scholarly journals Zur Psychotherapie der MS-Fatigue

2021 ◽  
Vol 27 (01) ◽  
pp. 56-62
Author(s):  
R. Schmidt ◽  
K. Piliavska ◽  
D. Schmid
Keyword(s):  
Chronic Pain ◽  
Life History ◽  
Inflammatory Disease ◽  
Multimodal Treatment ◽  
Interdisciplinary Approach ◽  
Psychological Trauma ◽  
Interdisciplinary Treatment ◽  
Psychosomatic Disorders ◽  
Interdisziplinäres Vorgehen ◽  
Close Relationship

Zusammenfassung Fatigue bei MS ist weit mehr, als der enge Bezug zur entzündlichen Erkrankung und deren direkten biopsychosozialen Folgen nahelegt. In ihrer Vielschichtigkeit ist sie durchaus dem chronischen Schmerz vergleichbar. Spätestens wenn es um die Behandlung geht, ist deshalb ein interdisziplinäres Vorgehen erforderlich, dass das Bedingungsgefüge erfasst, aus dem heraus sich die Fatigue manifestiert. In der daraus resultierenden multimodalen Behandlung kommt der Psychotherapie eine wichtige Rolle zu. Am besten selbst schon wieder multimodal angelegt, gehen ihre – den je individuellen Erfordernissen folgenden – Aufgaben über die Behandlung der Fatigue selbst und begleitender komorbider psychischer und psychosomatischer Störungen hinaus. Hinzu kommt insbesondere die persönliche Neuorientierung Betroffener sowie die Klärung lebensgeschichtlicher Belastungen, vielleicht auch psychischer Traumata und oft weitreichender existentieller Fragen, die in der Fatigue zu einem auch körperlichen Ausdruck kommen können. Psychotherapeutisch fundierte Verständnis- und Handlungsmodelle können schließlich auch einen Beitrag zum Verständnis der Fatigue bei MS und zur Weiterentwicklung angepasster interdisziplinärer Behandlungsangebote leisten. Schlüsselwörter: Bedingungsgefüge, Interdisziplinäre Teamarbeit, Multimodale Psychotherapie, Verkörpertes Leid, MS, Fatigue Abstract Fatigue in MS suggests much more than the close relationship to the inflammatory disease and its direct biopsychosocial consequences. In its complexity, fatigue can be compared to chronic pain. When it comes to treatment, an interdisciplinary approach is required that captures the set of conditions from which fatigue arises. Psychotherapy plays an important role in the resulting multimodal treatment. An individually oriented psychotherapy – preferably multimodal – has to transcend the treatment of fatigue itself and its accompanying comorbid psychological and psychosomatic disorders. In addition, work has to focus on the personal re-orientation of the patient. One must also consider clarifying burdens in the patientʼs life history, including possible psychological trauma and far-reaching existential questions. These can manifest physically and be expressed as fatigue. Finally, psychotherapeutic based models can contribute to the understanding of fatigue in MS, and further the development of adapted interdisciplinary treatment. Keywords: conditional structure, interdisciplinary teamwork, multimodal psychotherapy, embodied suffering

scholarly journals Silencing and Oblivion of Psychological Trauma, Its Unconscious Aspects, and Their Impact on the Inflation of Vajrayāna. An Analysis of Cross-Group Dynamics and Recent Developments in Buddhist Groups Based on Qualitative Data

Religions ◽  
2019 ◽  
Vol 10 (11) ◽  
pp. 622 ◽  
Author(s):  
Anders
Keyword(s):  
Group Dynamics ◽  
Interdisciplinary Approach ◽  
Psychological Trauma ◽  
Ongoing Research ◽  
Psychological Mechanisms ◽  
Teacher Student ◽  
New Concepts ◽  
Recent Developments ◽  
Student Relationship ◽  
The Impact

The commercialization of Buddhist philosophy has led to decontextualization and indoctrinating issues across groups, as well as abuse and trauma in that context. Methodologically, from an interdisciplinary approach, based on the current situation in international Buddhist groups and citations of victims from the ongoing research, the psychological mechanisms of rationalizing and silencing trauma were analyzed. The results show how supposedly Buddhist terminology and concepts are used to rationalize and justify economic, psychological and physical abuse. This is discussed against the background of psychological mechanisms of silencing trauma and the impact of ignoring the unconscious in that particular context. Inadequate consideration regarding the teacher–student relationship, combined with an unreflective use of Tibetan honorary titles and distorted conceptualizations of methods, such as the constant merging prescribed in so-called 'guru yoga', resulted in giving up self-responsibility and enhanced dependency. These new concepts, commercialized as 'karma purification' and 'pure view', have served to rationalize and conceal abuse, as well as to isolate the victims. Therefore, we are facing societal challenges, in terms of providing health and economic care to the victims and implementing preventive measures. This use of language also impacts on scientific discourse and Vajrayāna itself, and will affect many future generations.

