scholarly journals Dialectical Pain Management: Feasibility of a Hybrid Third-Wave Cognitive Behavioral Therapy Approach for Adults Receiving Opioids for Chronic Pain

Pain Medicine ◽  
2020 ◽  
Author(s):  
Deborah Barrett ◽  
Carrie E Brintz ◽  
Amanda M Zaski ◽  
Mark J Edlund
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Pain Management ◽  
Dialectical Behavior Therapy ◽  
Emotion Dysregulation ◽  
Qualitative Interviews ◽  
Self Report ◽  
Control Group ◽  
Global Rating ◽  
Pain Acceptance

Abstract Objectives This study evaluated the feasibility, acceptability, and potential effectiveness of a hybrid skills-based group intervention, dialectical pain management (DPM), for adults with chronic pain who are receiving long-term opioid therapy. DPM adapts dialectical behavior therapy, a rigorous psychotherapeutic approach to emotion dysregulation, to treat disorders of physiological dysregulation. Methods Individuals with chronic pain (N = 17) participated in one of two 8-week DPM intervention cohorts. At pre-test and post-test, participants completed quantitative self-report assessments measuring pain intensity and interference, depressive symptoms, pain acceptance, beliefs about pain medications, and global rating of change. Within 2 weeks after the intervention, participants completed qualitative interviews to assess participant satisfaction and obtain feedback about specific intervention components. Results Of the 17 enrolled, 15 participants completed the group with 12 (70%) attending six or more sessions. Participants reported high satisfaction with the intervention. Preliminary findings suggested a significant increase in pain acceptance and a significant reduction in depressive symptoms. Participants also reported an improved relationship with their pain conditions and increased flexibility in responding to pain and applying coping skills. Several participants showed a reduction in opioid dosage over the course of the intervention. Discussion Findings support that DPM is a feasible and well-received intervention for individuals with chronic pain. Additional research with a control group is needed to further determine the intervention’s efficacy and impact.

scholarly journals Educating Physicians in Family Medicine Residencies About Nonpharmacologic Approaches to Pain:

2020 ◽  
Vol 52 (3) ◽  
pp. 189-197
Author(s):  
Ann Marie Chiasson ◽  
Audrey J. Brooks ◽  
Mari Ricker ◽  
Patricia Lebensohn ◽  
Mei-Kuang Chen ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Family Medicine ◽  
Self Efficacy ◽  
Medical Knowledge ◽  
Primary Care Providers ◽  
Control Group ◽  
Chronic Pain Management ◽  
Care Providers ◽  
Pain Patients

Background and Objectives: Opioid misuse is at an all-time crisis level, and nationally enhanced resident and clinician education on chronic pain management is in demand. To date, broad-reaching, scalable, integrative pain management educational interventions have not been evaluated for effectiveness on learner knowledge or attitudes toward chronic pain management. Methods: An 11-hour integrative pain management (IPM) online course was evaluated for effect on resident and faculty attitudes toward and knowledge about chronic pain. Participants were recruited from family medicine residencies participating in the integrative medicine in residency program. Twenty-two residencies participated, with 11 receiving the course and 11 serving as a control group. Evaluation included pre/post medical knowledge and validated measures of attitude toward pain patients, self-efficacy for nondrug therapies, burnout, and compassion. Results: Forty-three participants (34.4%) completed the course. The intervention group (n=50), who received the course, improved significantly (P<.05) in medical knowledge, attitude toward pain patients, and self-efficacy to prescribe nondrug therapies while the control group (n=54) showed no improvement. There was no effect on burnout or compassion for either group. The course was positively evaluated, with 83%-94% rating the course content and delivery very high. All participants responded that they would incorporate course information into practice, and almost all thought what they learned in the course would improve patient care (98%). Conclusions: Our findings demonstrate the feasibility of an online IPM course as an effective and scalable intervention for residents and primary care providers in response to the current opioid crisis and need for better management of chronic pain. Future directions include testing scalability in formats that lead to improved completion rates, implementation in nonacademic settings, and evaluation of clinical outcomes such as decreased opioid prescribing.

