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Somers, Tamara J.

Overview:

Tamara J. Somers, PhD, is a Clinical Psychologist and an Assistant Professor in the Department of Psychiatry and Behavioral Sciences. Dr. Somers conducts research developing, testing, and implementing behavioral interventions for pain and other symptoms in patients with chronic disease (e.g., cancer, arthritis). She is particularly interested in developing behavioral interventions that are personalized to the needs of individual patients and using innovative delivery methods (mobile health) to deliver the interventions. Grant awards from the NIH, American Cancer Society, and other funding agencies support her research. Dr. Somers also co-directs a clinical psychology training program at the Duke Cancer Institute (DCI) that trains graduate students, clinical psychology interns, and post-doctoral fellows in psychosocial and behavioral symptom management interventions. She is the Director of Research for the Duke Cancer Patient Support Program at DCI. Dr. Somers maintains a small clinical practice at the Duke Faculty Practice at Erwin Square. 

Positions:

Associate Professor of Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2007

Ph.D. — University of Pittsburgh

Grants:

Optimizing Delivery of a Behavioral Cancer Pain Intervention Using a SMART

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal 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
Co-Sponsor
Start Date
July 01, 2017
End Date
June 30, 2020

Behavioral Weight and Symptom Management for Breast Cancer Survivors and Partners

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co-Sponsor
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
Co-Sponsor
Start Date
July 01, 2015
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
Principal 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

SPeeding Research-tested INTerventions (SPRINT)

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Cancer Institute
Role
Principal Investigator
Start Date
March 17, 2017
End Date
June 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
Principal Investigator
Start Date
September 10, 2013
End Date
August 31, 2015
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Publications:

Perceptions of Statin Discontinuation among Patients with Life-Limiting Illness.

Optimal management of chronic medications for patients with life-limiting illness is uncertain. Medication deprescribing may improve outcomes in this population, but patient concerns regarding deprescribing are unclear.The aim of this study was to quantify the perceived benefits and concerns of statin discontinuation among patients with life-limiting illness.Baseline data from a multicenter, pragmatic clinical trial of statin discontinuation were used.Cognitively intact participants with a life expectancy of 1-12 months receiving statin medications for primary or secondary prevention were enrolled.Responses to a 9-item questionnaire addressing patient concerns about discontinuing statins were collected. We used Pearson chi-square tests to compare responses by primary life-limiting diagnosis (cancer, cardiovascular disease, other).Of 297 eligible participants, 58% had cancer, 8% had cardiovascular disease, and 30% other primary diagnoses. Mean (standard deviation) age was 72 (11) years. Fewer than 5% of participants expressed concern that statin deprescribing indicated physician abandonment. About one in five participants reported being told to take statins for the rest of their life (18%) or feeling that discontinuation represented prior wasted effort (18%). Many participants reported benefits of stopping statins, including spending less money on medications (63%), potentially stopping other medications (34%), and having a better quality of life (25%). More participants with cardiovascular disease as a primary diagnosis perceived that quality-of-life benefits related to statin discontinuation (52%) than participants with cancer (27%) or noncardiovascular disease diagnoses (27%) [p = 0.034].Few participants expressed concerns about discontinuing statins; many perceived potential benefits. Cardiovascular disease patients perceived greater potential positive impact from statin discontinuation.

Authors
Tjia, J; Kutner, JS; Ritchie, CS; Blatchford, PJ; Bennett Kendrick, RE; Prince-Paul, M; Somers, TJ; McPherson, ML; Sloan, JA; Abernethy, AP; Furuno, JP
MLA Citation
Tjia, J, Kutner, JS, Ritchie, CS, Blatchford, PJ, Bennett Kendrick, RE, Prince-Paul, M, Somers, TJ, McPherson, ML, Sloan, JA, Abernethy, AP, and Furuno, JP. "Perceptions of Statin Discontinuation among Patients with Life-Limiting Illness." Journal of palliative medicine 20.10 (October 2017): 1098-1103.
PMID
28520522
Source
epmc
Published In
Journal of Palliative Medicine
Volume
20
Issue
10
Publish Date
2017
Start Page
1098
End Page
1103
DOI
10.1089/jpm.2016.0489

Effects of a Telephone- and Web-based Coping Skills Training Program Compared to an Education Program for Survivors of Critical Illness and Their Family Members: A Randomized Clinical Trial.

