Alex Zautra

Arizona State University | ASU · Department of Psychology

Social pain, such as rejection in a social context, is processed similarly to physical pain by the brain, suggesting a neurological link between the social world and pain. This chapter will review the sources of vulnerability and resilience conferred by social worlds of people in pain, present evidence suggesting a substantial overlap between socia...

The influence of shared enjoyment and positive affect (PA) on resilient thinking was examined in 191 middle‐aged adults (40–65 years), participating in a study of resilience. Participants completed diaries assessing positive events, shared enjoyment, PA, and resilient cognitions (RC). Multilevel structural equation modeling was utilized to examine...

Background Childhood abuse is a risk factor for the development of cognitive deficits in adulthood, a relation that is likely mediated by stress-sensitive psychological and physiological indicators. Purpose To evaluate whether the link between exposure to childhood abuse and cognitive function in middle adulthood is mediated by interleukin-6 (IL-6...

The degree of relationship between positive and negative emotional states or emotional complexity is a topic of ongoing debate. At issue is whether positive and negative emotions are opposite ends of a bipolar continuum or independent dimensions in a bivariate distribution. In this review, we summarize work suggesting that the distinction between p...

There is growing evidence that inflammatory responses may help to explain how emotions get “under the skin” to influence disease susceptibility. Moving beyond examination of individuals’ average level of emotion, this study examined how the breadth and relative abundance of emotions that individuals experience—emodiversity—is related to systemic in...

The objectives of this study were to assess within-person hypotheses regarding temporal cognition-pain associations: (1) do morning pain flares predict changes in two afternoon adaptive and maladaptive pain-related cognitions, and (2) do these changes in afternoon cognitions predict changes in end-of-day pain reports, which in turn, carry over to p...

Objectives: Functionalist emotion and ecological systems theories suggest emodiversity-the variety and relative abundance of individuals' emotion experiences-is beneficial for psychological and physical health and may change with age. This paper examines and provides recommendations for operationalization of diversity-type intraindividual variabil...

Introduction: Insomnia symptoms are associated with cardiovascular disease and multiple metabolic syndrome components, yet few studies have investigated their association with metabolic syndrome. Hypothesis: Insomnia symptoms will be significantly associated with prevalent metabolic syndrome. Methods: Middle-aged, community-dwelling adults, ages 40...

Introduction: Sedentary behavior and short sleep duration are independently associated with cardiovascular disease (CVD), but there is limited research on the interaction between sedentary behavior and sleep duration on CVD. Hypothesis: Short sleep duration combined with greater sedentary behavior will be significantly associated with CVD. Methods:...

Previous research suggests that for people living with chronic pain, pain expectancy can undermine access to adaptive resources and functioning. We tested and replicated the unique effect of pain expectancy on subsequent pain through two daily diary studies. We also extended previous findings by examining cognitive and affective antecedents of pain...

The indirect association of childhood abuse with prevalent hypertension in adulthood through sleep disturbance and pro-inflammatory biomarkers was investigated in 589 community-dwelling, middle-aged adults. Participants completed the Childhood Trauma Questionnaire and self-reported current sleep disturbance and medical diagnoses including hypertens...

Objectives: To determine if 1) Osteoarthritis (OA)-related pain is associated with the diurnal cortisol pattern and cortisol levels; 2) the diurnal pattern of cortisol varies with severity of OA pain and 3) the association between OA pain and cortisol is mediated by daily experience variables (DEV). Design: In a community-based study of changes...

In addition to recurrent pain, fatigue, and increased rates of physical disability, individuals with rheumatoid arthritis (RA) have an increased prevalence of some mental health disorders, particularly those involving affective or mood disturbances. This narrative Review provides an overview of mental health comorbidities in RA, and discusses how t...

In this paper we introduce “Humanization” as a value framework that may guide resilience interventions. We regard the humanization of relationships as a key to health, wellbeing, and the capacity for resilient adaptation to stress for individuals and across communities. Although humans are wired to connect (Lieberman, 2013), they often dehumanize o...

Purpose: Patients with symptoms but without an identified disease are a challenge to primary care providers. A 22-item measure is introduced and evaluated to offer medical care providers with an instrument to assess and discuss possible deficiencies in resilience resources that may contribute to symptoms without identifiable pathology. This instru...

Factors contributing to resilience in chronic pain have garnered increased attention in recent years, and research has identified physical and psychosocial characteristics and mechanisms that enhance adaptation to pain, and a host of iatrogenic effects of medications that attempt to end the pain altogether. Ambiguity remains regarding what constitu...

Although clinical models have traditionally defined pain by its consequences for the behavior and internal states of the sufferer, recent evidence has highlighted the importance of examining pain in the context of the broader social environment. Neuroscience research has highlighted commonalities of neural pathways connecting the experience of phys...