Implementation of a Brief Dialectical Behavioral Therapy (DBT) Skills Group in High Schools for At-Risk Youth: Going 4 Goals Protocol (Preprint)

2021 ◽  
Author(s):  
Tamika Zapolski ◽  
MacKenzie Whitener ◽  
Shirin Khazvand ◽  
Queenisha Crichlow ◽  
Rebecca Revilla ◽  
...  
Keyword(s):  
High School Students ◽  
Risk Taking ◽  
Emotion Dysregulation ◽  
Qualitative Interviews ◽  
Risky Behaviors ◽  
Control Group ◽  
School Students ◽  
Post Intervention ◽  
Skills Group ◽  
Risk Taking Behaviors

BACKGROUND Adolescence is a developmental period marked by engaging in risk-taking behaviors, with higher risk among youth who are impulsive or emotionally dysregulated. Thus, interventions that teach skills to reduce the risk for negative outcomes as a consequence of dysregulation are needed. Social and Emotional Learning (SEL) programs have been developed to address both adolescent emotion dysregulation and risk-taking behaviors. However, current programs have mostly been implemented among younger youth and have rarely been empirically evaluated for their effectiveness among high school students. OBJECTIVE The primary outcomes of the study are to test whether participating in the skills group intervention produces significant increases in the core DBT-A skills of mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness while also producing significant decreases in substance use and risky behaviors. These primary outcomes are based on changes in participant scores between baseline and post-intervention, as well as follow-ups at 1, 3, and 6 months in comparison to a control group of youth who are participating in the school’s health curriculum at the same time points. A secondary objective of this study is to also examine the acceptability, facilitators and barriers of the intervention through qualitative interviews with intervention participants and school staff. The current paper describes the protocol of the 9 session school-based adaptation of the DBT-A intervention and discussion of the strengths and limitations of the study, as well as future directions. METHODS N/A RESULTS N/A CONCLUSIONS N/A

Emotion dysregulation, temperamental vulnerability, and parental depression in adolescents: Correspondence between physiological and informant-report measures

2019 ◽  
Vol 31 (3) ◽  
pp. 1023-1035 ◽  
Author(s):  
Marie-Lotte Van Beveren ◽  
Sven C. Mueller ◽  
Caroline Braet
Keyword(s):  
Emotion Regulation ◽  
Depressive Symptoms ◽  
Emotion Dysregulation ◽  
Parent Report ◽  
Self Report ◽  
Sinus Arrhythmia ◽  
Parental Depressive Symptoms ◽  
Emotional Responding ◽  
Adolescents And Adults ◽  
Regulation Strategies

AbstractAlthough numerous studies reveal altered respiratory sinus arrhythmia (RSA) among children, adolescents, and adults who exhibit emotion dysregulation, effects of temperamental vulnerability and parental mental health on RSA remain unclear. We evaluated the relationship among emotion regulation, RSA, and RSA reactivity in a pooled sample of 24 vulnerable and 31 resilient adolescents (mean age = 13.69 years; 60% girls), including associations with temperamental vulnerability and parental depressive symptoms. Participants watched a neutral film clip while their resting RSA was recorded, and then completed a reward and frustration task, using an affective Posner paradigm. Temperament and emotion regulation were assessed via self-report and parent report, and parents reported on their own depressive symptoms. Low resting RSA was associated with temperamental negative emotionality, whereas greater RSA reactivity to frustration was associated with maladaptive emotion regulation strategies. No significant relations were found between RSA and parental depressive symptoms. This study elucidates the role of RSA as a biomarker of individual differences in emotion dysregulation and temperamental vulnerability and stresses the importance of considering multiple units of analyses, as well as functional domains, when studying emotional responding and regulation in adolescents.

Depressive symptoms and pain evaluations among persons with chronic pain: Catastrophizing, but not pain acceptance, shows significant effects

Pain ◽  
2009 ◽  
Vol 147 (1) ◽  
pp. 147-152 ◽  
Author(s):  
Elizabeth J. Richardson ◽  
Timothy J. Ness ◽  
Daniel M. Doleys ◽  
James H. Baños ◽  
Leanne Cianfrini ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Pain Catastrophizing ◽  
Pain Acceptance

Effects of Eight-Week-Web-Based Mindfulness Training on Pain Intensity, Pain Acceptance, and Life Satisfaction in Individuals With Chronic Pain

2016 ◽  
Vol 119 (3) ◽  
pp. 586-607 ◽  
Author(s):  
Jessica Henriksson ◽  
Emma Wasara ◽  
Michael Rönnlund
Keyword(s):  
Chronic Pain ◽  
Life Satisfaction ◽  
Treatment Group ◽  
Pain Intensity ◽  
Mindfulness Training ◽  
Control Group ◽  
Web Based ◽  
Pain Acceptance ◽  
Mindfulness Skills ◽  
Online Discussion Forum

