 28 days from the time of their AMI. The questionnaire assessed three spirituality variables-worship service/church attendance, prayer/meditation, and total DSE score. Patients also completed the Beck Depression Inventory to assess depressive symptoms and the ENRICHD Social Support Inventory to determine perceived social support. The sample was subsequently followed prospectively every 6 months for an average of 18 months to assess all-cause mortality and recurrent AMI. RESULTS: Of the 503 participants who completed the DSE questionnaire at the time of index AMI, 61 (12%) participants either died or sustained a recurrent MI during the follow-up period. After adjustment for gender, education level, ethnicity, and a composite medical prognosis risk score derived specifically for the ENRICHD trial, we observed no relationship between death or nonfatal AMI and total spirituality as measured by the DSE (p = .446), worship service attendance (p = .120), or frequency of prayer/meditation (p = .679). CONCLUSION: We found little evidence that self-reported spirituality, frequency of church attendance, or frequency of prayer is associated with cardiac morbidity or all-cause mortality post AMI in patients with depression and/or low perceived support.

Authors
Blumenthal, JA; Babyak, MA; Ironson, G; Thoresen, C; Powell, L; Czajkowski, S; Burg, M; Keefe, FJ; Steffen, P; Catellier, D; ENRICHD Investigators,
MLA Citation
Blumenthal, JA, Babyak, MA, Ironson, G, Thoresen, C, Powell, L, Czajkowski, S, Burg, M, Keefe, FJ, Steffen, P, Catellier, D, and ENRICHD Investigators, . "Spirituality, religion, and clinical outcomes in patients recovering from an acute myocardial infarction." Psychosom Med 69.6 (July 2007): 501-508.
PMID
17636153
Source
pubmed
Published In
Psychosomatic Medicine
Volume
69
Issue
6
Publish Date
2007
Start Page
501
End Page
508
DOI
10.1097/PSY.0b013e3180cab76c

Conflict about expressing emotions and chronic low back pain: associations with pain and anger.

UNLABELLED: There has been growing interest among researchers and clinicians in the role of ambivalence over emotional expression (AEE) in adjustment to chronic illness. Because of the salience of anger in chronic low back pain, this condition provides a particularly good model in which to examine the role of AEE. This study examined the relation of AEE to pain and anger in a sample of 61 patients with chronic low back pain. Patients completed standardized measures of AEE, pain, and anger. Correlational analyses showed that patients who had higher AEE scores reported higher levels of evaluative and affective pain as well as higher levels of state and trait anger and the tendency to hold in angry thoughts and feelings. Mediational analyses revealed that most of the associations between AEE and pain, and AEE and anger, were independent of one another. These findings suggest that a potentially important relationship exists between AEE and key aspects of living with persistent pain. PERSPECTIVE: This preliminary study suggests that there is a relation between ambivalence over emotional expression and pain and anger in patients with chronic low back pain. Patients who report greater conflict with regard to expressing emotions may be experiencing higher pain and anger.

Authors
Carson, JW; Keefe, FJ; Lowry, KP; Porter, LS; Goli, V; Fras, AM
MLA Citation
Carson, JW, Keefe, FJ, Lowry, KP, Porter, LS, Goli, V, and Fras, AM. "Conflict about expressing emotions and chronic low back pain: associations with pain and anger." J Pain 8.5 (May 2007): 405-411.
PMID
17276143
Source
pubmed
Published In
The Journal of Pain
Volume
8
Issue
5
Publish Date
2007
Start Page
405
End Page
411
DOI
10.1016/j.jpain.2006.11.004

Psychological interventions for arthritis pain management in adults: a meta-analysis.

CONTEXT: The psychosocial impact of arthritis can be profound. There is growing interest in psychosocial interventions for managing pain and disability in arthritis patients. OBJECTIVE: This meta-analysis reports on the efficacy of psychosocial interventions for arthritis pain and disability. DATA SOURCES: Articles evaluating psychosocial interventions for arthritis were identified through Cochrane Controlled Trials, EMBASE, Ovid MEDLINE, and Ovid PsycINFO data sources. STUDY SELECTION: Randomized controlled trials testing the efficacy of psychosocial interventions in arthritis pain management were reviewed. DATA EXTRACTION: Twenty-seven randomized controlled trials were analyzed. Pain intensity was the primary outcome. Secondary outcomes included psychological, physical, and biological functioning. DATA SYNTHESIS: An overall effect size of 0.177 (95% CI=0.256-0.094) indicated that patients receiving psychosocial interventions reported significantly lower pain than patients in control conditions (combined p=.01). Meta-analyses also supported the efficacy of psychosocial interventions for the secondary outcomes. CONCLUSIONS: These findings indicate that psychosocial interventions may have significant effects on pain and other outcomes in arthritis patients. Ample evidence for the additional benefit of such interventions over and above that of standard medical care was found.

Authors
Dixon, KE; Keefe, FJ; Scipio, CD; Perri, LM; Abernethy, AP
MLA Citation
Dixon, KE, Keefe, FJ, Scipio, CD, Perri, LM, and Abernethy, AP. "Psychological interventions for arthritis pain management in adults: a meta-analysis." Health Psychol 26.3 (May 2007): 241-250. (Review)
PMID
17500610
Source
pubmed
Published In
Health Psychology
Volume
26
Issue
3
Publish Date
2007
Start Page
241
End Page
250
DOI
10.1037/0278-6133.26.3.241

Attachment and pain: recent findings and future directions.

Authors
Porter, LS; Davis, D; Keefe, FJ
MLA Citation
Porter, LS, Davis, D, and Keefe, FJ. "Attachment and pain: recent findings and future directions." Pain 128.3 (April 2007): 195-198. (Review)
PMID
17321050
Source
pubmed
Published In
Pain
Volume
128
Issue
3
Publish Date
2007
Start Page
195
End Page
198
DOI
10.1016/j.pain.2007.02.001

Yoga for women with metastatic breast cancer: results from a pilot study.

Metastatic breast cancer (MBC) remains a terminal illness for which major treatment advances are slow to appear, and hence it is crucial that effective palliative interventions be developed to reduce the cancer-related symptoms of women with this condition during the remaining years of their lives. This pilot/feasibility study examined a novel, yoga-based palliative intervention, the Yoga of Awareness Program, in a sample of women with MBC. The eight-week protocol included gentle yoga postures, breathing exercises, meditation, didactic presentations, and group interchange. Outcome was assessed using daily measures of pain, fatigue, distress, invigoration, acceptance, and relaxation during two preintervention weeks and the final two weeks of the intervention. Thirteen women completed the intervention (mean age=59; mean time since diagnosis=7 years; two African American, 11 Caucasian). During the study, four participants had cancer recurrences, and the physical condition of several others deteriorated noticeably. Despite low statistical power, pre-to-post multilevel outcomes analyses showed significant increases in invigoration and acceptance. Lagged analyses of length of home yoga practice (controlling for individual mean practice time and outcome levels on the lagged days) showed that on the day after a day during which women practiced more, they experienced significantly lower levels of pain and fatigue, and higher levels of invigoration, acceptance, and relaxation. These findings support the need for further investigation of the effects of the Yoga of Awareness Program in women with MBC.

Authors
Carson, JW; Carson, KM; Porter, LS; Keefe, FJ; Shaw, H; Miller, JM
MLA Citation
Carson, JW, Carson, KM, Porter, LS, Keefe, FJ, Shaw, H, and Miller, JM. "Yoga for women with metastatic breast cancer: results from a pilot study." J Pain Symptom Manage 33.3 (March 2007): 331-341.
PMID
17349503
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
33
Issue
3
Publish Date
2007
Start Page
331
End Page
341
DOI
10.1016/j.jpainsymman.2006.08.009

Facilitating research participation and improving quality of life for African American prostate cancer survivors and their intimate partners. A pilot study of telephone-based coping skills training.

African American men experience worse prostate cancer outcomes compared with those of Caucasian men, not only in incidence and mortality rates, but also in coping with the side effects of treatment. Unfortunately, African American men have been significantly under-represented in research evaluating the efficacy of psychosocial interventions for improving coping in prostate cancer survivors. This pilot study explored the feasibility and efficacy of coping skills training (CST), an intervention developed to enhance coping with treatment side effects in a sample of African American prostate cancer survivors and their intimate partners. The intervention was delivered in a telephone-based format designed to facilitate research participation. A total of 40 couples were randomized to either 6 sessions of CST or usual care. Survivors completed measures of disease-specific quality of life (QOL) related to urinary, sexual, bowel, and hormonal symptom domains, as well as measures of global QOL (i.e., physical functioning and mental health). Partners completed measures of caregiver strain, mood, and vigor. Analysis of data from 30 couples (12 couples in CST, 18 couples in usual care) indicated that CST produced moderate to large treatment effects for QOL related to bowel, urinary, sexual, and hormonal symptoms. Partners who underwent CST reported less caregiver strain, depression, and fatigue, and more vigor, with moderate effect sizes observed that approached conventional levels of statistical significance. These preliminary findings suggest that telephone-based CST is a feasible approach that can successfully enhance coping inAfrican American prostate cancer survivors and their intimate partners. Cancer 2007. (c) 2006 American Cancer Society.

Authors
Campbell, LC; Keefe, FJ; Scipio, C; McKee, DC; Edwards, CL; Herman, SH; Johnson, LE; Colvin, OM; McBride, CM; Donatucci, C
MLA Citation
Campbell, LC, Keefe, FJ, Scipio, C, McKee, DC, Edwards, CL, Herman, SH, Johnson, LE, Colvin, OM, McBride, CM, and Donatucci, C. "Facilitating research participation and improving quality of life for African American prostate cancer survivors and their intimate partners. A pilot study of telephone-based coping skills training." Cancer 109.2 Suppl (January 15, 2007): 414-424.
PMID
17173280
Source
pubmed
Published In
Cancer
Volume
109
Issue
2 Suppl
Publish Date
2007
Start Page
414
End Page
424
DOI
10.1002/cncr.22355

An interdisciplinary expert consensus statement on assessment of pain in older persons.

This paper represents an expert-based consensus statement on pain assessment among older adults. It is intended to provide recommendations that will be useful for both researchers and clinicians. Contributors were identified based on literature prominence and with the aim of achieving a broad representation of disciplines. Recommendations are provided regarding the physical examination and the assessment of pain using self-report and observational methods (suitable for seniors with dementia). In addition, recommendations are provided regarding the assessment of the physical and emotional functioning of older adults experiencing pain. The literature underlying the consensus recommendations is reviewed. Multiple revisions led to final reviews of 2 complete drafts before consensus was reached.

Authors
Hadjistavropoulos, T; Herr, K; Turk, DC; Fine, PG; Dworkin, RH; Helme, R; Jackson, K; Parmelee, PA; Rudy, TE; Lynn Beattie, B; Chibnall, JT; Craig, KD; Ferrell, B; Ferrell, B; Fillingim, RB; Gagliese, L; Gallagher, R; Gibson, SJ; Harrison, EL; Katz, B; Keefe, FJ; Lieber, SJ; Lussier, D; Schmader, KE; Tait, RC; Weiner, DK; Williams, J
MLA Citation
Hadjistavropoulos, T, Herr, K, Turk, DC, Fine, PG, Dworkin, RH, Helme, R, Jackson, K, Parmelee, PA, Rudy, TE, Lynn Beattie, B, Chibnall, JT, Craig, KD, Ferrell, B, Ferrell, B, Fillingim, RB, Gagliese, L, Gallagher, R, Gibson, SJ, Harrison, EL, Katz, B, Keefe, FJ, Lieber, SJ, Lussier, D, Schmader, KE, Tait, RC, Weiner, DK, and Williams, J. "An interdisciplinary expert consensus statement on assessment of pain in older persons." Clin J Pain 23.1 Suppl (January 2007): S1-43.
PMID
17179836
Source
pubmed
Published In
Clinical Journal of Pain
Volume
23
Issue
1 Suppl
Publish Date
2007
Start Page
S1
End Page
43
DOI
10.1097/AJP.0b013e31802be869

Spirituality, religion, and clinical outcomes in patients recovering from an acute myocardial infarction (Psychosomatic Medicine (2007) 69, (501-508))

Authors
Blumenthal, JA; Babyak, MA; Ironson, G; Thoresen, C; Powell, L; Czajkowski, S; Burg, M; Keefe, FJ; Steffen, P; Catellier, D
MLA Citation
Blumenthal, JA, Babyak, MA, Ironson, G, Thoresen, C, Powell, L, Czajkowski, S, Burg, M, Keefe, FJ, Steffen, P, and Catellier, D. "Spirituality, religion, and clinical outcomes in patients recovering from an acute myocardial infarction (Psychosomatic Medicine (2007) 69, (501-508))." Psychosomatic Medicine 69.8 (2007): 826--.
Source
scival
Published In
Psychosomatic Medicine
Volume
69
Issue
8
Publish Date
2007
Start Page
826-
DOI
10.1097/PSY.0b013e31815adb80

Pain catastrophizing in the context of satisfaction with spousal responses: New perspectives and new opportunities

Authors
Keefe, FJ; Porter, L
MLA Citation
Keefe, FJ, and Porter, L. "Pain catastrophizing in the context of satisfaction with spousal responses: New perspectives and new opportunities." Pain 131.1-2 (2007): 1-2.
PMID
17590516
Source
scival
Published In
PAIN
Volume
131
Issue
1-2
Publish Date
2007
Start Page
1
End Page
2
DOI
10.1016/j.pain.2007.05.016

Effects of day-to-day affect regulation on the pain experience of patients with rheumatoid arthritis

Individual differences in the regulation of affect are known to impact pain and other symptoms in rheumatoid arthritis. However, no studies have yet used a rigorous daily diary methodology to address the question of whether current pain is reduced when positive or negative affects are effectively regulated. We used a prospective, repeated daily sampling design to infer the regulation of affect from day-to-day changes in affect intensity and examined how these changes in affect were prospectively related to pain from rheumatoid arthritis. Ninety-four adult patients diagnosed with rheumatoid arthritis completed daily measures of pain and positive and negative affect over a period of 30 days. Information on demographic and disease status variables was collected during a medical evaluation. Results of hierarchical linear model analyses indicated that the regulation of both positive and negative affect from the prior day to the current day predicted significantly greater decreases in pain that day, resulting in up to a 28% reduction in pain intensity. These findings were partly influenced by disease status and demographic variables. This study suggests that the day-to-day regulation of negative and positive affect is a key variable for understanding the pain experience of individuals with rheumatoid arthritis and is a potentially important target for intervention. © 2007 International Association for the Study of Pain.

Authors
Connelly, M; Keefe, FJ; Affleck, G; Lumley, MA; Anderson, T; Waters, S
MLA Citation
Connelly, M, Keefe, FJ, Affleck, G, Lumley, MA, Anderson, T, and Waters, S. "Effects of day-to-day affect regulation on the pain experience of patients with rheumatoid arthritis." Pain 131.1-2 (2007): 162-170.
PMID
17321049
Source
scival
Published In
PAIN
Volume
131
Issue
1-2
Publish Date
2007
Start Page
162
End Page
170
DOI
10.1016/j.pain.2007.01.002

Couple-oriented education and support intervention: Effects on individuals with osteoarthritis and their spouses

Objective: To determine whether a couple-oriented intervention for osteoarthritis (OA) was more efficacious than a patient-oriented intervention and whether each intervention was more efficacious than usual medical care. Research Design: 242 older adults with OA and their spouses were randomly assigned to patient-oriented education and support, couple-oriented education and support, or usual care. Results: Intent-to-treat analyses indicated no significant differences between the 3 study conditions in outcomes for individuals with OA or their spouses. Completers analyses showed that at the 6-month follow-up, contrary to prediction, individuals with OA who received the patient-oriented intervention reported greater reductions in pain and improvements in physical function than those who received the couple-oriented intervention. At the postintervention assessment, spouses who received the coupleoriented intervention reported greater reductions in stress and a trend toward less critical attitudes than spouses of individuals with OA who received the patient-oriented intervention. Moderator analyses indicated that female spouses and spouses with high marital satisfaction who received the couple-oriented intervention also experienced better outcomes in terms of depressive symptoms and caregiver mastery. Conclusions: A couples approach to education and support for OA may offer no advantage for individuals with OA but may prove helpful for spouses, thereby indirectly benefiting individuals with OA over time. © 2007 APA, all rights reserved.

Authors
Martire, LM; Schulz, R; Keefe, FJ; Rudy, TE; Starz, TW
MLA Citation
Martire, LM, Schulz, R, Keefe, FJ, Rudy, TE, and Starz, TW. "Couple-oriented education and support intervention: Effects on individuals with osteoarthritis and their spouses." Rehabilitation Psychology 52.2 (2007): 121-132.
Source
scival
Published In
Rehabilitation Psychology
Volume
52
Issue
2
Publish Date
2007
Start Page
121
End Page
132
DOI
10.1037/0090-5550.52.2.121

Partner-delivered reflexology: Effects on cancer pain and anxiety (Oncology Nursing Forum (2007) 34, (127))

Authors
Stephenson, NLN; Swanson, M; Dalton, J; Keefe, FJ; Engelke, M
MLA Citation
Stephenson, NLN, Swanson, M, Dalton, J, Keefe, FJ, and Engelke, M. "Partner-delivered reflexology: Effects on cancer pain and anxiety (Oncology Nursing Forum (2007) 34, (127))." Oncology Nursing Forum 34.2 (2007): 280--.
Source
scival
Published In
Oncology Nursing Forum
Volume
34
Issue
2
Publish Date
2007
Start Page
280-
DOI
10.1188/07.ONF.275-280

Getting a handle on process and change in CBT for chronic pain

Authors
Morley, S; Keefe, FJ
MLA Citation
Morley, S, and Keefe, FJ. "Getting a handle on process and change in CBT for chronic pain." Pain 127.3 (2007): 197-198.
PMID
17182182
Source
scival
Published In
PAIN
Volume
127
Issue
3
Publish Date
2007
Start Page
197
End Page
198
DOI
10.1016/j.pain.2006.10.025

Partner-delivered reflexology: Effects on cancer pain and anxiety

Purpose/Objectives: To compare the effects of partner-delivered foot reflexology and usual care plus attention on patients' perceived pain and anxiety. Design: The experimental pretest/post-test design included patient-partner dyads randomly assigned to an experimental or control group. Setting: Four hospitals in the southeastern United States. Sample: 42 experimental and 44 control subjects comprised 86 dyads of patients with metastatic cancer and their partners, representing 16 different types of cancer; 23% of patients had lung cancer, followed by breast, colorectal, and head and neck cancer and lymphoma. The subjects had a mean age of 58.3 years, 51% were female, 66% had a high school education or less, and 58% were Caucasian, 40% were African American, and 1% were Filipino. Methods: The intervention included a 15- to 30-minute teaching session on foot reflexology to the partner by a certified reflexologist, an optional 15- to 30-minute foot reflexology session for the partner, and a 30-minute, partner-delivered foot reflexology intervention for the patient. The control group received a 30-minute reading session from their partners. Main Research Variables: Pain and anxiety. Findings: Following the initial partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety. Conclusions: A nurse reflexologist taught partners how to perform reflexology on patients with metastatic cancer pain in the hospital, resulting in an immediate decrease in pain intensity and anxiety; minimal changes were seen in the control group, who received usual care plus attention. Implications for Nursing: Hospitals could have qualified professionals offer reflexology as a complementary therapy and teach interested partners the modality.

Authors
Stephenson, NLN; Swanson, M; Dalton, J; Keefe, FJ; Engelke, M
MLA Citation
Stephenson, NLN, Swanson, M, Dalton, J, Keefe, FJ, and Engelke, M. "Partner-delivered reflexology: Effects on cancer pain and anxiety." Oncology Nursing Forum 34.1 (2007): 127-132.
PMID
17562639
Source
scival
Published In
Oncology Nursing Forum
Volume
34
Issue
1
Publish Date
2007
Start Page
127
End Page
132
DOI
10.1188/07.ONF.127-132

Cognitive behavioral approaches to the treatment of pain.

How can cognitive-behavioral therapy benefit patients with persistent pain? The purpose of this review is to provide an overview of cognitive-behavioral treatment approaches to persistent pain. The review is divided into four sections. In the first section, we describe the conceptual back ground for cognitive-behavioral approaches to pain. In the second section, we describe the basic elements of a typical cognitive-behavioral treatment protocol used in pain management. In the third section, we address questions that health care professionals frequently ask about cognitive - behavioral treatment. In the fourth section, we discuss new clinical applications of cognitive-behavioral treatment.

Authors
Waters, SJ; McKee, DC; Keefe, FJ
MLA Citation
Waters, SJ, McKee, DC, and Keefe, FJ. "Cognitive behavioral approaches to the treatment of pain." Psychopharmacol Bull 40.4 (2007): 74-88. (Review)
PMID
18227779
Source
pubmed
Published In
Psychopharmacology bulletin
Volume
40
Issue
4
Publish Date
2007
Start Page
74
End Page
88

What physicians should know about spirituality and chronic pain.

Authors
Wachholtz, AB; Keefe, FJ
MLA Citation
Wachholtz, AB, and Keefe, FJ. "What physicians should know about spirituality and chronic pain." South Med J 99.10 (October 2006): 1174-1175.
PMID
17100061
Source
pubmed
Published In
Southern Medical Journal
Volume
99
Issue
10
Publish Date
2006
Start Page
1174
End Page
1175
DOI
10.1097/01.smj.0000242813.97953.1c

A comparison of conventional pain coping skills training and pain coping skills training with a maintenance training component: a daily diary analysis of short- and long-term treatment effects.

UNLABELLED: Pain coping skills training (PCST) has been shown to produce immediate improvements in pain and disability in rheumatoid arthritis (RA). However, some patients have difficulty maintaining these gains. This study compared a conventional PCST protocol with a PCST protocol that included maintenance training (PCST/MT). Patients with RA (n = 167) were randomly assigned to either conventional PCST, PCST/MT, arthritis education control, or standard care control. Daily data were collected on joint pain, coping, coping efficacy, and mood. Multilevel analyses showed that at posttreatment, conventional PCST was superior to all other conditions in joint pain, coping efficacy, and negative mood, whereas PCST/MT was superior to all other conditions in emotion-focused coping and positive mood. At 18 months follow-up, both PCST conditions were superior to standard care in joint pain and coping efficacy. Interpretation of follow-up outcomes was limited by higher dropout rates in the 2 PCST groups. For RA, a maintenance training component does not appear to produce significant improvements over conventional PCST. PERSPECTIVE: This article reports a trial evaluating a conventional pain coping skills training protocol and a similar protocol that included a maintenance training component. Overall, results indicate similar results for both the conventional and the modified protocols.

Authors
Carson, JW; Keefe, FJ; Affleck, G; Rumble, ME; Caldwell, DS; Beaupre, PM; Kashikar-Zuck, S; Sandstrom, M; Weisberg, JN
MLA Citation
Carson, JW, Keefe, FJ, Affleck, G, Rumble, ME, Caldwell, DS, Beaupre, PM, Kashikar-Zuck, S, Sandstrom, M, and Weisberg, JN. "A comparison of conventional pain coping skills training and pain coping skills training with a maintenance training component: a daily diary analysis of short- and long-term treatment effects." J Pain 7.9 (September 2006): 615-625.
PMID
16942947
Source
pubmed
Published In
The Journal of Pain
Volume
7
Issue
9
Publish Date
2006
Start Page
615
End Page
625
DOI
10.1016/j.jpain.2006.02.008

Telephone-based coping skills training for patients awaiting lung transplantation.

Impaired quality of life is associated with increased mortality in patients with advanced lung disease. Using a randomized controlled trial with allocation concealment and blinded outcome assessment at 2 tertiary care teaching hospitals, the authors randomly assigned 328 patients with end-stage lung disease awaiting lung transplantation to 12 weeks of telephone-based coping skills training (CST) or to usual medical care (UMC). Patients completed a battery of quality of life instruments and were followed for up to 3.4 years to assess all-cause mortality. Compared with UMC, CST produced lower scores on perceived stress, anxiety, depressive symptoms, and negative affect and improved scores on mental health functioning, optimism, vitality, and perceived social support. There were 29 deaths (9%) over a mean follow-up period of 1.1 year. Survival analyses revealed that there was no difference in survival between the 2 groups. The authors conclude that a telephone-based CST intervention can be effectively delivered to patients awaiting lung transplantation. Despite the severity of pulmonary disease in this patient population, significant improvements in quality of life, but not somatic measures or survival to transplant, were achieved.

Authors
Blumenthal, JA; Babyak, MA; Keefe, FJ; Davis, RD; Lacaille, RA; Carney, RM; Freedland, KE; Trulock, E; Palmer, SM
MLA Citation
Blumenthal, JA, Babyak, MA, Keefe, FJ, Davis, RD, Lacaille, RA, Carney, RM, Freedland, KE, Trulock, E, and Palmer, SM. "Telephone-based coping skills training for patients awaiting lung transplantation." J Consult Clin Psychol 74.3 (June 2006): 535-544.
PMID
16822110
Source
pubmed
Published In
Journal of Consulting and Clinical Psychology
Volume
74
Issue
3
Publish Date
2006
Start Page
535
End Page
544
DOI
10.1037/0022-006X.74.3.535

Effects of a brief coping skills training intervention on nociceptive flexion reflex threshold in patients having osteoarthritic knee pain: A preliminary laboratory study of sex differences

Studies have documented the efficacy of coping skills training (CST) for managing pain, distress, and disability in persons with arthritis. However, no laboratory studies have examined the effects of CST on descending modulation of nociception. This study used the nociceptive flexion reflex (NFR) to document pain and nociceptive responding among 62 men and women with osteoarthritis of the knee (mean age = 63.3 ± 7.5 years). Before and after a 45-minute CST session, participants completed laboratory assessments of NFR threshold and questionnaires evaluating pain and state anxiety. Results indicated significantly increased NFR thresholds and decreased pain ratings following CST for men and women. A significant time by sex interaction was observed for state anxiety, with women reporting greater decreases in anxiety following CST than men. This is the first study to demonstrate effects of a CST protocol on a measure of descending inhibition of nociception among patients with osteoarthritic knee pain. © 2006 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Authors
Emery, CF; Keefe, FJ; France, CR; Affleck, G; Waters, S; Fondow, MDM; McKee, DC; France, JL; Hackshaw, KV; Caldwell, DS; Stainbrook, D
MLA Citation
Emery, CF, Keefe, FJ, France, CR, Affleck, G, Waters, S, Fondow, MDM, McKee, DC, France, JL, Hackshaw, KV, Caldwell, DS, and Stainbrook, D. "Effects of a brief coping skills training intervention on nociceptive flexion reflex threshold in patients having osteoarthritic knee pain: A preliminary laboratory study of sex differences." Journal of Pain and Symptom Management 31.3 (2006): 262-269.
PMID
16563320
Source
scival
Published In
Journal of Pain and Symptom Management
Volume
31
Issue
3
Publish Date
2006
Start Page
262
End Page
269
DOI
10.1016/j.jpainsymman.2005.07.008

Older spouses' perceptions of partners' chronic arthritis pain: Implications for spousal responses, support provision, and caregiving experiences

This study of older patients with osteoarthritis and their spouses examined concordance between patients' and spouses' reports of patients' pain severity and the association of concordance with support and caregiving outcomes. Patients and spouses independently viewed videotapes of the patient performing simulated household tasks and provided ratings of patients' pain. Spousal overestimation of patients' pain was the most common type of nonconcordance. Spouses who were accurate in their perceptions of their partner's level of pain during a log-carrying task responded less negatively and provided emotional support that was more satisfying to patients. In addition, spouses who were accurate in their perceptions of their partner's pain during the log-carrying task reported less stress from providing support and assistance. Future research that uses such observational methods may be highly useful for understanding the effects of chronic illness on older couples. Copyright 2006 by the American Psychological Association.

Authors
Martire, LM; Keefe, FJ; Schulz, R; Ready, R; Beach, SR; Rudy, TE; Starz, TW
MLA Citation
Martire, LM, Keefe, FJ, Schulz, R, Ready, R, Beach, SR, Rudy, TE, and Starz, TW. "Older spouses' perceptions of partners' chronic arthritis pain: Implications for spousal responses, support provision, and caregiving experiences." Psychology and Aging 21.2 (2006): 222-230.
PMID
16768570
Source
scival
Published In
Psychology and Aging
Volume
21
Issue
2
Publish Date
2006
Start Page
222
End Page
230
DOI
10.1037/0882-7974.21.2.222

Disclosure between patients with gastrointestinal cancer and their spouses.

This study examined patterns of disclosure about cancer-related concerns between patients with GI cancer and their spouses, and associations between patient and spouse disclosure and patient adjustment, spouse adjustment, and aspects of relationship functioning. A sample of 47 patients and 45 of their spouses completed a measure of disclosure which included ratings of their level of disclosure and level of holding back from disclosure of cancer-related concerns. Patients completed a measure of quality of life, spouses completed a measure of caregiver strain, and all participants completed measures of psychological distress and relationship functioning (intimacy, empathy, and partner avoidance and criticism). Data analyses revealed that patients and spouses reported moderately high levels of disclosure and low levels of holding back, with patients reporting higher levels of disclosure than spouses. Among patients and spouses, low levels of disclosure and high levels of holding back were associated with poorer relationship functioning. There were also some indications that high levels of holding back, and to a lesser extent low levels of disclosure, were associated with increased psychological distress for both patients and spouses. However, there were no indications that patient or spouse disclosure was harmful for the other person. Considered overall, the results of this study suggest that levels of disclosure between cancer patients and their spouses may be important in understanding how they adjust as a couple to the demands of the patient's illness.

Authors
Porter, LS; Keefe, FJ; Hurwitz, H; Faber, M
MLA Citation
Porter, LS, Keefe, FJ, Hurwitz, H, and Faber, M. "Disclosure between patients with gastrointestinal cancer and their spouses." Psychooncology 14.12 (December 2005): 1030-1042.
PMID
15712247
Source
pubmed
Published In
Psycho-Oncology
Volume
14
Issue
12
Publish Date
2005
Start Page
1030
End Page
1042
DOI
10.1002/pon.915

Ambivalence over emotional expression in patients with gastrointestinal cancer and their caregivers: associations with patient pain and quality of life.

This study examined the role of patient and caregiver ambivalence over emotional expression (AEE) in pain and quality of life (QOL) in a sample of 78 patients with gastrointestinal (GI) cancer. Measures of ambivalence over emotional expression as well as ratings of patient pain and pain behavior were collected from patients and caregivers. Measures of pain catastrophizing, perceptions of social support, and QOL were obtained from patients. Data analyses revealed that patients high in AEE engaged in more catastrophizing and reported higher levels of pain behaviors and poorer QOL. In addition, patients whose caregivers were high in AEE engaged in more catastrophizing, had higher levels of pain and pain behavior, and reported lower emotional well-being. Patient catastrophizing mediated the effects of both patient and caregiver AEE on some patient outcomes. Taken together, these findings suggest that emotional regulation in both patients and their caregivers may be an important factor in understanding cancer patients' experience of and coping with symptoms such as pain.