Objective: Psychological distress may contribute to chronic activation of acute-phase inflammation. The current study investigated how financial stressors influence psychosocial functioning and inflammation. This study examined a) the direct relations between financial stress and inflammation; b) whether the relationships between financial stress...

Getting Past Recovery: Implications of a Resilience Paradigm for Psychosocial Intervention Research on Physical and Behavioral Health

This paper reports on the first test of the value of an online curriculum in social intelligence (SI). Built from current social and cognitive neuroscience research findings, the 50 session SI program was administered, with facilitation in Spanish by classroom instructors, to 207 students from Universidad Rey Juan Carlos in Madrid as part of their...

Childhood trauma is associated with premature declines in health in midlife and old age. Pathways that have been implicated, but less studied include social-emotional regulation, biological programming, and habitual patterns of thought and action. In this study we fo-cused on childhood trauma's influence via alterations in social-emotional regulati...

The February-March 2014 special issue of the American Psychologist featured articles summarizing select contributions from the field of psychology to the assessment and treatment of chronic pain. The articles examined a range of psychosocial and family factors that influence individual adjustment and contribute to disparities in pain care. The revi...

This study tested the effectiveness of a computerized mindfulness-based cognitive therapy intervention compared to computerized pain management psychoeducation in a randomized study. Using an intention to treat (ITT) approach, 124 adult participants who reported experiencing pain that was unrelated to cancer and of at least 6 months duration were r...

Childhood trauma increases one's likelihood of premature health declines in midlife and old age. Relatively little is known, however, regarding pathways underlying this relationship. Using data from a 30-day daily diary of participants in Midlife (n=191, M age =54, SD=7.50, 46% women), we examined whether childhood trauma is associated with emotion...

This study examined the relationships between daily negative financial events and positive and negative interpersonal events, as well as the moderating effects of life circumstances, for a sample of 182 adults between the age of 40 and 65 providing 30 days of diary data collected between 2008 and 2011. There was a significant and positive relations...

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 ra...

Resilience is a natural capacity to recover from adversity, sustain well-being, and grow from the experience. To enhance resilience in a high-stress, post-disaster context, we argue that it is vital to introduce positive stimuli to buffer the effects of negative stimuli. We review empirical evidence for the positive effects of various forms of cont...

Chronic pain with comorbid depression is characterized by poor mood regulation and stress-related pain. This study aims to compare depressed and non-depressed pain patients in mood and pain stress reactivity and recovery, and test whether a post-stress positive mood induction moderates pain recovery. Women with fibromyalgia and/or osteoarthritis (N...

There may be significant individual differences in physiological regulatory responses to the experience of pain and stress. Respiratory sinus arrhythmia is a physiological indicator that may have implications for efficient physiological responses to pain and stress. Fatigue is an indicator of inefficient self-regulation under stressful conditions....

The processes of individual adaptation to chronic pain are complex and occur across multiple domains. The current study examined the social, cognitive, and affective context of daily pain adaptation in individuals with fibromyalgia and osteoarthritis. Using a sample of 260 women with fibromyalgia or osteoarthritis, this study examined the contribut...

The mind and body are thought to interact in a manner that influences health, but modelling the right aspects of each so as to best inform treatment is a tricky proposition. A new study discusses how stress can affect rheumatoid arthritis symptoms.

Background: Patients with fibromyalgia (FM) experience pain as well as deficits in positive affect and social relations that are not explicitly addressed in most behavioral treatments. Purpose: The purpose of this study is to compare the effects of a 12-module online intervention targeting socioemotional regulation via mindful awareness/acceptan...

Background: The processes of individual adaptation to chronic pain are complex and occur across multiple domains. Purpose: The current study examined the social, cognitive, and affective context of daily pain adaptation in chronic pain. Methods: Using a sample of 260 women with fibromyalgia or osteoarthritis, this study examined the contributions o...

Background Poor sleep contributes to adult morbidity and mortality. Purpose The study examined the extent to which trait positive affect (PA) and PA reactivity, defined as the magnitude of change in daily PA in response to daily events, were linked to sleep outcomes. Methods Analyses are based on data from 100 respondents selected from the National...

Pain is a complex construct that contributes to profound physical and psychological dysfunction, particularly in individuals coping with chronic pain. The current paper builds upon previous research, describes a balanced conceptual model that integrates aspects of both psychological vulnerability and resilience to pain, and reviews protective and e...

The objectives of this study were to examine whether (1) daily pain-related changes in physical functioning differed between happily partnered, unhappily partnered, and unpartnered female chronic pain patients, and (2) affect and pain cognitions mediated the partner status effect on pain-related changes in physical functioning. Two hundred fifty-on...

This article examines the role of positive events in older women's adaptation to rheumatoid arthritis (RA). In Study 1, 80 women with RA were compared with 80 healthy older women (all aged 50–75 yrs). Measures included the Inventory of Small Life Events (ISLE) for older people (A. J. Zautra et al, 1990). The women with RA showed a less-active patte...