Many survivors of critical illness and their family members experience significant psychological distress after discharge.To compare effects of a coping skills training (CST) program with an education program on patient and family psychological distress.In this 5-center clinical trial, adult patients who received mechanical ventilation >48 hours and one family member of each patient were randomized to six weekly CST telephone sessions plus access to a study website or a critical illness education program.The primary outcome was the patient Hospital Anxiety and Depression Scale (HADS) at 3 months. Secondary outcomes included 3- and 6-month HADS subscales and the Impact of Events Scale-Revised. Among the 175 patients randomized to CST (n=86) or education (n=89), there was no significant difference between CST and education in either 3-month HADS scores (difference 1.3 [95% CI: -0.9, 3.4], p=0.24) or secondary patient and family outcomes. In pre-specified analyses, among patients with high baseline distress (n=60), CST recipients had greater improvement in 6-month HADS score (difference -4.6, [95% CI: -8.6, -0.6], p=0.02) than education. Among patients ventilated >7 days (n=47), education recipients had greater improvement in 3-month HADS score (difference -4.0 [95% CI: -8.1,-0.05] p=0.047) than CST.CST did not improve psychological distress symptoms compared to an education program. However, CST improved symptoms of distress at 6 months among patients with high baseline distress while the education program improved distress at 3 months among those ventilated for >7 days. Future efforts to address psychological distress among critical illness survivors should target high-risk populations. Clinical trial registration available at www.clinicaltrials.gov, ID NCT0198325.

Authors
Cox, CE; Hough, CL; Carson, SS; White, DB; Kahn, JM; Olsen, MK; Jones, DM; Somers, TJ; Kelleher, SA; Porter, LS
MLA Citation
Cox, CE, Hough, CL, Carson, SS, White, DB, Kahn, JM, Olsen, MK, Jones, DM, Somers, TJ, Kelleher, SA, and Porter, LS. "Effects of a Telephone- and Web-based Coping Skills Training Program Compared to an Education Program for Survivors of Critical Illness and Their Family Members: A Randomized Clinical Trial." American journal of respiratory and critical care medicine (September 5, 2017).
PMID
28872898
Source
epmc
Published In
American journal of respiratory and critical care medicine
Publish Date
2017
DOI
10.1164/rccm.201704-0720oc

Optimizing delivery of a behavioral pain intervention in cancer patients using a sequential multiple assignment randomized trial SMART.

Pain is common in cancer patients and results in lower quality of life, depression, poor physical functioning, financial difficulty, and decreased survival time. Behavioral pain interventions are effective and nonpharmacologic. Traditional randomized controlled trials (RCT) test interventions of fixed time and dose, which poorly represent successive treatment decisions in clinical practice. We utilize a novel approach to conduct a RCT, the sequential multiple assignment randomized trial (SMART) design, to provide comparative evidence of: 1) response to differing initial doses of a pain coping skills training (PCST) intervention and 2) intervention dose sequences adjusted based on patient response. We also examine: 3) participant characteristics moderating intervention responses and 4) cost-effectiveness and practicality.Breast cancer patients (N=327) having pain (ratings≥5) are recruited and randomly assigned to: 1) PCST-Full or 2) PCST-Brief. PCST-Full consists of 5 PCST sessions. PCST-Brief consists of one 60-min PCST session. Five weeks post-randomization, participants re-rate their pain and are re-randomized, based on intervention response, to receive additional PCST sessions, maintenance calls, or no further intervention. Participants complete measures of pain intensity, interference and catastrophizing.Novel RCT designs may provide information that can be used to optimize behavioral pain interventions to be adaptive, better meet patients' needs, reduce barriers, and match with clinical practice. This is one of the first trials to use a novel design to evaluate symptom management in cancer patients and in chronic illness; if successful, it could serve as a model for future work with a wide range of chronic illnesses.