Authors
Porter, LS; Keefe, FJ; Lipkus, I; Hurwitz, H
MLA Citation
Porter, LS, Keefe, FJ, Lipkus, I, and Hurwitz, H. "Ambivalence over emotional expression in patients with gastrointestinal cancer and their caregivers: associations with patient pain and quality of life." Pain 117.3 (October 2005): 340-348.
PMID
16153771
Source
pubmed
Published In
PAIN
Volume
117
Issue
3
Publish Date
2005
Start Page
340
End Page
348
DOI
10.1016/j.pain.2005.06.021

Loving-kindness meditation for chronic low back pain: results from a pilot trial.

PURPOSE: Loving-kindness meditation has been used for centuries in the Buddhist tradition to develop love and transform anger into compassion. This pilot study tested an 8-week loving-kindness program for chronic low back pain patients. METHOD: Patients (N = 43) were randomly assigned to the intervention or standard care. Standardized measures assessed patients' pain, anger, and psychological distress. FINDINGS: Post and follow-up analyses showed significant improvements in pain and psychological distress in the loving-kindness group, but no changes in the usual care group. Multilevel analyses of daily data showed that more loving-kindness practice on a given day was related to lower pain that day and lower anger the next day. CONCLUSIONS: Preliminary results suggest that the loving-kindness program can be beneficial in reducing pain, anger, and psychological distress in patients with persistent low back pain. IMPLICATIONS: Clinicians may find loving-kindness meditation helpful in the treatment of patients with persistent pain.

Authors
Carson, JW; Keefe, FJ; Lynch, TR; Carson, KM; Goli, V; Fras, AM; Thorp, SR
MLA Citation
Carson, JW, Keefe, FJ, Lynch, TR, Carson, KM, Goli, V, Fras, AM, and Thorp, SR. "Loving-kindness meditation for chronic low back pain: results from a pilot trial." J Holist Nurs 23.3 (September 2005): 287-304.
PMID
16049118
Source
pubmed
Published In
Journal of Holistic Nursing
Volume
23
Issue
3
Publish Date
2005
Start Page
287
End Page
304
DOI
10.1177/0898010105277651

A pilot study investigating the utility of the cognitive-behavioral model of insomnia in early-stage lung cancer patients.

This pilot study investigated the utility of a cognitive-behavioral model in understanding insomnia in early-stage lung cancer patients. Nineteen patients meeting criteria for insomnia and a comparison group of 13 patients not meeting these criteria completed questionnaires assessing dysfunctional sleep-related thoughts, poor sleep hygiene, lung cancer symptoms, mood, quality of life, and insomnia symptoms. Participants also completed standard sleep logs and wore an Actiwatch while sleeping each day for 7 days. Findings indicated that the insomnia group reported significantly more dysfunctional sleep-related thoughts, higher levels of pain and anxiety, and lower quality of life than those in the comparison group. Men in the insomnia group reported significantly higher levels of fatigue than men in the comparison group, whereas women demonstrated no group differences. These pilot findings support the utility of the cognitive-behavioral model in understanding insomnia in early-stage lung cancer patients and the hypothesis that insomnia is related to poor clinical status.

Authors
Rumble, ME; Keefe, FJ; Edinger, JD; Porter, LS; Garst, JL
MLA Citation
Rumble, ME, Keefe, FJ, Edinger, JD, Porter, LS, and Garst, JL. "A pilot study investigating the utility of the cognitive-behavioral model of insomnia in early-stage lung cancer patients." J Pain Symptom Manage 30.2 (August 2005): 160-169.
PMID
16125031
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
30
Issue
2
Publish Date
2005
Start Page
160
End Page
169
DOI
10.1016/j.jpainsymman.2005.02.013

Partner-guided cancer pain management at the end of life: a preliminary study.

This preliminary study tested the efficacy of a partner-guided cancer pain management protocol for patients who are at the end of life. Seventy-eight advanced cancer patients meeting criteria for hospice eligibility and their partners were randomly assigned to a partner-guided pain management training intervention, or usual care control condition. The partner-guided pain management training protocol was a three-session intervention conducted in patients' homes that integrated educational information about cancer pain with systematic training of patients and partners in cognitive and behavioral pain coping skills. Data analyses revealed that the partner-guided pain management protocol produced significant increases in partners' ratings of their self-efficacy for helping the patient control pain and self-efficacy for controlling other symptoms. Partners receiving this training also showed a trend to report improvements in their levels of caregiver strain. Overall, the results of this preliminary study suggest that a partner-guided pain management protocol may have benefits in the context of cancer pain at the end of life. Given the significance of pain at the end of life, future research in this area appears warranted.

Authors
Keefe, FJ; Ahles, TA; Sutton, L; Dalton, J; Baucom, D; Pope, MS; Knowles, V; McKinstry, E; Furstenberg, C; Syrjala, K; Waters, SJ; McKee, D; McBride, C; Rumble, M; Scipio, C
MLA Citation
Keefe, FJ, Ahles, TA, Sutton, L, Dalton, J, Baucom, D, Pope, MS, Knowles, V, McKinstry, E, Furstenberg, C, Syrjala, K, Waters, SJ, McKee, D, McBride, C, Rumble, M, and Scipio, C. "Partner-guided cancer pain management at the end of life: a preliminary study." J Pain Symptom Manage 29.3 (March 2005): 263-272.
PMID
15781177
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
29
Issue
3
Publish Date
2005
Start Page
263
End Page
272
DOI
10.1016/j.jpainsymman.2004.06.014

Forgiveness and chronic low back pain: a preliminary study examining the relationship of forgiveness to pain, anger, and psychological distress.

UNLABELLED: Clinical observations suggest that many patients with chronic pain have difficulty forgiving persons they perceive as having unjustly offended them in some way. By using a sample of 61 patients with chronic low back pain, this study sought to determine the reliability and variability of forgiveness assessments in patients and to examine the relationship of forgiveness to pain, anger, and psychological distress. Standardized measures were used to assess patients' current levels of forgiveness, forgiveness self-efficacy, pain, anger, and psychological distress. Results showed that forgiveness-related constructs can be reliably assessed in patients with persistent pain, and that patients vary considerably along dimensions of forgiveness. Furthermore, correlational analyses showed that patients who had higher scores on forgiveness-related variables reported lower levels of pain, anger, and psychological distress. Additional analyses indicated that state anger largely mediated the association between forgiveness and psychological distress, as well as some of the associations between forgiveness and pain. These findings indicate that forgiveness can be reliably assessed in patients with persistent pain, and that a relationship appears to exist between forgiveness and important aspects of living with persistent pain. PERSPECTIVE: This preliminary study suggests there is a relationship between forgiveness and pain, anger, and psychological distress in patients with chronic low back pain. Patients who report an inability to forgive others might be experiencing higher pain and psychological distress that are mediated by relatively higher levels of state anger.

Authors
Carson, JW; Keefe, FJ; Goli, V; Fras, AM; Lynch, TR; Thorp, SR; Buechler, JL
MLA Citation
Carson, JW, Keefe, FJ, Goli, V, Fras, AM, Lynch, TR, Thorp, SR, and Buechler, JL. "Forgiveness and chronic low back pain: a preliminary study examining the relationship of forgiveness to pain, anger, and psychological distress." J Pain 6.2 (February 2005): 84-91.
PMID
15694874
Source
pubmed
Published In
The Journal of Pain
Volume
6
Issue
2
Publish Date
2005
Start Page
84
End Page
91
DOI
10.1016/j.jpain.2004.10.012

Does personality at college entry predict number of reported pain conditions at mid-life? A longitudinal study.

UNLABELLED: The purpose of this study was to evaluate whether personality traits, as assessed by the Minnesota Multiphasic Personality Inventory (MMPI), at time of college entry can predict the number of reported pain conditions at an approximate 30-year follow-up for 2332 subjects, 1834 men and 498 women, who were administered the MMPI on entry to the University of North Carolina (Chapel Hill) between 1964 and 1966. In 1997, a follow-up was conducted in which subjects were administered a self-report questionnaire regarding whether they had experienced 1 or more chronic pain conditions. Analyses of the relationship between the MMPI clinical scales at college entrance and the report of number of chronic pain conditions at follow-up were conducted. Among male participants, elevations of Scales 1 (Hypochondriasis), 3 (Hysteria), and 5 (Masculinity/Femininity) predicted increases in number of chronic pain conditions at follow-up. For female participants, elevations in Scales 1, 3, and 6 (Paranoia) predicted increases in number of chronic pain conditions at follow-up. The current study suggests that a statistically significant relationship exists between MMPI responses at college entry and reports of chronic pain conditions at mid-life. PERSPECTIVE: This study found a small, but significant relationship between elevations on MMPI scales measuring hypochondriasis and hysteria and the report of chronic pain conditions at follow-up. The study is important because it is the first to examine how personality assessed in younger adults relates to the number of chronic pain conditions reported 30 years later.

Authors
Applegate, KL; Keefe, FJ; Siegler, IC; Bradley, LA; McKee, DC; Cooper, KS; Riordan, P
MLA Citation
Applegate, KL, Keefe, FJ, Siegler, IC, Bradley, LA, McKee, DC, Cooper, KS, and Riordan, P. "Does personality at college entry predict number of reported pain conditions at mid-life? A longitudinal study." J Pain 6.2 (February 2005): 92-97.
PMID
15694875
Source
pubmed
Published In
The Journal of Pain
Volume
6
Issue
2
Publish Date
2005
Start Page
92
End Page
97
DOI
10.1016/j.jpain.2004.11.001

Psychological approaches to understanding and treating disease-related pain.

Psychologists are increasingly involved in the assessment and treatment of disease-related pain such as pain secondary to arthritis or cancer. This review is divided into four sections. In the first section, we provide a conceptual background on this area that discusses the limitations of the biomedical model of disease-related pain and traces the evolution of psychosocial theories of pain. In the second section, we discuss special issues and challenges involved in working with persons having disease-related pain, including the reluctance of some persons to report pain and to become involved in psychological treatments for pain. Section three provides an overview of psychosocial research conducted on arthritis pain and cancer pain that addresses both psychosocial factors related to pain and psychosocial interventions for pain management. In the final section, we describe important future directions, including strategies for disseminating psychosocial treatments and disparities in pain management.

Authors
Keefe, FJ; Abernethy, AP; C Campbell, L
MLA Citation
Keefe, FJ, Abernethy, AP, and C Campbell, L. "Psychological approaches to understanding and treating disease-related pain." Annu Rev Psychol 56 (2005): 601-630. (Review)
PMID
15709948
Source
pubmed
Published In
Annual Review of Psychology
Volume
56
Publish Date
2005
Start Page
601
End Page
630
DOI
10.1146/annurev.psych.56.091103.070302

Mood disorders in the medically ill: Scientific review and recommendations

Objective: The purpose of this review is to assess the relationship between mood disorders and development, course, and associated morbidity and mortality of selected medical illnesses, review evidence for treatment, and determine needs in clinical practice and research. Data Sources: Data were culled from the 2002 Depression and Bipolar Support Alliance Conference proceedings and a literature review addressing prevalence, risk factors, diagnosis, and treatment. This review also considered the experience of primary and specialty care providers, policy analysts, and patient advocates. The review and recommendations reflect the expert opinion of the authors. Study Selection/Data Extraction: Reviews of epidemiology and mechanistic studies were included, as were open-label and randomized, controlled trials on treatment of depression in patients with medical comorbidities. Data on study design, population, and results were extracted for review of evidence that includes tables of prevalence and pharmacological treatment. The effect of depression and bipolar disorder on selected medical comorbidities was assessed, and recommendations for practice, research, and policy were developed. Conclusions: A growing body of evidence suggests that biological mechanisms underlie a bidirectional link between mood disorders and many medical illnesses. In addition, there is evidence to suggest that mood disorders affect the course of medical illnesses. Further prospective studies are warranted. © 2005 Society of Biological Psychiatry.

Authors
Evans, DL; Charney, DS; Lewis, L; Golden, RN; Gorman, JM; Krishnan, KRR; Nemeroff, CB; Bremner, JD; Carney, RM; Coyne, JC; Delong, MR; Frasure-Smith, N; Glassman, AH; Gold, PW; Grant, I; Gwyther, L; Ironson, G; Johnson, RL; Kanner, AM; Katon, WJ; Kaufmann, PG; Keefe, FJ; Ketter, T; Laughren, TP; Leserman, J; Lyketsos, CG; McDonald, WM; McEwen, BS; Miller, AH; Musselman, D; O'Connor, C; Petitto, JM; Pollock, BG; Robinson, RG; Roose, SP; Rowland, J; Sheline, Y; Sheps, DS; Simon, G; Spiegel, D et al.
MLA Citation
Evans, DL, Charney, DS, Lewis, L, Golden, RN, Gorman, JM, Krishnan, KRR, Nemeroff, CB, Bremner, JD, Carney, RM, Coyne, JC, Delong, MR, Frasure-Smith, N, Glassman, AH, Gold, PW, Grant, I, Gwyther, L, Ironson, G, Johnson, RL, Kanner, AM, Katon, WJ, Kaufmann, PG, Keefe, FJ, Ketter, T, Laughren, TP, Leserman, J, Lyketsos, CG, McDonald, WM, McEwen, BS, Miller, AH, Musselman, D, O'Connor, C, Petitto, JM, Pollock, BG, Robinson, RG, Roose, SP, Rowland, J, Sheline, Y, Sheps, DS, Simon, G, and Spiegel, D et al. "Mood disorders in the medically ill: Scientific review and recommendations." Biological Psychiatry 58.3 (2005): 175-189.
PMID
16084838
Source
scival
Published In
Biological Psychiatry
Volume
58
Issue
3
Publish Date
2005
Start Page
175
End Page
189
DOI
10.1016/j.biopsych.2005.05.001

Psychosocial issues confronting young women with breast cancer

The current paper reviews the literature regarding psychosocial issues confronting young women with breast cancer. The findings indicate that younger women with breast cancer experience a lower quality of life after cancer compared to older women. In part, this lower quality of life results from the effects of medical treatment. The effects of surgery and removal of the breast result in more negative feelings regarding body image, particularly for young women. With systemic treatment, many younger women experience the sudden onset of menopause, with the attendant symptoms of hot flashes, decreased sexual desire, and vaginal dryness. These physical effects along with a variety of relationship issues contribute to a high level of sexual concerns for young women. From a psychosocial perspective, breast cancer affects both females and their male partners. Both partners experience psychological distress including depression and anxiety. Within the relationship, emotional support from the partner is important in women's adjustment. In terms of psychosocial interventions for breast cancer, findings suggest that the most frequently employed interventions, which treat the woman without her partner, are not optimal. Initial findings provide encouraging evidence that couple-based psychosocial interventions for women and their partners might be of particular assistance to both partners. © 2005,2006 IOS Press. All rights reserved.

Authors
Baucom, DH; Porter, LS; Kirby, JS; Gremore, TM; Keefe, FJ
MLA Citation
Baucom, DH, Porter, LS, Kirby, JS, Gremore, TM, and Keefe, FJ. "Psychosocial issues confronting young women with breast cancer." Breast Disease 23 (2005): 103-113.
PMID
16823173
Source
scival
Published In
Breast Disease
Volume
23
Publish Date
2005
Start Page
103
End Page
113

Impact of depressive symptoms on the treatment of generalized social anxiety disorder

Patients with depression are often excluded from studies on the treatment of social anxiety disorder (SAD), leaving gaps in our knowledge about the impact of depressive affect on treatment for SAD. Patients participated in a randomized, placebo-controlled study of treatment for SAD. As in previous studies, patients were excluded from the study if they met criteria for major depressive disorder in the past 6 months. This exclusion notwithstanding, patients who enrolled in the study exhibited a range of depressive symptoms, permitting an examination of the impact of depressive symptoms on treatment outcome for SAD. Assessment measures included the Clinical Global Impression Scale, Hamilton Rating Scale for Depression, Brief Social Phobia Scale, and Beck Depression Inventory. Higher levels of depressive symptoms were related to more severe social anxiety overall, and to less change in social anxiety symptoms over the course of the study. Patients who were deemed nonresponders to treatment had higher levels of depressive symptoms at pretreatment than those who responded. In addition, patients who dropped out of the study had higher levels of depressive symptoms at pretreatment than those who completed the study. These results suggest that modifications should be made to existing treatments to improve outcomes and decrease attrition in the substantial proportion of patients with SAD who also evidence depressive symptoms. Such modifications are likely to be more important when treating patients with SAD and comorbid major depressive disorder. © 2005 Wiley-Liss, Inc.

Authors
Ledley, DR; Huppert, JD; Foa, EB; Davidson, JRT; Keefe, FJ; Potts, NLS
MLA Citation
Ledley, DR, Huppert, JD, Foa, EB, Davidson, JRT, Keefe, FJ, and Potts, NLS. "Impact of depressive symptoms on the treatment of generalized social anxiety disorder." Depression and Anxiety 22.4 (2005): 161-167.
PMID
16175565
Source
scival
Published In
Depression and Anxiety
Volume
22
Issue
4
Publish Date
2005
Start Page
161
End Page
167
DOI
10.1002/da.20121

Laboratory pain perception and clinical pain in post-menopausal women and age-matched men with osteoarthritis: relationship to pain coping and hormonal status.

The present study examined relationships between pain coping, hormone replacement therapy, and laboratory and clinical pain reports in post-menopausal women and age-matched men with osteoarthritis. Assessment of nociceptive flexion reflex threshold was followed by an assessment of electrocutaneous pain threshold and tolerance. Participants rated their arthritis pain using the Arthritis Impact Measurement Scales. To assess pain coping, participants completed measures of emotion-focused coping, problem-focused coping, and pain catastrophizing. Results indicated that women were more likely than men to report using emotion-focused pain strategies, and that emotion-focused coping was associated with more arthritic pain and lower electrocutaneous pain tolerance. Correlations between coping measures and pain reports revealed that catastrophizing was associated with greater arthritis pain and lower pain threshold and tolerance levels. However, catastrophizing was not related to nociceptive flexion reflex threshold, suggesting that the observed relationship between catastrophizing and subjective pain does not rely on elevated nociceptive input. A comparison of men (n=58), post-menopausal women receiving hormone replacement therapy (n=32), and post-menopausal women not receiving hormone replacement therapy (n=42) revealed no significant group differences in arthritis pain, electrocutaneous pain threshold or tolerance, or nociceptive flexion reflex threshold. Thus, older adults with osteoarthritis do not exhibit the pattern of sex differences in response to experimental pain procedures observed in prior studies, possibly due to the development of disease-related changes in pain coping strategies. Accordingly, individual differences in clinical and experimental pain may be better predicted by pain coping than by sex or hormonal differences.

Authors
France, CR; Keefe, FJ; Emery, CF; Affleck, G; France, JL; Waters, S; Caldwell, DS; Stainbrook, D; Hackshaw, KV; Edwards, C
MLA Citation
France, CR, Keefe, FJ, Emery, CF, Affleck, G, France, JL, Waters, S, Caldwell, DS, Stainbrook, D, Hackshaw, KV, and Edwards, C. "Laboratory pain perception and clinical pain in post-menopausal women and age-matched men with osteoarthritis: relationship to pain coping and hormonal status." Pain 112.3 (December 2004): 274-281.
PMID
15561382
Source
pubmed
Published In
PAIN
Volume
112
Issue
3
Publish Date
2004
Start Page
274
End Page
281
DOI
10.1016/j.pain.2004.09.007

Prostate cancer in African Americans: relationship of patient and partner self-efficacy to quality of life.

This study examined the relationship between patient and partner ratings of self-efficacy for symptom control and quality of life (QOL) among 40 African American prostate cancer survivors and their intimate partners. Data analyses revealed that cancer survivors who had rated their self-efficacy for symptom control higher reported better QOL related to urinary, bowel, and hormonal symptoms and better general health QOL (i.e., better physical functioning and better mental health). Data analyses also revealed that partners who rated their self-efficacy for helping the patient manage symptoms as higher reported better QOL (i.e., less negative mood and less caregiver strain). Finally, exploratory analyses indicated that higher self-efficacy in patients was associated with less anxiety and caregiver strain in partners, and higher self-efficacy in partners was associated with better adjustment to bowel and hormonal symptoms and better mental health in patients. The clinical implications of these findings are discussed and future directions for research on self-efficacy in African American prostate cancer survivors are identified.

Authors
Campbell, LC; Keefe, FJ; McKee, DC; Edwards, CL; Herman, SH; Johnson, LE; Colvin, OM; McBride, CM; Donattuci, CF
MLA Citation
Campbell, LC, Keefe, FJ, McKee, DC, Edwards, CL, Herman, SH, Johnson, LE, Colvin, OM, McBride, CM, and Donattuci, CF. "Prostate cancer in African Americans: relationship of patient and partner self-efficacy to quality of life." J Pain Symptom Manage 28.5 (November 2004): 433-444.
PMID
15504620
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
28
Issue
5
Publish Date
2004
Start Page
433
End Page
444
DOI
10.1016/j.jpainsymman.2004.02.020

Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia.

BACKGROUND: Generalized social phobia is common, persistent, and disabling and is often treated with selective serotonin reuptake inhibitor drugs or cognitive behavioral therapy. OBJECTIVE: We compared fluoxetine (FLU), comprehensive cognitive behavioral group therapy (CCBT), placebo (PBO), and the combinations of CCBT/FLU and CCBT/PBO. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Two academic outpatient psychiatric centers. PATIENTS: Subjects meeting a primary diagnosis of generalized social phobia were recruited via advertisement. Seven hundred twenty-two were screened, and 295 were randomized and available for inclusion in an intention-to-treat efficacy analysis; 156 (52.9%) were male, 226 (76.3%) were white, and mean age was 37.1 years. INTERVENTIONS: Treatment lasted for 14 weeks. Fluoxetine and PBO were administered at doses from 10 mg/d to 60 mg/d (or equivalent). Group comprehensive cognitive behavioral therapy was administered weekly for 14 sessions. MAIN OUTCOME MEASURES: An independent blinded evaluator assessed response with the Brief Social Phobia Scale and Clinical Global Impressions scales as primary outcomes. A videotaped behavioral assessment served as a secondary outcome, using the Subjective Units of Distress Scale. Adverse effects were measured by self-rating. Each treatment was compared by means of chi2 tests and piecewise linear mixed-effects models. RESULTS: Clinical Global Impressions scales response rates in the intention-to-treat sample were 29 (50.9%) (FLU), 31 (51.7%) (CCBT), 32 (54.2%) (CCBT/FLU), 30 (50.8%) (CCBT/PBO), and 19 (31.7%) (PBO), with all treatments being significantly better than PBO. On the Brief Social Phobia Scale, all active treatments were superior to PBO. In the linear mixed-effects models analysis, FLU was more effective than CCBT/FLU, CCBT/PBO, and PBO at week 4; CCBT was also more effective than CCBT/FLU and CCBT/PBO. By the final visit, all active treatments were superior to PBO but did not differ from each other. Site effects were found for the Subjective Units of Distress Scale assessment, with FLU and CCBT/FLU superior to PBO at Duke University Medical Center, Durham, NC. Treatments were well tolerated. CONCLUSIONS: All active treatments were superior to PBO on primary outcomes. Combined treatment did not yield any further advantage. Notwithstanding the benefits of treatment, many patients remained symptomatic after 14 weeks.

Authors
Davidson, JRT; Foa, EB; Huppert, JD; Keefe, FJ; Franklin, ME; Compton, JS; Zhao, N; Connor, KM; Lynch, TR; Gadde, KM
MLA Citation
Davidson, JRT, Foa, EB, Huppert, JD, Keefe, FJ, Franklin, ME, Compton, JS, Zhao, N, Connor, KM, Lynch, TR, and Gadde, KM. "Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia." Arch Gen Psychiatry 61.10 (October 2004): 1005-1013.
PMID
15466674
Source
pubmed
Published In
Archives of General Psychiatry
Volume
61
Issue
10
Publish Date
2004
Start Page
1005
End Page
1013
DOI
10.1001/archpsyc.61.10.1005

Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study.

This study tested the separate and combined effects of spouse-assisted pain coping skills training (SA-CST) and exercise training (ET) in a sample of patients having persistent osteoarthritic knee pain. Seventy-two married osteoarthritis (OA) patients with persistent knee pain and their spouses were randomly assigned to: SA-CST alone, SA-CST plus ET, ET alone, or standard care (SC). Patients in SA-CST alone, together with their spouses, attended 12 weekly, 2-h group sessions for training in pain coping and couples skills. Patients in SA-CST + ET received spouse-assisted coping skills training and attended 12-weeks supervised ET. Patients in the ET alone condition received just an exercise program. Data analyses revealed: (1) physical fitness and strength: the SA-CST + ET and ET alone groups had significant improvements in physical fitness compared to SA-CST alone and patients in SA-CST + ET and ET alone had significant improvements in leg flexion and extension compared to SA-CST alone and SC, (2) pain coping: patients in SA-CST + ET and SA-CST alone groups had significant improvements in coping attempts compared to ET alone or SC and spouses in SA-CST + ET rated their partners as showing significant improvements in coping attempts compared to ET alone or SC, and (3) self-efficacy: patients in SA-CST + ET reported significant improvements in self-efficacy and their spouses rated them as showing significant improvements in self-efficacy compared to ET alone or SC. Patients receiving SA-CST + ET who showed increased self-efficacy were more likely to have improvements in psychological disability. An intervention that combines spouse-assisted coping skills training and exercise training can improve physical fitness, strength, pain coping, and self-efficacy in patients suffering from pain due to osteoarthritis.

Authors
Keefe, FJ; Blumenthal, J; Baucom, D; Affleck, G; Waugh, R; Caldwell, DS; Beaupre, P; Kashikar-Zuck, S; Wright, K; Egert, J; Lefebvre, J
MLA Citation
Keefe, FJ, Blumenthal, J, Baucom, D, Affleck, G, Waugh, R, Caldwell, DS, Beaupre, P, Kashikar-Zuck, S, Wright, K, Egert, J, and Lefebvre, J. "Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study." Pain 110.3 (August 2004): 539-549.
PMID
15288394
Source
pubmed
Published In
PAIN
Volume
110
Issue
3
Publish Date
2004
Start Page
539
End Page
549
DOI
10.1016/j.pain.2004.03.022

Gender differences in pain, coping, and mood in individuals having osteoarthritic knee pain: a within-day analysis.

This study examined gender differences in prospective within-day assessments of pain, pain coping, and mood in men and women having OA, and analyzed gender differences in dynamic relations between pain, mood, and pain coping. A sample of 64 women and 36 men diagnosed as having pain due to osteoarthritis of the knee(s) rated their pain, pain coping, and mood two times each day (once in the afternoon and once in the evening) for 30 days using a booklet format. Two gender differences were found in between person-analyses: women used more problem focused coping than men, and women who catastrophized were less likely than men to report negative mood. Several within-day and across-day gender differences were noted. First, women were much more likely to show a significant increase in pain over the day. Second, men were more likely than women to experience an increase in coping efficacy over the day. Third, men were more likely than women to use emotion-focused coping when their mood was more negative. Finally, men were more likely than women to experience an increase in negative mood and a decrease in positive mood in the morning after an evening of increased pain. Taken together, these findings underscore the importance of obtaining multiple daily assessments when studying gender differences in the pain experience.

Authors
Keefe, FJ; Affleck, G; France, CR; Emery, CF; Waters, S; Caldwell, DS; Stainbrook, D; Hackshaw, KV; Fox, LC; Wilson, K
MLA Citation
Keefe, FJ, Affleck, G, France, CR, Emery, CF, Waters, S, Caldwell, DS, Stainbrook, D, Hackshaw, KV, Fox, LC, and Wilson, K. "Gender differences in pain, coping, and mood in individuals having osteoarthritic knee pain: a within-day analysis." Pain 110.3 (August 2004): 571-577.
PMID
15288397
Source
pubmed
Published In
PAIN
Volume
110
Issue
3
Publish Date
2004
Start Page
571
End Page
577
DOI
10.1016/j.pain.2004.03.028

The role of biomechanics and inflammation in cartilage injury and repair.

Osteoarthritis is a painful and debilitating disease characterized by progressive degenerative changes in the articular cartilage and other joint tissues. Biomechanical factors play a critical role in the initiation and progression of this disease, as evidenced by clinical and animal studies of alterations in the mechanical environment of the joint caused by trauma, joint instability, disuse, or obesity. The onset of these changes after joint injury generally has been termed posttraumatic arthritis and can be accelerated by factors such as a displaced articular fracture. Within this context, there is considerable evidence that interactions between biomechanical factors and proinflammatory mediators are involved in the progression of cartilage degeneration in posttraumatic arthritis. In vivo studies have shown increased concentrations of inflammatory cytokines and mediators in the joint in mechanically induced models of osteoarthritis. In vitro explant studies confirm that mechanical load is a potent regulator of matrix metabolism, cell viability, and the production of proinflammatory mediators such as nitric oxide and prostaglandin E2. Knowledge of the interaction of inflammatory and biomechanical factors in regulating cartilage metabolism would be beneficial to an understanding of the etiopathogenesis of posttraumatic osteoarthritis and in the improvement of therapies for joint injury.

Authors
Guilak, F; Fermor, B; Keefe, FJ; Kraus, VB; Olson, SA; Pisetsky, DS; Setton, LA; Weinberg, JB
MLA Citation
Guilak, F, Fermor, B, Keefe, FJ, Kraus, VB, Olson, SA, Pisetsky, DS, Setton, LA, and Weinberg, JB. "The role of biomechanics and inflammation in cartilage injury and repair." Clin Orthop Relat Res 423 (June 2004): 17-26. (Review)
PMID
15232421
Source
pubmed
Published In
Clinical Orthopaedics and Related Research ®
Issue
423
Publish Date
2004
Start Page
17
End Page
26

Psychological aspects of persistent pain: current state of the science.

UNLABELLED: This article provides an overview of current research on psychological aspects of persistent pain. It is divided into 3 sections. In section 1, recent studies are reviewed that provide evidence that psychological factors are related to adjustment to persistent pain. This section addresses research on factors associated with increased pain and poorer adjustment to pain (ie, pain catastrophizing, pain-related anxiety and fear of pain, and helplessness) and factors associated with decreased pain and improved adjustment to pain (ie, self-efficacy, pain coping strategies, readiness to change, and acceptance). In section 2, we review recent research on behavioral and psychosocial interventions for patients with persistent pain. Topics addressed include early intervention, tailoring treatment, telephone/Internet-based treatment, caregiver-assisted treatment, and exposure-based protocols. In section 3, we conclude with a general discussion that highlights steps needed to advance this area of research including developing more comprehensive and integrative conceptual models, increasing attention to the social context of pain, examining the link of psychological factors to pain-related brain activation patterns, and investigating the mechanisms underlying the efficacy of psychological treatments for pain. PERSPECTIVE: This is one of several invited commentaries to appear in The Journal of Pain in recognition of The Decade of Pain Research. This article provides an overview of current research on psychological aspects of persistent pain, and highlights steps needed to advance this area of research.