The value of two self-help programs that rely on automated instructional materials were tested versus an attention control in a community sample with symptoms of depression. A randomized controlled trial was designed to examine the effects of a brief, daily intervention targeting either personal control/mastery (MC) or mindful awareness/acceptance...

Background Pain catastrophizing is a powerful predictor of pain adaptation, and both stable and time-varying aspects may influence overall emotional well-being. Purpose This study aims to test the independent influences of state and trait pain catastrophizing on the relationship between daily intensity and negative affect, positive affect, and depr...

This paper presents a two-factor model to classify biological elements, affective and cognitive characteristics, and social determinants of successful adaptation to chronic pain. The two factors, vulnerability and resilience, identify variables that are further differentiated into stable and modifiable indicators that influence adaptation to chroni...

Psychosomatic disorders are composed of an array of psychological, biologic, and environmental features. The existing evidence points to a role for genetic factors in explaining individual differences in the development and maintenance of a variety of disorders, but studies to date have not shown consistent and replicable effects. As such, the atte...

Relationships between positive affect, negative affect, and pain were analyzed as a prospective function of stressful events in a sample of rheumatoid arthritis patients and as a cross-sectional function of an information processing disposition in persons with fibromyalgia. Positive affect and negative affect were statistically separate factors ove...

Method. A randomized controlled trial was designed to examine the effects of a brief, daily intervention targeting either personal control/mastery (MC) or mindful awareness/acceptance (MA) compared with a placebo treatment that consisted of tips to a healthy life-style (HT). . Using an automated interactive voice response (IVR) system, eighty-four...

Neighborhood social cohesion (NSC) may contribute to understanding how neighborhood contexts influence the physical and mental health of residents. We examined the relation of NSC to self-rated mental and physical health and evaluated the mediating role of NSC on relations between neighborhood socioeconomic status, ethnic composition, and health. A...

In this chapter, the authors define community resilience and identify the components that predict it will occur. Three dimensions are highlighted: recovery, sustainability, and growth. Their discussion focuses on communities like those of Sudanese refugees who have experienced forced migration, emphasizing the importance that community plays to fut...

Moving from a disease model of stress and coping to the more integrative model of positive influences represents a fundamental shift in our understanding of how people adapt to and grow in their environment. This new paradigm has raised stress and coping approaches into a framework that models the extent to which personal strengths and other psycho...

To examine how anxious and avoidant adult attachment styles moderate within-day associations between pain intensity, pain catastrophizing, and social coping. Two-hundred and ten women with osteoarthritis and/or fibromyalgia from the community completed an initial questionnaire assessing attachment dimensions and a 30 day electronic diary. Outcomes...

Stress resilience factors, and interventions to ease stress and enhance resilience, are gaining increasing attention for the treatment of rheumatic conditions. This Review presents a digest of empirical work on the factors that determine the risk of adapting poorly to a rheumatic condition, and on the resilience factors that counteract such risks....

The goal of this paper is to introduce community gardening as a promising method of furthering well-being and resilience on multiple levels: individual, social group, and natural environment. We examine empirical evidence for the benefits of gardening, and we advocate the development and testing of social ecological models of community resilience t...

Forty-five women with fibromyalgia (FM) engaged in a 30-day electronic diary assessment, recording daily ratings of pain and 2 forms of maladaptive coping: pain catastrophizing and pain attention. Participants were genotyped for the val(158)met single nucleotide polymorphism (rs4680) in the catechol-O-methyltransferase (COMT) gene. COMT genotype mo...

This chapter covers a number of recent developments in theory and research on the concept of resilience, focusing on applications at the adult level of analysis. Various cutting-edge contributions to a recent comprehensive survey of the field by the authors are reviewed. Different characterizations of the current uses of the term are presented, and...

Resilience has been regarded narrowly as a quintessential individual property by most investigators. Social resilience, however, is inherently a multilevel construct, revealed by capacities of individuals, but also groups, to foster, engage in, and sustain positive social relationships and to endure and recover from stressors and social isolation....

Socioeconomic disparities in pain may be attributable to both greater frequency in stressful financial events as well as greater vulnerability to economic hardship for those at the lower end of the socioeconomic spectrum. This study investigated the effects of economic hardship and daily financial worry on daily pain among women with a chronic musc...

In this paper two complementary models are presented to guide needs assessment efforts for prevention programs. Each of these models focuses on events as the core elements in the study of human needs. One model is concerned with the nature and impact of stressful events on psychological distress; the other model is concerned with personal growth an...

The study used a daily process design to examine the role of psychological resilience and positive emotions in the day-to-day experience of pain catastrophizing. A sample of 95 men and women with chronic pain completed initial assessments of neuroticism, psychological resilience, and demographic data, and then completed short diaries regarding pain...

