Rehabilitation Services Use and Patient Reported Outcomes among Older Adults in the United States

Classical conditioning differences associated with chronic pain: a systematic review

Prominent clinical models of chronic pain propose a fundamental role of classical conditioning in the development of pain-related disability. If classical conditioning is key to this process, then people with chronic pain may show a different response to pain-related conditioned stimuli (CS) than healthy controls. We set out to determine whether this is the case by undertaking a comprehensive and systematic review of the literature. To identify studies comparing classical conditioning between people with chronic pain and healthy controls, the databases MEDLINE, PsychINFO, PsychARTICLES, Scopus, CINAHL, were searched using key words and MESH headings consistent with ‘classical conditioning’ AND ‘pain’.

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Prognosis of undiagnosed chest pain: linked electronic health record cohort study

Objective To ascertain long term cardiovascular outcomes in patients whose chest pain remained undiagnosed six months after first presentation.Design Cohort study.Setting UK electronic health record...

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Chest pain in primary care: what happens to the undiagnosed majority?

Acute chest pain is an alarming symptom, and the exclusion of a cardiac or other serious cause is the first priority. Through the process a proportion of patients undergo investigation and in some...

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Validation of the German fear of pain questionnaire in a sample of children with mixed chronic pain conditions

Abstract

Background

To date, no German instrument exists to measure pain-related fear in paediatric pain populations. The objective of the current study was to determine the construct validity of the translated German fear of pain questionnaire for children (GFOPQ-C) in a sample of children with mixed chronic pain disorders by testing the underlying factor structure, and its psychometric properties.

Method

N = 241 children with mixed chronic pain disorders (aged 8–19 years) presenting to a specialized pain clinic completed the GFOPQ-C and several other pain, fear and disability measures.

Results

The two-factor structure of the FOPQ-C (fear, avoidance) was replicated. Internal consistency for the shortened German version was good for both subscales (Fear subscale: α = 0.89; avoidance subscale: α = 0.76). As expected, the fear subscale correlated highly with anxiety sensitivity (r = 0.63), pain catastrophizing (r = 0.62) and general anxiety (r = 0.54), while the avoidance subscale was more closely related to disability (r = 0.24) and school functioning (r = 0.28). Pain-related fear differed in children with chronic pain depending on their pain location with higher fear ratings in children with abdominal pain and musculoskeletal pain.

Conclusion

The GFOPQ-C is a valid instrument that assesses two distinct dimensions of pain-related fear in children: fear and avoidance. Future research is needed to evaluate the impact of increased pain-related fear on outcomes over time as well as to examine pain-related fear among healthy children. This will enhance our knowledge of who might be particularly vulnerable to potentially dysfunctional trajectories, such as ongoing pain or anxiety symptoms.

Significance

The current study validates the first tool to assess pain-related fear in German-speaking children with chronic pain. Findings support two distinct domains: fear and activity avoidance.

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The Association of Neuromuscular Attributes with Performance-based Mobility among Community-dwelling Older Adults with Symptomatic Lumbar Spinal Stenosis

[Perspectives] The body as image: image as body

Pain is invisible and its experience highly subjective, making it hard to communicate. This essay grew out of the Encountering Pain Conference at University College London that shared the findings of the face2face and Pain: Speaking the Threshold projects with patients, clinicians, academics, and artists. We explore narratives triggered by images co-created with pain patients and placed between doctor and patient in the pain clinic during the face2face project.

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