Authors
Keefe, FJ; Rumble, ME; Scipio, CD; Giordano, LA; Perri, LM
MLA Citation
Keefe, FJ, Rumble, ME, Scipio, CD, Giordano, LA, and Perri, LM. "Psychological aspects of persistent pain: current state of the science." J Pain 5.4 (May 2004): 195-211. (Review)
PMID
15162342
Source
pubmed
Published In
The Journal of Pain
Volume
5
Issue
4
Publish Date
2004
Start Page
195
End Page
211
DOI
10.1016/j.jpain.2004.02.576

Self-discrepancy in chronic low back pain: relation to pain, depression, and psychological distress.

Self-discrepancies occur when patients' evaluations of their actual self differ from their views of who they ideally would like to be (ideal self) or feel they ought to be (ought self), or from patients' perceptions of how significant others wish they could be (ideal-other self) or ought to be (ought-other self). These self-discrepancies may be related to psychological functioning and adjustment to pain. This study sought to: 1) determine the reliability of self-discrepancy assessments in patients; 2) determine whether each of the four types of self-discrepancies (actual self vs. ideal self, actual self vs. ought self, actual self vs. ideal-other self and actual self vs. ought-other self) measure a distinct type of self-discrepancy; and, 3) examine the relationship of self-discrepancies to pain intensity, depression, and psychological distress in 93 chronic low back pain patients. A semi-structured questionnaire assessed self-discrepancies. Standardized measures were used to assess pain intensity, depression, and psychological distress. Results showed that self-discrepancies can be reliably assessed in patients with persistent pain. Furthermore, data analyses showed that patients who had large ought-other self-discrepancies reported more severe pain and higher levels of psychological distress. Patients who had large ideal self-discrepancies reported higher levels of depression and psychological distress. Taken together, these findings suggest that self-discrepancy can be reliably assessed in patients with persistent pain and demonstrate that self-discrepancies are related in meaningful ways to measures of pain, depression, and psychological distress in chronic low back pain patients.

Authors
Waters, SJ; Keefe, FJ; Strauman, TJ
MLA Citation
Waters, SJ, Keefe, FJ, and Strauman, TJ. "Self-discrepancy in chronic low back pain: relation to pain, depression, and psychological distress." J Pain Symptom Manage 27.3 (March 2004): 251-259.
PMID
15010103
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
27
Issue
3
Publish Date
2004
Start Page
251
End Page
259
DOI
10.1016/j.jpainsymman.2003.07.001

Health psychology: what will the future bring?

This commentary highlights several important themes and trends in this series of articles focusing on the future of health psychology. First, the challenges posed by changes in populations will only be met if health psychologists can develop a contextual competency. Second, with increasing evidence for the efficacy of health psychology interventions comes heightened interest in testing the effectiveness of these interventions. Third, issues of cost-effectiveness of health psychology will become increasingly important. Fourth, the growing integration of technological advances (e.g., telehealth, the Internet) into health psychology has major implications. Finally, the numerous changes outlined in this series of articles will demand that health psychologists extend and refine their theoretical models including the biopsychosocial model.

Authors
Keefe, FJ; Blumenthal, JA
MLA Citation
Keefe, FJ, and Blumenthal, JA. "Health psychology: what will the future bring?." Health Psychol 23.2 (March 2004): 156-157.
PMID
15008660
Source
pubmed
Published In
Health Psychology
Volume
23
Issue
2
Publish Date
2004
Start Page
156
End Page
157
DOI
10.1037/0278-6133.23.2.156

Fluxetine, comprehensive cognitive behavioral therapy (CCBT) and placebo in generalized social phobia

Authors
Davidson, JT; Foa, EB; Huppert, JD; Keefe, FJ; Franklin, ME; Compton, JS; Zhao, N; Connor, KM; Lynch, TR; Gadde, KM
MLA Citation
Davidson, JT, Foa, EB, Huppert, JD, Keefe, FJ, Franklin, ME, Compton, JS, Zhao, N, Connor, KM, Lynch, TR, and Gadde, KM. "Fluxetine, comprehensive cognitive behavioral therapy (CCBT) and placebo in generalized social phobia." Archives of General Psychiatry 61 (2004): 1005-1013. (Academic Article)
Source
manual
Published In
Archives of General Psychiatry
Volume
61
Publish Date
2004
Start Page
1005
End Page
1013

Self-discrepancy in chronic low back pain: Relation to pain, depression, and psychological distress

Authors
Waters, SJ; Keefe, FJ; Strauman, TJ
MLA Citation
Waters, SJ, Keefe, FJ, and Strauman, TJ. "Self-discrepancy in chronic low back pain: Relation to pain, depression, and psychological distress." Journal of Pain and Symptom Management 27 (2004): 253-261. (Academic Article)
Source
manual
Published In
Journal of Pain and Symptom Management
Volume
27
Publish Date
2004
Start Page
253
End Page
261

Tailoring cognitive-behavioral treatment for cancer pain

Though it has been shown that cancer patients report cognitive, behavioral, and physiologic responses to pain, little attention has been paid to the benefits of cognitive-behavioral therapy (CBT) protocols tailored to patient characteristics. To determine whether a profile-tailored CBT treatment program was more effective than either standard CBT or usual care in changing outcomes for patients with cancer-related pain, 131 patients receiving treatment at four sites were randomly assigned to standard CBT, profile-tailored CBT, or usual care. CBT patients attended five 50-minute treatment sessions. When compared to standard CBT patients, profile-tailored CBT patients experienced substantial improvement from baseline to immediately post-intervention in worst pain, least pain, less interference of pain with sleep, and less confusion. From baseline to one-month post-intervention, profile-tailored patients saw greater improvement in less interference of pain with activities, walking, relationships, and sleep; less composite pain interference; and less mobility and confusion symptom distress. Standard CBT and usual care patients experienced little change. Compared to profile-tailored CBT patients, standard CBT patients showed greater improvement at six-months post-intervention with less average pain, less pain now, better bowel patterns, lower summary symptom distress, better mental quality of life, and greater improvement in Karnofsky performance status; usual care patients showed little change. More research is needed to refine the matching of cognitive-behavioral treatments to psychophysiologic patient profiles, and to determine a treatment period that does not burden those patients too fatigued to participate in a five-week program. Delivery of CBT by home visits, phone, or Internet needs to be explored further. © 2004 by The American Society of Pain Management Nurses.

Authors
Dalton, JA; Keefe, FJ; Carlson, J; Youngblood, R
MLA Citation
Dalton, JA, Keefe, FJ, Carlson, J, and Youngblood, R. "Tailoring cognitive-behavioral treatment for cancer pain." Pain Management Nursing 5.1 (2004): 3-18.
PMID
14999649
Source
scival
Published In
Pain Management Nursing
Volume
5
Issue
1
Publish Date
2004
Start Page
3
End Page
18
DOI
10.1016/S1524-9042(03)00027-4

Acceptance and change in the context of chronic pain

Research and clinical developments over the past 20 years are beginning to shed new light on thoughts, sensations, emotions, their role in influencing behavior, and the particular ways in which private experiences contribute to human suffering (e.g. Hayes et al., 2001). This has led to different approaches to treating a broad array of behavior problems, approaches that incorporate a partnership of acceptance and change. We have defined acceptance of chronic pain as an active willingness to engage in meaningful activities in life regardless of pain-related sensations, thoughts, and other related feelings that might otherwise hinder that engagement. It is about not engaging in unnecessary struggles with private experiences, struggles that often intensify the aversiveness of those experiences and enhance their life disrupting influences. What is novel about this approach is that it is not simply a new psychological variable but a description of a different set of processes of pain and suffering. This approach is fully situated within the broader empirical tradition of the behavioral and cognitive therapies. The examination of its potential merits is already underway.

Authors
McCracken, LM; Carson, JW; Eccleston, C; Keefe, FJ
MLA Citation
McCracken, LM, Carson, JW, Eccleston, C, and Keefe, FJ. "Acceptance and change in the context of chronic pain." Pain 109.1-2 (2004): 4-7.
PMID
15082120
Source
scival
Published In
Pain
Volume
109
Issue
1-2
Publish Date
2004
Start Page
4
End Page
7
DOI
10.1016/j.pain.2004.02.006

Gender differences in patient-spouse interactions: A sequential analysis of behavioral interactions in patients having osteoarthritic knee pain

Theory and research suggest that spousal responses to displays of pain behavior can vary markedly. To our knowledge, observational research on spousal responses to pain behavior has been carried out only in chronic low back pain patients, but not in other populations. In this study systematic observations were conducted of interactions occurring between 50 married osteoarthritis patients (25 male and 25 female) and their respective spouses. Observations were conducted as the patient and spouse performed three common household tasks: sweeping the floor, folding laundry, and carrying small, artificial logs from one side of the room to the other. Contrary to prior research on chronic low back pain this study found that in osteoarthritis patients spouse facilitative behavior preceded and followed patient pain behavior significantly more often than did spouse solicitous behavior. A gender difference in spousal responding to pain behavior also was observed in that wives were significantly more likely to show facilitative behavior preceding and following patient pain behavior than were husbands. The implications of these findings for future research and clinical interventions focused on patient-spouse interactions are discussed. © 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Authors
Smith, SJA; Keefe, FJ; Caldwell, DS; Romano, J; Baucom, D
MLA Citation
Smith, SJA, Keefe, FJ, Caldwell, DS, Romano, J, and Baucom, D. "Gender differences in patient-spouse interactions: A sequential analysis of behavioral interactions in patients having osteoarthritic knee pain." Pain 112.1-2 (2004): 183-187.
PMID
15494199
Source
scival
Published In
PAIN
Volume
112
Issue
1-2
Publish Date
2004
Start Page
183
End Page
187
DOI
10.1016/j.pain.2004.08.019

The communal coping model and interpersonal context: Problems or process?

Authors
Thorn, BE; Keefe, FJ; Anderson, T
MLA Citation
Thorn, BE, Keefe, FJ, and Anderson, T. "The communal coping model and interpersonal context: Problems or process?." Pain 110.3 (2004): 505-507.
PMID
15288389
Source
scival
Published In
Pain
Volume
110
Issue
3
Publish Date
2004
Start Page
505
End Page
507
DOI
10.1016/j.pain.2004.05.006

The influence of social skills on private and interpersonal emotional disclosure of negative events

This study examined the influence of social skills on emotional disclosure in private and interpersonal settings. Eighty-five women with either high or low social skills disclosed an emotionally painful event in private (i.e., to a tape recorder) orto another participant with either high or low social skills (interpersonal condition). Increases in negative affect were greatest when disclosure was in the private (vs. interpersonal) condition and also when the discloser had high social skill (vs. low social skill). Interestingly, increases in positive affect were greatest in the interpersonal condition where both discloser and facilitator had high social skills. However, these facilitators themselves experienced decreases in their positive affect. The authors propose that an interactive transfer of positive affect between individuals of high social skills can provide an interpersonal interaction conducive to self-disclosure.

Authors
Anderson, T; Carson, KL; Darchuk, AJ; Keefe, FJ
MLA Citation
Anderson, T, Carson, KL, Darchuk, AJ, and Keefe, FJ. "The influence of social skills on private and interpersonal emotional disclosure of negative events." Journal of Social and Clinical Psychology 23.5 (2004): 635-652.
Source
scival
Published In
Journal of Social and Clinical Psychology
Volume
23
Issue
5
Publish Date
2004
Start Page
635
End Page
652
DOI
10.1521/jscp.23.5.635.50747

Effects of brief pain education on hospitalized cancer patients with moderate to severe pain

The purpose of this randomized controlled study was to assess the effects of a structured pain education program on the pain experience of hospitalized cancer patients Eligible cancer pain patients were randomly assigned to either an experimental group (receiving pain education 10-15 min per day for 5 days, n=15) or a standard care control group (n=15). The effects of the intervention on six pain-related variables were evaluated using three instruments. Pain intensity, pain interference with daily life, negative beliefs about opioids, beliefs about endurance of pain, pain catastrophizing (an individual's tendency to focus on and exaggerate the threat value of painful stimuli and negatively evaluate his or her own ability to deal with pain), and sense of control over pain were evaluated by the Brief Pain Inventory-Short Form Taiwanese version (BPI-T), Pain and Opioid Analgesic Beliefs Scale-Cancer (POABS-CA), and the Catastrophizing subscale and the sense of control over pain measure from the Coping Strategies Questionnaire (CSQ). The results indicated that, after completing treatment, patients who had received structured pain education had significantly less pain intensity on average, negative pain beliefs regarding opioids, pain endurance beliefs, and pain catastrophizing than patients in the control group. In addition, patients in the pain education group showed a significant increase in their sense of control over pain. These preliminary results strongly suggest that structured pain education can effectively improve the pain experience of hospitalized cancer patients and should be further implemented clinically.

Authors
Lai, Y-H; Guo, S-L; Keefe, FJ; Tsai, S-L; Chien, C-C; Sung, Y-C; Chen, M-L
MLA Citation
Lai, Y-H, Guo, S-L, Keefe, FJ, Tsai, S-L, Chien, C-C, Sung, Y-C, and Chen, M-L. "Effects of brief pain education on hospitalized cancer patients with moderate to severe pain." Supportive Care in Cancer 12.9 (2004): 645-652.
PMID
15127282
Source
scival
Published In
Supportive Care in Cancer
Volume
12
Issue
9
Publish Date
2004
Start Page
645
End Page
652
DOI
10.1007/s00520-004-0626-1

Patterns of opioid analgesic prescription among patients with osteoarthritis.

This study describes patterns of opioid analgesic prescription during a one-year period among a sample of patients with osteoarthritis (OA). The study sample included 3,061 patients with prior ICD-9 codes indicating a diagnosis of OA who were treated at a federal Veterans Affairs Medical Center. Specific opioid variables included: any opioid prescription, number of specific opioid drugs prescribed, total number of opioid prescriptions, total number of days supply of opioids, and daily opioid doses. We also examined relationships of demographic characteristics to opioid variables. Results revealed that 41% of patients received at least one opioid prescription. Opioids were prescribed significantly less frequently among African-Americans than Caucasians and the number of opioid prescriptions declined with increasing age. The mean annual supply of opioids was 104 days. Days' supply of opioids was also lower for African Americans and older patients. Daily opioid doses were, on average, below recommended daily doses for the treatment of OA. Findings of this study suggest that opioids are frequently prescribed to individuals with OA and that these drugs may be gaining acceptability for the treatment of chronic musculoskeletal pain. Additional research is needed to examine reasons for racial differences in opioid prescribing, as well as the prescription of these medications at fairly low doses.

Authors
Dominick, KL; Bosworth, HB; Dudley, TK; Waters, SJ; Campbell, LC; Keefe, FJ
MLA Citation
Dominick, KL, Bosworth, HB, Dudley, TK, Waters, SJ, Campbell, LC, and Keefe, FJ. "Patterns of opioid analgesic prescription among patients with osteoarthritis." J Pain Palliat Care Pharmacother 18.1 (2004): 31-46.
PMID
15148007
Source
pubmed
Published In
Journal of Pain & Palliative Care Pharmacotherapy (Haworth)
Volume
18
Issue
1
Publish Date
2004
Start Page
31
End Page
46

Psychological Considerations in the Surgical Treatment of Patients With Chronic Pain

Authors
Williams, DA; Gehrman, C; Ashmore, J; Keefe, FJ
MLA Citation
Williams, DA, Gehrman, C, Ashmore, J, and Keefe, FJ. "Psychological Considerations in the Surgical Treatment of Patients With Chronic Pain." Techniques in Neurosurgery 8.3 (September 2003): 168-175.
Source
crossref
Published In
Techniques in Neurosurgery
Volume
8
Issue
3
Publish Date
2003
Start Page
168
End Page
175
DOI
10.1097/00127927-200308030-00005

Persistent pain and depression: a biopsychosocial perspective.

This review highlights recent research findings on the relationship between persistent pain and depression and discusses the implications of these findings for future research in persons who suffer from both pain and depression. First, we briefly discuss advances in theories of pain that underscore the important role that depression can play in the chronic pain experience. Second, we discuss depression in persons suffering from chronic pain from a biopsychosocial perspective that takes into account both biological and psychosocial mechanisms linking pain and depression. Third, we address biomedical, psychosocial, and combined medical-psychosocial approaches to treatment in persons with persistent pain and depression. We conclude by highlighting future directions for research related to screening and diagnosis of depression in persons having persistent pain, treatment of comorbid pain and depression, and individual and subgroup differences in the experience of persistent pain and depression.

Authors
Campbell, LC; Clauw, DJ; Keefe, FJ
MLA Citation
Campbell, LC, Clauw, DJ, and Keefe, FJ. "Persistent pain and depression: a biopsychosocial perspective." Biol Psychiatry 54.3 (August 1, 2003): 399-409. (Review)
PMID
12893114
Source
pubmed
Published In
Biological Psychiatry
Volume
54
Issue
3
Publish Date
2003
Start Page
399
End Page
409

The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life.

This preliminary study examined the self-efficacy of family caregivers with regard to helping cancer patients manage pain at end of life. A sample of 63 family caregivers of hospice-eligible cancer patients with pain provided ratings of their self-efficacy in assisting the patient in pain management and rated their own mood and level of caregiver strain. Patients completed measures of pain and quality of life. Data analyses revealed that caregivers who rated their self-efficacy as high reported much lower levels of caregiver strain as well as decreased negative mood and increased positive mood. Caregiver self-efficacy in managing the patient's pain was related to the patient's physical well-being. In dyads where the caregiver reported high self-efficacy, the patient reported having more energy, feeling less ill, and spending less time in bed. Considered overall, the results of this study suggest that caregiver self-efficacy in pain management is important in understanding how caregivers adjust to the demands of caring for cancer patients who have pain at the end of life.

Authors
Keefe, FJ; Ahles, TA; Porter, LS; Sutton, LM; McBride, CM; Pope, MS; McKinstry, ET; Furstenberg, CP; Dalton, J; Baucom, DH
MLA Citation
Keefe, FJ, Ahles, TA, Porter, LS, Sutton, LM, McBride, CM, Pope, MS, McKinstry, ET, Furstenberg, CP, Dalton, J, and Baucom, DH. "The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life." Pain 103.1-2 (May 2003): 157-162.
PMID
12749970
Source
pubmed
Published In
PAIN
Volume
103
Issue
1-2
Publish Date
2003
Start Page
157
End Page
162

Anger and persistent pain: current status and future directions.

Authors
Greenwood, KA; Thurston, R; Rumble, M; Waters, SJ; Keefe, FJ
MLA Citation
Greenwood, KA, Thurston, R, Rumble, M, Waters, SJ, and Keefe, FJ. "Anger and persistent pain: current status and future directions." Pain 103.1-2 (May 2003): 1-5. (Review)
PMID
12749952
Source
pubmed
Published In
PAIN
Volume
103
Issue
1-2
Publish Date
2003
Start Page
1
End Page
5

The social context of gastrointestinal cancer pain: a preliminary study examining the relation of patient pain catastrophizing to patient perceptions of social support and caregiver stress and negative responses.

A number of studies have shown that catastrophizing is an important predictor of pain and disability in persons having persistent pain conditions. The newly developed communal model of catastrophizing maintains that catastrophizing is a part of broader, interpersonal style of coping in which coping efforts are directed at interpersonal goals, rather than solely at pain reduction. This study examined the potential interpersonal correlates of pain catastrophizing in a sample of 70 patients having gastrointestinal cancers and their caregivers. Measures of pain catastrophizing, perceptions of social support, pain level, and pain behavior were obtained from patients. Caregivers completed measures that included their judgments about the patient's pain level, caregiver stress, and their tendency to engage in negative responses (critical or avoidant behaviors). Overall, patients who engaged in catastrophizing reported receiving higher levels of instrumental support. Caregivers of patients who catastrophized, rated the patient as having more pain and engaging in more pain behavior. Caregivers of patients who catastrophized, also reported higher levels of caregiver stress and critical behaviors. Taken together, these preliminary findings suggest that pain catastrophizing has interpersonal correlates and support the need for additional research examining the social context of pain catastrophizing.

Authors
Keefe, FJ; Lipkus, I; Lefebvre, JC; Hurwitz, H; Clipp, E; Smith, J; Porter, L
MLA Citation
Keefe, FJ, Lipkus, I, Lefebvre, JC, Hurwitz, H, Clipp, E, Smith, J, and Porter, L. "The social context of gastrointestinal cancer pain: a preliminary study examining the relation of patient pain catastrophizing to patient perceptions of social support and caregiver stress and negative responses." Pain 103.1-2 (May 2003): 151-156.
PMID
12749969
Source
pubmed
Published In
PAIN
Volume
103
Issue
1-2
Publish Date
2003
Start Page
151
End Page
156

Relationship between pain-specific beliefs and adherence to analgesic regimens in Taiwanese cancer patients: A preliminary study

This pilot cross-sectional study aimed to 1) explore pain beliefs and adherence to prescribed analgesics in Taiwanese cancer patients, and 2) examine how selected pain beliefs, pain sensory characteristics, and demographic factors predict analgesic adherence. Pain beliefs were measured by the Chinese version of Pain and Opioid Analgesic Beliefs Scale - Cancer (POABS-CA) and the Survey of Pain Attitudes (SOPA). Analgesic adherence was measured by patient self-report of all prescribed pain medicine taken during the previous 7 days. Only 66.5% of hospitalized cancer patients with pain (n = 194) adhered to their analgesic regimen. Overall, patients had relatively high mean scores in beliefs about disability, medications, negative effects, and pain endurance, and low scores in control and emotion beliefs. Medication and control beliefs significantly predicted analgesic adherence. Patients with higher medication beliefs and lower control beliefs were more likely to be adherent. Findings support the importance of selected pain beliefs in patients' adherence to analgesics, suggesting that pain beliefs be assessed and integrated into pain management and patient education to enhance adherence. © U.S. Cancer Pain Relief Committee, 2002.

Authors
Lai, Y-H; Keefe, FJ; Sun, W-Z; Tsai, L-Y; Cheng, P-L; Chiou, J-F; Wei, L-L
MLA Citation
Lai, Y-H, Keefe, FJ, Sun, W-Z, Tsai, L-Y, Cheng, P-L, Chiou, J-F, and Wei, L-L. "Relationship between pain-specific beliefs and adherence to analgesic regimens in Taiwanese cancer patients: A preliminary study." Journal of Pain and Symptom Management 24.4 (2003): 415-423.
PMID
12505210
Source
scival
Published In
Journal of Pain and Symptom Management
Volume
24
Issue
4
Publish Date
2003
Start Page
415
End Page
423
DOI
10.1016/S0885-3924(02)00509-2

Feasibility of a dyadic intervention for management of osteoarthritis: A pilot study with older patients and their spousal caregivers

Authors
Martire, LM; Schulz, R; Keefe, FJ; Starz, TW; Osial, TA; Dew, MA; Reynolds, CF
MLA Citation
Martire, LM, Schulz, R, Keefe, FJ, Starz, TW, Osial, TA, Dew, MA, and Reynolds, CF. "Feasibility of a dyadic intervention for management of osteoarthritis: A pilot study with older patients and their spousal caregivers." Aging and Mental Health 7 (2003): 55-62. (Academic Article)
Source
manual
Published In
Aging and Mental Health
Volume
7
Publish Date
2003
Start Page
55
End Page
62

Self-reports of pain intensity and direct observations of pain behavior: When are they correlated?

Meta-analytic techniques were utilized to investigate the relationship between self-reports of pain intensity and direct observations of pain behavior. Estimation of the overall effect size from 29 studies and 85 effect sizes yielded a moderately positive association, z=0.26. High variability across studies permitted a random-effects moderator analysis that determined chronicity of pain, the timing of the pain assessment, the use of global measures of pain behavior, and pain site significantly moderate the relationship between self-reports of pain intensity and direct observations of pain behavior. These findings indicate that self-reports of pain intensity and direct observations of pain behavior are more likely to be significantly related to each other when the individual being studied has acute pain (z=0.35), when the self-report of pain intensity data are collected soon after the observation of pain behavior (z=0.40), when global composite measures are used to quantify pain behavior (z=0.37), and when the person being observed suffers from chronic low back pain (z=0.30). Other factors not found to be significant moderators include: extent of observer training, relevance of the pain-inducing task, and pain behavior observation measure used. The implications of the findings for the assessment of pain are discussed. © 2003 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.

Authors
Labus, JS; Keefe, FJ; Jensen, MP
MLA Citation
Labus, JS, Keefe, FJ, and Jensen, MP. "Self-reports of pain intensity and direct observations of pain behavior: When are they correlated?." Pain 102.1-2 (2003): 109-124.
PMID
12620602
Source
scival
Published In
Pain
Volume
102
Issue
1-2
Publish Date
2003
Start Page
109
End Page
124
DOI
10.1016/s0304-3959(02)00354-8

One- and two-item measures of pain beliefs and coping strategies

Pain-related beliefs and pain coping strategies are central components of current cognitive-behavioral models of chronic pain, and have been found in numerous studies to be associated significantly with psychosocial and physical disability. However, the length of most measures of pain-related beliefs and coping restricts the ability of clinicians and researchers to perform a thorough assessment of these variables in many situations. The availability of very brief versions of existing scales would make possible the assessment of a range of important pain beliefs and coping strategies in settings where subject or patient assessment burden is an issue. In this study, one- and two-item versions of the subscales of several commonly used measures of pain beliefs and coping strategies were developed using both rational and empirical procedures. The findings support the validity of these brief subscales. The appropriate use and limitations of these measures are discussed. © 2003 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.

Authors
Jensen, MP; Keefe, FJ; Lefebvre, JC; Romano, JM; Turner, JA
MLA Citation
Jensen, MP, Keefe, FJ, Lefebvre, JC, Romano, JM, and Turner, JA. "One- and two-item measures of pain beliefs and coping strategies." Pain 104.3 (2003): 453-469.
PMID
12927618
Source
scival
Published In
Pain
Volume
104
Issue
3
Publish Date
2003
Start Page
453
End Page
469
DOI
10.1016/S0304-3959(03)00076-9

Symptom Distress, Catastrophic Thinking, and Hope in Nasopharyngeal Carcinoma Patients

The purposes of this study were to explore symptom distress, catastrophic thinking (catastrophizing) and hope, and factors predicting hope in Taiwanese nasopharyngeal carcinoma (NPC) patients within 3 years of receiving radiation therapy (RT). Instruments used were the modified Symptom Distress Scale, disease catastrophizing scale (modified from Coping Strategies Questionnaire), and Herth's Hope Index. Adult NPC patients (N = 115; 33 undergoing RT, 44 who completed RT within 1 year, and 38 who completed RT more than 1 year but less than 3 years) were recruited from an outpatient RT center in Northern Taiwan. Although participants' overall symptom distress was mild to moderate, they scored moderate level for several distressful symptoms: dry mouth, fatigue, hearing difficulty, loss of appetite, insomnia, and pain. Patients undergoing RT had greater symptom distress than subjects in the other 2 groups. Regression analysis revealed that catastrophizing was the only predictor of hope. Patients who engaged in catastrophizing reported much lower levels of hope. Particular care and attention are recommended to help NPC patients deal with the top distressful symptoms listed. Nursing interventions to reduce catastrophic thinking and enhance hope are discussed.

Authors
Lai, Y-H; Chang, JT-C; Keefe, FJ; Chiou, C-F; Chen, S-C; Feng, S-C; Dou, S-J; Liao, M-N
MLA Citation
Lai, Y-H, Chang, JT-C, Keefe, FJ, Chiou, C-F, Chen, S-C, Feng, S-C, Dou, S-J, and Liao, M-N. "Symptom Distress, Catastrophic Thinking, and Hope in Nasopharyngeal Carcinoma Patients." Cancer Nursing 26.6 (2003): 485-493.
PMID
15022980
Source
scival
Published In
Cancer Nursing
Volume
26
Issue
6
Publish Date
2003
Start Page
485
End Page
493

Distress and motivation for smoking cessation among lung cancer patients' relatives who smoke.

BACKGROUND: Heightened distress at the time of a loved one's lung cancer diagnosis may motivate relatives to quit smoking or could undermine cessation. METHODS: Relatives of new lung cancer patients at Duke were surveyed by telephone to assess diagnosis-related depression, distress, and motivation for smoking cessation. RESULTS: Relatives who reported above average avoidant and intrusive thinking patterns, depressive symptoms or worry were more likely to report that the patient's diagnosis increased their intentions to quit than the less distressed. CONCLUSIONS: Interventions are needed that encourage smoking cessation as a strategy for adaptively coping with a loved ones' lung cancer diagnosis.

Authors
McBride, CM; Pollak, KI; Garst, J; Keefe, F; Lyna, P; Fish, L; Hood, L
MLA Citation
McBride, CM, Pollak, KI, Garst, J, Keefe, F, Lyna, P, Fish, L, and Hood, L. "Distress and motivation for smoking cessation among lung cancer patients' relatives who smoke." Journal of cancer education : the official journal of the American Association for Cancer Education 18.3 (2003): 150-156. (Academic Article)
PMID
14512262
Source
manual
Published In
Journal of Cancer Education
Volume
18
Issue
3
Publish Date
2003
Start Page
150
End Page
156

Feasibility of a dyadic intervention for management of osteoarthritis: A pilot study with older patients and their spousal caregivers

This study evaluated a novel intervention for older osteoarthritis (OA) patients and their spousal caregivers that consisted of standard patient education supplemented by information related to effectively managing arthritis as a couple. Twenty-four female OA patients and their husbands were randomly assigned to either an educational intervention that was targeted at both patient and spouse or to a patient education intervention that was targeted at only the patient. Findings revealed that both interventions were evaluated favorably but the couple intervention was better attended than the patient intervention. In addition, patients in the couple intervention experienced greater increased efficacy in managing arthritis pain and other symptoms. The findings of this pilot study point to the utility of a dyadic intervention approach to management of OA in late life.

Authors
Martire, LM; Schulz, R; Keefe, FJ; Starz, TW; Jr, TAO; Dew, MA; III, CFR
MLA Citation
Martire, LM, Schulz, R, Keefe, FJ, Starz, TW, Jr, TAO, Dew, MA, and III, CFR. "Feasibility of a dyadic intervention for management of osteoarthritis: A pilot study with older patients and their spousal caregivers." Aging and Mental Health 7.1 (2003): 53-60.
PMID
12554315
Source
scival
Published In
Aging and Mental Health
Volume
7
Issue
1
Publish Date
2003
Start Page
53
End Page
60
DOI
10.1080/1360786021000007045

New directions in research on pain and ethnicity: a comment on Riley, Wade, Myers, Sheffield, Pappas, and Price (2002).

