Positive affect as a factor of resilience in the pain-negative affect relationship in patients with rheumatoid arthritis.
ABSTRACT The purpose of this study is to examine positive affect (PA) as a factor of resilience in the relationships between pain and negative affect (NA) in a sample of patients with rheumatoid arthritis.
Forty-three patients (30 women; mean age, 57 years) were interviewed weekly by telephone for 8 weeks. Multilevel modeling was applied to study the within-week relationships among the variables.
There was a Pain x PA interaction effect on NA (beta=-0.05, P<.01) indicating a weaker relationship between pain and NA in weeks with more PA. Pain (beta=0.37, P<.002), interpersonal stress (beta=2.42, P<.001), depression (beta=0.26, P<.01), average perceived stress (beta=10.80, P<.001), and also weekly PA (beta=-0.1, P<.01) had a main effect upon NA.
Positive affect is most influential in reducing NA during weeks of higher pain and may be a factor of resilience, helping patients experiencing pain fluctuations as less distressful than at lower levels of PA.
SourceAvailable from: Fuschia M Sirois[Show abstract] [Hide abstract]
ABSTRACT: Introduction Bisopsychosocial approaches to arthritis emphasize the importance of psychological and individual difference factors as predisposing, precipitating or perpetuating factor in arthritis through their interface with pain-related, inflammatory, and immunological responses. Rather than just focusing on understanding how loss is experienced, positive psychological approaches emphasize the importance of promoting and understanding how adjustment is experienced. In this narrative review, four positive psychological qualities are introduced and current empirical and theoretical research on their potential role for facilitating adjustment to arthritis is reviewed. These qualities include two which have received more research attention – optimism and benefit finding – and two that have received less attention but are nonetheless promising - gratitude and self-compassion. Conclusion Available research supports the proposition that optimism and benefit finding can serve as resilience factors for arthritis patients as each is associated with better psychological and physical well-being. The extent of their role for promoting adjustment may be limited by disease severity and duration. Theory and limited research on gratitude and self-compassion is suggestive of a possible role for these qualities in adjustment to arthritis and therefore they warrant further research attention.
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ABSTRACT: Objective: This study compared the impact of cognitive-behavioral therapy for pain (CBT-P), mindful awareness and acceptance treatment (M), and arthritis education (E) on day-to-day pain- and stress-related changes in cognitions, symptoms, and affect among adults with rheumatoid arthritis (RA). Method: One hundred forty-three RA patients were randomized to 1 of the 3 treatment conditions. CBT-P targeted pain-coping skills; M targeted awareness and acceptance of current experience to enhance coping with a range of aversive experiences; E provided information regarding RA pain and its management. At pre- and posttreatment, participants completed 30 consecutive evening diaries assessing that day's pain, fatigue, pain-related catastrophizing and perceived control, morning disability, and serene and anxious affects. Results: Multilevel models compared groups in the magnitude of within-person change in daily pain and stress reactivity from pre- to posttreatment. M yielded greater reductions than did CBT-P and E in daily pain-related catastrophizing, morning disability, and fatigue and greater reductions in daily stress-related anxious affect. CBT-P yielded less pronounced declines in daily pain-related perceived control than did M and E. Conclusions: For individuals with RA, M produces the broadest improvements in daily pain and stress reactivity relative to CBT-P and E. These findings also highlight the utility of a diary-based approach to evaluating the treatment-related changes in responses to daily life. (PsycINFO Database Record (c) 2014 APA, all rights reserved).Journal of Consulting and Clinical Psychology 11/2014; 83(1). DOI:10.1037/a0038200 · 4.85 Impact Factor
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ABSTRACT: Migraine has close associations with depression and anxiety. Catastrophizing, an alarmist reaction to pain, has been proposed as one of the mediators in the relationship between headache and emotional distress. However, much experimental evidence is needed to make such a view more validated. The aims of this study are to examine the effects of mood induction on the pain responses and to investigate the role of pain catastrophizing in the relationship between pain and mood amongst a sample of patients with migraine. For this purpose, 60 patients with migraine were recruited from a headache clinic in Tehran-Iran and were randomly assigned into one of three groups: negative mood induced group, positive mood induced group and control group. The following instruments and measures were used in this study: mood induction by presenting different types of films (positive, negative), a computerized cognitive task to elicit pain, Beck Depression Inventory and Pain Catastrophizing Scale. The results showed that while the induction of depressed mood increased the pain intensity, the induction of positive mood reduced it significantly (p < 0.05). Further analyses revealed that catastrophizing is as a confounding factor in the relationship between pain and mood. Once catastrophizing scores were entered into the analyses as a covariate, the significant effect of mood on the pain intensity reduced. In conclusion, both mood and catastrophizing are important factors in understanding the migraine pain. Clinical implications of these findings are discussed in the paper. Copyright © 2014 John Wiley & Sons, Ltd.Key Practitioner MessagePain-related catastrophizing and mood induction are important factors in understanding pain intensity amongst patients with migraine pain.Catastrophizing as a confounding factor in the relationship between pain and mood may partially mediate the relationship between mood and pain.Therapeutic interventions should focus on the reduction of depression and catastrophizing.Clinical Psychology & Psychotherapy 12/2014; DOI:10.1002/cpp.1939 · 2.59 Impact Factor