Participant's perception of negative cognition in low back pain: a pilot study.
ABSTRACT It has been theorized that low back pain contributes to the development of negative cognition (negative thinking) which may predispose a person towards chronicity. The objective of this paper is to examine the role of negative cognition in non-depressed participants who have previously experienced low back pain.
Ten students enrolled in a course at the University of Kansas were involved in a 4 week educational project. The participants completed self-rated assessments of depression using the 21 item Beck Depression Inventory (BDI-21) and the visual analogue pain scale (VAS). The study was broken into 3 phases over 4 weeks. Phase 1 focused on the VAS and the BDI-21 along with questions pertaining to low back pain. Phase 2 included 2 questions with 1 of the questions focusing on common negative distortions. Phase 3 focused on 11 clinical-type questions relating to awareness of negative thinking and chronic low back pain.
Phase 1 showed that 7 of the students had a history of chronic low back pain while 8 students believed they had negative thoughts when low back pain occurred. Conversely, only 1 student had experienced negative thoughts prior to a low back pain episode. The initial BDI-21 scores demonstrated a mean score of 5.5 with a mean VAS of 5.75. After students were exposed to the idea that they may have negative cognition processes (phase 2), 4 students indicated that they noticed themselves thinking negatively and attempted to alter such processes. Phase 3 results indicated that 4 of the students did attempt to change negative thinking after being made aware that negative thinking could be present.
The results of this study showed that a majority of participants believed that a person's negative thoughts can impair a person toward activity yet none of the participants believed that such had occurred to them. Further research in the area of negative cognition and chronic low back pain is needed.
Article: Cognitive bias in back pain patients attending osteopathy: testing the enmeshment model in reference to future thinking.[show abstract] [hide abstract]
ABSTRACT: Depressive symptoms are common in chronic pain. Previous research has found differences in information-processing biases in depressed pain patients and depressed people without pain. The schema enmeshment model of pain (SEMP) has been proposed to explain chronic pain patients' information-processing biases. Negative future thinking is common in depression but has not been explored in relation to chronic pain and information-processing models. The study aimed to test the SEMP with reference to future thinking. An information-processing paradigm compared endorsement and recall bias between depressed and non-depressed chronic low back pain patients and control participants. Twenty-five depressed and 35 non-depressed chronic low back pain patients and 25 control participants (student osteopaths) were recruited from an osteopathy practice. Participants were asked to endorse positive and negative ill-health, depression-related, and neutral (control) adjectives, encoded in reference to either current or future time-frame. Incidental recall of the adjectives was then tested. While the expected hypothesis of a recall bias by depressed pain patients towards ill-health stimuli in the current condition was confirmed, the recall bias was not present in the future condition. Additionally, patterns of endorsement and recall bias differed. Results extend understanding of future thinking in chronic pain within the context of the SEMP.European Journal of Pain 01/2005; 8(6):525-31. · 3.94 Impact Factor
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ABSTRACT: About 50% of the population will be affected by a mental disorder during their lifetime; the most common forms are mood and anxiety disorders and abuse of or dependence on drugs or alcohol. The standard forms of therapy are medication and various forms of psychotherapy. The cost of treating disease is escalating, and the health care system will never be able to meet the need for treatment in this large group of patients. Hence, development of effective self help strategies is important. In this paper, the scientific basis for promoting exercise as treatment for mental disorders is evaluated on the basis of a review of the literature. Beneficial psychological effects of exercise are best documented for mild to moderate forms of unipolar depression and chronic fatigue syndrome; in these disorders, exercise is an alternative to traditional forms of treatment. A therapeutic effect may also be achieved in panic and generalised anxiety disorder, schizophrenia, conversion and somatoform pain disorder, and alcohol abuse and dependence. Beneficial effects of exercise are well documented. A simple and inexpensive approach like exercise is helpful and might be important for public health.Tidsskrift for Den norske legeforening 11/2000; 120(25):3054-6.
Article: General practice consultation rates for psychiatric disorders in patients aged 65 and over: prospective cohort study.[show abstract] [hide abstract]
ABSTRACT: To examine consultation rates for psychiatric disorder in general practice among patients aged 65 years and over; and to examine the effect of sociodemographic factors (gender, age, social class and accommodation) on consultation rates. Prospective cohort study. The fourth national survey of morbidity in general practice carried out between September 1991 and August 1992. Sixty volunteer practices in England and Wales took part; study population comprised a 1% sample of the population (502,493 patients). GPs recorded the reasons for all consultations and these were converted into an ICD9 code. Trained fieldworkers collected sociodemographic data on the patients in the survey. Psychiatric disorders were categorised by compiling the appropriate ICD9 codes. Annual consultation rates (per 1000 patients) according to psychiatric disorder and sociodemographic factors were calculated after adjustment for differing length of follow-up. Only 4.4% of all consultations were for psychiatric disorders. Women had consultation rates 75% higher than men. Social class had no effects on rates. Consultation rates were highest for neurotic disorders and depression. Those living alone had highest rates for depression, whilst those living in residential and nursing homes had substantially higher consultation rates for dementia and bipolar affective disorder. Consultation rates were significantly lower than expected from previous epidemiological studies. This indicates that there is considerable hidden morbidity that is being untreated in primary care. Social class appears to have no effect on consultations for psychiatric disorder in the elderly. The increasing age of the population may result in a significant increase in consultations for dementia, but not for depression or neurosis.International Journal of Geriatric Psychiatry 02/2001; 16(1):57-63. · 2.42 Impact Factor