Authors
Edwards, C; Keefe, F
MLA Citation
Edwards, C, and Keefe, F. "New directions in research on pain and ethnicity: a comment on Riley, Wade, Myers, Sheffield, Pappas, and Price (2002)." Pain 100.3 (December 2002): 211-212.
PMID
12467991
Source
pubmed
Published In
PAIN
Volume
100
Issue
3
Publish Date
2002
Start Page
211
End Page
212

Changing face of pain: evolution of pain research in psychosomatic medicine.

OBJECTIVE: This article provides an overview of how psychosomatic research on pain has evolved over the past 60 years as exemplified by studies published in Psychosomatic Medicine. METHODS: Each issue of Psychosomatic Medicine from 1939 to 1999 was reviewed to identify papers that dealt with pain, painful medical conditions, or pain management. A total of 150 papers were identified and grouped into seven categories: 1) case studies; 2) studies of personality traits and other individual differences; 3) psychophysiological studies of pain; 4) studies using pain induction techniques; 5) studies examining the relation of relation of race, ethnicity, and culture to pain; 6) studies of pain unique to women; and 7) studies examining treatments for pain. RESULTS: A substantial number of studies on pain and painful conditions were published in the Journal in the 1940s and 1950s, and that number has almost doubled in the most recent full decade of the Journal. Within the pain area, however, the topics of interest to psychosomatic researchers have been, and continue to be, quite diverse. Although publications on certain methods or topics (eg, psychodynamic case studies, physiological correlates of pain) have decreased over time, publications on other topics (eg, personality traits and individual differences) have remained relatively constant, and publications on still other topics (eg, studies using pain induction techniques; studies of race, ethnicity, and culture; women's pain; and treatment studies) have flourished recently. CONCLUSIONS: Considered overall, the results of our review suggest that the face of pain research published in PM has changed considerably in the past 60 years. Given the ongoing commitment of psychosomatic researchers to this area, we expect this evolution to continue in the years to come.

Authors
Keefe, FJ; Lumley, MA; Buffington, ALH; Carson, JW; Studts, JL; Edwards, CL; Macklem, DJ; Aspnes, AK; Fox, L; Steffey, D
MLA Citation
Keefe, FJ, Lumley, MA, Buffington, ALH, Carson, JW, Studts, JL, Edwards, CL, Macklem, DJ, Aspnes, AK, Fox, L, and Steffey, D. "Changing face of pain: evolution of pain research in psychosomatic medicine." Psychosom Med 64.6 (November 2002): 921-938. (Review)
PMID
12461198
Source
pubmed
Published In
Psychosomatic Medicine
Volume
64
Issue
6
Publish Date
2002
Start Page
921
End Page
938

Cancer pain at the end of life: a biopsychosocial perspective.

Authors
Sutton, LM; Porter, LS; Keefe, FJ
MLA Citation
Sutton, LM, Porter, LS, and Keefe, FJ. "Cancer pain at the end of life: a biopsychosocial perspective." Pain 99.1-2 (September 2002): 5-10. (Review)
PMID
12237179
Source
pubmed
Published In
PAIN
Volume
99
Issue
1-2
Publish Date
2002
Start Page
5
End Page
10

Perceptions of patients' self-efficacy for managing pain and lung cancer symptoms: correspondence between patients and family caregivers.

This study examined the degree of correspondence between lung cancer patients and their family caregivers in their perceptions of the patients' self-efficacy for managing pain and other symptoms of lung cancer, and the association of this correspondence to demographic, disease, and psychosocial variables. Thirty patients who were newly diagnosed with lung cancer and their primary family caregivers completed telephone interviews assessing the patient's symptoms, the patient's self-efficacy for managing symptoms, the quality of the relationship between the patient and caregiver, patient and caregiver psychological distress, and caregiver strain. Although patients and their caregivers showed a moderate degree of agreement in their perceptions of the patient's self-efficacy for managing pain and other symptoms, there was considerable variability in the degree of congruence. Factors that contributed to lower levels of congruence included low patient-rated self-efficacy, female gender of the patient, high patient psychological distress, and high caregiver strain. Caregivers were about evenly split in their tendency to overestimate versus underestimate the patient's self-efficacy. A poorer quality of relationship between the caregiver and the patient (as rated by the patient), high levels of patient-rated symptoms, and high levels of caregiver strain were associated with caregivers overestimating patient self-efficacy.

Authors
Porter, LS; Keefe, FJ; McBride, CM; Pollak, K; Fish, L; Garst, J
MLA Citation
Porter, LS, Keefe, FJ, McBride, CM, Pollak, K, Fish, L, and Garst, J. "Perceptions of patients' self-efficacy for managing pain and lung cancer symptoms: correspondence between patients and family caregivers." Pain 98.1-2 (July 2002): 169-178.
PMID
12098629
Source
pubmed
Published In
PAIN
Volume
98
Issue
1-2
Publish Date
2002
Start Page
169
End Page
178

Point of view.

Authors
Keefe, FJ; McKee, D; Lynch, T
MLA Citation
Keefe, FJ, McKee, D, and Lynch, T. "Point of view." Spine (Phila Pa 1976) 27.11 (June 1, 2002): 1237-.
PMID
12045524
Source
pubmed
Published In
Spine
Volume
27
Issue
11
Publish Date
2002
Start Page
1237

Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis.

This article provides an overview of the emerging literature on biopsychosocial assessment and treatment for two of the most common forms of arthritis: osteoarthritis and rheumatoid arthritis. The article is divided into 3 parts. In the 1st part, the basic elements of the biopsychosocial approach to assessing and treating persons having arthritis is described. In the 2nd part, the authors evaluate studies of biopsychosocial approaches to the assessment of arthritis pain and disability. Six research areas are reviewed: learned helplessness, depression, stress, pain coping, self-efficacy, and the social context of arthritis. The 3rd part of the article reviews studies that testing the efficacy of biopsychosocial treatment approaches for persons having osteoarthritis and rheumatoid arthritis.

Authors
Keefe, FJ; Smith, SJ; Buffington, ALH; Gibson, J; Studts, JL; Caldwell, DS
MLA Citation
Keefe, FJ, Smith, SJ, Buffington, ALH, Gibson, J, Studts, JL, and Caldwell, DS. "Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis." J Consult Clin Psychol 70.3 (June 2002): 640-655. (Review)
PMID
12090374
Source
pubmed
Published In
Journal of Consulting and Clinical Psychology
Volume
70
Issue
3
Publish Date
2002
Start Page
640
End Page
655

Behavioral medicine: 2002 and beyond.

This article highlights future directions for research and practice in behavioral medicine. Topics addressed include social and environmental issues, the role of technology, translational research, improving and developing interventions, and professional training and retraining.

Authors
Keefe, FJ; Buffington, ALH; Studts, JL; Rumble, ME
MLA Citation
Keefe, FJ, Buffington, ALH, Studts, JL, and Rumble, ME. "Behavioral medicine: 2002 and beyond." J Consult Clin Psychol 70.3 (June 2002): 852-856.
PMID
12090388
Source
pubmed
Published In
Journal of Consulting and Clinical Psychology
Volume
70
Issue
3
Publish Date
2002
Start Page
852
End Page
856

The assessment of pain behavior: implications for applied psychophysiology and future research directions.

Persons who have pain engage in behaviors such as resting in bed, taking medication, moving in a guarded fashion, or grimacing that communicate the fact that pain is being experienced. Pain-related behaviors increasingly are viewed as an important target in pain assessment. Traditionally, pain behavior has been assessed through interview or self-recording methods (e.g. diary records). Pain behaviors, however, are overt and can be recorded through direct observation. Over the past 20 years, observation methods have been developed to assess pain behavior in patients having persistent pain conditions. Although these methods are not widely used in applied psychophysiological settings, they potentially could be quite useful. The purpose of this paper is to review the literature on such observation methods. The paper is divided into five parts. The first part provides a description of the basic elements of pain behavior observation protocols. The second part presents information on the psychometric properties of the most commonly used protocols. The third part highlights applications of pain behavior observation protocols. The fourth part briefly describes the strengths and limitations of pain behavior observation. The paper concludes with a discussion of the implications of pain behavior observation for applied psychophysiology and future directions for research and practice in this area.

Authors
Keefe, FJ; Smith, S
MLA Citation
Keefe, FJ, and Smith, S. "The assessment of pain behavior: implications for applied psychophysiology and future research directions." Appl Psychophysiol Biofeedback 27.2 (June 2002): 117-127. (Review)
PMID
12206046
Source
pubmed
Published In
Applied Psychophysiology and Biofeedback
Volume
27
Issue
2
Publish Date
2002
Start Page
117
End Page
127

Automated telephone as an adjunct for the treatment of chronic pain: A pilot study

The objective of this study was to test whether Interactive Voice Response (IVR) can be used to enhance the therapeutic outcome of patients receiving group cognitive behavioral therapy (CBT) for chronic pain. Ten subjects with chronic pain syndromes participated in 10 weeks of group CBT followed by 4 months of Therapeutic Interactive Voice Response (TIVR). Our specially designed TIVR is based on a computerized telephone system in which callers are asked questions and respond by using the telephone keypad. It was created to reinforce pain coping skills and to provide messages for relaxation, sleep induction, and emotional support that can be accessed by patients on demand. Within-subject analysis showed that maximum positive change for nearly all outcome measures was observed at the post-TIVR point. For some measures, improvement compared to baseline was significant after TIVR despite the fact it had not been significant after CBT. Measures showing this pattern included SF-36 Mental Health Composite Score (P < .0004), McGill Pain Questionnaire pain (P < .01), Coping Strategies Questionnaire Catastrophizing (P < .0006), Treatment Outcomes in Pain Survey Total Pain Experience (P < .03), and Perceived Family/Social Disability (P < .02). Our preliminary results suggest that TIVR can be used to improve coping skills adherence and to prevent relapse into pain behavior. © 2002 by the American Pain Society.

Authors
Naylor, MR; Helzer, JE; Naud, S; Keefe, FJ
MLA Citation
Naylor, MR, Helzer, JE, Naud, S, and Keefe, FJ. "Automated telephone as an adjunct for the treatment of chronic pain: A pilot study." Journal of Pain 3.6 (2002): 429-438.
PMID
14622728
Source
scival
Published In
Journal of Pain
Volume
3
Issue
6
Publish Date
2002
Start Page
429
End Page
438
DOI
10.1054/jpai.2002.129563

Behavioral medicine and clinical health psychology: A view from the decade of behavior

Authors
Smith, TW; Kendall, PC; Keefe, FJ
MLA Citation
Smith, TW, Kendall, PC, and Keefe, FJ. "Behavioral medicine and clinical health psychology: A view from the decade of behavior." Journal of Consulting and Clinical Psychology 70 (2002): 459-462. (Academic Article)
Source
manual
Published In
Journal of Consulting and Clinical Psychology
Volume
70
Publish Date
2002
Start Page
459
End Page
462

Cognitive behavioral approaches to the treatment of pain

How can cognitive-behavioral therapy benefit patients with persistent pain? The purpose of this review is to provide an overview of cognitive-behavioral treatment approaches to persistent pain. The review is divided into four sections. In the first section, we describe the conceptual background for cognitive-behavioral approaches to pain. In the second section, we describe the basic elements of a typical cognitive-behavioral treatment protocol used in pain management. In the third section, we address questions that healthcare professionals frequently ask about cognitive-behavioral treatment. In the fourth section, we discuss new clinical applications of cognitive-behavioral treatment.

Authors
Waters, SJ; McKee, DC; Keefe, FJ
MLA Citation
Waters, SJ, McKee, DC, and Keefe, FJ. "Cognitive behavioral approaches to the treatment of pain." Economics of Neuroscience 4.2 (2002): 57-63.
Source
scival
Published In
Economics of Neuroscience
Volume
4
Issue
2
Publish Date
2002
Start Page
57
End Page
63

Memory for pain: The relationship of pain catastrophizing to the recall of daily rheumatoid arthritis pain

Objective: The assumption that individuals are capable of accurately recalling past painful experiences has been a fundamental tenet of a number of cognitive-behavioral theories of pain, including the gate control theory. However, there has been very little research on the topic in the past, and the results have often been contradictory. A general conclusion that can be drawn is that memory for pain is variable, and there is need to identify what factors contribute to this variability in memory for pain. The current study examined the relation of catastrophizing to the recall of persistent pain associated with rheumatoid arthritis. Methods: Participants in this study were 45 individuals with persistent pain due to rheumatoid arthritis. Each participant was asked to complete a daily pain diary for a period of 30 days. Participants were subsequently asked to recall the pain they experienced over the entire period of time rather than provide a single, average rating. Results: The results of a series of hierarchical regression analyses indicated that level of catastrophizing was related to the recall of both pain intensity and pain variability. This relation was statistically significant even after controlling for actual pain and variability and other background variables. Conclusions: Participants who scored higher on catastrophizing demonstrated better accuracy in the recall of general pain intensity and pattern over a 30-day diary period. The results of the study are discussed in terms of future studies as well as their potential clinical importance.

Authors
Lefebvre, JC; Keefe, FJ
MLA Citation
Lefebvre, JC, and Keefe, FJ. "Memory for pain: The relationship of pain catastrophizing to the recall of daily rheumatoid arthritis pain." Clinical Journal of Pain 18.1 (2002): 56-63.
PMID
11803304
Source
scival
Published In
Clinical Journal of Pain
Volume
18
Issue
1
Publish Date
2002
Start Page
56
End Page
63
DOI
10.1097/00002508-200201000-00009

The Role of Depression Screening in Lumbar Disc Herniations and Spinal Stenosis: A Comment on Levy, Hanscom, & Boden

Authors
Keefe, FJ; McKee, D; Lynch, T
MLA Citation
Keefe, FJ, McKee, D, and Lynch, T. "The Role of Depression Screening in Lumbar Disc Herniations and Spinal Stenosis: A Comment on Levy, Hanscom, & Boden." Spine 27 (2002): 1237-. (Academic Article)
Source
manual
Published In
Spine
Volume
27
Publish Date
2002
Start Page
1237

Behavioral medicine and clinical health psychology: Introduction to the special issue, a view from the decade of behavior

This collection of articles follows prior special issues on behavioral medicine published in the Journal of Consulting and Clinical Psychology in 1982 and 1992. From the vantage point of the Decade of Behavior, the field has grown in scope, depth of basic science foundations, and evidence of applied utility. Yet many challenges remain-especially in addressing a wide range of health problems across diverse populations and in a health care context characterized by rapid changes in technology and by a growing concern with costs and evidence-based practice.

Authors
Smith, TW; Kendall, PC; Keefe, FJ
MLA Citation
Smith, TW, Kendall, PC, and Keefe, FJ. "Behavioral medicine and clinical health psychology: Introduction to the special issue, a view from the decade of behavior." Journal of Consulting and Clinical Psychology 70.3 (2002): 459-462.
PMID
12090362
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
70
Issue
3
Publish Date
2002
Start Page
459
End Page
462
DOI
10.1037//0022-006X.70.3.459

The management of persistent pain in older persons

Authors
Ickowicz, E; Ferrell, B; Casarett, D; Epplin, J; Fine, P; Gloth, M; Herr, K; Katz, P; Keefe, F; Koo, PJS; O'Grady, M; Szwabo, P; Vallerand, AH; Weiner, D
MLA Citation
Ickowicz, E, Ferrell, B, Casarett, D, Epplin, J, Fine, P, Gloth, M, Herr, K, Katz, P, Keefe, F, Koo, PJS, O'Grady, M, Szwabo, P, Vallerand, AH, and Weiner, D. "The management of persistent pain in older persons." Journal of the American Geriatrics Society 50.6 SUPPL. (2002): S205-S224.
PMID
12067390
Source
scival
Published In
Journal of the American Geriatrics Society
Volume
50
Issue
6 SUPPL.
Publish Date
2002
Start Page
S205
End Page
S224

Race, ethnicity and pain.

The current paper provides a brief overview of research on the effects of race and ethnicity on pain. More specifically, the article reviews the utility of the concepts of race and ethnicity for pain research, suggests operational definitions of race and ethnicity, reviews the literature on the effects of race and ethnicity on laboratory and clinical pain, and provides suggestions for future research.

Authors
Edwards, CL; Fillingim, RB; Keefe, F
MLA Citation
Edwards, CL, Fillingim, RB, and Keefe, F. "Race, ethnicity and pain." Pain 94.2 (November 2001): 133-137. (Review)
PMID
11690726
Source
pubmed
Published In
PAIN
Volume
94
Issue
2
Publish Date
2001
Start Page
133
End Page
137

Chest pain in the absence of coronary artery disease: a biopsychosocial perspective.

Authors
Thurston, RC; Keefe, FJ; Bradley, L; Rama Krishnan, KR; Caldwell, DS
MLA Citation
Thurston, RC, Keefe, FJ, Bradley, L, Rama Krishnan, KR, and Caldwell, DS. "Chest pain in the absence of coronary artery disease: a biopsychosocial perspective." Pain 93.2 (August 2001): 95-100. (Review)
PMID
11427319
Source
pubmed
Published In
PAIN
Volume
93
Issue
2
Publish Date
2001
Start Page
95
End Page
100

Pain and emotion: new research directions.

Recently, there has been growing interest in the relation between pain and emotion. Numerous recent studies have been conducted in this area. This article provides an introduction to this interesting area by highlighting selected research topics including studies on: stress and pain, negative emotional states and pain, catastrophizing and pain, the fear of pain, emotional regulation processes and pain, the effects of enhancing emotional regulation on pain, and the relation of emotional distress to treatment seeking in persons having pain. The article concludes with a discussion of important directions for future research in this area.

Authors
Keefe, FJ; Lumley, M; Anderson, T; Lynch, T; Studts, JL; Carson, KL
MLA Citation
Keefe, FJ, Lumley, M, Anderson, T, Lynch, T, Studts, JL, and Carson, KL. "Pain and emotion: new research directions." J Clin Psychol 57.4 (April 2001): 587-607. (Review)
PMID
11255208
Source
pubmed
Published In
Journal of Clinical Psychology
Volume
57
Issue
4
Publish Date
2001
Start Page
587
End Page
607

Living with rheumatoid arthritis: the role of daily spirituality and daily religious and spiritual coping.

The objective of this preliminary study was to evaluate more fully the role of daily spiritual experiences and daily religious/spiritual coping in the experience of individuals with pain due to rheumatoid arthritis (RA). Thirty-five individuals with RA were asked to keep a structured daily diary for 30 consecutive days. The diary included standardized measures designed to assess spiritual experiences, religious and spiritual pain coping, salience of religion in coping, religious/spiritual coping efficacy, pain, mood, and perceived social support. The participants in this study reported having spiritual experiences, such as feeling touched by the beauty of creation or feeling a desire to be closer or in union with God, on a relatively frequent basis. These participants also reported using positive religious and spiritual coping strategies much more frequently than negative religious and spiritual coping strategies. Although most of the variance in these measures was due to differences between persons, each measure also displayed a significant variability in scores from day to day. Indeed, there was just as much (or more) variability in these measures over time as there was variability in pain. Individuals who reported frequent daily spiritual experiences had higher levels of positive mood, lower levels of daily negative mood, and higher levels of each of the social support domains. Individuals who reported that religion was very salient in their coping with pain reported much higher levels of instrumental, emotional, arthritis-related, and general social support. Coping efficacy was significantly related to pain, mood, and social support in that on days that participants rated their ability to control pain and decrease pain using spiritual/religious coping methods as high, they were much less likely to have joint pain and negative mood and much more likely to have positive mood and higher levels of general social support. Taken together, these results suggest that daily spiritual experiences and daily religious/spiritual coping variables are important in understanding the experience of persons who have RA. They also suggest that newly developed daily diary methods may provide a useful methodology for studying religious and spiritual dimensions of living with arthritis.

Authors
Keefe, FJ; Affleck, G; Lefebvre, J; Underwood, L; Caldwell, DS; Drew, J; Egert, J; Gibson, J; Pargament, K
MLA Citation
Keefe, FJ, Affleck, G, Lefebvre, J, Underwood, L, Caldwell, DS, Drew, J, Egert, J, Gibson, J, and Pargament, K. "Living with rheumatoid arthritis: the role of daily spirituality and daily religious and spiritual coping." J Pain 2.2 (April 2001): 101-110.
PMID
14622831
Source
pubmed
Published In
The Journal of Pain
Volume
2
Issue
2
Publish Date
2001
Start Page
101
End Page
110
DOI
10.1054/jpai.2001.19296

Theoretical perspectives on the relation between catastrophizing and pain

The tendency to "catastrophize" during painful stimulation contributes to more intense pain experience and increased emotional distress. Catastrophizing has been broadly conceived as an exaggerated negative "mental set" brought to bear during painful experiences. Although findings have been consistent in showing a relation between catastrophizing and pain, research in this area has proceeded in the relative absence of a guiding theoretical framework. This article reviews the literature on the relation between catastrophizing and pain and examines the relative strengths and limitations of different theoretical models that could be advanced to account for the pattern of available findings. The article evaluates the explanatory power of a schema activation model, an appraisal model, an attention model, and a communal coping model of pain perception. It is suggested that catastrophizing might best be viewed from the perspective of hierarchical levels of analysis, where social factors and social goals may play a role in the development and maintenance of catastrophizing, whereas appraisal-related processes may point to the mechanisms that link catastrophizing to pain experience. Directions for future research are suggested.

Authors
Sullivan, MJL; Thorn, B; Haythornthwaite, JA; Keefe, F; Martin, M; Bradley, LA; Lefebvre, JC
MLA Citation
Sullivan, MJL, Thorn, B, Haythornthwaite, JA, Keefe, F, Martin, M, Bradley, LA, and Lefebvre, JC. "Theoretical perspectives on the relation between catastrophizing and pain." Clinical Journal of Pain 17.1 (2001): 52-64.
PMID
11289089
Source
scival
Published In
Clinical Journal of Pain
Volume
17
Issue
1
Publish Date
2001
Start Page
52
End Page
64
DOI
10.1097/00002508-200103000-00008

Erratum: Pain and emotion: New research directions (Journal of Clinical Psychology (2001) 57 (587-607)

Authors
Keefe, FJ; Lumley, M; Anderson, T; Lynch, T; Studts, JL; Carson, KL
MLA Citation
Keefe, FJ, Lumley, M, Anderson, T, Lynch, T, Studts, JL, and Carson, KL. "Erratum: Pain and emotion: New research directions (Journal of Clinical Psychology (2001) 57 (587-607)." Journal of Clinical Psychology 57.12 (2001): 1597--.
Source
scival
Published In
Journal of Clinical Psychology
Volume
57
Issue
12
Publish Date
2001
Start Page
1597-
DOI
10.1002/jclp.1122

The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing.

One hundred and sixty-eight patients with osteoarthritis (OA) of the knees participated in this study. Of the participants, 72 were men and 96 were women. All participants completed the Arthritis Impact Measurement Scales (AIMS), underwent a 10 min standardized observation session to assess their pain behavior, and completed the Catastrophizing Scale of the Coping Strategies Questionnaire (CSQ) and the Depression Scale of the Symptom Checklist 90 Revised (SCL-90R). The study found that there were significant differences in pain, pain behavior, and physical disability in men and women having OA. Women had significantly higher levels of pain and physical disability, and exhibited more pain behavior during an observation session than men. Further analyses revealed that catastrophizing mediated the relationship between gender and pain-related outcomes. Once catastrophizing was entered into the analyses, the previously significant effects of gender were no longer found. Interestingly, catastrophizing still mediated the gender-pain relationship even after controlling for depression. These findings underscore the importance of both gender and catastrophizing in understanding the OA pain experience and may have important implications for pain assessment and treatment.

Authors
Keefe, FJ; Lefebvre, JC; Egert, JR; Affleck, G; Sullivan, MJ; Caldwell, DS
MLA Citation
Keefe, FJ, Lefebvre, JC, Egert, JR, Affleck, G, Sullivan, MJ, and Caldwell, DS. "The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing." Pain 87.3 (September 2000): 325-334.
PMID
10963912
Source
pubmed
Published In
PAIN
Volume
87
Issue
3
Publish Date
2000
Start Page
325
End Page
334

The relationship of daily mood and stressful events to symptoms in juvenile rheumatic disease.

OBJECTIVES: The purpose of this study was 3-fold: 1) to assess the feasibility of a daily diary for use with children with juvenile rheumatic disease (JRD), 2) to describe daily variation in mood, stressful events, and symptoms in children with JRD, and 3) to examine the extent to which daily mood and daily stressful events predict daily symptoms in children with JRD. METHODS: Twelve children with JRD completed a daily booklet for 7 days. The daily booklet included measures of daily mood, daily stressful events, daily symptoms, and daily function. The children also completed a visual analog scale for pain and the Children's Depression Inventory. RESULTS: Subjects showed good compliance with scheduled completion and return of the daily diaries. Results indicated that children with JRD showed variability in daily mood, frequency of daily stressful events, and daily symptoms across days. Multilevel fixed effects models showed that more negative daily mood and more daily stressful events significantly predicted increased reports of fatigue, stiffness, and cutting back on daily activities. Negative daily mood also correlated with increases in daily reported pain. CONCLUSIONS: These results indicate that daily diary research is both feasible and potentially informative in children with JRD. Our data emphasize the need for further investigation into the role of daily mood and daily stressful events on disease course in JRD.

Authors
Schanberg, LE; Sandstrom, MJ; Starr, K; Gil, KM; Lefebvre, JC; Keefe, FJ; Affleck, G; Tennen, H
MLA Citation
Schanberg, LE, Sandstrom, MJ, Starr, K, Gil, KM, Lefebvre, JC, Keefe, FJ, Affleck, G, and Tennen, H. "The relationship of daily mood and stressful events to symptoms in juvenile rheumatic disease." Arthritis Care Res 13.1 (February 2000): 33-41.
PMID
11094924
Source
pubmed
Published In
Arthritis Care and Research
Volume
13
Issue
1
Publish Date
2000
Start Page
33
End Page
41

The relationship of daily mood and stressful events to symptoms in junvile rheumatic disease: A preliminary study using daily measures

Authors
Schanberg, LE; Jacobs, MR; Starr, K; Gil, KM; Lefebvre, JC; Keefe, FJ; Affleck, G
MLA Citation
Schanberg, LE, Jacobs, MR, Starr, K, Gil, KM, Lefebvre, JC, Keefe, FJ, and Affleck, G. "The relationship of daily mood and stressful events to symptoms in junvile rheumatic disease: A preliminary study using daily measures." Arthritis Care & Research 13 (2000): 33-41. (Academic Article)
Source
manual
Published In
Arthritis Care & Research
Volume
13
Publish Date
2000
Start Page
33
End Page
41

Understanding the adoption of arthritis self-management: Stages of change profiles among arthritis patients

Clinical observations and recent studies suggest that arthritis patients vary considerably in their involvement in self-management efforts. In the literature on health promotion, there is growing recognition that patients may be at different stages of change with respect to the adoption of self- management strategies. The major goal of the present study was to examine whether cluster analysis could be used to identify homogeneous subgroups of patients having persistent arthritis pain based on their responses to a stages of change questionnaire. Participants in this study (103 patients having rheumatoid arthritis and 74 patients having osteoarthritis) completed a stages-of-change measure specific to adoption of a self-management approach to their arthritis. A cluster analysis identified five distinct subgroups of arthritis patients: (1) precontemplation - 44% of the sample; (2) contemplation - 11% of the sample; (3) preparation - 22% of the sample; (4) unprepared action - 6% of the sample; and (5) prepared maintenance - 17% of the sample. These subgroups are generally consistent with what might be expected based on the transtheoretical model of stages of change by Prochaska and DiClemente (Prochaska JO, DiClemente CC. Towards a comprehensive, transtheoretical model of change: states of change and addictive behaviors. In: Miller WR, Heather N, editors. Applied clinical psychology, 2nd ed. Treating addictive behaviors, New York: Plenum Press, 1998. pp. 3-24.), and may have important clinical implications. For example, it is possible that the arthritis subgroups identified may predict arthritis patients' participation in and responsiveness to pain-coping skills training, exercise interventions, or other formal self-management training programs. Also, one may be able enhance the outcomes of self-management interventions for arthritis by tailoring treatment to the patient's particular stage. (C) 2000 International Association for the Study of Pain.

Authors
Keefe, FJ; Lefebvre, JC; Kerns, RD; Rosenberg, R; Beaupre, P; Prochaska, J; Prochaska, JO; Caldwell, DS
MLA Citation
Keefe, FJ, Lefebvre, JC, Kerns, RD, Rosenberg, R, Beaupre, P, Prochaska, J, Prochaska, JO, and Caldwell, DS. "Understanding the adoption of arthritis self-management: Stages of change profiles among arthritis patients." Pain 87.3 (2000): 303-313.
PMID
10963910
Source
scival
Published In
Pain
Volume
87
Issue
3
Publish Date
2000
Start Page
303
End Page
313
DOI
10.1016/S0304-3959(00)00294-3

Effects of coping on health outcome among women with gastrointestinal disorders

Background: Studies have shown that the nature and quality of coping may positively or negatively affect health outcome; however, this relationship has not been well studied among patients with gastrointestinal (GI) disorders. Objectives: The primary objective was to study the effect of different coping strategies on the health outcome of women with GI disorders and how these coping strategies may modify the effects of education, GI disease type, neuroticism, and abuse severity on health outcome. Methods: We followed 174 patients in a referral GI clinic for 12 months to assess their health status as a derived variable of daily pain, bed disability days, psychological distress, daily dysfunction, number of visits to physicians, and number of surgeries and procedures. We obtained at baseline their GI diagnosis (functional vs. organic), neuroticism score (NEO Personality Inventory), sexual and/or physical abuse history, and scores on two coping questionnaires. Regressions analyses were used to determine the relative effect of the coping measures on health outcome and their modifying effects on education, GI disease type, neuroticism, and abuse severity. Results: A higher score on the Catastrophizing scale and a lower score on the Self- Perceived Ability to Decrease Symptoms scale (Coping Strategies Questionnaire) predicted poor health outcome. Less education, a functional GI diagnosis, a higher neuroticism score, and greater abuse severity also contributed to poor health status. However, the effect of GI disease type and neuroticism on health outcome was significantly reduced by the coping measures. Conclusions: Maladaptive coping (eg, catastrophizing) and decreased self-perceived ability to decrease symptoms may adversely affect health outcome and may modify the effect of GI disease type and neuroticism on health outcome.