Process-outcome associations in an interdisciplinary treatment for chronic pain and comorbid mental disorders based on Acceptance and Commitment Therapy

Pain Medicine ◽  
2021 ◽  
Author(s):  
Ludwig Ohse ◽  
Ronald Burian ◽  
Eric Hahn ◽  
Hannah Burian ◽  
Thi Minh Tam Ta ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Mental Disorders ◽  
Clinical Outcomes ◽  
Acceptance And Commitment Therapy ◽  
Psychological Flexibility ◽  
Post Treatment ◽  
Interdisciplinary Treatment ◽  
Pain Acceptance ◽  
Acceptance And Commitment ◽  
Comorbid Mental Disorders

Abstract Objective Numerous studies support the effectiveness of Acceptance and Commitment Therapy (ACT) for chronic pain, yet little research has been conducted about its underlying mechanisms of change, especially regarding patients with comorbid mental disorders. The present investigation addressed this issue by examining associations of processes targeted by ACT (pain acceptance, mindfulness, psychological flexibility) and clinical outcomes (pain intensity, somatic symptoms, physical health, mental health, depression, general anxiety). Subjects Participants were 109 patients who attended an ACT-based interdisciplinary treatment program for chronic pain and comorbid mental disorders in a routine care psychiatric day hospital. Methods Pre- to post-treatment differences in processes and outcomes were examined with Wilcoxon signed-rank tests and effect size r. Associations between changes in processes and changes in outcomes were analyzed with correlation and multiple regression analyses. Results Pre- to post-treatment effect sizes were mostly moderate to large (r between |0.21| and |0.62|). Associations between changes in processes and changes in outcomes were moderate to large for both, bivariate correlations (r between |0.30| and |0.54|) and shared variances accounting for all three processes combined (R2 between 0.21 and 0.29). Conclusion The present investigation suggests that changes in pain acceptance, mindfulness and psychological flexibility are meaningfully associated with changes in clinical outcomes. It provides evidence on particular process-outcome associations that had not been investigated in this way before. The focus on comorbid mental disorders informs clinicians about a population of chronic pain patients that often has a severe course of illness and has seldom been studied.

Recognizing the Co-occurrence of Chronic Pain and Mental Illness

2020 ◽  
pp. 16-26
Author(s):  
Jan Jaracz
Keyword(s):  
Chronic Pain ◽  
General Population ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Epidemiological Data ◽  
Convincing Evidence ◽  
Medical Problems ◽  
Close Relationship ◽  
Negative Effect ◽  
Irritable Bowel

Epidemiological data regarding chronic pain and psychiatric disorders are reviewed. Particular attention is given to the interplay between pain and depressive and anxiety disorders. In the general population, 19 to 33% of responders report chronic pain, with higher rates in elderly people. Major depression is one of the most common medical problems, affecting nearly 6% of the population, with a lifetime prevalence of 11 to 14%. The presence of depression in persons with chronic pain is significantly higher (21%) than that in the general population, and this proportion is even higher (52–85%) in specific populations of patients attending specialist clinics. Conversely, convincing evidence published in numerous studies has documented that at least 50% of depressed patients report painful symptoms. Pain exerts a negative effect on treatment and a poorer outcome in multiple domains of quality of life. Moreover, pain increases the economic burden resulting from depression. A close relationship between pain and depression has been established in the functional somatic syndromes of fibromyalgia and irritable bowel syndrome. An association between anxiety disorders and pain has also been documented. Epidemiological studies have provided evidence suggesting the common co-occurrence of pain and selected psychiatric disorders. This is an indication for practitioners to examine patients with pain for symptoms of depression and anxiety disorders and conversely to interview patients with psychiatric disorders in regard to the presence or absence of pain. These studies also provide the inspiration for further investigations of the intriguing shared biological basis or pain and psychiatric disorders.

scholarly journals Early Changes in Pain Acceptance Predict Pain Outcomes in Interdisciplinary Treatment for Chronic Pain

2019 ◽  
Vol 8 (9) ◽  
pp. 1373 ◽  
Author(s):  
Probst ◽  
Jank ◽  
Dreyer ◽  
Seel ◽  
Wagner ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Pain Perception ◽  
Rating Scale ◽  
Post Treatment ◽  
Interdisciplinary Treatment ◽  
Binary Logistic Regression Analysis ◽  
Pain Acceptance ◽  
Pain Outcomes ◽  
The Impact