This study examined the effects of an eight-week-web-based mindfulness program designed for individuals with chronic pain. A sample of 107 participants with chronic pain ( M = 51.0 years, SD = 9.3) were randomly assigned to a treatment group and a control group. The mindfulness program involved 20 minutes of training per day, six days a week, for eight weeks. During this period, the control group was invited to an online discussion forum involving pain-related topics. A total of 77 participants completed the postintervention assessment ( n = 36 in the treatment group, n = 41 in the control group). The group assigned to mindfulness training showed increased mindfulness skills (Cohen’s d = 1.18), reduced pain intensity ( d = 0.47–0.82), reduced pain-related interference/suffering ( d = 0.39–0.85), heightened pain acceptance ( d = 0.66), reduced affective distress ( d = 0.67), and higher ratings of life satisfaction ( d = 0.54) following the training with no or minor changes up for the control group ( d values 0.01–0.23), a pattern substantiated by significant group-by-time interactions. Despite limitations of this study, including a less than ideal control group to isolate effects of mindfulness and lack of a long-term follow-up, the results appear promising and may motivate further investigations.

scholarly journals Converging evidence for enduring perceptions of low social status in individuals in remission from depression.

2021 ◽  
Author(s):  
Julia Gillard ◽  
Siobhan Gormley ◽  
Kirsty Griffiths ◽  
Caitlin Hitchcock ◽  
Jason Stretton ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Social Status ◽  
Community Sample ◽  
Self Report ◽  
Control Group ◽  
Social Risk ◽  
History Of ◽  
Mental Health Difficulties ◽  
Depressive Episodes

BackgroundThe risk of depressive relapse and recurrence is amplified by social risk factors including the perception of low social status. MethodsWe aimed to identify enduring difficulties with the perception of social status in a community sample with a self-reported history of mental health difficulties (Study 1) and, more specifically, in individuals in clinical remission from depression, relative to a never-depressed control group, and relative to a group experiencing a current depressive episode (Study 2). ResultsIn Study 1, elevated depressive symptoms were associated with perceptions of low social status which significantly differed between individuals with and without a self-reported history of mental health difficulties. Study 2 found enduring deficits in perceptions of social status in remitted depressed individuals, in the absence of current symptoms. LimitationsWe were unable to discern between historical or current clinical diagnosis in the community sample of Study 1, as we were reliant on self-report. We were unable to explore the effects of medication or causal relationships between depressive symptoms and social status as the studies were cross-sectional in nature. ConclusionsThese findings suggest that disrupted socio-cognitive profiles across a range of affiliative processes may confer increased vulnerability to future depressive episodes in those in remission.

scholarly journals The Effectiveness of Dialectical Behavior Therapy on Sleep Quality and Pain Management in Multiple Sclerosis

2020 ◽  
Vol 6 (4) ◽  
pp. 205-213
Author(s):  
Marie Abdolghaderi ◽  
◽  
Mohammad Narimani ◽  
Akbar Atadokht ◽  
Abbas Abolghasemi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Pain Management ◽  
Sleep Quality ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Common Symptom ◽  
Significant Difference ◽  
And Control

Background: Pain can interfere with the daily functioning of patients with Multiple Sclerosis (MS). Furthermore, sleep disturbance is a common symptom of MS. The dialectical behavior therapy program is presented as a detailed structured treatment program that was demonstrated that has effects on the treatment of psychosomatic disorders such as pain and sleep disorders. Objectives: To investigate the effectiveness of dialectical behavior therapy on sleep quality and pain management in patients with MS. Materials & Methods: This research has been carried out as a quasi-experimental with pretest, posttest, and a control group. A total of 24 people were selected through a convenient sampling method from the patients of the MS-Society of Guilan Province, Iran. Then, they are randomly divided into 2 equal groups (experimental and control). The study data were collected through Pittsburgh sleep quality scale and pain self-efficacy questionnaires. The intervention process was performed for the experimental group as 8 training sessions of 90 minutes long. The obtained data were analyzed by univariate analysis of covariance and multivariate analysis of covariance in SPSS v. 24. Results: The results showed a significant difference between the experimental and control groups in terms of pain management (F=4.04) and sleep quality (F=5.64) (P<0.05) and dialectical behavior therapy had a significant statistical effect on sleep quality and pain management. Conclusion: Based on these findings, dialectical behavior therapy can be used to improve the quality of sleep and manage pain in patients with MS.