Authors
Drossman, DA; Leserman, J; Li, Z; Keefe, F; Hu, YJB; Toomey, TC
MLA Citation
Drossman, DA, Leserman, J, Li, Z, Keefe, F, Hu, YJB, and Toomey, TC. "Effects of coping on health outcome among women with gastrointestinal disorders." Psychosomatic Medicine 62.3 (2000): 309-317.
PMID
10845344
Source
scival
Published In
Psychosomatic Medicine
Volume
62
Issue
3
Publish Date
2000
Start Page
309
End Page
317

Mammography pain in women treated conservatively for breast cancer

In this study, pain during mammography in women treated conservatively for breast cancer was examined. It studied pain intensity and its relation to a variety of demographic, medical, and pain coping variables as well as to objective measures of breast compression. Ninety-nine women, treated with lumpectomy (with or without radiation) and undergoing follow-up screening mammography, were asked about strategies they use to cope with everyday pain and then were asked to report pain experienced during the mammogram. Treated and untreated breasts were rated separately and compared with a sample of 125 control women with no history of breast cancer. Women reported significantly greater pain in the treated breast (41% greater than the untreated breast and 32% greater than the control group). There was no consistent relationship between mammography pain and pain coping. Average intensity of pain at last mammogram was the best predictor of pain in both breasts. Women treated conservatively for breast cancer experience significantly greater pain during mammography of their treated breast. Radiologists and technologists can identify women at risk for a painful mammogram by asking about the pain at last mammogram. By applying pain-reducing interventions, they might be able to make the mammography experience more tolerable for these women.

Authors
Kornguth, PJ; Keefe, FJ; Wright, KR; Delong, DM
MLA Citation
Kornguth, PJ, Keefe, FJ, Wright, KR, and Delong, DM. "Mammography pain in women treated conservatively for breast cancer." Journal of Pain 1.4 (2000): 268-274.
PMID
14622609
Source
scival
Published In
The Journal of Pain
Volume
1
Issue
4
Publish Date
2000
Start Page
268
End Page
274
DOI
10.1054/jpai.2000.7884

Pain behavior observation: current status and future directions.

Individuals who have pain engage in certain pain-related behaviors that tend to communicate their pain to others. There is growing recognition that the careful observation of such pain behaviors is an important component of a comprehensive pain assessment. This article provides an overview of the current status of behavioral observation methods used to assess pain behavior. The first half of this article describes and evaluates the most commonly used pain behavior observation methods. These include self-observation methods such as activity diaries, and direct observation methods such as the use of standard behavior sampling methods and naturalistic observation methods. The second half of the article discusses several important future clinical and research applications of pain behavior observation methods. The need to develop practical, clinical methods for incorporating pain behavior observation methods into practice settings is emphasized. Important future research topics include studying the social context of pain behavior (eg, by examining how spouses respond to displays of pain behavior), examining the predictive validity of pain behavior (ie, how observed pain behaviors predict future disability and impairment), and identifying pain behavior subgroups within heterogeneous chronic pain populations. Further development and refinement of pain behavior observation methods is likely to increase our understanding of the varied ways that patients adapt to persistent pain.

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Pain behavior observation: current status and future directions." Curr Rev Pain 4.1 (2000): 12-17.
PMID
10998710
Source
pubmed
Published In
Current review of pain
Volume
4
Issue
1
Publish Date
2000
Start Page
12
End Page
17

Pain in nursing home residents: an exploration of prevalence, staff perspectives, and practical aspects of measurement.

OBJECTIVE: To help rectify the underdiagnosis of chronic pain in frail nursing home residents by developing a new feasible pain self-report instrument, the structured pain interview; to use this new tool to estimate pain prevalence and staff's knowledge of residents' pain in two nursing homes; and to compare the performance differences of the structured pain interview and the commonly used 0-10 scale. DESIGN: Cross-sectional survey. SETTING: One 120-bed VA-affiliated and one 125-bed university-affiliated, community-based nursing home in Durham, North Carolina. PATIENTS: One hundred fifty-eight chronic care nursing home residents without aphasia, acute illness, persistent vegetative status, or severe hearing impairment and 3 1 nursing home nurses. OUTCOME MEASURES: Pain prevalence according to resident self-report and nurse report; stability of response to the structured pain interview and 0-10 scale over 1 month; agreement between residents and nurses on the structured pain interview and 0-10 scale. RESULTS: Fifty-eight percent of the VA and 45% of the community nursing home residents reported pain. Forty-two percent at the VA and 20% at the community home were unable to respond to the 0-10 scale, compared with 7.5% and 14% using the structured pain interview. Stability of response to the structured pain interview at 1 month was 0.56 at the VA (nurse-resident agreement 0.38) and 0.72 in the community (nurse-resident agreement 0.07), which was very comparable to the 0-10 scale. CONCLUSIONS: We have developed a highly feasible tool for examining pain prevalence in nursing homes. This tool uncovered considerable miscommunication regarding pain between residents and staff. Improvement in pain communication between nursing home residents and staff is needed, so that more effective pain treatment programs can be developed for this vulnerable population.

Authors
Weiner, D; Peterson, B; Ladd, K; McConnell, E; Keefe, F
MLA Citation
Weiner, D, Peterson, B, Ladd, K, McConnell, E, and Keefe, F. "Pain in nursing home residents: an exploration of prevalence, staff perspectives, and practical aspects of measurement." Clin J Pain 15.2 (June 1999): 92-101.
PMID
10382922
Source
pubmed
Published In
Clinical Journal of Pain
Volume
15
Issue
2
Publish Date
1999
Start Page
92
End Page
101

Predicting peak oxygen uptake among older patients with chronic illness.

PURPOSE: To compare three equations developed to predict VO2 among patients diagnosed with one of two chronic diseases: essential hypertension (HTN), and fibromyalgia (FM). The equations included the American College of Sports Medicine (ACSM) equation, the FAST equation developed from the Fitness and Arthritis in Seniors Trial (FAST), and an equation developed by Foster et al. METHODS: One hundred twenty-two HTN subjects and 68 FM subjects completed a maximum exercise test according to the Duke/Wake Forest protocol. Measured peak VO2 was then compared with the VO2 predicted by the ACSM, FAST and FOSTER equations, using several statistical methods. RESULTS: The ACSM equation overpredicted peak VO2 in the HTN group by 10.0 +/- 4.0 mL/kg-1/min-1, and in the FM group by 8.6 +/- 4.9 mL/kg-1/min-1 (P < 0.0001). The FAST equation, however, underestimated peak VO2 by 1.5 +/- 4.2 mL/kg-1/min-1 (P < 0.01) and 1.0 +/- 3.3 mL/kg-1/min-1 (P < 0.0001) in the HTN and FM groups, respectively. The FOSTER equation overestimated peak VO2 by 2.3 +/- 3.6 mL/kg-1/min-1 in the HTN group and by 2.1 +/- 3.5 mL/kg-1/min-1 in the FM group (P < 0.0001). A large degree of variability was found for each of the equations. CONCLUSION: Results of this investigation indicate that all three equations produced peak VO2 values that were statistically different from measured values. Although the ACSM equation overestimated VO2 by more than 2 metabolic equivalents (METs) in each patient group, both the FAST and FOSTER equations produced differences that were less than 1 MET. Further research is needed to examine the FAST and FOSTER equations among other patient populations and with other exercise protocols.

Authors
Dominick, KL; Gullette, EC; Babyak, MA; Mallow, KL; Sherwood, A; Waugh, R; Chilikuri, M; Keefe, FJ; Blumenthal, JA
MLA Citation
Dominick, KL, Gullette, EC, Babyak, MA, Mallow, KL, Sherwood, A, Waugh, R, Chilikuri, M, Keefe, FJ, and Blumenthal, JA. "Predicting peak oxygen uptake among older patients with chronic illness." J Cardiopulm Rehabil 19.2 (March 1999): 81-89.
PMID
10200913
Source
pubmed
Published In
Journal of cardiopulmonary rehabilitation
Volume
19
Issue
2
Publish Date
1999
Start Page
81
End Page
89

The relationship of arthritis self-efficacy to daily pain, daily mood, and daily pain coping in rheumatoid arthritis patients

There is an increasing awareness in the medical community that psychosocial variables such as beliefs in self-efficacy are important determinants of treatment outcome. However, before measures of self-efficacy are widely incorporated into clinical practice, there needs to be a better understanding of how they relate to daily pain, mood and coping. In the present study 128 rheumatoid arthritis patients completed diaries for 30 days in which they provided daily ratings of joint pain, negative and positive mood, the use of pain coping strategies, and coping efficacy. The patients then participated in an evaluation session during which measures of self-efficacy (the Arthritis Self Efficacy Scale (ASES)), demographic variables, and medical status were collected. A series of hierarchical regression analyses was conducted to determine the degree to which self-efficacy measures collected at the time of the evaluation session were related to daily diary measures collected during the 30 preceding days. The results revealed that self-efficacy was significantly related to daily ratings of pain, mood, coping and coping efficacy. Interestingly, the findings regarding self-efficacy were obtained even after taking into account the effects of important demographic and medical status variables. Taken together, these results suggest that self-efficacy ratings collected from arthritis patients at the time of an evaluation session may well be related to recent experiences of daily pain and mood, as well as the daily use and perceived effectiveness of pain coping strategies. Copyright (C) 1999 Elsevier Science Ireland Ltd.

Authors
Lefebvre, JC; Keefe, FJ; Affleck, G; Raezer, LB; Starr, K; Caldwell, DS; Tennen, H
MLA Citation
Lefebvre, JC, Keefe, FJ, Affleck, G, Raezer, LB, Starr, K, Caldwell, DS, and Tennen, H. "The relationship of arthritis self-efficacy to daily pain, daily mood, and daily pain coping in rheumatoid arthritis patients." Pain 80.1-2 (1999): 425-435.
PMID
10204758
Source
scival
Published In
PAIN
Volume
80
Issue
1-2
Publish Date
1999
Start Page
425
End Page
435
DOI
10.1016/S0304-3959(98)00242-5

Spouse-assisted coping skills training in the management of knee pain in osteoarthritis: Long-term follow-up results

Objective. To evaluate the long-term effects of a spouse-assisted coping skills intervention in patients with osteoarthritis (OA) of the knees, and to evaluate how pre- to posttreatment changes in marital adjustment and self- efficacy relate to long-term improvements in pain, psychological disability, physical disability, pain coping, and pain behavior. Methods. A follow-up study was conducted with 88 OA patients who had been randomly assigned to 1 of 3 treatment conditions: 1) spouse-assisted coping skills training (spouse- assisted CST), 2) a conventional CST intervention with no spouse involvement, and 3) an arthritis education-spousal support (AE-SS) control condition. To evaluate long-term outcome, comprehensive measures of self-efficacy, marital adjustment, pain, psychological disability, physical disability, pain coping, and pain behavior were collected from these individuals at 6 and 12 months posttreatment. Results. Data analysis revealed that, at 6-month follow-up, patients in the spouse-assisted CST condition scored higher on measures of coping and self-efficacy than those in the AE-SS control group. At 6-month follow-up, patients who received CST without spouse involvement showed a significantly higher frequency of coping attempts and reported higher levels of marital adjustment than those in the AE-SS control group. At 12-month follow-up, patients in the spouse-assisted CST condition had significantly higher overall self-efficacy than those in the AE-SS control condition. In addition, patients in both the spouse-assisted CST and CST only conditions tended to show improvements in physical disability at the 12-month follow-up. Individual differences in outcome were noted at the 12-month follow-up. Patients in the spouse-assisted CST condition who reported initial (pre- to posttreatment) increases in marital adjustment had lower levels of psychological disability, physical disability, and pain behavior at 12-month follow-up. However, for patients in the conventional CST and AE-SS control conditions, increases in marital adjustment occurring over the initial phase of treatment were related to increases in pain and decreases in scores on the Pain Control in Rational Thinking factor of the Coping Strategies Questionnaire. Finally, patients in the spouse-assisted CST condition who showed pre- to posttreatment increases in self-efficacy were more likely to show decreases in pain, psychological disability, and physical disability at 12-month follow-up. Conclusions. These findings suggest that spouse-assisted CST can enhance self-efficacy and improve the coping abilities of OA patients in the long term. Individual differences in the long-term outcome of spouse- assisted CST were noted, with some patients (those showing increases in marital satisfaction and self-efficacy) showing much better outcomes than others.

Authors
Keefe, FJ; Caldwell, DS; Baucom, D; Salley, A; Robinson, E; Timmons, K; Beaupre, P; Weisberg, J; Helms, M
MLA Citation
Keefe, FJ, Caldwell, DS, Baucom, D, Salley, A, Robinson, E, Timmons, K, Beaupre, P, Weisberg, J, and Helms, M. "Spouse-assisted coping skills training in the management of knee pain in osteoarthritis: Long-term follow-up results." Arthritis Care and Research 12.2 (1999): 101-111.
PMID
10513498
Source
scival
Published In
Arthritis Care and Research
Volume
12
Issue
2
Publish Date
1999
Start Page
101
End Page
111

Chronic pain-associated behaviors in the nursing home: Resident versus caregiver perceptions

Pain assessment in nursing home residents poses challenges since many of these individuals are too cognitively impaired to respond to traditional self-report instruments. Assessment of pain behavior in this population offers a logical alternative. The purpose of this study was to compare perceptions of behaviors identified as being pain-related in 42 nursing home residents with chronic pain, as reported by residents themselves, their nursing home caregivers and their family caregivers. Our specific research agenda was to identify the most salient behaviors that signal pain in nursing home residents; to determine the test-retest agreement of residents' self-perceived pain behaviors; to learn of the confidence that caregivers feel regarding assessment of residents' pain behavior; and to examine the agreement between caregivers and residents about pain behaviors in particular residents. We also wanted to compare residents' and caregivers' ratings of the residents' pain intensity. Finally, we explored the beliefs of nursing home staff about the influence of dementia on pain and pain assessment. Twenty-two of 26 pain-related behaviors identified by residents showed fair to perfect test-retest agreement (kappas 0.40-1). For the vast majority of pain-related behavior items, kappas for resident-caregiver agreement were <0.30. Agreement with regard to pain intensity was similarly poor (r=-0.19-0.34). Confidence in pain rating was high for both nurse (on average, 7.2 on a scale of 0-10) and family (on average, 6.7) caregivers. Seventy-one percent of nurses felt that pain assessment is more difficult in demented individuals, but that cognitive function does not influence pain prevalence. While nursing home residents with chronic pain and their caregivers have different perceptions regarding which behaviors are pain-related, additional studies are required to determine the underpinnings of these differing perceptions and to determine the extent to which formal pain behavior observation protocols will be useful for evaluating nursing home residents with chronic pain. Copyright (C) 1999 Elsevier Science Ireland Ltd.

Authors
Weiner, D; Peterson, B; Keefe, F
MLA Citation
Weiner, D, Peterson, B, and Keefe, F. "Chronic pain-associated behaviors in the nursing home: Resident versus caregiver perceptions." Pain 80.3 (1999): 577-588.
PMID
10342419
Source
scival
Published In
PAIN
Volume
80
Issue
3
Publish Date
1999
Start Page
577
End Page
588
DOI
10.1016/S0304-3959(98)00249-8

Psychosocial assessment of pain in patients having rheumatic diseases

This article provides an overview of psychosocial approaches to assessing factors relevant to the understanding and management of arthritis pain. The article is divided into two major sections. Section one provides a conceptual background that highlights the role that psychosocial factors play in the pain experience. Section two briefly describes and evaluates methods used to assess psychological factors (e.g., pain behavior, pain coping, and self-efficacy) and social factors (e.g., social support, marital adjustment) that can affect adjustment to persistent pain.

Authors
Keefe, FJ; Bonk, V
MLA Citation
Keefe, FJ, and Bonk, V. "Psychosocial assessment of pain in patients having rheumatic diseases." Rheumatic Disease Clinics of North America 25.1 (1999): 81-103.
PMID
10083960
Source
scival
Published In
Rheumatic Disease Clinics of North America
Volume
25
Issue
1
Publish Date
1999
Start Page
81
End Page
103
DOI
10.1016/S0889-857X(05)70056-9

Pain: Biopsychosocial mechanisms and management

Traditionally, pain has been viewed as a asensory event warning of tissue damage or illness. This explanation fails to account for many of the experiences of people suffering from clinically painful conditions. Over the past two decades, a new biopsychosocial perspective on pain has emerged. This perspective emphasizes that pain is a dynamic process that not only is influenced by biological, psychological, and social mechanisms of pain, but also produces biological, psychological, and social changes that can affect future responses to pain. This review presents findings from recent studies of the biological, psychological, and social mechanisms of pain and discusses the implications of these findings for pain research, assessment, prevention, and treatment, as well as for health care policy.

Authors
Keefe, FJ; France, CR
MLA Citation
Keefe, FJ, and France, CR. "Pain: Biopsychosocial mechanisms and management." Current Directions in Psychological Science 8.5 (1999): 137-141.
Source
scival
Published In
Current Directions in Psychological Science
Volume
8
Issue
5
Publish Date
1999
Start Page
137
End Page
141

Effects of Disease and Gender on Daily Pain, Mood, and Coping

Authors
Affleck, G; Tennen, H; Keefe, FJ; Lefebvre, JC; Kashikar Zuck, S; Wright, K; Starr, K; Caldwell, DS
MLA Citation
Affleck, G, Tennen, H, Keefe, FJ, Lefebvre, JC, Kashikar Zuck, S, Wright, K, Starr, K, and Caldwell, DS. "Effects of Disease and Gender on Daily Pain, Mood, and Coping." Pain 83 (1999): 601-610. (Academic Article)
Source
manual
Published In
Pain
Volume
83
Publish Date
1999
Start Page
601
End Page
610

Catastrophizing research: Avoiding conceptual errors and maintaining a balanced perspective

This Commentary addresses some common conceptual errors and methodological issues raised by the Focus article by Geisser, Robinson, and Riley. One conceptual error, the problem of confounding coping with outcome, is evident in their assertion that catastrophizing is not a form of coping, but rather a maladaptive pain belief. Catastrophizing clearly fits current definitions of coping, even though it may be associated with negative outcomes. A second conceptual error is the tendency to oversimplify the coping process that is evident in the tendency to divide coping strategies into dichotomous categories (eg, active vs passive, adaptive vs maladaptive). Methodological issues raised by this article include: (1) the need to recognize the strengths of existing pain co ping instruments (eg, the Coping Strategies Questionnaire), and (2) the utility of new and alternative coping measures. This Commentary concludes with a discussion of important directions for future research on pain coping.

Authors
Keefe, FJ; Lefebvre, JC; Smith, SJ; Geisser, ME; Robinson, ME; III, JLR
MLA Citation
Keefe, FJ, Lefebvre, JC, Smith, SJ, Geisser, ME, Robinson, ME, and III, JLR. "Catastrophizing research: Avoiding conceptual errors and maintaining a balanced perspective." Pain Forum 8.4 (1999): 176-182.
Source
scival
Published In
Pain Forum
Volume
8
Issue
4
Publish Date
1999
Start Page
176
End Page
182

Everyday life with osteoarthritis or rheumatoid arthritis: Independent effects of disease and gender on daily pain, mood, and coping

The effects of disease (form of arthritis) and gender on pain, mood, and pain coping strategies were examined in a prospective 30-day diary study of 71 patients with osteoarthritis (OA) and 76 with rheumatoid arthritis (RA). Diary instruments included joint pain ratings, POMS-B checklists for positive and negative mood, and the Daily Coping Inventory. Women's average daily pain was 72% greater than men's pain, and RA patients' average daily pain was 42% greater than OA patients' pain. Hierarchical Linear Models were estimated for (a) within-person associations between pain and next-day mood; coping and next-day pain; and coping and next-day mood; and (b) the independent effects of disease and gender on individual intercepts for pain, mood, and coping and on individual slopes for pain-coping-mood relations. Women, regardless of their disease, and RA patients, regardless of their gender, reported more daily pain. Women used more emotion-focused strategies each day than did men, regardless of their disease and even after controlling for their greater pain. Men were more likely than women to report an increase in negative mood the day after a more painful day. RA patients' pain worsened, but OA patients' pain improved, following a day with more emotion-focused coping. Implications for research and clinical practice are summarized.

Authors
Affleck, G; Tennen, H; Keefe, FJ; Lefebvre, JC; Kashikar-Zuck, S; Wright, K; Starr, K; Caldwell, DS
MLA Citation
Affleck, G, Tennen, H, Keefe, FJ, Lefebvre, JC, Kashikar-Zuck, S, Wright, K, Starr, K, and Caldwell, DS. "Everyday life with osteoarthritis or rheumatoid arthritis: Independent effects of disease and gender on daily pain, mood, and coping." Pain 83.3 (1999): 601-609.
PMID
10568869
Source
scival
Published In
PAIN
Volume
83
Issue
3
Publish Date
1999
Start Page
601
End Page
609
DOI
10.1016/S0304-3959(99)00167-0

Self-management of fibromyalgia: the role of formal coping skills training and physical exercise training programs.

There has been growing interest in the use of formal self-management training programs for people with fibromyalgia (FM). In these programs, health care professionals serve as trainers and provide education about FM and guided instruction in specific self-management strategies. A review of the literature on formal self-management training programs for FM suggests that they can be divided into groups: 1) those emphasizing training in coping skills (e.g., relaxation, activity pacing, and problem-solving techniques), and 2) those emphasizing training in physical exercise (e.g., cardiovascular fitness, strength, and endurance training). In this article, we review studies that have tested the efficacy of both types of programs. In addition, we identify key individual and contextual variables that are related to outcome and highlight future directions in the research and development of self-management programs.

Authors
Sandstrom, MJ; Keefe, FJ
MLA Citation
Sandstrom, MJ, and Keefe, FJ. "Self-management of fibromyalgia: the role of formal coping skills training and physical exercise training programs." Arthritis Care Res 11.6 (December 1998): 432-447. (Review)
PMID
10030175
Source
pubmed
Published In
Arthritis Care and Research
Volume
11
Issue
6
Publish Date
1998
Start Page
432
End Page
447

Predictors of pain self-report in nursing home residents.

The purpose of this study was to examine the influence of cognitive function and other biopsychosocial factors on test-retest agreement, four-week variability, and intensity of self-reported pain using the verbal 0 to 10 scale and a pain thermometer in 115 nursing home residents over four weeks. Pain was assessed twice on three days during week 1, and once each during weeks 2, 3 and 4. A forward stepwise regression procedure was used to examine the influence of biopsychosocial parameters (age, race, gender, educational status, marital status, comorbidity, cognitive function, depression, social support, physical function and self-rated health) on pain intensity, test-retest agreement and variability. There was a quadratic association between cognitive function and test-retest agreement with the 0-10 scale; residents with Folstein scores of 22-26 were more likely to show disagreement (50% of 34) than residents with scores < 22 or > 26 (7% of 71). Higher Folstein scores were also associated with greater pain intensity for both pain scales (p < 0.001). Baseline pain intensity was significantly related to pain variability (0-10 scale only). The clinician should be cognizant of these relationships when interpreting verbalizations of pain in long-term care facilities.

Authors
Weiner, DK; Peterson, BL; Logue, P; Keefe, FJ
MLA Citation
Weiner, DK, Peterson, BL, Logue, P, and Keefe, FJ. "Predictors of pain self-report in nursing home residents." Aging (Milano) 10.5 (October 1998): 411-420.
PMID
9932145
Source
pubmed
Published In
Aging
Volume
10
Issue
5
Publish Date
1998
Start Page
411
End Page
420

Social context of pain in children with Juvenile Primary Fibromyalgia Syndrome: parental pain history and family environment.

OBJECTIVE: The purpose of this study was to describe parental pain history and the family environment as it relates to the functional status of children with Juvenile Primary Fibromyalgia Syndrome (JPFS). DESIGN AND OUTCOME MEASURES: Twenty-nine parents of children with JPFS completed a pain history questionnaire, Von Korff Chronic Pain Grading system, and the Family Environment Scale (FES). Twenty-one adolescents with JPFS completed the FES, the Visual Analogue Scale for Pain, the modified Fibromyalgia Impact Questionnaire for Children, the Arthritis Impact Measurement Scales, and the Symptom Checklist-90-Revised. Correlational analyses were performed. RESULTS: Parents of children with JPFS reported multiple chronic pain conditions, including but not limited to fibromyalgia. Parental pain history and the family environment correlated with the health status of adolescents with JPFS. Children with JPFS perceived the family environment as significantly more cohesive than did their parents. Greater incongruence between parent and child responses on the FES positively correlated with greater impairment. CONCLUSIONS: These results suggest that family environment and parental pain history ày be related to how children cope with JPFS. Behavioral interventions targeting the family may improve the long-term functional status of children with JPFS.

Authors
Schanberg, LE; Keefe, FJ; Lefebvre, JC; Kredich, DW; Gil, KM
MLA Citation
Schanberg, LE, Keefe, FJ, Lefebvre, JC, Kredich, DW, and Gil, KM. "Social context of pain in children with Juvenile Primary Fibromyalgia Syndrome: parental pain history and family environment." Clin J Pain 14.2 (June 1998): 107-115.
PMID
9647451
Source
pubmed
Published In
Clinical Journal of Pain
Volume
14
Issue
2
Publish Date
1998
Start Page
107
End Page
115

Sampling of empirically supported psychological treatments from health psychology: smoking, chronic pain, cancer, and bulimia nervosa.

Interventions in health psychology and behavioral medicine represent an integral area of research for the development of psychological therapies to enhance health behaviors, manage symptoms and sequelae of disease, treat psychological symptoms and disorders, prolong survival in the face of a life-threatening illness, and improve quality of life. A sampling of interventions in health psychology and behavioral medicine is offered that meet the criteria for empirically supported treatments for smoking cessation, chronic pain, cancer, and bulimia nervosa. Evidence for empirically supported treatments is identified, along with promising interventions that do not yet meet the criteria as outlined by D. L. Chambless and S. D. Hollon (1998). Evidence for the effectiveness and clinical significance of these interventions is reviewed, and issues in this area of research are outlined.

Authors
Compas, BE; Haaga, DA; Keefe, FJ; Leitenberg, H; Williams, DA
MLA Citation
Compas, BE, Haaga, DA, Keefe, FJ, Leitenberg, H, and Williams, DA. "Sampling of empirically supported psychological treatments from health psychology: smoking, chronic pain, cancer, and bulimia nervosa." Journal of consulting and clinical psychology 66.1 (February 1998): 89-112. (Review)
PMID
9489263
Source
epmc
Published In
Journal of Consulting and Clinical Psychology
Volume
66
Issue
1
Publish Date
1998
Start Page
89
End Page
112
DOI
10.1037//0022-006x.66.1.89

Evaluating persistent pain in long term care residents: What role for pain maps?

The purpose of this study was to examine the utility of the pain map as a pain assessment tool in frail nursing home residents. The study was conducted in two phases. In Phase 1, nursing home staff's knowledge of the locations of resident pain complaints was examined. We found significant deficiencies in this knowledge. In Phase 2, we examined the following test characteristics of pain extensity (number of painful body areas annotated on pain map): (1) test-retest reliability, (2) convergent validity as compared with pain intensity measured by a pain thermometer (modified vertical verbal descriptor scale) and an 11 point numerical graphic rating scale (NGRS), and (3) predictive validity with depression, functional impairment and self- rated health. Pain map scoring was performed by counting the number of involved body areas (i.e., numbered segments) using an established scoring template. Test-retest reliability by body area was excellent. Pain extensity was modestly associated with pain thermometer-scored pain intensity but not with NGRS-scored pain intensity. Pain extensity also demonstrated modest predictive validity with self-rated health, but not with depression or functional impairment. The advantage of knowing where residents hurt is that this allows staff to target their assessment and thus determine the functional implications of residents pain. It appears that pain maps acid a useful dimension to pain assessment in residents of long term care facilities.

Authors
Weiner, D; Peterson, B; Keefe, F
MLA Citation
Weiner, D, Peterson, B, and Keefe, F. "Evaluating persistent pain in long term care residents: What role for pain maps?." Pain 76.1-2 (1998): 249-257.
PMID
9696480
Source
scival
Published In
PAIN
Volume
76
Issue
1-2
Publish Date
1998
Start Page
249
End Page
257
DOI
10.1016/S0304-3959(98)00059-1

Perspectives on pain-related suffering: presentations and discussions

Authors
Barsky, ; A, ; Baszener, ; I, ; Bradley, ; L, ; Casey, ; K, ; Chapman, ; R, C; Gracely, ; R, ; Haythornthwaite, ; J, ; Jackson, ; J, ; Jensen, ; M, ; Keefe, ; J, F; Liebeskind, ; J, ; Logan, ; H, ; McGrath, ; P, ; McGuire, ; B, D; Melzack, ; R, ; Morris, ; D, ; Post, ; G, S; Price, ; D, ; Rouse, ; F, ; Spro,
MLA Citation
Barsky, , A, , Baszener, , I, , Bradley, , L, , Casey, , K, , Chapman, , R, C, Gracely, , R, , Haythornthwaite, , J, , Jackson, , J, , Jensen, , M, , Keefe, , J, F, Liebeskind, , J, , Logan, , H, , McGrath, , P, , McGuire, , B, D, Melzack, , R, , Morris, , D, , Post, , G, S, Price, , D, , Rouse, , F, , and Spro, . "Perspectives on pain-related suffering: presentations and discussions." Advances in Mind-Body Medicine 14 (1998): 167-203. (Academic Article)
Source
manual
Published In
Advances in Mind-Body Medicine
Volume
14
Publish Date
1998
Start Page
167
End Page
203

Current status and future directions of pain behavior observation

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Current status and future directions of pain behavior observation." Current Review of Pain 2 (1998): 61-65. (Academic Article)
Source
manual
Published In
Current Review of Pain
Volume
2
Publish Date
1998
Start Page
61
End Page
65

Cognitive processes and the pain experience

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Cognitive processes and the pain experience." Journal of Musculoskeletal Pain 6.3 (1998): 41-45.
Source
scival
Published In
Journal of Musculoskeletal Pain (Haworth)
Volume
6
Issue
3
Publish Date
1998
Start Page
41
End Page
45
DOI
10.1300/J094v06n03_08

Pain coping strategies that predict patients' and spouses' ratings of patients' self-efficacy.