Authors
Kelleher, SA; Dorfman, CS; Plumb Vilardaga, JC; Majestic, C; Winger, J; Gandhi, V; Nunez, C; Van Denburg, A; Shelby, RA; Reed, SD; Murphy, S; Davidian, M; Laber, EB; Kimmick, GG; Westbrook, KW; Abernethy, AP; Somers, TJ
MLA Citation
Kelleher, SA, Dorfman, CS, Plumb Vilardaga, JC, Majestic, C, Winger, J, Gandhi, V, Nunez, C, Van Denburg, A, Shelby, RA, Reed, SD, Murphy, S, Davidian, M, Laber, EB, Kimmick, GG, Westbrook, KW, Abernethy, AP, and Somers, TJ. "Optimizing delivery of a behavioral pain intervention in cancer patients using a sequential multiple assignment randomized trial SMART." Contemporary clinical trials 57 (June 2017): 51-57.
PMID
28408335
Source
epmc
Published In
Contemporary Clinical Trials
Volume
57
Publish Date
2017
Start Page
51
End Page
57
DOI
10.1016/j.cct.2017.04.001

Cognitive problems following hematopoietic stem cell transplant: relationships with sleep, depression and fatigue.

Cognitive problems are a significant, persistent concern for patients undergoing hematopoietic stem cell transplant (HSCT). Sleep is important for many cognitive tasks; however, the relationship between sleep and cognitive problems for HSCT patients is unknown. This study examined the relationship between sleep and cognitive problems for HSCT patients from pre to post transplant. Patients undergoing HSCT (N=138) completed questionnaires at pre-transplant and during the 12 months following transplant. Questionnaires assessed sleep and cognitive problems as well as commonly co-occurring symptoms: depressive symptoms, fatigue and pain. Post hoc analyses examined the relationship of specific sleep problems with cognitive problems. Sleep problems covaried with cognitive problems even after controlling for depressive symptoms, fatigue and pain. Depressive symptoms and fatigue were also uniquely related to cognitive problems. Post hoc analyses suggest that sleep somnolence, shortness of breath, snoring and perceptions of inadequate sleep may contribute to the association found between sleep and cognitive problems. Findings suggest that sleep problems are associated with and may contribute to cognitive problems for HSCT patients. However, sleep problems are rarely screened for or discussed during clinic visits. Assessing and treating specific sleep problems in addition to depressive symptoms and fatigue may have implications for improving cognitive problems for HSCT patients.

Authors
Ghazikhanian, SE; Dorfman, CS; Somers, TJ; O'Sullivan, ML; Fisher, HM; Edmond, SN; Wren, AA; Kelleher, SA; Rowe Nichols, KA; Chao, N; Shelby, RA
MLA Citation
Ghazikhanian, SE, Dorfman, CS, Somers, TJ, O'Sullivan, ML, Fisher, HM, Edmond, SN, Wren, AA, Kelleher, SA, Rowe Nichols, KA, Chao, N, and Shelby, RA. "Cognitive problems following hematopoietic stem cell transplant: relationships with sleep, depression and fatigue." Bone marrow transplantation 52.2 (February 2017): 279-284.
PMID
27941775
Source
epmc
Published In
Bone Marrow Transplantation
Volume
52
Issue
2
Publish Date
2017
Start Page
279
End Page
284
DOI
10.1038/bmt.2016.248

Using Patient Reported Outcomes in Oncology Clinical Practice.

Patient reported outcomes (PROs) are increasingly being implemented into the care of patients with cancer. The use of a standard set of PROs (e.g., pain) in cancer is becoming established and there is interest in what additional PROs might provide valuable information. The goal of this observational study was to examine how the PROs of self-efficacy for pain and other symptoms assessed at the point of service were associated with pain, symptom severity and distress, and physical and psychosocial functioning in a sample of breast and gastrointestinal patients. We also sought to examine differences in these relationships by cancer type (breast and gastrointestinal) as well as understand differences in self-assessment mode (paper/pencil or electronic tablet).178 patients with breast (n=65) and gastrointestinal cancer (n = 113) completed the Chronic Pain Self Efficacy Scale, M.D. Anderson Symptom Inventory, and Functional Assessment of Cancer Therapy-General questionnaires. Measures were completed with paper and pencil and electronically using a tablet computer while patients waited for their clinical appointment. Responses from the initial completed questionnaires on both the paper and electronic instruments were analyzed.Patients' self-efficacy scores for pain and other symptoms correlated positively with pain, symptom severity and distress, and physical and psychosocial functioning; patients with lower levels of self-efficacy reported poorer outcomes and functioning overall. The results were independent of cancer type and mode of assessment. No statistically significant differences were found in the PROs when collected by electronic technology versus paper-pencil mode; patients were very satisfied with using the tablet computer to complete the PRO measures.Our results suggest that self-efficacy for pain and symptom management may be a beneficial addition to clinic-based PRO assessment batteries for patients with cancer and other chronic diseases. Existing short, validated symptom self-efficacy scales could easily be integrated into clinical practice to help healthcare providers identify patients that might benefit from intervention. Study results also support existing research that suggests electronic approaches are a practical way to collect PRO data, including self-efficacy data, in the clinic. Overall, our data suggest that patients who have particularly low levels of self-efficacy for pain and symptom management may be at risk for higher levels of pain and disability. Thus, if self-efficacy for pain and symptom management were routinely collected at the time of clinical service, psychosocial interventions to improve self-efficacy for pain and symptom management, and in turn overall quality of life, could be implemented in a timely fashion.