Negative Affect, Self-Report of Depressive Symptoms, and Clinical Depression: Relation to the Experience of Chronic Pain

2000 ◽  
Vol 16 (2) ◽  
pp. 110-120 ◽  
Author(s):  
Michael E. Geisser ◽  
Randy S. Roth ◽  
Mary E. Theisen ◽  
Michael E. Robinson ◽  
Joseph L. Riley
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Negative Affect ◽  
Clinical Depression ◽  
Self Report

Pattern of Cumulative Treatment Hours on Pain Impact and PROMIS Outcomes

2021 ◽  
Author(s):  
Hongjin Li ◽  
Diane M Flynn ◽  
Krista B Highland ◽  
Larisa A Burke ◽  
Honor M Mcquinn ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Pain Management ◽  
Pain Treatment ◽  
Additive Models ◽  
Self Report ◽  
Interdisciplinary Treatment ◽  
Additional Patient ◽  
Impact Fatigue ◽  
Interdisciplinary Pain Treatment ◽  
Interdisciplinary Pain Management

ABSTRACT Introduction Participation in interdisciplinary treatments is associated with improvement in pain intensity, physical function, and additional pain-related outcome domains. However, the effect of cumulative treatment hours on outcomes remains unknown among military patients. The present analysis examined the relationship between cumulative interdisciplinary treatment hours and pain management outcomes at a single interdisciplinary pain management center (IPMC). Materials and Methods This is a retrospective observational study of data previously collected as standard of care at the Madigan Army Medical Center, approved by the Institutional Review Board. We included patients who received treatment at the IPMC and completed at least two self-report assessment batteries: one at baseline and at least one between 90 and 180 days after baseline (n = 882). The primary outcome was pain impact. Secondary outcomes included fatigue, depression, anxiety, and sleep-related impairment. Results Generalized additive models indicated that cumulative treatment hours were significantly associated with improvement in pain impact, fatigue, and depression. Patients who had higher baseline pain impact, who had mild or no depressive symptoms, and who were &gt;40 years of age had greater improvements in pain impact following treatment, relative to those with lower pain impact, moderate-to-severe depressive symptoms, and were 40 years of age or younger, respectively. Additional research is needed to elucidate the effect of different therapies and additional patient factors in understanding the “therapeutic dose” of interdisciplinary pain management. Conclusions A higher number of cumulative treatment hours was associated with improvement of pain impact, fatigue, and depression among military personnel receiving interdisciplinary pain treatment. At least 30 hours of sustained interdisciplinary treatment appears to be the threshold for improvement in pain impact and related outcomes.

Efficacy of an online intervention for treatment of depressive disorders: a three-arm randomized controlled trial comparing guided and unguided self-help with waitlist control (Preprint)

2021 ◽  
Author(s):  
Krämer Rico
Keyword(s):  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Depressive Symptomatology ◽  
Controlled Trial ◽  
Intervention Group ◽  
Online Intervention ◽  
Self Report ◽  
Secondary Outcome ◽  
Control Group

BACKGROUND Digital health applications are efficacious treatment options for mild-to-moderate depressive disorders. However, the extent to which psychological guidance increases the efficacy of these applications is controversial. OBJECTIVE We evaluated the efficacy of the online intervention “Selfapy” for unipolar depression. We also investigated differences between a psychotherapist-guided vs. unguided version compared with those from a control group. METHODS A cohort of 401 participants with mild-to-severe depressive disorders were assigned randomly to either participate in a guided version of Selfapy (involving weekly telephone calls of 25-min duration), an unguided version of Selfapy, or to the waiting list (control group). Selfapy is a cognitive behavioral therapy-based intervention for depressive disorders of duration 12 weeks. Symptom assessment was undertaken at T1 (before study entrance), T2 (after 6 weeks), T3 (post-treatment, after 12 weeks), and T4 (follow-up, after 6 months). The main outcome was reduction in depressive symptoms in the Beck Depression Inventory (BDI-II) from T1 to T3. Secondary-outcome parameters were the Quick Inventory of Depressive Symptomatology – Self Report (QIDS-SR 16) and Beck Anxiety Inventory (BAI). RESULTS A total of 297 out of 401 participants (74.06%) completed the post-measurement at T3. In the primary analysis, both intervention groups showed a significantly higher reduction in depressive symptoms (BDI-II) from T1 to T3 compared with that in the control group, with high within-effect sizes (guided: d = 1.46; unguided d = 1.36). No significant differences were found for guided vs. unguided treatment groups. The response rate (BDI-II) for intention-to-treat data in the guided version was 46.4%, 40.0% for the unguided version, and 2.0% in the control group. After 6 months (T4), treatment effects could been maintained for both intervention groups (BDI-II) without differences between either intervention group. CONCLUSIONS Conclusions: Selfapy can help to reduce depressive symptoms in guided or unguided version. Follow-up data suggest that these effects could be maintained. The guided version was not superior to the unguided version. CLINICALTRIAL Trial Registration: Current Controlled Trial DRKS00017191 Date of registration: 14 May 2019 INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1186/s13063-021-05218-4

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