This study examined the relationship of pain coping strategies to osteoarthritis patients' ratings of self-efficacy and to spouses' ratings of the patients' self-efficacy. Subjects, 130 individuals having osteoarthritis of the knees and persistent knee pain, completed a pain coping strategies measure (the Coping Strategies Questionnaire), a measure of self-efficacy (the Arthritis Self-Efficacy Scale), and a measure of pain (the McGill Pain Questionnaire). Two sets of regression analyses were conducted, one examining the degree to which pain coping strategies predicted patients' self-efficacy ratings, and the other examining the degree to which coping strategies predicted spouses' ratings of the patients' self-efficacy. Several pain coping strategies were found to predict a significant proportion of variance in patients' ratings of self-efficacy: (i) ignoring pain sensations was related to higher self-efficacy for pain; (ii) coping self statements were related to higher self-efficacy for controlling other arthritis symptoms (e.g., fatigue or mood symptoms: and (iii) catastrophizing was related to lower self-efficacy for pain, and self-efficacy for other arthritis symptoms. Pain coping strategies were also found to predict a significant proportion of variance in spouses' ratings of the patients' self-efficacy. Specifically: (i) diverting attention was related to lower spousal ratings of self-efficacy for pain; (ii) praying or hoping was related to lower spousal ratings of self-efficacy for function; and (iii) catastrophizing was related to lower spousal ratings of self-efficacy for control of fatigue or mood symptoms. The findings regarding coping strategies were particularly interesting in that they were obtained even after controlling for pain intensity and demographic variables. The pain coping strategies identified are potentially important targets for cognitive-behavioral assessment and treatment efforts. Interventions designed to increase the use of adaptive pain coping strategies and decrease the use of maladaptive pain coping strategies could enhance self-efficacy, reduce pain, and improve the physical and psychological functioning of individuals having osteoarthritis.

Authors
Keefe, FJ; Kashikar-Zuck, S; Robinson, E; Salley, A; Beaupre, P; Caldwell, D; Baucom, D; Haythornthwaite, J
MLA Citation
Keefe, FJ, Kashikar-Zuck, S, Robinson, E, Salley, A, Beaupre, P, Caldwell, D, Baucom, D, and Haythornthwaite, J. "Pain coping strategies that predict patients' and spouses' ratings of patients' self-efficacy." Pain 73.2 (November 1997): 191-199.
PMID
9415505
Source
pubmed
Published In
PAIN
Volume
73
Issue
2
Publish Date
1997
Start Page
191
End Page
199

Pain coping and the pain experience in children with juvenile chronic arthritis.

This study examined the pain experience and pain coping of children with juvenile chronic arthritis (JCA). The purpose of the study was to describe present pain and the pain coping strategies utilized by children with juvenile chronic arthritis and examine pain coping strategies and pain efficacy as a predictor of pain intensity and distribution. Fifty-six children with JCA rated their present pain using two measures of pain intensity, the Oucher and the pain thermometer, and reported on the number of pain locations using a body map. In addition, each child completed the Child Version of the Coping Strategies Questionnaire (CSQ-C) and health status was determined by a physician's disease activity rating. On average, children reported current pain in the low to middle range on the different pain scales, although there was considerable variability in pain ratings. Up to 30% of all children had pain ratings higher than or equal to the middle range on both the Oucher and the pain thermometer. On average, children reported pain in more than two body areas. Correlational analyses were conducted to examine how the composite factors on the CSQ-C (Pain Control and Rational Thinking, and Coping Attempts) related to variations in reported pain intensity and location. Children who scored higher on the Pain Control and Rational Thinking factor of the CSQ-C had much lower ratings of pain intensity and reported pain in fewer body areas. Hierarchical regression analyses indicated that disease activity and scores on the Pain Control and Rational Thinking factor of the CSQ-C each accounted for a unique, statistically significant proportion of variance in the measures of pain intensity and pain location. Behavioral and cognitive therapy interventions designed to increase pain coping efficacy may be useful adjuncts in treating pain in children with chronic arthritis.

Authors
Schanberg, LE; Lefebvre, JC; Keefe, FJ; Kredich, DW; Gil, KM
MLA Citation
Schanberg, LE, Lefebvre, JC, Keefe, FJ, Kredich, DW, and Gil, KM. "Pain coping and the pain experience in children with juvenile chronic arthritis." Pain 73.2 (November 1997): 181-189.
PMID
9415504
Source
pubmed
Published In
PAIN
Volume
73
Issue
2
Publish Date
1997
Start Page
181
End Page
189

Pain coping and the pain experience during mammography: a preliminary study.

This study examined how pain coping efficacy and pain coping strategies were related to reports of pain during mammography. Subjects were 125 women over the age of 50 undergoing screening mammograms. Prior to their mammogram, all subjects completed the Coping Strategies Questionnaire (CSQ) to assess how they cope with day-to-day pain experiences. Ratings of pain during the mammogram were collected using a 6-point pain/discomfort scale, a 100-mm Visual Analog Scale, the adjective checklist of the McGill Pain Questionnaire, and the Brief Pain Inventory. Up to 93% of the women reported the mammogram examination was painful. On average, women rated the mammography pain in the low to moderate range. Considerable variability in pain ratings was found, however, with some women reporting severe pain and others reporting little or no pain. Correlational analyses were conducted to examine how coping efficacy (CSQ ratings of ability to decrease pain and ability to control pain) and coping strategies (CSQ pain coping strategy subscales) related to variations in pain report. There was a pattern for ratings of ability to decrease pain to be related to lower ratings of current mammography pain. Women who rated their ability to decrease pain as high reported lower average levels of mammography pain, lower ratings on the mammography pain/discomfort scale, and were much more likely to report having had lower levels of pain during their last mammogram. These findings suggest that women who rate their coping efficacy in decreasing day-to-day pain as low may be at higher risk for having a painful mammogram. Individual pain coping strategies were not generally correlated with pain ratings. Behavioral interventions (e.g., patient controlled breast compression) and cognitive therapy interventions (e.g., training in the use of calming self-statements or distraction techniques) designed to increase coping efficacy potentially could be useful in reducing pain in women who are at risk for pain during mammography.

Authors
Kashikar-Zuck, S; Keefe, FJ; Kornguth, P; Beaupre, P; Holzberg, A; Delong, D
MLA Citation
Kashikar-Zuck, S, Keefe, FJ, Kornguth, P, Beaupre, P, Holzberg, A, and Delong, D. "Pain coping and the pain experience during mammography: a preliminary study." Pain 73.2 (November 1997): 165-172.
PMID
9415502
Source
pubmed
Published In
PAIN
Volume
73
Issue
2
Publish Date
1997
Start Page
165
End Page
172

Self-efficacy for arthritis pain: relationship to perception of thermal laboratory pain stimuli.

OBJECTIVE: To examine how self-efficacy for arthritis pain relates to the perception of controlled laboratory pain stimuli. METHODS: Forty patients with osteoarthritis completed self-report measures of self-efficacy for arthritis pain. They then participated in a single experimental session in which measures of thermal pain threshold and tolerance were collected, as well as measures of the perceived intensity and unpleasantness of a range of thermal pain stimuli. RESULTS: Correlational analyses revealed that patients reporting high self-efficacy for arthritis pain rated the thermal pain stimuli as less unpleasant than those reporting low self-efficacy. When subjects scoring very high and very low in self-efficacy were compared, it was found that subjects scoring high on self-efficacy for arthritis pain had significantly higher pain thresholds and pain tolerance than those scoring low on self-efficacy. CONCLUSIONS: These results indicate that self-efficacy for arthritis pain is related to judgments of thermal pain stimuli. Implications for the understanding of arthritis pain and for future laboratory research are discussed.

Authors
Keefe, FJ; Lefebvre, JC; Maixner, W; Salley, AN; Caldwell, DS
MLA Citation
Keefe, FJ, Lefebvre, JC, Maixner, W, Salley, AN, and Caldwell, DS. "Self-efficacy for arthritis pain: relationship to perception of thermal laboratory pain stimuli." Arthritis Care Res 10.3 (June 1997): 177-184.
PMID
9335629
Source
pubmed
Published In
Arthritis Care and Research
Volume
10
Issue
3
Publish Date
1997
Start Page
177
End Page
184

Biobehavioral pain research: a multi-institute assessment of cross-cutting issues and research needs.

In 1994 ten NIH institutes sponsored an interagency workshop focusing on biobehavioral pain research. The workshop had three major goals: (1) to review the current status of biobehavioral pain research (2) to identify critical research needs, and (3) to enhance interdisciplinary and interagency cooperation in pain research. The purpose of this article is to summarize the presentations at this meeting and to highlight some of the key research recommendations. Research topics addressed include (a) understanding critical interfaces between biology and behavior; (b) pain, suffering, and emotion; (c) pain and behavior; (d) behavior-related interventions; (e) commonalities and differences in pain expression, experience, and treatment; and (f) pain in special populations. The article concludes with a summary of NIH pain research activities that have taken place since the workshop.

Authors
Keefe, FJ; Jacobs, M; Underwood-Gordon, L
MLA Citation
Keefe, FJ, Jacobs, M, and Underwood-Gordon, L. "Biobehavioral pain research: a multi-institute assessment of cross-cutting issues and research needs." Clin J Pain 13.2 (June 1997): 91-103.
PMID
9186016
Source
pubmed
Published In
Clinical Journal of Pain
Volume
13
Issue
2
Publish Date
1997
Start Page
91
End Page
103

Cognitive behavioral control of arthritis pain.

Cognitive-behavioral approaches appear to offer a viable alternative for the management of arthritis pain. Controlled studies have documented the efficacy of CBT protocols for managing pain in individuals having OA and RA. Preliminary studies examining the efficacy of CBT for FM patients have also yielded encouraging results. A number of clinical and research issues need attention if CBT is to be incorporated into rheumatology practice settings. These issues include identifying the most important components of CBT, developing strategies for matching CBT interventions to patients' readiness for behavior change, testing the efficacy of different therapy formats (e.g., individual versus group), broadening the scope of CBT to address issues other than pain, and insurance reimbursement.

Authors
Keefe, FJ; Caldwell, DS
MLA Citation
Keefe, FJ, and Caldwell, DS. "Cognitive behavioral control of arthritis pain." Med Clin North Am 81.1 (January 1997): 277-290. (Review)
PMID
9012765
Source
pubmed
Published In
Medical Clinics of North America
Volume
81
Issue
1
Publish Date
1997
Start Page
277
End Page
290

Pain coping strategies and coping efficacy in rheumatoid arthritis: a daily process analysis.

Data from daily diaries were used to analyze pain coping processes in rheumatoid arthritis patients. For 30 consecutive days, 53 individuals described the pain coping strategies they used that day and rated the efficacy of their coping, joint pain, and positive and negative mood. Relations among variables were examined across-persons and within-persons over time. At the across-persons level of analysis, (i) daily coping efficacy was unrelated to pain coping or pain intensity, and (ii) the more frequent daily use of a wide variety of pain coping strategies was correlated with greater pain. Within-person analyses provided unique information about the relations among coping, pain, and mood not apparent in the across-persons results. Specifically, these analyses showed that increases in daily coping efficacy were not only related to decreases in pain, but also to decreases in negative mood and increases in positive mood. Time-lagged effects of coping and coping efficacy were also found. Individuals who reported high levels of coping efficacy on one day had lower levels of pain on the subsequent day. The daily use of pain reduction efforts and relaxation strategies also contributed to an improvement in next-day pain and an enhancement of positive mood. The implications of these findings for the assessment of pain and coping in rheumatoid arthritis patients are discussed.

Authors
Keefe, FJ; Affleck, G; Lefebvre, JC; Starr, K; Caldwell, DS; Tennen, H
MLA Citation
Keefe, FJ, Affleck, G, Lefebvre, JC, Starr, K, Caldwell, DS, and Tennen, H. "Pain coping strategies and coping efficacy in rheumatoid arthritis: a daily process analysis." Pain 69.1-2 (January 1997): 35-42.
PMID
9060010
Source
pubmed
Published In
PAIN
Volume
69
Issue
1-2
Publish Date
1997
Start Page
35
End Page
42

Pain coping strategies and coping efficacy in rheumatoid arthritis: A daily process analysis

Authors
Keefe, FJ; Affleck, G; Lefebvre, JC; Starr, K; Caldwell, DS; Tennen, H
MLA Citation
Keefe, FJ, Affleck, G, Lefebvre, JC, Starr, K, Caldwell, DS, and Tennen, H. "Pain coping strategies and coping efficacy in rheumatoid arthritis: A daily process analysis." Pain 69 (1997): 43-48. (Academic Article)
Source
manual
Published In
Pain
Volume
69
Publish Date
1997
Start Page
43
End Page
48

Personality disorders in the chronic pain population: Basic concepts, empirical findings, and clinical implications

Personality traits and characteristics have repeatedly been studied in the chronic pain literature. Accurate personality disorder diagnosis is now being conducted in the psychiatric literature through the use of semistructured interview techniques. There have been four studies to date that have used similar technology to diagnose personality disorders in chronicpain patients. Accurate personality disorder diagnosis can be beneficial if used appropriately to guide treatment decisions and to help treating clinicians work within a common paradigm. Unfortunately, there has yet to be a rigorous investigation of personality disorder diagnosis using semistructured instruments widely used in psychiatric research. The authors suggest that a diathesis-stress model may best help to explain the relatively high prevalence of personality disorder seen in the chronic pain population.

Authors
Polatin, PB; Gatchel, RJ; Fishbain, DA; Weisberg, JN; Keefe, FJ
MLA Citation
Polatin, PB, Gatchel, RJ, Fishbain, DA, Weisberg, JN, and Keefe, FJ. "Personality disorders in the chronic pain population: Basic concepts, empirical findings, and clinical implications." Pain Forum 6.1 (1997): 1-21.
Source
scival
Published In
Pain Forum
Volume
6
Issue
1
Publish Date
1997
Start Page
1
End Page
21

Methodological considerations for diagnosis of personality disorders in chronic pain patients

Authors
Weisberg, JN; Keefe, FJ
MLA Citation
Weisberg, JN, and Keefe, FJ. "Methodological considerations for diagnosis of personality disorders in chronic pain patients." PAIN FORUM 6.1 (1997): 20-21.
Source
wos-lite
Published In
APS Journal
Volume
6
Issue
1
Publish Date
1997
Start Page
20
End Page
21

Persistent pain: Cognitive-behavioral approaches to assessment and treatment

Authors
Keefe, FJ; Jacobs, M; Edwards, C
MLA Citation
Keefe, FJ, Jacobs, M, and Edwards, C. "Persistent pain: Cognitive-behavioral approaches to assessment and treatment." Seminars in Anesthesia 16.2 (1997): 117-126.
Source
scival
Published In
Seminars in Anesthesia, Perioperative Medicine and Pain
Volume
16
Issue
2
Publish Date
1997
Start Page
117
End Page
126
DOI
10.1016/S0277-0326(97)80023-2

Pain: From mechanisms to management

Authors
Keefe, FJ; Lefebvre, JC
MLA Citation
Keefe, FJ, and Lefebvre, JC. "Pain: From mechanisms to management." Health Psychology 16 (1997): 307-309. (Academic Article)
Source
manual
Published In
Health Psychology
Volume
16
Publish Date
1997
Start Page
307
End Page
309

A computer-assisted observational method for assessing spouses' ratings of osteoarthritis patients' pain

This article presents preliminary data on a new method for analysing spouses' ratings of their marital partner's pain. Subjects were 19 individuals with persistent osteoarthritic knee pain and their spouses. Spouses viewed a videotape of the patient engaging in a series of daily activities (sitting, walking, standing, and reclining) and simultaneously made continuous ratings of the patient's pain using a computer-controlled mouse. Ratings made by the spouse were directly compared to ratings of pain provided by the patient to establish agreement about both the mean level of pain as well as the temporal synchrony between patients' and spouses' ratings. There was a significant positive correlation between spouses' mean ratings of pain and the patient's mean ratings of their own pain. However, when individual patient-spouse dyads were examined separately using time series analyse's individual differences in synchrony were clearly apparent. In some couples there was very high synchrony between patient's and spouse's ratings, while in other couples there was very low synchrony between these ratings. The level of synchrony was found to be higher in couples where the spouse was female and in which the patient had pain for a shorter duration or lower levels of physical disability. Although these findings are preliminary, they suggest that further research using this approach is warranted.

Authors
Beaupre, P; Keefe, FJ; Lester, N; Affleck, G; Freedrickson, B; Caldwell, DS
MLA Citation
Beaupre, P, Keefe, FJ, Lester, N, Affleck, G, Freedrickson, B, and Caldwell, DS. "A computer-assisted observational method for assessing spouses' ratings of osteoarthritis patients' pain." Psychology, Health and Medicine 2.2 (1997): 99-108.
Source
scival
Published In
Psychology, Health and Medicine
Volume
2
Issue
2
Publish Date
1997
Start Page
99
End Page
108

Intervention specific response rates in behavioral treatments for chronic pain

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Intervention specific response rates in behavioral treatments for chronic pain." Mind-Body Medicine 2 (1997): 190-196. (Academic Article)
Source
manual
Published In
Mind-Body Medicine
Volume
2
Publish Date
1997
Start Page
190
End Page
196

Pain coping and the pain experience during mammography

Authors
Kashikar Zuck, S; Keefe, FJ; Kornguth, P; Beaupre, P; Holzberg, A; Delong, D
MLA Citation
Kashikar Zuck, S, Keefe, FJ, Kornguth, P, Beaupre, P, Holzberg, A, and Delong, D. "Pain coping and the pain experience during mammography." Pain 73 (1997): 165-172. (Academic Article)
Source
manual
Published In
Pain
Volume
73
Publish Date
1997
Start Page
165
End Page
172

The control group dilemma in clinical research: Applications for psychosocial and behavioral medicine trials

Objective: Clinical research on psychosocial and behavioral medicine interventions has burgeoned in the past two decades, so much so that sole reliance on standard no-treatment control conditions may no longer be appropriate or feasible. We discuss the ethical, theoretical, scientific, and statistical considerations that shape current clinical outcomes research for psychosocial and behavioral medicine interventions. Method and Results: Secondary analysis of a psychosocial randomized trial (N = 127) illustrates some of these points. Conclusions: A new design for randomized clinical trials is described that does not require a no-treatment control group, and that reveals dose-response relationships between interventions and treatment outcomes.

Authors
Schwartz, CE; Chesney, MA; Irvine, MJ; Keefe, FJ
MLA Citation
Schwartz, CE, Chesney, MA, Irvine, MJ, and Keefe, FJ. "The control group dilemma in clinical research: Applications for psychosocial and behavioral medicine trials." Psychosomatic Medicine 59.4 (1997): 362-371.
PMID
9251155
Source
scival
Published In
Psychosomatic Medicine
Volume
59
Issue
4
Publish Date
1997
Start Page
362
End Page
371

The coping strategies questionnaire: A large sample, item level factor analysis

Objective: The Coping Strategies Questionnaire (CSQ), a measure of coping in chronic pain patients, was subjected to item-level exploratory factor analysis. Subjects: A sample of 965 chronic pain patients were used in the analysis. Results: Principal components analysis using a varimax rotation procedure identified nine factors that accounted for 54.5% of the variance. Of these nine factors, the first five represent subscales of the original CSQ subscales. The catastrophizing subscale replicated with significant loadings for all six original items, and ignoring sensations replicated with five of six items. Factors representing reinterpreting pain sensations, coping self- statements, and diverting attention subscales also appeared. The items from the praying and hoping subscale split into separate praying and hoping factors (factors 6 and 8). When reliability coefficients were calculated, factors 7 through 9 had unacceptably low internal consistency and thus were not considered stable factors. Correlations between factors 1 through 6 and other measures of psychological and physical functioning were calculated in the construct validation portion of this study. Previously found relationships were replicated in that the correlations between CSQ factor scores and measures of pain, depression, and disability were in the same direction in this data set as those previously reported.

Authors
Robinson, ME; III, JLR; Myers, CD; Sadler, IJ; Kvaal, SA; Geisser, ME; Keefe, FJ
MLA Citation
Robinson, ME, III, JLR, Myers, CD, Sadler, IJ, Kvaal, SA, Geisser, ME, and Keefe, FJ. "The coping strategies questionnaire: A large sample, item level factor analysis." Clinical Journal of Pain 13.1 (1997): 43-49.
PMID
9084951
Source
scival
Published In
Clinical Journal of Pain
Volume
13
Issue
1
Publish Date
1997
Start Page
43
End Page
49
DOI
10.1097/00002508-199703000-00007

Religious coping in the nursing home: a biopsychosocial model.

OBJECTIVE: To examine psychosocial and physical health correlates of religious coping in medically ill chronically institutionalized older adults. Religious coping is defined as the extent to which persons use religious beliefs and practices to help them to cope. METHOD: This is a cross-sectional cohort study conducted in a 120 bed VA-affiliated and a 125 bed university affiliated community-based nursing home in Durham, North Carolina. Participants were 115 chronic care nursing home residents; mean age of the sample was seventy-nine years, 44 percent were women, and 17 percent were African Americans. Subjects were enrolled for a one-month period during which comprehensive psychosocial and health assessments were performed, including evaluation of cognitive function (Mini-Mental State Exam), physical function (Barthel index), severity of medical comorbidity (Cumulative Illness Rating Scale), self-reported physical pain (vertical verbal descriptor scale), depressive symptoms (Geriatric Depression Scale), social support (social network), and religious coping (Religious Coping Index). RESULTS: Over 43 percent of the sample scored in the depressed range of the Geriatric Depression Scale. Almost 60 percent reported they used religion at least to a large extent when coping with their problems; 34 percent said that it was the most important factor that enabled them to cope. Patients who used religion to cope had greater social support (p = .01), more severe medical illness (p = .04), and better cognitive functioning (p = .02). CONCLUSIONS: Religious beliefs and practices are frequently used by chronically institutionalized older adults to help them to cope. Religious coping is associated with more severe medical illness, higher social support, and better cognitive functioning.

Authors
Koenig, HG; Weiner, DK; Peterson, BL; Meador, KG; Keefe, FJ
MLA Citation
Koenig, HG, Weiner, DK, Peterson, BL, Meador, KG, and Keefe, FJ. "Religious coping in the nursing home: a biopsychosocial model." Int J Psychiatry Med 27.4 (1997): 365-376.
PMID
9565732
Source
pubmed
Published In
International journal of psychiatry in medicine
Volume
27
Issue
4
Publish Date
1997
Start Page
365
End Page
376
DOI
10.2190/M2D6-5YDG-M1DD-A958

Pain in arthritis and musculoskeletal disorders: the role of coping skills training and exercise interventions.

There is growing recognition of the limitations of conventional, biomedical approaches to the management of pain in individuals having arthritis and musculoskeletal disorders. This article provides an overview of newly developed biopsychosocial approaches to the management of pain in this population. The presentation is divided into three sections. In the first section, a biopsychosocial model of pain is presented. This model highlights the role that biological factors (eg., disease severity, comorbid conditions), cognitive-behavioral factors (eg., thoughts, emotions, and behaviors), and environmental factors (eg., spouse or family responses to pain behavior) can play in influencing the pain experience. In the second section, we provide an overview of two newly developed treatment protocols based on the biopsychosocial model of pain: a pain coping skills training protocol and an exercise training protocol. Practical aspects of implementing these protocols are illustrated by highlighting how they are applied in the management of patients having persistent osteoarthritic pain. In the final section of the article, we pinpoint several important future directions for research in this area. Future studies need to explore the utility of combining pain coping skills and exercise training protocols. In addition, there is a need to identify variables that predict patients' response to biopsychosocial treatments.

Authors
Keefe, FJ; Kashikar-Zuck, S; Opiteck, J; Hage, E; Dalrymple, L; Blumenthal, JA
MLA Citation
Keefe, FJ, Kashikar-Zuck, S, Opiteck, J, Hage, E, Dalrymple, L, and Blumenthal, JA. "Pain in arthritis and musculoskeletal disorders: the role of coping skills training and exercise interventions." J Orthop Sports Phys Ther 24.4 (October 1996): 279-290. (Review)
PMID
8892142
Source
pubmed
Published In
The Journal of orthopaedic and sports physical therapy
Volume
24
Issue
4
Publish Date
1996
Start Page
279
End Page
290
DOI
10.2519/jospt.1996.24.4.279

Pain measurement in elders with chronic low back pain: traditional and alternative approaches.

Pain evaluation typically relies upon the use of self-report instruments. The validity of these tools is questionable in many older adults, however, particularly those with cognitive impairment. Rating of pain behavior (e.g. grimacing, sighing) by an objective observer represents an alternative pain assessment strategy which has been validated in subjects of heterogeneous ages. The purpose of this study was to examine, in a group of community-dwelling elderly with low back pain and lumbosacral osteoarthritis, the concurrent validity of observational pain behavior rating techniques as compared with self-report instruments and the degree to which pain and pain behavior relate to disability. Thirty-nine cognitively intact subjects, age > 65 years, without depression, other sources of pain, or other known spinal pathology underwent the following measures: (1) pain self-report using the verbal 0-10 scale, vertical verbal descriptor scale, Arthritis Impact Measurement Scales and McGill Pain Questionnaire; (2) pain behavior was sampled during two protocols, one, identical to that used by Keefe and Block (Behav. Ther., 13 (1982) 363-375), that required subjects to sit, stand, walk, and recline for 1-2 minute periods (which we have labelled the traditional protocol), and a second, more demanding protocol that was designed to simulate activities of daily living that place a premium on axial movement (the 'ADL' protocol); (3) disability was assessed using the Roland questionnaire, a 6 month global disability question and the Jette Functional Status Index; and (4) radiographic evaluation of the lumbosacral spine; osteoarthritis was quantitated using a previously validated scoring system. Interrelationships among pain, pain behavior and disability measures were tested using canonical correlations. Self-reported pain was associated with pain behavior frequency; the association was stronger when the ADL protocol was used, as compared with the traditional protocol. The association between pain and disability was modestly strong with both self-report instruments and pain behavior observation when the ADL protocol was used, but not when the traditional protocol was used. Our findings suggest that pain behavior observation is a valid assessment tool in the elderly. In addition, it seems that observation of elders during performance of activities of daily living may be a more sensitive and valid way of assessing pain behavior than observing pain behavior during sitting, walking, standing, or reclining.

Authors
Weiner, D; Pieper, C; McConnell, E; Martinez, S; Keefe, F
MLA Citation
Weiner, D, Pieper, C, McConnell, E, Martinez, S, and Keefe, F. "Pain measurement in elders with chronic low back pain: traditional and alternative approaches." Pain 67.2-3 (October 1996): 461-467.
PMID
8951942
Source
pubmed
Published In
PAIN
Volume
67
Issue
2-3
Publish Date
1996
Start Page
461
End Page
467

Spouse-assisted coping skills training in the management of osteoarthritic knee pain.

OBJECTIVE: To evaluate the effects of a spouse-assisted pain-coping skills training intervention on pain, psychological disability, physical disability, pain-coping, and pain behavior in patients with osteoarthritis (OA) of the knees. METHODS: Eighty-eight OA patients with persistent knee pain were randomly assigned to 1 of 3 conditions: 1) spouse-assisted pain-coping skills training, (spouse-assisted CST), 2) a conventional CST intervention with no spouse involvement (CST), or 3) an arthritis education-spousal support (AE-SS) control condition. All treatment was carried out in 10 weekly, 2-hour group sessions. RESULTS: Data analysis revealed that at the completion of treatment, patients in the spouse-assisted CST condition had significantly lower levels of pain, psychological disability, and pain behavior, and higher scores on measures of coping attempts, marital adjustment, and self-efficacy than patients in the AE-SS control condition. Compared to patients in the AE-SS control condition, patients who received CST without spouse involvement had significantly higher post-treatment levels of self-efficacy and marital adjustment and showed a tendency toward lower levels of pain and psychological disability and higher scores on measures of coping attempts and ratings of the perceived effectiveness of pain-coping strategies. CONCLUSION: These findings suggest that spouse-assisted CST has potential as a method for reducing pain and disability in OA patients.

Authors
Keefe, FJ; Caldwell, DS; Baucom, D; Salley, A; Robinson, E; Timmons, K; Beaupre, P; Weisberg, J; Helms, M
MLA Citation
Keefe, FJ, Caldwell, DS, Baucom, D, Salley, A, Robinson, E, Timmons, K, Beaupre, P, Weisberg, J, and Helms, M. "Spouse-assisted coping skills training in the management of osteoarthritic knee pain." Arthritis Care Res 9.4 (August 1996): 279-291.
PMID
8997917
Source
pubmed
Published In
Arthritis Care and Research
Volume
9
Issue
4
Publish Date
1996
Start Page
279
End Page
291

Pain during mammography: characteristics and relationship to demographic and medical variables.

Reports of pain during mammography show that there is great variability in both the incidence of reported pain (0.2-62%) and the intensity of that pain. Much of that variability may be due to the measures used to rate mammography pain. This is the first study that has examined the incidence, quality and intensity of mammography pain using a variety of pain measures. A sample of 119 women undergoing screening mammography was studied using four pain scales, three well-validated measures frequently used in the pain research literature as well as a pain/discomfort measure frequently reported in the radiology literature. A large proportion (up to 91%) of women report having some degree of pain during mammography. The intensity of that pain was typically in the low to moderate range, but a small proportion of women (< 15%) reported intense pain. The incidence of reported pain was related to the pain measure used. Pain measures that provided a woman with many options for reporting pain were associated with a higher incidence of pain than a scale that provided only one or two options. Thus, some of the variability in reported incidence of pain during mammography can be explained by the pain scale used in the study. Demographic and medical variables could explain 18-20% of the variance in mammography pain. Two of the variables that were shown to consistently predict a painful mammographic experience were (1) average pain at the last mammogram and (2) breast density. This study demonstrated that the pain measure selected for use in a particular study may depend on the population being studied. A college education was found to be an important predictor of pain scores on the McGill Pain Questionnaire. Thus, this pain measure may be of limited usefulness in studying a population of women with little formal education.

Authors
Kornguth, PJ; Keefe, FJ; Conaway, MR
MLA Citation
Kornguth, PJ, Keefe, FJ, and Conaway, MR. "Pain during mammography: characteristics and relationship to demographic and medical variables." Pain 66.2-3 (August 1996): 187-194.
PMID
8880840
Source
pubmed
Published In
PAIN
Volume
66
Issue
2-3
Publish Date
1996
Start Page
187
End Page
194

Pain coping strategies in children with juvenile primary fibromyalgia syndrome: correlation with pain, physical function, and psychological distress.

OBJECTIVES: The purpose of this study was twofold: 1) to describe the coping strategies used by children with juvenile primary fibromyalgia syndrome (JPFS), and 2) to examine how pain coping relates to measures of pain, disability/function, psychological distress, and pain behavior. METHODS: Sixteen children with JPFS completed the Child Version of the Coping Strategies Questionnaire (CSQ-C), the visual analog scale for pain, the McGill Pain Questionnaire, the Fibromyalgia Impact Questionnaire modified for children, the Arthritis Impact Measurement Scales 2, and the Symptom Checklist-90-Revised. Subjects also also underwent pain behavior observation. Pearson's product moment correlations were conducted to examine the relationship of coping to measures of pain and disability. RESULTS: The Pain Control and Rational Thinking composite factor score on the CSQ-C correlated with measures of pain severity, functional disability, and psychological distress. Results supported the internal reliability of the CSQ-C in assessing pain coping. CONCLUSIONS: These results suggest that the CSQ-C may provide a reliable measure for assessing variations in pain coping in JPFS patients. Behavioral interventions aimed at increasing the perception of pain control may be beneficial in treating JPFS.