Authors
Kelleher, SA; Somers, TJ; Locklear, T; Crosswell, AD; Abernethy, AP
MLA Citation
Kelleher, SA, Somers, TJ, Locklear, T, Crosswell, AD, and Abernethy, AP. "Using Patient Reported Outcomes in Oncology Clinical Practice." Scandinavian journal of pain 13 (October 2016): 6-11.
PMID
27818717
Source
epmc
Published In
Scandinavian Journal of Pain
Volume
13
Publish Date
2016
Start Page
6
End Page
11
DOI
10.1016/j.sjpain.2016.05.035

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

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

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

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

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

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

Retaining critical therapeutic elements of behavioral interventions translated for delivery via the Internet: recommendations and an example using pain coping skills training.

Evidence supporting the efficacy of behavioral interventions based on principles of cognitive behavioral therapies has spurred interest in translating these interventions for delivery via the Internet. However, the benefits of this dissemination method cannot be realized unless the translated interventions are as effective as possible. We describe a challenge that must be overcome to ensure this occurs--Internet interventions must retain therapeutic components and processes underlying the success of face-to-face interventions on which they are based. These components and processes vary in the ease with which they can be translated to the online environment. Moreover, some are subtle and may be overlooked, despite being recognized as essential to the success of face-to-face interventions. We provide preliminary guidance for retaining critical therapeutic components and processes in the translation process, using Pain Coping Skills Training for osteoarthritis pain to illustrate methods. Directions for future research are also discussed.

Authors
Rini, C; Porter, LS; Somers, TJ; McKee, DC; Keefe, FJ
MLA Citation
Rini, C, Porter, LS, Somers, TJ, McKee, DC, and Keefe, FJ. "Retaining critical therapeutic elements of behavioral interventions translated for delivery via the Internet: recommendations and an example using pain coping skills training." Journal of medical Internet research 16.12 (December 19, 2014): e245-.
PMID
25532216
Source
epmc
Published In
Journal of Medical Internet Research
Volume
16
Issue
12
Publish Date
2014
Start Page
e245
DOI
10.2196/jmir.3374

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

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

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

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

COGNITIVE PROBLEMS IN SCT PATIENTS THREE MONTHS POST-TRANSPLANT: ASSOCIATED PSYCHOSOCIAL FACTORS

Authors
Edmond, SN; O'Sullivan, ML; Somers, TJ; Rowe, K; Shelby, RA
MLA Citation
Edmond, SN, O'Sullivan, ML, Somers, TJ, Rowe, K, and Shelby, RA. "COGNITIVE PROBLEMS IN SCT PATIENTS THREE MONTHS POST-TRANSPLANT: ASSOCIATED PSYCHOSOCIAL FACTORS." ANNALS OF BEHAVIORAL MEDICINE 47 (April 2014): S102-S102.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
47
Publish Date
2014
Start Page
S102
End Page
S102

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

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

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

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

The context of pain in arthritis: self-efficacy for managing pain and other symptoms.

Arthritis pain may be best understood in the context of a biospychosocial model of pain. The biopsychosocial model of pain suggests that adjustment to arthritis pain is multifaceted and is influenced by biological, psychological, and social factors. One psychological construct that appears to be particularly helpful in understanding arthritis pain is patients' self-efficacy for managing pain and other symptoms. In recent work, investigators have included self-efficacy for managing pain and other symptoms as key outcome measures in behavioral and psychosocial intervention studies. The goal of this article was to review recent intervention studies that have examined the effect of behavioral and psychosocial interventions on self-efficacy for managing pain and other symptoms. Throughout the article, we make several suggestions for future clinical and research considerations regarding the role of self-efficacy for managing pain and other symptoms in the context of arthritis pain.