This article discusses the construct of resilience and suggests potential benefits of taking a resilience-based approach in social science research. Inspired by the early work of Werner on resilient children, the authors provide conceptual guidelines and suggest methods of inquiry into how people and communities stay healthy, even thrive in stressf...

The purpose of this study was to examine the interaction of daily concurrent positive interpersonal events (PIE) and negative interpersonal events (NIE) on the daily experience of negative affect and fatigue in a sample of men and women with rheumatoid arthritis. Two hypotheses were made. The blunting hypothesis predicted that NIE would nullify the...

To assess whether alleged childhood maltreatment is associated with daily cortisol secretion in women with chronic pain. Women with fibromyalgia (FM group, n = 35) or with osteoarthritis only (OA group, n = 35) completed diaries and collected three saliva samples daily for 30 days, with compliance monitored electronically. Childhood abuse and negle...

Reports an error in "Genetic influences on the dynamics of pain and affect in fibromyalgia" by Patrick H. Finan, Alex J. Zautra, Mary C. Davis, Kathryn Lemery–Chalfant, Jonathan Covault and Howard Tennen ( Health Psychology , 2010[Mar], Vol 29[2], 134-142). In the article, grant information was omitted from the author note. The authors wish to ackn...

Unlabelled: Fatigue is a common, disabling symptom for individuals with rheumatoid arthritis (RA). This study 1) examined sex differences in the relations between daily changes in positive and negative interpersonal events and same-day and next-day fatigue and 2) tested positive affect and negative affect as mediators of the associations between c...

Biological and psychological bases for the covariation of pain and fatigue in fibromyalgia (FM) are reviewed. FM is characterized as a disorder of central sensitization, with pain and fatigue as the most prominent symptoms. The roles of sleep disturbance and affective dysregulation as both precipitants and consequences of pain and fatigue in FM are...

Perceived control and similar concepts are of central importance in studies of coping, adjustment, and well-being; research suggests that these concepts might be usefully considered in a transactional, person-environment framework. The studies reported here assessed internal-external control and personal mastery in samples of at-risk older adults c...

This study examined whether breathing rate affected self-reported pain and emotion following thermal pain stimuli in women with fibromyalgia syndrome (FM: n=27) or age-matched healthy control women (HC: n=25). FM and HC were exposed to low and moderate thermal pain pulses during paced breathing at their normal rate and one-half their normal rate. T...

Chronic pain is an affliction that affects a large proportion of the general population and is often accompanied by a myriad of negative emotional, cognitive, and physical effects. However, current pain adaptation paradigms do not account for the many chronic pain patients who demonstrate little or no noticeable impairment due to the effects of chr...

The purpose of the present investigation was to determine if variation in the catechol-O-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genes is associated with pain-related positive affective regulation in fibromyalgia (FM). Forty-six female patients with FM completed an electronic diary that included daily assessments of positive affect...

The purpose of this study was to assess the relative effects of coping self-efficacy and catastrophizing on physical functioning. Over a 9-month period, studying changes in self-efficacy as possible mediator between catastrophizing changes and physical functioning changes might provide evidence for the most promising treatment target. Data came fro...

This study set to explore whether variables related to cognitive-affective assets would complement measures of psychological vulnerability for the prediction of physical functioning and pain tolerance in 138 women with Fibromyalgia Syndrome (FMS). Depression, anxiety, stress response and negative affect were defined a priori as measures of vulnerab...

To assess the relative effectiveness of combining self-management and strength training for improving functional outcomes in patients with early knee osteoarthritis. We conducted a randomized intervention trial lasting 24 months at an academic medical center. Community-dwelling middle-aged adults (n = 273) ages 35-64 years with knee osteoarthritis,...

Supportive close relationships are important for health. Mutuality, the reciprocal sharing of thoughts and feelings in close relationships, is linked with better outcomes for patients with rheumatoid arthritis (RA) in cross-sectional data. Hypothesizing that mutuality has a beneficial impact on inflammation, we tested potentially causal relations o...

Beginning with the Framingham Study (Dawber, Meadors, & Moore, 1951), risk factor research has a long and successful history of identifying biological and psychosocial vulnerabilities to chronic, as well as acute, illness. How do people sustain themselves while ill, and how do so many who are ill recover? In this chapter we offer resilience as an i...

Dynamical systems modeling was used to analyze fluctuations in the pain prediction process of people with rheumatoid arthritis. 170 people diagnosed with rheumatoid arthritis completed 29 consecutive days of diaries. Difference scores between pain predictions and next-day pain experience ratings provided a time series of pain prediction accuracy. P...

IntroductionDiathesesBiopsychosocial Factors of StressOutcomesImplications for TreatmentFuture DirectionsReferences