Authors
Schanberg, LE; Keefe, FJ; Lefebvre, JC; Kredich, DW; Gil, KM
MLA Citation
Schanberg, LE, Keefe, FJ, Lefebvre, JC, Kredich, DW, and Gil, KM. "Pain coping strategies in children with juvenile primary fibromyalgia syndrome: correlation with pain, physical function, and psychological distress." Arthritis Care Res 9.2 (April 1996): 89-96.
PMID
8970266
Source
pubmed
Published In
Arthritis Care and Research
Volume
9
Issue
2
Publish Date
1996
Start Page
89
End Page
96

The influence of gender and psychological factors on pain perception

Authors
Fillingim, RB; Keefe, FJ; Light, KC; Booker, DK; Maixner, W
MLA Citation
Fillingim, RB, Keefe, FJ, Light, KC, Booker, DK, and Maixner, W. "The influence of gender and psychological factors on pain perception." Journal of Gender, Culture, and Health 1 (1996): 21-36. (Academic Article)
Source
manual
Published In
Journal of Gender, Culture, and Health
Volume
1
Publish Date
1996
Start Page
21
End Page
36

Cognitive behavioral therapy for managing pain

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Cognitive behavioral therapy for managing pain." The Clinical Psychologist 49 (1996): 4-5. (Academic Article)
Source
manual
Published In
The Clinical Psychologist
Volume
49
Publish Date
1996
Start Page
4
End Page
5

From the gate Control Theory to the neuromatrix - Revolution or evolution?

Authors
Keefe, FJ; Lefebvre, JC; Starr, KR
MLA Citation
Keefe, FJ, Lefebvre, JC, and Starr, KR. "From the gate Control Theory to the neuromatrix - Revolution or evolution?." PAIN FORUM 5.2 (1996): 143-146.
Source
wos-lite
Published In
APS Journal
Volume
5
Issue
2
Publish Date
1996
Start Page
143
End Page
146

A practical guide to biobehavioral assessment and treatment of chronic pain

The authors describe the biobehavioral management of chronic pain. They first discuss how to conduct a thorough pain assessment that includes an evaluation of medical-psychiatric and cognitive-behavioral factors. They describe the most useful self-report measures as well as cognitive-behavioral techniques for assessing pain, such as diary records, behavioral observation, and the evaluation of pain coping strategies and negative pain-related cognitions. The second half of the article focuses on the biobehavioral treatment of chronic pain and includes a detailed review of both pharmacological and cognitive-behavioral treatment strategies.

Authors
Keefe, FJ; Goli, V
MLA Citation
Keefe, FJ, and Goli, V. "A practical guide to biobehavioral assessment and treatment of chronic pain." Journal of Practical Psychiatry and Behavioral Health 2.3 (1996): 151-161.
Source
scival
Published In
Journal of Practical Psychiatry and Behavioral Health
Volume
2
Issue
3
Publish Date
1996
Start Page
151
End Page
161

Pain in young adults-III: Comparison of three coping assessment methods

Authors
Lester, N; Lefebvre, JC; Keefe, FJ
MLA Citation
Lester, N, Lefebvre, JC, and Keefe, FJ. "Pain in young adults-III: Comparison of three coping assessment methods." Clinical Journal of Pain 12 (1996): 291-300. (Academic Article)
Source
manual
Published In
Clinical Journal of Pain
Volume
12
Publish Date
1996
Start Page
291
End Page
300

Pain in young adults-III: Relationships of three pain-coping measures to pain and activity interference

The study had two purposes: (a) to examine the relationships among coping strategies measured by the Coping Strategies Questionnaire (CSQ) (1), the Vanderbilt Pain Management Inventory (VPMI) (2), and the Ways of Coping inventory (WOC) (3) and identify the higher-order composite factors representing these relationships; and (b) to determine the degree to which individual coping scale scores and composite coping factor scores could explain variability in the pain intensity and pain-related activity interference reported by young adults. Measures of pain coping were collected from 206 young adults using the CSQ, VPMI, and WOC, along with measures of pain intensity, pain location, and the extent to which pain interfered with daily activities. Results indicated considerable variability in the reported frequency of use of pain-coping strategies and in pain intensity, location, and activity interference. Principal components factor analysis identified three higher-order coping factors (Emotional and Other-Directed Coping, Active Cognitive Coping, and Self-Efficacy for Pain Control) that explained 87% of the variance in individual coping scale scores. The degree to which individual scale scores and composite factor scores explained variability in pain intensity and activity interference variables was determined through a series of multiple regression analyses. The results revealed that individual scale scores, particularly the CSQ scales of catastrophizing and praying or hoping, were best able to explain the variance in measures of pain and activity interference. Taken together, these findings provide further support for the importance of coping variables in explaining the experience of pain and adjustment in young adults.

Authors
Lester, N; Lefebvre, JC; Keefe, FJ
MLA Citation
Lester, N, Lefebvre, JC, and Keefe, FJ. "Pain in young adults-III: Relationships of three pain-coping measures to pain and activity interference." Clinical Journal of Pain 12.4 (1996): 291-300.
PMID
8969874
Source
scival
Published In
Clinical Journal of Pain
Volume
12
Issue
4
Publish Date
1996
Start Page
291
End Page
300
DOI
10.1097/00002508-199612000-00008

Cluster analyses of pain patients' responses to the SCL-90R.

This study sought to identify distinct subgroups of chronic pain patients based on responses to the Symptom Checklist 90-revised (SCL-90R), a measure of psychological distress. Two scoring methods were used: the standard scoring that accompanies the manual, and a scoring method based upon factor scores obtained in an earlier study using low back pain patients. Two separate cluster analyses assigned patients into 2 groups: one based on standard scores and one based on factor scores. Results of this study support the hypothesis that distinct and replicable subgroups of chronic pain patients can be identified using the SCL-90R. Depending upon group membership, patients significantly differed on measures of qualitative pain and quantitative pain report, depressive symptoms, medication usage, and pain-related behaviors. This study supports the use of SCL-90R factor scoring with pain patients as greater differentiation between clusters was found for pain report and pain-related behavior when this method was used. Guidelines for clinical application of SCL-90R cluster groups is provided.

Authors
Williams, DA; Urban, B; Keefe, FJ; Shutty, MS; France, R
MLA Citation
Williams, DA, Urban, B, Keefe, FJ, Shutty, MS, and France, R. "Cluster analyses of pain patients' responses to the SCL-90R." Pain 61.1 (April 1995): 81-91.
PMID
7644252
Source
epmc
Published In
PAIN
Volume
61
Issue
1
Publish Date
1995
Start Page
81
End Page
91
DOI
10.1016/0304-3959(94)00165-b

Pain in young adults. II: The use and perceived effectiveness of pain-coping strategies.

OBJECTIVE: The first goal of the study was to determine the internal reliability of the Coping Strategies Questionnaire (CSQ) in young adults. The second goal was to examine the relation of the CSQ to reported pain levels. The third goal was to investigate the relationship between the CSQ and concomitant pain problems. The fourth goal was to compare young adults and different chronic pain samples in terms of the frequency of coping strategy use and perceived effectiveness of coping strategies. DESIGN: The study included 252 undergraduate students who were given the CSQ, a demographic and pain level questionnaire, and a concomitant pain problem survey. RESULTS: The results indicated that the CSQ was internally reliable when used to assess pain coping strategy use among young adults. Catastrophizing was found to be associated with both pain level and concomitant pain problems, with subjects reporting higher levels of catastrophizing having higher levels of pain and a higher frequency of both migraine headaches and low back pain. Finally, differences were found when comparing the perceived effectiveness in controlling and decreasing pain, and in the use of specific coping strategies in the young adult and chronic pain samples. The young adult sample reported a greater perceived efficacy in controlling and decreasing pain, compared to a sample of low back pain patients and a sample of myofacial pain patients. CONCLUSIONS: The results indicate that the CSQ is a reliable measure for the study of pain-coping strategies used in this population, and one that relates to differences reported in the experience of pain.

Authors
Lefebvre, JC; Lester, N; Keefe, FJ
MLA Citation
Lefebvre, JC, Lester, N, and Keefe, FJ. "Pain in young adults. II: The use and perceived effectiveness of pain-coping strategies." Clin J Pain 11.1 (March 1995): 36-44.
PMID
7787337
Source
pubmed
Published In
Clinical Journal of Pain
Volume
11
Issue
1
Publish Date
1995
Start Page
36
End Page
44

Effects of Cigarette Smoking on Perception of Thermal Pain

The effects of cigarette smoking on pain perception were evaluated in 18 healthy smokers. Thermal pain stimuli were used to assess pain detection threshold and tolerance and to collect subjective ratings of the intensity and unpleasantness of painful stimuli. After overnight abstinence, pain perception was evaluated before and after 3 experimental treatments. Participants smoked normal cigarettes, smoked denicotinized cigarettes, or remained abstinent. Smoking normal cigarettes produced relative increases in pain tolerance compared with abstinence. Smoking denicotinized cigarettes produced intermediate effects on tolerance not different from the other 2 treatments. Effects were not detected for pain threshold or subjective pain ratings. Results suggest that cigarette smoking can have antinociceptive effects, which may depend both on nicotine and on other factors associated with smoking. © 1995 American Psychological Association.

Authors
Lane, JD; Lefebvre, JC; Rose, JE; Keefe, FJ
MLA Citation
Lane, JD, Lefebvre, JC, Rose, JE, and Keefe, FJ. "Effects of Cigarette Smoking on Perception of Thermal Pain." Experimental and Clinical Psychopharmacology 3.2 (1995): 140-147.
Source
scival
Published In
Experimental and Clinical Psychopharmacology
Volume
3
Issue
2
Publish Date
1995
Start Page
140
End Page
147

The MMPI in chronic pain: Security blanket or sound investment

Authors
Keefe, FJ; Lefebvre, JC; Beaupre, PM
MLA Citation
Keefe, FJ, Lefebvre, JC, and Beaupre, PM. "The MMPI in chronic pain: Security blanket or sound investment." Pain Forum 4 (1995): 101-103. (Academic Article)
Source
manual
Published In
Pain Forum
Volume
4
Publish Date
1995
Start Page
101
End Page
103

Critical issues in pain management training for psychologists

Authors
Edens, JL; Wilson, JJ; Gil, KM; Keefe, FJ
MLA Citation
Edens, JL, Wilson, JJ, Gil, KM, and Keefe, FJ. "Critical issues in pain management training for psychologists." American Pain Society Journal (1995): 14-17. (Academic Article)
Source
manual
Published In
American Pain Society Journal
Publish Date
1995
Start Page
14
End Page
17

Personality assessment and the Minnesota Multiphasic Personality Inventory: 50 Years on: Do we still need our security blanket?

Personality assessment has a long history in the investigation of pain problems, and perhaps it is time to reflect on its relevance in the context of understanding pain. Although number of different personality inventories have been developed recently, the Minnesota Multiphasic Personality Inventory (MMPI) is still the most widely used personality inventory and, in terms of detailed debate, particular emphasis will be placed on the MMPI and its successor, the MMPI-2. Although much of the subsequent discussion will be of a more general nature, the authors contend that its continued use is understandable, but no longer justifiable, and will argue that, even in its latest incarnation, the MMPI is overdependent on outdated concepts of psychopathology, and that the recent critiques of the MMPI, while illuminating, have failed to address a more fundamental set of problems with personality assessment, which inherently constrain and limit its utility.

Authors
Main, CJ; Spanswick, CC; Bradley, LA; Keefe, FJ; Lefebvre, JC; Beaupre, PM; Turk, DC; Fernandez, E; Sanders, SH
MLA Citation
Main, CJ, Spanswick, CC, Bradley, LA, Keefe, FJ, Lefebvre, JC, Beaupre, PM, Turk, DC, Fernandez, E, and Sanders, SH. "Personality assessment and the Minnesota Multiphasic Personality Inventory: 50 Years on: Do we still need our security blanket?." Pain Forum 4.2 (1995): 90-113.
Source
scival
Published In
Pain Forum
Volume
4
Issue
2
Publish Date
1995
Start Page
90
End Page
113

Pain in young adults: I. Relationship to gender and family pain history.

OBJECTIVES/DESIGN: Two studies were carried out to examine how gender and family pain history related to pain and activity interference in young adults. The first study (n = 252 college students) examined how gender and family pain history related to pain intensity and the second study (n = 206 college students) examined how these variables related to pain intensity, location, and activity interference. Whenever possible, data from the two studies were combined for purposes of data analyses. RESULTS: Results indicated that more than half of the young adults studied reported experiencing some type of pain at the time of the investigation. The intensity of the pain was in the low range and the most frequent sites of pain were in the head and legs or feet. Gender differences were noted, with women reporting a greater number of sites of pain. Family pain history was found to be related to pain and activity interference. Subjects who had a strong family history of pain problems reported a greater number of pain sites, and higher levels of pain-related activity interference. CONCLUSIONS: Generalizability of results is limited due to the group of young adults studied, yet several conclusions relative to this group may be suggested. First, this group of young adults do appear to experience pain. Second, there may be gender differences in the types of pain they report and the ways they react to pain. Third, family history of pain may be related to the pain experiences of this group of young adults.

Authors
Lester, N; Lefebvre, JC; Keefe, FJ
MLA Citation
Lester, N, Lefebvre, JC, and Keefe, FJ. "Pain in young adults: I. Relationship to gender and family pain history." Clin J Pain 10.4 (December 1994): 282-289.
PMID
7858357
Source
pubmed
Published In
Clinical Journal of Pain
Volume
10
Issue
4
Publish Date
1994
Start Page
282
End Page
289

Mammography pain and discomfort: a cognitive-behavioral perspective.

Although some women report having little pain or discomfort during mammography, other women find mammography to be a painful and uncomfortable experience. Cognitive and behavioral factors may influence the perception of pain and discomfort during mammography. This review critically evaluates the research on mammography pain from a cognitive-behavioral perspective. The review is in three sections. The first reviews studies measuring pain and discomfort in women who have recently had mammograms and studies investigating the relative importance of pain and discomfort in influencing women's decisions to have a mammogram. The second section presents a cognitive-behavioral model of mammography pain that is based on theories of behavior and self-regulation developed by Kanfer and Hagerman (1987). The review concludes with a discussion of the implications of the cognitive-behavioral perspective for clinical management and research on mammography pain and discomfort.

Authors
Keefe, FJ; Hauck, ER; Egert, J; Rimer, B; Kornguth, P
MLA Citation
Keefe, FJ, Hauck, ER, Egert, J, Rimer, B, and Kornguth, P. "Mammography pain and discomfort: a cognitive-behavioral perspective." Pain 56.3 (March 1994): 247-260. (Review)
PMID
8022619
Source
pubmed
Published In
PAIN
Volume
56
Issue
3
Publish Date
1994
Start Page
247
End Page
260

Appraisal and coping with rheumatoid arthritis related problems across three areas: Household activities, leisure activities, and pain management

Authors
Giorgino, KB; Blalock, SJ; DeVellis, RF; DeVellis, BM; Keefe, FJ; Jordan, JM
MLA Citation
Giorgino, KB, Blalock, SJ, DeVellis, RF, DeVellis, BM, Keefe, FJ, and Jordan, JM. "Appraisal and coping with rheumatoid arthritis related problems across three areas: Household activities, leisure activities, and pain management." Arthritis Care and Research 7 (1994): 20-28. (Academic Article)
Source
manual
Published In
Arthritis Care and Research
Volume
7
Publish Date
1994
Start Page
20
End Page
28

Catastrophizing, depression and the sensory, affective and evaluative aspects of chronic pain

Research has shown that catastrophizing is related to increased depression and chronic pain. However, some researchers have questioned the utility of catastrophizing as a separate construct, suggesting that it may just be a symptom of depression. The present investigation used path analysis to determine if catastrophizing was related to McGill Pain Questionnaire scores when controlling for depression as assessed by the Beck Depression Inventory in a group of 85 chronic pain patients. According to Fields' model of the relationship between pain and depression, we predicted that catastrophizing would mediate the relationship between depression and the evaluative and affective aspects of pain, but not the sensory aspect. The resulting path coefficients appear to support these predictions. The results suggest that catastrophizing is a separate construct which may impact on pain perception and treatment. The data also provide some support for Field's neurobiological model of the relationship between depression and pain.

Authors
Geisser, ME; Robinson, ME; Keefe, FJ; Weiner, ML
MLA Citation
Geisser, ME, Robinson, ME, Keefe, FJ, and Weiner, ML. "Catastrophizing, depression and the sensory, affective and evaluative aspects of chronic pain." Pain 59.1 (1994): 79-83.
PMID
7854806
Source
scival
Published In
PAIN
Volume
59
Issue
1
Publish Date
1994
Start Page
79
End Page
83
DOI
10.1016/0304-3959(94)90050-7

Self-efficacy and pain behavior among subjects with fibromyalgia

Given the lack of objective physical measures for assessing fibrompalgia syndrome (FS), the role of pain assessment is particularly important. The role of psychological factors is controversial among FS patients. This study was designed to better understand the relationship between pain behaviors and psychological variables. Specifically, this study (1) refined a pain behavior observation (PBO) methodology for use with FS patients, (2) determined whether stretching is a valid pain behavior, and (3) assessed whether psychological variables including self-efficacy and/ or depression can predict pain behaviors after controlling for disease severity and age. The 73 FS subjects meeting the American College of Rheumatology classification system completed questionnaires measuring self-efficacy, depression, and pain. Trained physicians conducted tender-point examinations. Subjects were videotaped using a standardized procedure. Two trained raters independently coded all pain behaviors. Kappa coefficients and correlations among pain behaviors and self-reported pain indicated that the PBO method was both reliable and valid. However, the newly defined pain behavior 'stretching' was found to be negatively associated with self-reported pain. Hierarchical multiple regression (MR) analyses revealed that depression did not predict pain behavior over and above myalgic scores and age; however, in 3 separate MR analyses, self-efficacy for function, pain, and other symptoms each predicted pain behavior over and above myalgic scores and age. This study indicated that the original pain behavior scoringmethodology is appropriate for use with the FS population and should not be modified to include the pain behavior 'stretching'. Self-efficacy was related to pain behavior while depression was not among this FS sample.

Authors
Buckelew, SP; Parker, JC; Keefe, FJ; Deuser, WE; Crews, TM; Conway, R; Kay, DR; Hewett, JE
MLA Citation
Buckelew, SP, Parker, JC, Keefe, FJ, Deuser, WE, Crews, TM, Conway, R, Kay, DR, and Hewett, JE. "Self-efficacy and pain behavior among subjects with fibromyalgia." Pain 59.3 (1994): 377-384.
PMID
7708412
Source
scival
Published In
PAIN
Volume
59
Issue
3
Publish Date
1994
Start Page
377
End Page
384
DOI
10.1016/0304-3959(94)90024-8

Appraisal of and coping with arthritis-related problems in household activities, leisure activities, and pain management

Purpose. We examined whether or not there are systematic differences in how people appraise different types of illness-related problems and in how they cope with these problems. Methods. Two hundred thirty-five adults with recently diagnosed rheumatoid arthritis completed a mailed questionnaire followed by a telephone interview. A series of stress appraisal and coping variables were assessed in relation to three areas: household activities, leisure activities, and pain management. Results. Pain differed significantly from household and leisure activities with regard to several appraisal and coping variables. Participants reported the least control over problems with pain, while attaching the most importance to pain control. Leisure activities also stood out as unique on several variables. Participants perceived greater ability and were more satisfied with their ability in relation to leisure activities. Conclusion. These findings show that, at least early in the disease, appraisal and coping strategies differ across the areas of household activities, leisure activities, and pain management.

Authors
Giorgino, KB; Blalock, SJ; DeVellis, RF; DeVellis, BM; Keefe, FJ; Jordan, JM
MLA Citation
Giorgino, KB, Blalock, SJ, DeVellis, RF, DeVellis, BM, Keefe, FJ, and Jordan, JM. "Appraisal of and coping with arthritis-related problems in household activities, leisure activities, and pain management." Arthritis Care and Research 7.1 (1994): 20-28.
Source
scival
Published In
Arthritis Care and Research
Volume
7
Issue
1
Publish Date
1994
Start Page
20
End Page
28

Predictors of response to pain management treatment. The role of family environment and changes in cognitive processes.

OBJECTIVE: The purpose of the present study was to examine factors that influence individual differences in treatment response after multidisciplinary pain management. DESIGN: Pre-post assessment design. PATIENTS: 119 chronic pain inpatients. MAIN MEASURES: Outcome measures included pain report from the McGill Pain Questionnaire, emotional distress from the Symptom Checklist-90 Revised, and activity discomfort from the Activity Discomfort Scale. Process measures included the Family Environment Scale, the Coping Strategies Questionnaire, and the Inventory of Negative Thoughts in Response to Pain. RESULTS: Results indicated that pretreatment family environment, cognitive coping strategies, and negative thinking accounted for small yet significant proportions of the variance in outcome. The proportion of variance accounted for by the changes in cognitive coping and negative thinking was somewhat higher. An increase in pain control and rational thinking was related to decreases in depression and anxiety, pain report, and activity discomfort. Decreases in negative social cognitions were related to decreased depression at posttreatment. CONCLUSIONS: Changes in coping strategies and negative thinking may be important mechanisms related to improvement, or lack of improvement, in a range of outcome measures. Patients from families who are controlling and disorganized, and patients high on negative thinking at pretreatment may represent high-risk groups in need of further individually tailored interventions.

Authors
Tota-Faucette, ME; Gil, KM; Williams, DA; Keefe, FJ; Goli, V
MLA Citation
Tota-Faucette, ME, Gil, KM, Williams, DA, Keefe, FJ, and Goli, V. "Predictors of response to pain management treatment. The role of family environment and changes in cognitive processes." The Clinical journal of pain 9.2 (June 1993): 115-123.
PMID
8358134
Source
epmc
Published In
Clinical Journal of Pain
Volume
9
Issue
2
Publish Date
1993
Start Page
115
End Page
123

Biopsychosocial contributions to the management of arthritis disability

The contributions of MACs and RRTCs to the generation of arthritis-related biopsychosocial research over the last 15 years have been enormous. However, the assimilation of biopsychosocial concepts into mainstream clinical practice, professional education, and public awareness will require a sustained national effort.

Authors
Parker, JC; Bradley, LA; DeVellis, RM; Gerber, LH; Holman, HR; Keefe, FJ; Lawrence, TS; Liang, MH; Lorig, KR; Nicassio, PM; Revenson, TA; Rogers, MP; Wallston, KA; Wilson, MG; Wolfe, F
MLA Citation
Parker, JC, Bradley, LA, DeVellis, RM, Gerber, LH, Holman, HR, Keefe, FJ, Lawrence, TS, Liang, MH, Lorig, KR, Nicassio, PM, Revenson, TA, Rogers, MP, Wallston, KA, Wilson, MG, and Wolfe, F. "Biopsychosocial contributions to the management of arthritis disability." Arthritis and Rheumatism 36.7 (1993): 885-889.
PMID
8318036
Source
scival
Published In
Arthritis and Rheumatism
Volume
36
Issue
7
Publish Date
1993
Start Page
885
End Page
889

Cognitive-behavioral treatment of rheumatoid arthritis pain: Understanding and enhancing maintenance of treatment gains

Authors
Keefe, FJ; Van Horn, Y
MLA Citation
Keefe, FJ, and Van Horn, Y. "Cognitive-behavioral treatment of rheumatoid arthritis pain: Understanding and enhancing maintenance of treatment gains." Arthritis Care and Research 6 (1993): 213-222. (Academic Article)
Source
manual
Published In
Arthritis Care and Research
Volume
6
Publish Date
1993
Start Page
213
End Page
222

Cognitive-behavioral treatment of rheumatoid arthritis pain: Maintaining treatment gains

Objective. This paper critically reviews research studies examining the long-term effects of cognitive-behavioral therapy interventions for managing pain in rheumatoid arthritis patients. Methods and Results. The first section of the paper evaluates long-term results obtained in studies of cognitive-behavioral therapy, arthritis education interventions, and combined cognitive-behavioral therapy-arthritis education interventions. These studies show that although some rheumatoid arthritis patients are able to maintain initial improvements in pain and disability, other rheumatoid arthritis patients do not. In the second section of this review, a cognitive-behavioral model of maintenance of pain coping skills is presented. This model may be useful in increasing our understanding of the relapse process and in planning interventions to enhance and prolong cognitive-behavioral therapy treatment gains. The final section of this paper addresses important future directions for research. The need for empirical studies of relapse and maintenance processes is underscored. Conclusions. Controlled studies are needed to test the utility of new cognitive-behavioral interventions designed to enhance the long-term maintenance of treatment gains in RA patients. We suggest that a focus on issues of relapse and maintenance may be just as important for medical and surgical interventions for rheumatoid arthritis pain, as it is for cognitive-behavioral therapy interventions.

Authors
Keefe, FJ; Horn, YV
MLA Citation
Keefe, FJ, and Horn, YV. "Cognitive-behavioral treatment of rheumatoid arthritis pain: Maintaining treatment gains." Arthritis Care and Research 6.4 (1993): 213-222.
PMID
7918717
Source
scival
Published In
Arthritis Care and Research
Volume
6
Issue
4
Publish Date
1993
Start Page
213
End Page
222

Disease severity in rheumatoid arthritis: relationships of plasma tumor necrosis factor-alpha, soluble interleukin 2-receptor, soluble CD4/CD8 ratio, neopterin, and fibrin D-dimer to traditional severity and functional measures.

Rheumatoid arthritis is a complex inflammatory disease of unknown cause. Although various laboratory and clinical measurements are useful in managing these patients, there is a need for better tests to quantitatively assess disease activity. The purpose of this study was to investigate the association of certain immune and inflammation (I-I) parameters with four traditional disease severity measures and a functional measure in rheumatoid arthritis patients. A single set of patient blood samples was analyzed, and four traditional disease severity measures and patient functional statuses were determined from 64 consecutive outpatients with rheumatoid arthritis. Plasma tumor necrosis factor-alpha (TNF), soluble interleukin-2 receptor (sIL-2R), sCD4 and sCD8 (and the sCD4/sCD8 ratio), neopterin, and fibrin D-dimer were analyzed in relationship to Westergren erythrocyte sedimentation rate (ESR), physician assessment of disease activity, joint pain count, grip strength, and Arthritis Impact Measurement Scale (AIMS) scores. Rheumatoid arthritis patients had higher mean levels of all I-I measures (except sCD4) compared to healthy subjects. Initial significant correlations between TNF, sIL-2R, and D-dimer and several disease severity and functional measures were detected. When we controlled for the covariates age, gender, race, and medications, regression analyses indicated that, as a group, the I-I measures were significantly related to grip strength, physician disease severity rating, ESR, and total joint pain. When the predictive values of the I-I measures were tested controlling for the covariates and ESR, D-dimer was independently and significantly associated with variability in grip strength, physician disease severity, and AIMS physical disability, while TNF was associated with a significant amount of variability in total joint pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors
Beckham, JC; Caldwell, DS; Peterson, BL; Pippen, AM; Currie, MS; Keefe, FJ; Weinberg, JB
MLA Citation
Beckham, JC, Caldwell, DS, Peterson, BL, Pippen, AM, Currie, MS, Keefe, FJ, and Weinberg, JB. "Disease severity in rheumatoid arthritis: relationships of plasma tumor necrosis factor-alpha, soluble interleukin 2-receptor, soluble CD4/CD8 ratio, neopterin, and fibrin D-dimer to traditional severity and functional measures." J Clin Immunol 12.5 (September 1992): 353-361.
PMID
1430106
Source
pubmed
Published In
Journal of Clinical Immunology
Volume
12
Issue
5
Publish Date
1992
Start Page
353
End Page
361

Behavioral and cognitive-behavioral approaches to chronic pain: recent advances and future directions.

Behavioral and cognitive-behavioral approaches to chronic pain are receiving increasing attention from researchers and clinicians. This article reviews and highlights recent research advances and future research directions. Assessment research reviewed includes studies examining the social context of pain, the relationship of chronic pain to depression, cognitive variables affecting pain, and comprehensive assessment measures. Treatment outcome studies reviewed are those evaluating the effects of behavioral and cognitive-behavioral treatments for chronic pain. These studies focus on comparisons of behavioral treatment with control conditions, comparisons of two behavioral treatments, and prevention of chronic pain. Future directions for assessment and treatment research are outlined.

Authors
Keefe, FJ; Dunsmore, J; Burnett, R
MLA Citation
Keefe, FJ, Dunsmore, J, and Burnett, R. "Behavioral and cognitive-behavioral approaches to chronic pain: recent advances and future directions." J Consult Clin Psychol 60.4 (August 1992): 528-536. (Review)
PMID
1506501
Source
pubmed
Published In
Journal of Consulting and Clinical Psychology
Volume
60
Issue
4
Publish Date
1992
Start Page
528
End Page
536

Coping with pain: conceptual concerns and future directions

Authors
Keefe, FJ; Jr, ANS; Lefebvre, JC
MLA Citation
Keefe, FJ, Jr, ANS, and Lefebvre, JC. "Coping with pain: conceptual concerns and future directions." Pain 51.2 (1992): 131-134.
PMID
1484712
Source
scival
Published In
PAIN
Volume
51
Issue
2
Publish Date
1992
Start Page
131
End Page
134
DOI
10.1016/0304-3959(92)90253-8

Spontaneous coping strategies to manage acute pain and anxiety during electrodiagnostic studies

Electrodiagnostic studies produce both anxiety and pain, which can prevent adequate examination and limit the usefulness of test results. This study examined the spontaneous coping strategies used to manage the pain and anxiety experienced during electrodiagnostic testing. Fifty patients (26 women and 24 men) evaluated in our electrodiagnostic laboratory were administered visual analogue scale (VAS) pain and anxiety measures and the Spielberger State-Trait Anxiety Inventory (STAI) before the procedure. Immediately after the procedure, subjects reported pain, anxiety, and coping strategies used during electrodiagnostic testing using the VAS, the STAI, and a situation-specific version of the Coping Strategies Questionnaire (CSQ-S). The CSQ-S appears to be a valid and reliable measure of spontaneous coping strategies. Multiple-regression analyses revealed that frequent use of catastrophizing, diverting attention, and coping self-statement strategies was significantly and positively correlated with pain, whereas reinterpreting pain was significantly and negatively associated with pain. Judgments of control over pain were also significantly and negatively associated with anxiety experienced during electrodiagnostic studies. Physicians' ratings of pain and anxiety were highly correlated with patients' self-reports. This study suggests that ineffective coping strategies may enhance the pain and anxiety experienced during electromyography. Alternatively, teaching subjects active self-control skills and increasing patients' self-efficacy beliefs may help manage this situation-specific acute anxiety and, possibly, the associated pain. © 1992.