Authors
Somers, TJ; Wren, AA; Shelby, RA
MLA Citation
Somers, TJ, Wren, AA, and Shelby, RA. "The context of pain in arthritis: self-efficacy for managing pain and other symptoms." Curr Pain Headache Rep 16.6 (December 2012): 502-508. (Review)
PMID
23054977
Source
pubmed
Published In
Current Pain and Headache Reports
Volume
16
Issue
6
Publish Date
2012
Start Page
502
End Page
508
DOI
10.1007/s11916-012-0298-3

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

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

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

ELECTRONIC PATIENT REPORTED OUTCOMES (EPRO) TO GUIDE THE IMPLEMENTATION OF BEHAVIORAL CANCER PAIN INTERVENTIONS

Authors
Somers, TJ; Keefe, FJ; Abernethy, A
MLA Citation
Somers, TJ, Keefe, FJ, and Abernethy, A. "ELECTRONIC PATIENT REPORTED OUTCOMES (EPRO) TO GUIDE THE IMPLEMENTATION OF BEHAVIORAL CANCER PAIN INTERVENTIONS." ANNALS OF BEHAVIORAL MEDICINE 43 (April 2012): S222-S222.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
43
Publish Date
2012
Start Page
S222
End Page
S222

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

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

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

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

SELF-COMPASSION IN PATIENTS WHO ARE OBESE AND HAVE PERSISTENT MUSCULOSKELETAL PAIN: RELATIONSHIP OF SELF-COMPASSION TO PAIN- AND WEIGHT-RELATED FACTORS

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 WHO ARE OBESE AND HAVE PERSISTENT MUSCULOSKELETAL PAIN: RELATIONSHIP OF SELF-COMPASSION TO PAIN- AND WEIGHT-RELATED FACTORS." ANNALS OF BEHAVIORAL MEDICINE 41 (April 2011): S217-S217.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
41
Publish Date
2011
Start Page
S217
End Page
S217

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

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

PERCEIVED RISK OF BREAST CANCER, BELIEFS ABOUT MAMMOGRAPHY, AND PSYCHOLOGICAL DISTRESS IN BREAST CANCER SURVIVORS AND HEALTHY WOMEN AT THE TIME OF MAMMOGRAPHY

Authors
Shelby, RA; Keefe, FJ; Bovbjerg, DH; Skinner, CS; Somers, TJ; Soo, MS; Red, S; Stinnett, S; Luce, MF; Sumkin, J
MLA Citation
Shelby, RA, Keefe, FJ, Bovbjerg, DH, Skinner, CS, Somers, TJ, Soo, MS, Red, S, Stinnett, S, Luce, MF, and Sumkin, J. "PERCEIVED RISK OF BREAST CANCER, BELIEFS ABOUT MAMMOGRAPHY, AND PSYCHOLOGICAL DISTRESS IN BREAST CANCER SURVIVORS AND HEALTHY WOMEN AT THE TIME OF MAMMOGRAPHY." INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE 17 (August 2010): 278-278.
Source
wos-lite
Published In
International Journal of Behavioral Medicine
Volume
17
Publish Date
2010
Start Page
278
End Page
278

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

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

PAIN IN SOCIAL CONTEXT: PAIN AND FUNCTIONING OF RHEUMATOID ARTHRITIS PATIENTS BASED ON MARITAL STATUS AND MARITAL ADJUSTMENT

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 IN SOCIAL CONTEXT: PAIN AND FUNCTIONING OF RHEUMATOID ARTHRITIS PATIENTS BASED ON MARITAL STATUS AND MARITAL ADJUSTMENT." ANNALS OF BEHAVIORAL MEDICINE 39 (April 2010): 150-150.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
39
Publish Date
2010
Start Page
150
End Page
150

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

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

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

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

Cancer genetics service interest in women with a limited family history of breast cancer.