Studies have shown that pain acceptance is associated with a better pain outcome. The current study explored whether changes in pain acceptance in the very early treatment phase of an interdisciplinary cognitive-behavioral therapy (CBT)-based treatment program for chronic pain predict pain outcomes. A total of 69 patients with chronic, non-malignant pain (at least 6 months) were treated in a day-clinic for four-weeks. Pain acceptance was measured with the Chronic Pain Acceptance Questionnaire (CPAQ), pain outcomes included pain intensity (Numeric Rating Scale, NRS) as well as affective and sensory pain perception (Pain Perception Scale, SES-A and SES-S). Regression analyses controlling for the pre-treatment values of the pain outcomes, age, and gender were performed. Early changes in pain acceptance predicted pain intensity at post-treatment measured with the NRS (B = −0.04 (SE = 0.02); T = −2.28; p = 0.026), affective pain perception at post-treatment assessed with the SES-A (B = −0.26 (SE = 0.10); T = −2.79; p = 0.007), and sensory pain perception at post-treatment measured with the SES-S (B = -0.19 (SE = 0.08); T = -2.44; p = 0.017) . Yet, a binary logistic regression analysis revealed that early changes in pain acceptance did not predict clinically relevant pre-post changes in pain intensity (at least 2 points on the NRS). Early changes in pain acceptance were associated with pain outcomes, however, the impact was beneath the threshold defined as clinically relevant.

scholarly journals Online paediatric chronic pain management: assessing the needs of UK adolescents and parents, using a cross-sectional survey

2020 ◽  
pp. 204946372094034
Author(s):  
Anna Hurley-Wallace ◽  
Daniel E Schoth ◽  
Suzanne Lilley ◽  
Glyn Williams ◽  
Christina Liossi
Keyword(s):  
Social Media ◽  
Chronic Pain ◽  
Pain Management ◽  
Online Survey ◽  
Interdisciplinary Treatment ◽  
Future Research ◽  
Chronic Pain Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Social Media Platforms

Background: Adolescent chronic pain is prevalent, and interdisciplinary treatment is recommended. Although it is well known that technology is a key part of adolescents’ daily lives, there have not been any online, interdisciplinary interventions developed for adolescents with chronic pain in a UK healthcare context. Little is known about how adolescents currently use online resources to manage chronic pain, or what guidance they seek. Methods: Ninety-five participants from the community answered this mixed-methods, online survey (adolescent n = 54, parent n = 41), which assessed the needs of UK-based adolescents for a new online chronic pain management resource. Results: Findings indicated that, at the time of the survey, adolescents frequently used social media platforms, such as Instagram, for chronic pain management. Desired techniques for a new interdisciplinary resource for adolescents included ‘advice on explaining chronic pain to others’ (86.7% of adolescents) and sleep hygiene (82.2% of adolescents), though access to a range of pain management techniques was desired. Qualitative results indicated endorsement of a new programme by adolescents and parents. Conclusions: Adolescents and parents had a positive outlook towards the development of a UK-specific online resource to help manage chronic pain. Such an intervention should aim to be made accessible via the National Health Service. Adolescent use of social media platforms to seek support for chronic pain requires further exploration in future research.

Interdisciplinary treatment of chronic pain

2000 ◽  
Vol 4 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Margaret A. Gardea ◽  
Robert J. Gatchel
Keyword(s):  
Chronic Pain ◽  
Interdisciplinary Treatment

The Biopsychosocial Model of the Assessment, Prevention, and Treatment of Chronic Pain

US Neurology ◽  
2016 ◽  
Vol 12 (02) ◽  
pp. 98 ◽  
Author(s):  
Kelley Bevers ◽  
Lynette Watts ◽  
Nancy D Kishino ◽  
Robert J Gatchel ◽  
◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Biopsychosocial Model ◽  
Emotional Reactivity ◽  
Functional Restoration ◽  
Interdisciplinary Treatment ◽  
Specific Patient ◽  
Increased Risk ◽  
Prevention And Treatment ◽  
Pain Patients

The biopsychosocial model has been demonstrated to be the most heuristic approach to chronic pain assessment, prevention, and treatment. Currently, this model also provides the best foundation for tailoring the most comprehensive pain management program for each specific patient. Chronic pain patients have an increased risk for developing deficits in physical functioning, emotional reactivity, and cognition. Interdisciplinary treatment, based on the biopsychosocial model, is vital to address these multifaceted issues facing chronic pain sufferers. These interdisciplinary pain management strategies have progressed with advancements in science and technology in an attempt to provide the best possible outcomes for pain patients. However, while research has made enormous advances, there are still some clinical research gaps to be addressed. This article will begin with a historical overview of pain management in order to demonstrate the evolution in theory from ancient practices to the modern biopsychosocial model. Additionally, functional restoration and other early interdisciplinary intervention programs will be highlighted for their importance and effectiveness in chronic pain management, assessment, and prevention.

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