Authors
Buckelew, SP; Conway, RC; Shutty, MS; Lawrence, JA; Grafing, MR; Anderson, SK; Hewett, JE; Keefe, FJ
MLA Citation
Buckelew, SP, Conway, RC, Shutty, MS, Lawrence, JA, Grafing, MR, Anderson, SK, Hewett, JE, and Keefe, FJ. "Spontaneous coping strategies to manage acute pain and anxiety during electrodiagnostic studies." Archives of Physical Medicine and Rehabilitation 73.6 (1992): 594-598.
PMID
1622311
Source
scival
Published In
Archives of Physical Medicine and Rehabilitation
Volume
73
Issue
6
Publish Date
1992
Start Page
594
End Page
598

The Outcome Evaluation Questionnaire: Description and initial findings

Authors
Keefe, FJ; Linton, SJ; Lefebvre, JC
MLA Citation
Keefe, FJ, Linton, SJ, and Lefebvre, JC. "The Outcome Evaluation Questionnaire: Description and initial findings." Scandinavian Journal of Behavior Therapy 21 (1992): 19-33. (Academic Article)
Source
manual
Published In
Scandinavian Journal of Behavior Therapy
Volume
21
Publish Date
1992
Start Page
19
End Page
33

Pain behavior concepts and controversies

This article summarizes recent research on pain behavior observation and highlights a number of controversial issues involved in applying this approach to the assessment of chronic pain patients. The article is divided into two major sections. In the first section, a number of observation methods used to record pain behavior in standardized situations and naturalistic settings are described. The reliability and validity of these observation methods, and their advantages and disadvantages, are discussed. The second section addresses five criticisms of the pain behavior construct. These criticisms include: the pain behavior construct is too simplistic, the focus on pain behavior denies the existence of pain, the questions of whether pain behavior is an expression of pain or a coping response, the measures of pain behavior may not be useful in clinical settings, and the notion that pain behavior has been oversold. The criticisms are evaluated from a behavioral perspective and the discussion highlights the potential utility of the pain behavior construct. The paper concludes with suggestions for future research. © 1992.

Authors
Keefe, FJ; Dunsmoret, J
MLA Citation
Keefe, FJ, and Dunsmoret, J. "Pain behavior concepts and controversies." APS Journal 1.2 (1992): 92-100.
Source
scival
Published In
APS Journal
Volume
1
Issue
2
Publish Date
1992
Start Page
92
End Page
100

The multifaceted nature of pain behavior

Authors
Keefe, FJ; Dunsmore, J
MLA Citation
Keefe, FJ, and Dunsmore, J. "The multifaceted nature of pain behavior." APS Journal 1.2 (1992): 112-114.
Source
scival
Published In
APS Journal
Volume
1
Issue
2
Publish Date
1992
Start Page
112
End Page
114

Grading the severity of chronic pain

Summary This research develops and evaluates a simple method of grading the severity of chronic pain for use in general population surveys and studies of primary care pain patients. Measures of pain intensity, disability, persistence and recency of onset were tested for their ability to grade chronic pain severity in a longitudinal study of primary care back pain (n = 1213), headache (n = 779) and temporomandibular disorder pain (n = 397) patients. A Guttman scale analysis showed that pain intensity and disability measures formed a reliable hierarchical scale. Pain intensity measures appeared to scale the lower range of global severity while disability measures appeared to scale the upper range of global severity. Recency of onset and days in pain in the prior 6 months did not scale with pain intensity or disability. Using simple scoring rules, pain severity was graded into 4 hierarchical classes: Grade I, low disability-low intensity; Grade II, low disability-high intensity; Grade III, high disability-moderately limiting; and Grade IV, high disability-severely limiting. For each pain site. Chronic Pain Grade measured at baseline showed a highly statistically significant and monotonically increasing relationship with unemployment rate, pain-related functional limitations, depression, fair to poor self-rated health, frequent use of opioid analgesics, and frequent pain-related doctor visits both at baseline and at 1-year follow-up. Days in Pain was related to these variables, but not as strongly as Chronic Pain Grade. Recent onset cases (first onset within the prior 3 months) did not show differences in psychological and behavioral dysfunction when compared to persons with less recent onset. Using longitudinal data from a population-based study (n = 803), Chronic Pain Grade at baseline predicted the presence of pain in the prior 2 weeks, Chronic Pain Grade and pain-related functional limitations at 3-year follow-up. Grading chronic pain as a function of pain intensity and pain-related disability may be useful when a brief ordinal measure of global pain severity is required. Pain persistence, measured by days in pain in a fixed time period, provides useful additional information.

Authors
Korff, MV; Ormel, J; Keefe, FJ; Dworkin, SF
MLA Citation
Korff, MV, Ormel, J, Keefe, FJ, and Dworkin, SF. "Grading the severity of chronic pain." Pain 50.2 (1992): 133-149.
PMID
1408309
Source
scival
Published In
Pain
Volume
50
Issue
2
Publish Date
1992
Start Page
133
End Page
149
DOI
10.1016/0304-3959(92)90154-4

Psychological and behavioral aspects of pain

Authors
Keefe, FJ; Robinson, E
MLA Citation
Keefe, FJ, and Robinson, E. "Psychological and behavioral aspects of pain." Current Opinion in Anaestheosiology 5 (1992): 698-704. (Academic Article)
Source
manual
Published In
Current Opinion in Anaestheosiology
Volume
5
Publish Date
1992
Start Page
698
End Page
704

Psychological well-being among people with recently diagnosed rheumatoid arthritis: Do self-perceptions of abilities make a difference?

Objective. Satisfaction with abilities and perceived importance of abilities are 2 factors involved in the process of self-evaluation. We examined the role that these factors play in adjustment to rheumatoid arthritis (RA). Methods. Data were collected, via telephone interview and mailed questionnaire, from 234 individuals with recently diagnosed RA. Disease severity information was obtained from participants' physicians. Results. Consistent with study hypotheses, satisfaction was associated with psychological well-being only among those who viewed as very important the abilities being evaluated. Conclusion. These findings increase understanding of the conditions under which low levels of satisfaction are likely to be associated with psychological distress.

Authors
Blalock, SJ; DeVellis, BM; DeVellis, RF; Giorgino, KB; Sauter, SVH; Jordan, JM; Keefe, FJ; Mutran, EJ
MLA Citation
Blalock, SJ, DeVellis, BM, DeVellis, RF, Giorgino, KB, Sauter, SVH, Jordan, JM, Keefe, FJ, and Mutran, EJ. "Psychological well-being among people with recently diagnosed rheumatoid arthritis: Do self-perceptions of abilities make a difference?." Arthritis and Rheumatism 35.11 (1992): 1267-1272.
PMID
1445441
Source
scival
Published In
Arthritis and Rheumatism
Volume
35
Issue
11
Publish Date
1992
Start Page
1267
End Page
1272

Behavior of patients with lung cancer: Description and associations with oncologic and pain variables

Although reflexes are recognized as protective responses to noxious stimuli, less is known about voluntary behavioral responses to cancer pain, which could provide clinicians with important diagnostic and therapeutic information. Forty-five patients with lung cancer were studied in their homes on 2 occasions to identify pain behaviors and to examine relationships between behaviors and selected variables. Patients completed the McGill Pain Questionnaire (MPQ) and Visual Analogue scale (VAS). Using a videotape observation method, patients sat, stood, walked, and reclined for 10 min. Videotapes were scored using 5 position-related and 31 pain-related behavior definitions. Within 3 days scored behaviors were described to patients who reported whether each scored behavior was performed: to express pain; because pain prevented usual behavior; to control pain; or as a habit. Patients reported that pain was controlled by 42 different behaviors; the number of different pain-reduction behaviors was correlated with pain intensity (r = 0.44) and pain quality (r = 0.64). Simultaneous multiple regression indicated that length of time pain was experienced, number of pain sites, pain quality, and pain intensity accounted for 41% of the variance in the number of pain control behaviors. None of the taped behaviors was reported as performed to express pain, and few of the patients reported that pain prevented behavior during the video session. Results clarify the pain-behavior construct, provide insight about the multidimensional nature of lung cancer pain, and suggest directions for behavioral interventions to augment pharmacological therapy for lung cancer pain.

Authors
Wilkie, DJ; Keefe, FJ; Dodd, MJ; Copp, LA
MLA Citation
Wilkie, DJ, Keefe, FJ, Dodd, MJ, and Copp, LA. "Behavior of patients with lung cancer: Description and associations with oncologic and pain variables." Pain 51.2 (1992): 231-240.
PMID
1484719
Source
scival
Published In
Pain
Volume
51
Issue
2
Publish Date
1992
Start Page
231
End Page
240
DOI
10.1016/0304-3959(92)90264-C

A multi-center evaluation of the McGill Pain Questionnaire: Results from more than 1700 chronic pain patients

We argue that the conflicting results reported in previous studies examining the factor structure of the McGill Pain Questionnaire Pain Rating Index (PRI) can be explained by differences in the patient samples and statistical analyses used across studies. In an effort to clarify the factor structure of the PRI, 3 different factor models were compared using confirmatory factor analysis in 2 samples of low-back pain patients (N = 1372) and in a third sample of patients suffering from other chronic pain problems (N = 423). A 4-factor model, similar to those obtained in previous studies where multiple criteria were used to determine the number of factors extracted, best explained covariation among PRI subclasses. However, relatively high interfactor correlations (approximately two-thirds of the variance explained by the best fitting factor structure was common variance) cast doubt on the discriminant validity of PRI subscales; examination of relationships between the PRI and MMPI subscales also failed to provide evidence of the discriminant validity or clinical utility of PRI subscales. Reducing the information from the 10 PRI sensory subclasses to a single subscale score may seriously limit the usefulness of the PRI. Alternate methods of using PRI data are suggested.

Authors
Holroyd, KA; Holm, JE; Keefe, FJ; Turner, JA; Bradley, LA; Murphy, WD; Johnson, P; Anderson, K; Hinkle, AL; O'Malley, WB
MLA Citation
Holroyd, KA, Holm, JE, Keefe, FJ, Turner, JA, Bradley, LA, Murphy, WD, Johnson, P, Anderson, K, Hinkle, AL, and O'Malley, WB. "A multi-center evaluation of the McGill Pain Questionnaire: Results from more than 1700 chronic pain patients." Pain 48.3 (1992): 301-311.
PMID
1534399
Source
scival
Published In
Pain
Volume
48
Issue
3
Publish Date
1992
Start Page
301
End Page
311
DOI
10.1016/0304-3959(92)90077-O

The Outcome Evaluation Questionnaire: Preliminary findings from a sampe of actue pain patients

Authors
Linton, SJ; Keefe, FJ; Jansson, O; Aslaksen, K
MLA Citation
Linton, SJ, Keefe, FJ, Jansson, O, and Aslaksen, K. "The Outcome Evaluation Questionnaire: Preliminary findings from a sampe of actue pain patients." Scandinavian Journal of Behavior Therapy 21 (1992): 163-170. (Academic Article)
Source
manual
Published In
Scandinavian Journal of Behavior Therapy
Volume
21
Publish Date
1992
Start Page
163
End Page
170

Pain beliefs and the use of cognitive-behavioral coping strategies.

Patients' beliefs about chronic pain, such as how long it will last and whether it is a mysterious experience, have been shown to be related to compliance with treatment programs. The present study examined whether these pain beliefs related to a specific component of pain management, namely the frequency of use and the perceived effectiveness of cognitive and behavioral coping strategies. One hundred twenty chronic pain patients were administered the Pain Beliefs and Perceptions inventory (PBAPI) and the Coping Strategies questionnaire (CSQ). A cluster analysis of 2 pain beliefs (that pain is enduring and that pain is mysterious) was conducted revealing 3 distinct subgroups of patients based upon these 2 beliefs. Multivariate analysis of variance was used to detect whether the use of cognitive-behavioral pain coping strategies differed in patients in the 3 pain beliefs subgroups. The results indicated that patients belonging to the group characterized by the belief that pain was enduring and mysterious were less likely to use cognitive coping strategies (e.g., reinterpretation of pain sensation), more likely to catastrophize, and less likely to rate their coping strategies as effective in controlling and decreasing pain than patients believing their pain to be understandable and of short duration. The implications of these results for understanding the patient's choice of and compliance with treatment and coping efforts is discussed.

Authors
Williams, DA; Keefe, FJ
MLA Citation
Williams, DA, and Keefe, FJ. "Pain beliefs and the use of cognitive-behavioral coping strategies." Pain 46.2 (August 1991): 185-190.
PMID
1749641
Source
epmc
Published In
PAIN
Volume
46
Issue
2
Publish Date
1991
Start Page
185
End Page
190
DOI
10.1016/0304-3959(91)90074-8

Analyzing pain in rheumatoid arthritis patients. Pain coping strategies in patients who have had knee replacement surgery.

This study used the Coping Strategies Questionnaire (CSQ) to investigate pain coping strategies in 52 rheumatoid arthritis patients who reported having knee pain 1 year or more following knee replacement surgery. Data analysis revealed that, as a group, these patients were active copers in that they reported frequent use of a variety of pain coping strategies. Pain coping strategies were found to be related to measures of pain and adjustment. Patients who rated their ability to control and decrease pain high and who rarely engaged in catastrophizing (i.e., who scored high on the Pain Control and Rational Thinking factor of the CSQ) had much lower levels of pain and psychological disability than patients who did not. Coping strategies were not found to relate to age, gender, obesity status or disability/compensation status. Taken together, these results suggest that an analysis of pain coping strategies may be helpful in understanding pain in arthritis patients who have pain following joint replacement surgery.

Authors
Keefe, FJ; Caldwell, DS; Martinez, S; Nunley, J; Beckham, J; Williams, DA
MLA Citation
Keefe, FJ, Caldwell, DS, Martinez, S, Nunley, J, Beckham, J, and Williams, DA. "Analyzing pain in rheumatoid arthritis patients. Pain coping strategies in patients who have had knee replacement surgery." Pain 46.2 (August 1991): 153-160.
PMID
1749638
Source
epmc
Published In
PAIN
Volume
46
Issue
2
Publish Date
1991
Start Page
153
End Page
160
DOI
10.1016/0304-3959(91)90070-e

Biofeedback as a means to alter electromyographic activity in a total knee replacement patient.

This paper presents a single case controlled study of a 75-year-old male having bilateral total knee replacement. Baseline EMG recordings demonstrated differential levels of vastus medialis and vastus lateralis muscle activity in both knees during exercise, with increased vastus lateralis activity compared to vastus medialis activity. The purpose of the study was to use electromyographic (EMG) biofeedback training to train the patient to equalize vastus medialis and vastus lateralis EMG activity during exercise. After 11 and 13 training sessions for the left and right knees, respectively, differences between vastus medialis and vastus lateralis activity had markedly decreased. Following the termination of biofeedback training, EMG activity during exercise showed a return toward baseline levels. Several concomitant changes in psychological and physical function were noted. These results suggested that EMG biofeedback can be used to train vastus medialis and vastus lateralis activity in total knee replacement patients, and that biofeedback training may produce positive benefits in other functional areas.

Authors
Beckham, JC; Keefe, FJ; Caldwell, DS; Brown, CJ
MLA Citation
Beckham, JC, Keefe, FJ, Caldwell, DS, and Brown, CJ. "Biofeedback as a means to alter electromyographic activity in a total knee replacement patient." Biofeedback Self Regul 16.1 (March 1991): 23-35.
PMID
2012824
Source
pubmed
Published In
Applied Psychophysiology and Biofeedback
Volume
16
Issue
1
Publish Date
1991
Start Page
23
End Page
35

Analyzing pain in rheumatoid arthritis patients: Pain coping strategies in patients who have had knee replacement surgery

Authors
Keefe, FJ; Caldwell, DS; Martinez, S; Nunley, J; Beckham, J; Williams, DA
MLA Citation
Keefe, FJ, Caldwell, DS, Martinez, S, Nunley, J, Beckham, J, and Williams, DA. "Analyzing pain in rheumatoid arthritis patients: Pain coping strategies in patients who have had knee replacement surgery." Pain 46 (1991): 154-160. (Academic Article)
Source
manual
Published In
Pain
Volume
46
Publish Date
1991
Start Page
154
End Page
160

Pain coping strategies in rheumatoid arthritis: Relationships to pain, disability, depression and daily hassles

The present study investigated the relation of pain coping strategies to physical disability, pain, psychological disability, depression and daily hassles in rheumatoid arthritis (RA) patients. Subjects were 65 RA patients recruited from an outpatient rheumatology clinic. Each subject completed the Coping Strategies Questionnaire (CSQ), The Arthritis Impact Measurement Scale (AIMS), the Beck Depression Inventory (BDI) and the Hassles Scale. Correlational analyses indicated that the Pain Control and Rational Thinking (PCRT) factor of the CSQ was strongly related to measures of adjustment. Regression analyses revealed that after controlling for demographic variables (age, gender) and medical variables (functional classification, disability support status), the PCRT factor of the CSQ explained a significant proportion of variance in physical disability, pain, psychological disability, depression, and hassles severity. Patients scoring high on the PCRT factor had lower levels of physical disability, pain, psychological disability, depression and hassles severity. Taken together, these findings suggest that pain coping strategies in RA patients are significantly related to pain and disability. © 1991 Association for Advancement of Behavior Therapy. All rights reserved.

Authors
Beckham, JC; Keefe, FJ; Caldwell, DS; Roodman, AA
MLA Citation
Beckham, JC, Keefe, FJ, Caldwell, DS, and Roodman, AA. "Pain coping strategies in rheumatoid arthritis: Relationships to pain, disability, depression and daily hassles." Behavior Therapy 22.1 (1991): 113-124.
Source
scival
Published In
Behavior Therapy
Volume
22
Issue
1
Publish Date
1991
Start Page
113
End Page
124
DOI
10.1016/S0005-7894(05)80249-7

Behavioral assessment of pain: Non-verbal measures in animals and humans

Authors
Keefe, FJ; Fillingim, RB; Williams, DA
MLA Citation
Keefe, FJ, Fillingim, RB, and Williams, DA. "Behavioral assessment of pain: Non-verbal measures in animals and humans." Institute of Laboratory Animal Resources News 33 (1991): 3-13. (Academic Article)
Source
manual
Published In
Institute of Laboratory Animal Resources News
Volume
33
Publish Date
1991
Start Page
3
End Page
13

Coping strategies of patients with lung cancer-related pain

Previous findings in patients with nonmalignant pain indicate a relationship between pain coping strategies and psychological factors. Although coping strategies have been explored in patients with cancer pain, relationships with such factors have not been reported. We wished to examine relationships between selected pain and psychological variables and the use of pain coping strategies. Forty-five patients with pain related to lung cancer indicated how they expressed their pain to others and completed the McGill-Melzack Pain Questionnaire (MPQ), State-Trait Anxiety Inventory, Visual Analogue Scale of pain intensity, and the Coping Strategies Questionnaire (CSQ). Forty-two percent of the patients reported that they tried not to let others know they had pain, and 40% indicated they told others when they had pain. Preferences for not telling others was associated with more frequent pain coping attempts for all CSQ subscales but those of catastrophizing and reinterpreting pain sensation. State anxiety demonstrated positive correlation with catastrophizing coping strategies (r = 0.48) and negative correlation with ability to control (r = -0.50) and decrease (r = -0.50) pain. The number of pain sites was correlated with coping self-statements (r = 0.34). Pain intensity and state anxiety demonstrated similar relationships. Pain quality as measured with the MPQ demonstrated moderately strong correlation with diverting attention, praying and hoping, catastrophizing, and increased activity. Interventions aimed at reinforcing or expanding a patient's pain coping repertoire should be developed with consideration given to the patient's anxiety level, pain intensity, pain quality, and pain expression preference.

Authors
Wilkie, DJ; Keefe, FJ
MLA Citation
Wilkie, DJ, and Keefe, FJ. "Coping strategies of patients with lung cancer-related pain." Clinical Journal of Pain 7.4 (1991): 292-299.
PMID
1809442
Source
scival
Published In
Clinical Journal of Pain
Volume
7
Issue
4
Publish Date
1991
Start Page
292
End Page
299

Editorial

Authors
Keefe, FJ
MLA Citation
Keefe, FJ. "Editorial." Annals of Behavioral Medicine 13.3 (1991): ii-.
Source
scival
Published In
Annals of Behavioral Medicine
Volume
13
Issue
3
Publish Date
1991
Start Page
ii

Pain coping skills training in the management of osteoarthritic knee pain: A comparative study

Authors
Keefe, FJ; Caldwell, DS; Williams, DA; Gil, KM; Mitchell, D; Robertson, C; Martinez, S; Nunley, J; Beckham, JC; Crisson, JE; Helms, M
MLA Citation
Keefe, FJ, Caldwell, DS, Williams, DA, Gil, KM, Mitchell, D, Robertson, C, Martinez, S, Nunley, J, Beckham, JC, Crisson, JE, and Helms, M. "Pain coping skills training in the management of osteoarthritic knee pain: A comparative study." Behavior Therapy 21.1 (December 1990): 49-62.
Source
crossref
Published In
Behavior Therapy
Volume
21
Issue
1
Publish Date
1990
Start Page
49
End Page
62
DOI
10.1016/S0005-7894(05)80188-1

A comparison of coping strategies in chronic pain patients in different age groups.

This study examined the effects of age on the frequency of use and perceived effectiveness of coping strategies in patients having chronic pain. Subjects were chronic pain patients in four age groups (young, middle, older, and geriatric). All subjects completed the Coping Strategies Questionnaire, which measures the use and perceived effectiveness of a variety of cognitive and behavioral coping strategies in controlling and decreasing pain. Subjects also completed measures of pain, depression, and psychological distress. Data analysis revealed that there were no significant age differences in either the use or perceived effectiveness of pain coping strategies. Correlational analyses based on data combined from the different age groups suggested that, while certain pain coping strategies appear to be adaptive (e.g., coping self-statements), other coping strategies appear to be maladaptive (e.g., catastrophizing, diverting attention, increasing behavioral activities). Patients who rated their ability to decrease pain as relatively high, reported lower levels of depression and pain. These findings are consistent with a contextual perspective on coping which postulates that few, if any, age differences in coping are to be expected when individuals are coping with a similar life event.

Authors
Keefe, FJ; Williams, DA
MLA Citation
Keefe, FJ, and Williams, DA. "A comparison of coping strategies in chronic pain patients in different age groups." Journal of gerontology 45.4 (July 1990): P161-P165.
PMID
2365972
Source
epmc
Published In
Journal of Gerontology: Social Sciences
Volume
45
Issue
4
Publish Date
1990
Start Page
P161
End Page
P165
DOI
10.1093/geronj/45.4.p161

Behavioral assessment of chronic orofacial pain.

Orofacial pain is usually evaluated and treated from a biomedical perspective. There is no question that the large majority of individuals having acute orofacial pain benefit from timely and appropriate medical intervention. When orofacial pain persists, however, the likelihood that this pain can influence and be influenced by behavioral factors increases. While some individuals are able to adapt and cope with chronic orofacial pain, others develop significant behavioral problems. These problems may include an overly sedentary lifestyle, dependence on habit-forming narcotic medications, or severe depression or anxiety. The hallmark of the behavioral perspective on chronic pain is the insistence that a careful assessment and treatment of such behavioral problems is just as important as appropriate biomedical intervention.(1)

Authors
Keefe, FJ; Beckham, JC
MLA Citation
Keefe, FJ, and Beckham, JC. "Behavioral assessment of chronic orofacial pain." Anesth Prog 37.2-3 (March 1990): 76-81. (Review)
PMID
2085202
Source
pubmed
Published In
Anesthesia Progress: a journal for pain and anxiety control
Volume
37
Issue
2-3
Publish Date
1990
Start Page
76
End Page
81

Analyzing chronic low back pain: the relative contribution of pain coping strategies.

Sixty-two chronic low back pain patients were administered the Coping Strategies Questionnaire (CSQ) to assess the frequency of use and perceived effectiveness of a variety of cognitive and behavioral pain coping strategies. Analysis of individual variables revealed that CSQ factors, gender, physical examination findings, and chronicity of pain had significant effects on one or more of a series of pain, psychological distress or behavioral measures. To assess the relative contribution of each of these variables hierarchical stepwise regression analyses were carried out. These analyses revealed that the Helplessness factor of the CSQ explained 50% of the variance in psychological distress (Global Severity Index of the SCL-90R), and 46% of the variance in depression (Beck Depression Inventory). Patients scoring high on this CSQ factor had significantly higher levels of psychological distress. None of the demographic or medical status variables explained a significant proportion of variance in the psychological distress measures. The Diverting Attention and Praying factor of the CSQ explained a moderate (9%), but significant amount of variance in pain report. Patients scoring high on this factor had higher scores on the McGill Pain Questionnaire. Coping strategies were not strongly related to pain behavior measures such as guarding or uptime. A consideration of pain coping strategies may allow one to design pain coping skills training interventions so as to fit the needs of the individual low back pain patient.

Authors
Keefe, FJ; Crisson, J; Urban, BJ; Williams, DA
MLA Citation
Keefe, FJ, Crisson, J, Urban, BJ, and Williams, DA. "Analyzing chronic low back pain: the relative contribution of pain coping strategies." Pain 40.3 (March 1990): 293-301.
PMID
2139204
Source
epmc
Published In
PAIN
Volume
40
Issue
3
Publish Date
1990
Start Page
293
End Page
301
DOI
10.1016/0304-3959(90)91126-4

Behavioral assessment of low back pain: identification of pain behavior subgroups.

A hierarchical cluster analysis procedure was used to identify homogeneous subgroups of low back pain patients who show similar pain behavior patterns during a videotaped behavior sample. Subjects, 106 chronic low back pain patients, were divided into 2 samples. The cluster analysis procedure identified 4 very similar subgroups in sample 1 and sample 2. The first subgroup showed a low or moderate level of guarding and a low level of other pain behaviors. The second subgroup showed a high level of guarding and a moderate level of rubbing of the painful area. The third subgroup showed high levels of guarding and moderate levels of bracing and rubbing. The fourth subgroup exhibited a very high level of rubbing and moderate levels of bracing. The subgroups identified may require somewhat different approaches to pain assessment and treatment. The results of this study suggest that the variability in pain behavior evident in low back pain populations may be due to the fact that within these populations there are homogeneous subgroups of patients who differ in the motor pain behaviors they display.

Authors
Keefe, FJ; Bradley, LA; Crisson, JE
MLA Citation
Keefe, FJ, Bradley, LA, and Crisson, JE. "Behavioral assessment of low back pain: identification of pain behavior subgroups." Pain 40.2 (February 1990): 153-160.
PMID
2137905
Source
pubmed
Published In
PAIN
Volume
40
Issue
2
Publish Date
1990
Start Page
153
End Page
160

Development of a behavioral observation technique for the assessment of pain behaviors in cancer patients

The present study assessed the reliability and validity of a behavioral observation technique designed to assess pain behaviors in cancer patients. Data supported the reliability of the procedure in that the level of interobserver agreement was quite acceptable. The validity of the technique was supported in that the pain behavior scores correlated significantly, as predicted, with the Sickness Impact Profile-Physical Scale and the Global Adjustment to Illness Scale, but not with the Sickness Impact Profile-Psychosocial Scale. Pain behavior scores and ratings of pain intensity, as measured on a visual analogue scale, were not significantly correlated. Additional support for the construct validity of the measure was provided in that nurses' and students' judgments of pain intensity correlated highly with pain behavior scores. Therefore, the behavioral observation method holds promise as a reliable, valid measure of pain behavior in a cancer pain population. © 1990 Association for Advancement of Behavior Therapy.

Authors
Ahles, TA; Coombs, DW; Jensen, L; Stukel, T; Maurer, LH; Keefe, FJ
MLA Citation
Ahles, TA, Coombs, DW, Jensen, L, Stukel, T, Maurer, LH, and Keefe, FJ. "Development of a behavioral observation technique for the assessment of pain behaviors in cancer patients." Behavior Therapy 21.4 (1990): 449-460.
Source
scival
Published In
Behavior Therapy
Volume
21
Issue
4
Publish Date
1990
Start Page
449
End Page
460
DOI
10.1016/S0005-7894(05)80358-2

Dimensions of pain-related cognitive coping: Cross-validation of the factor structure of the Coping Strategy Questionnaire

Previous research has demonstrated a relationship between cognitive pain coping activity and adjustment in pain patients. The empirically derived dimensions of coping activity, as measured by scales from the Coping Strategy Questionnaire (CSQ), however, have varied across investigations. The purpose of this investigation was to determine both the content and number of dimensions of the CSQ and to explore the potential moderating influence that sociodemographic and patient history variables may have on the latent structure of the CSQ. A total of 620 patients from 5 different chronic pain patient samples were used to assess the generalizability of the dimensions across samples. Confirmatory factor analytic procedures identified a 3-factor solution in most of the samples that was robust across various demographic characteristics. Two factors appeared particularly robust: one reflected conscious use of cognitive coping strategies (with high loadings on ignoring pain and coping self-statements) and another reflected self-efficacy beliefs concerning pain (with high loadings on ability to control and decrease pain). A third factor, which was somewhat less stable, appeared to reflect avoidance of pain by attention to non-pain-related mental activity (with high loadings on diverting attention and praying and hoping). Scales reflecting catastrophizing cognitions and behavioral coping strategies did not consistently load on the above dimensions. Issues concerning the conceptualization and measurement of pain-related cognitive coping dimensions are discussed.

Authors
Lawson, K; Reesor, KA; Keefe, FJ; Turner, JA
MLA Citation
Lawson, K, Reesor, KA, Keefe, FJ, and Turner, JA. "Dimensions of pain-related cognitive coping: Cross-validation of the factor structure of the Coping Strategy Questionnaire." Pain 43.2 (1990): 195-204.
PMID
2087331
Source
scival
Published In
Pain
Volume
43
Issue
2
Publish Date
1990
Start Page
195
End Page
204

Coping with rheumatoid arthritis pain: catastrophizing as a maladaptive strategy.

The present study examined catastrophizing in rheumatoid arthritis (RA) patients. Subjects were 223 RA patients who were participants in a longitudinal study. Each patient completed the Catastrophizing scale of the Coping Strategies Questionnaire (CSQ) on 2 occasions separated by 6 months (time 1, time 2). The Catastrophizing scale is designed to measure negative self-statements, castastrophizing thoughts and ideation (sample items = 'I worry all the time about whether it will end,' 'It is awful and I feel that it overwhelms me'). Data analysis revealed that the Catastrophizing sc