Women with a limited family history of breast cancer may be interested in cancer genetics information although their objective risk of breast cancer may not indicate routine referral to cancer genetics services. This study examined factors related to interest and use of cancer genetics services in a community sample of women with a limited family history of breast cancer (N = 187) who had no previous contact with cancer genetics services. Participants provided demographic information and ratings of perceived risk, cancer distress, attitudes, and intentions to initiate cancer genetics services. Participants were given information about a cancer genetics clinic that served women having concerns about their breast cancer risk. Women were contacted within 6 weeks and 8 months following their study appointment. Six weeks following their study appointment, 25% of women had initiated cancer genetics services. Eight months following their study appointment, 18% of women reported having completed a cancer genetics service appointment. Baseline intentions independently predicted both initiation at 6 weeks and appointment at 8 months. Cancer distress was positively associated with cancer genetics service initiation and appointment. Results suggest that some women with a limited family history of breast cancer are interested in seeking out cancer genetics information. Women with a limited family history of breast cancer may benefit from the availability of cancer genetics information provided through primary healthcare settings.

Authors
Somers, TJ; Michael, JC; Klein, WMP; Baum, A
MLA Citation
Somers, TJ, Michael, JC, Klein, WMP, and Baum, A. "Cancer genetics service interest in women with a limited family history of breast cancer." J Genet Couns 18.4 (August 2009): 339-349.
PMID
19440660
Source
pubmed
Published In
Journal of Genetic Counseling
Volume
18
Issue
4
Publish Date
2009
Start Page
339
End Page
349
DOI
10.1007/s10897-009-9224-1

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

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

Coping with genetic testing for breast cancer susceptibility

OBJECTIVE:: To examine how women cope with genetic testing for heightened susceptibility to breast cancer. METHODS:: Participants were 126 White women (age = 44 ± 9 years) who were participants in a larger study of genetic testing for risk of different chronic diseases. All women were at higher-than-average risk for breast cancer due to a personal and/or family history and were considering genetic testing. Distress (Symptom Checklist-90-Revised, Impact of Event Scale, Perceived Stress Scale, Spielberger State-Trait Anxiety Inventory, and the Center for Epidemiological Studies Depression Scale) was assessed at four assessments; one before and three after the decision to have genetic testing. The majority of women (n = 100) had testing. The follow-up assessments occurred at 1 week after receiving results (or 3-4 months after baseline if testing was not elected), and then at 3 and 6 months after the second assessment. Coping (Brief COPE) was measured at the first and third assessments. RESULTS:: Coping was relatively stable over time and did not vary as a function of genetic test results. Active coping strategies were used more often by women with a personal cancer history than by women without cancer. Use of avoidant coping was reliably and positively associated with distress over time independent of cancer history and test result. CONCLUSIONS:: The identification of specific coping styles that were associated with more or less distress is useful as a means of identifying and targeting coping interventions and predicting which participants may be at risk for distress. Copyright © 2009 by the American Psychosomatic Society.

Authors
Dougall, AL; Smith, AW; Somers, TJ; Posluszny, DM; Rubinstein, WS; Baum, A
MLA Citation
Dougall, AL, Smith, AW, Somers, TJ, Posluszny, DM, Rubinstein, WS, and Baum, A. "Coping with genetic testing for breast cancer susceptibility." Psychosomatic Medicine 71.1 (2009): 98-105.
PMID
19124622
Source
scival
Published In
Psychosomatic Medicine
Volume
71
Issue
1
Publish Date
2009
Start Page
98
End Page
105
DOI
10.1097/PSY.0b013e318190d7b4

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 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

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

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

Psychological distress and quality of life associated with genetic testing for breast cancer risk

This study investigated short- and long-term psychological outcomes associated with BRCA1/2 genetic testing in women with a personal or family history of breast cancer. Participants included 126 women considering genetic testing. Questionnaires were administered prior to testing, one week, three and six months after result disclosure. Results indicated no systematic effects of testing based on personal cancer history. Mutation carriers and women who elected not to be tested reported greater perceived risk and intrusive and avoidant thoughts at follow-up time points than did women who received negative (uninformative) or variant results. Mutation carriers reported more distress at the three-month follow-up but by six months the effects of test result on distress dissipated and groups were comparable. Cluster analyses identified two groups of individuals based on distress at baseline; these groups were used to predict psychological outcomes after testing. Distress remained constant in both groups: those who were high at baseline remained high and those who were low remained low. Test results did not moderate this effect. Results suggest that genetic testing for BRCA1/2 does not increase distress or have deleterious effects on quality of life over the long term. However, sub-groups of women may report more distress over time. These data indicate the need for more targeted counseling to individuals who report high levels of distress when considering genetic testing. Copyright © 2007 John Wiley & Sons, Ltd.

Authors
Smith, AW; Dougall, AL; Posluszny, DM; Somers, TJ; Rubinstein, WS; Baum, A
MLA Citation
Smith, AW, Dougall, AL, Posluszny, DM, Somers, TJ, Rubinstein, WS, and Baum, A. "Psychological distress and quality of life associated with genetic testing for breast cancer risk." Psycho-Oncology 17.8 (2008): 767-773.
PMID
17992698
Source
scival
Published In
Psycho-Oncology
Volume
17
Issue
8
Publish Date
2008
Start Page
767
End Page
773
DOI
10.1002/pon.1291

Avoidance behavior in panic disorder: The moderating influence of perceived control

The relations among anxiety sensitivity, perceived control, and agoraphobia were examined in 239 patients diagnosed with panic disorder (PD). Most patients exhibited agoraphobia accompanying their PD (98% situational avoidance; 90% experiential avoidance; and 80% endorsed interoceptive fear and avoidance). Anxiety sensitivity and perceived emotional control were associated with agoraphobia, and perceived threat control was found to moderate the relationship between anxiety sensitivity and agoraphobia. Lower levels of perceived control were associated with a stronger relationship between anxiety sensitivity and agoraphobia. Results were consistent for self-reported and clinician-rated agoraphobia. Implications for the role of perceived control in agoraphobia development and treatment are discussed. © 2005 Elsevier Ltd. All rights reserved.

Authors
White, KS; Brown, TA; Somers, TJ; Barlow, DH
MLA Citation
White, KS, Brown, TA, Somers, TJ, and Barlow, DH. "Avoidance behavior in panic disorder: The moderating influence of perceived control." Behaviour Research and Therapy 44.1 (2006): 147-157.
PMID
16300725
Source
scival
Published In
Behaviour Research and Therapy
Volume
44
Issue
1
Publish Date
2006
Start Page
147
End Page
157
DOI
10.1016/j.brat.2005.07.009

Posttraumatic stress associated with cancer history and BRCA1/2 genetic testing

Objective: A subset of women who are at elevated cancer risk due to family history exhibit evidence of cancer-specific distress. These stress responses may represent symptoms of posttraumatic stress disorder (PTSD). The present study assessed rates of PTSD related to personal or family cancer history and BRCA1/2 testing. Methods: Participants were 84 women enrolled in a larger project focused on genetic testing decisions. Semistructured diagnostic interviews were used to identify instances of threshold and subthreshold PTSD. Results: Results indicated that 16.7% of the women reported current threshold or subthreshold PTSD related to personal or family cancer history. An additional 26.2% reported past-only cancer-related threshold or subthreshold PTSD. Of the 65 women who received BRCA1/2 results and completed the test-related PTSD module, only 7.7% reported threshold or subthreshold PTSD related to the genetic testing process. However, when rates were examined based on carrier status, 25.0% of BRCA1/2 carriers reported test-related threshold or subthreshold PTSD compared with only 10.0% of variants and 2.3% of noncarriers. Conclusions: Results from this study suggest that both personal and family cancer diagnoses can be significant stressors for a subset of high-risk women. Rates of threshold and subthreshold PTSD related to genetic testing appear to be less common, although carriers may be at higher risk for significant posttraumatic symptoms. Copyright © 2005 by the American Psychosomatic Society.

Authors
Hamann, HA; Somers, TJ; Smith, AW; Inslicht, SS; Baum, A
MLA Citation
Hamann, HA, Somers, TJ, Smith, AW, Inslicht, SS, and Baum, A. "Posttraumatic stress associated with cancer history and BRCA1/2 genetic testing." Psychosomatic Medicine 67.5 (2005): 766-772.
PMID
16204436
Source
scival
Published In
Psychosomatic Medicine
Volume
67
Issue
5
Publish Date
2005
Start Page
766
End Page
772
DOI
10.1097/01.psy.0000181273.74398.d7
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