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| Publications of Francis J. Keefe :chronological alphabetical combined listing:%% Journal Articles @article{fds376035, Author = {Hooker, JE and Brewer, JR and McDermott, KA and Kanaya, M and Somers, TJ and Keefe, F and Kelleher, S and Fisher, HM and Burns, J and Jeddi, RW and Kulich, R and Polykoff, G and Parker, RA and THRIVE Study Team, and Greenberg, J and Vranceanu, A-M}, Title = {Improving multimodal physical function in adults with heterogeneous chronic pain; Protocol for a multisite feasibility RCT.}, Journal = {Contemp Clin Trials}, Volume = {138}, Pages = {107462}, Year = {2024}, Month = {March}, url = {http://dx.doi.org/10.1016/j.cct.2024.107462}, Abstract = {BACKGROUND: Chronic pain is associated with substantial impairment in physical function, which has been identified as a top concern among persons with pain. GetActive-Fitbit, a mind-body activity program, is feasible, acceptable, and associated with improvement in physical function among primarily White, sedentary individuals with pain. In preparation for a multisite efficacy trial, we must examine feasibility across multiple sites with diverse patient populations. Here we describe the protocol of a multisite, feasibility RCT comparing GetActive-Fitbit with a time- and attention-matched educational comparison (Healthy Living for Pain). We aim to 1) test multisite fidelity of clinician training; 2) evaluate multisite feasibility benchmarks, including recruitment of chronic pain patients taking <5000 steps/day and racial and ethnic minorities; and 3) optimize fidelity and study protocol in preparation for a future multisite efficacy trial. METHODS: Clinician training fidelity was assessed via roleplays and mock group sessions. Feasibility (i.e., recruitment, acceptability, credibility, adherence, satisfaction), multimodal physical function (e.g., self-report, 6-Minute Walk Test, step-count), and other psychosocial outcomes are assessed at baseline, posttest, and 6 months. Protocol optimization will be assessed using exit interviews and cross-site meetings. RESULTS: The trial is ongoing. Clinician training is complete. 87 participants have been recruited. 54 completed baseline assessments and randomization, 44 are mid-intervention, and 9 have completed the intervention and posttest. CONCLUSIONS: This study addresses the critical need for feasible, acceptable mind-body-activity interventions for chronic pain that follow evidence-based guidelines and improve all aspects of physical function across diverse populations. Results will inform a future fully-powered multisite efficacy trial. CLINICAL TRIAL REGISTRATION: NCT05700383.}, Doi = {10.1016/j.cct.2024.107462}, Key = {fds376035} } @article{fds373556, Author = {Cook, CE and O'Halloran, B and McDevitt, A and Keefe, FJ}, Title = {Specific and shared mechanisms associated with treatment for chronic neck pain: study protocol for the SS-MECH trial.}, Journal = {J Man Manip Ther}, Volume = {32}, Number = {1}, Pages = {85-95}, Year = {2024}, Month = {February}, url = {http://dx.doi.org/10.1080/10669817.2023.2267391}, Abstract = {BACKGROUND: Treatment mechanisms involve the steps or processes through which an intervention unfolds and produces change in an outcome variable. Treatment mechanisms can be specific to the intervention provided (i.e. pain modulation) or shared with other treatments (i.e. reduced fear of movement). Whether specific and shared treatment mechanisms are different across interventions and whether they lead to the outcomes seen in trials is largely unknown. The management of individuals with chronic neck pain routinely include manual therapy (MT) and resistance exercise (RE), as both approaches are included in clinical practice guidelines and both yield similar outcomes. OBJECTIVES: Our study plans to answer two research questions: 1) what are the specific mechanisms associated with MT versus interventions (and are these different), and 2) what are the shared mechanisms associated with these interventions, and do specific or shared mechanisms mediate clinical outcomes? METHODS: This study will involve a 2-group parallel (1:1) single-blinded randomized trial to compare the specific and potential shared treatment mechanisms between these two approaches. We will enroll individuals with a history of chronic neck pain and evaluate whether specific or shared mechanisms mediate clinical outcomes. RESULTS: We hypothesize that MT and RE approaches will both exhibit different specific treatment mechanisms, and that both approaches will exhibit shared treatment mechanisms, which will notably influence outcomes at both discharge and 6-months. CONCLUSIONS: This study is important because it will help identify what specific or shared treatment mechanisms are associated with different interventions and, how different treatment mechanisms influence clinical outcomes.}, Doi = {10.1080/10669817.2023.2267391}, Key = {fds373556} } @article{fds376088, Author = {Burns, JW and Jensen, MP and Thorn, BE and Lillis, TA and Carmody, J and Gerhart, J and Keefe, F}, Title = {Cognitive Therapy, Mindfulness-Based Stress Reduction, and Behavior Therapy for the Treatment of Chronic Pain: Predictors and Moderators of Treatment Response.}, Journal = {J Pain}, Year = {2024}, Month = {January}, url = {http://dx.doi.org/10.1016/j.jpain.2024.01.003}, Abstract = {Psychosocial interventions for people with chronic pain produce significant improvements in outcomes, but these effects on average are modest with much variability in the benefits conferred on individuals. To enhance the magnitude of treatment effects, characteristics of people that might predict the degree to which they respond more or less well could be identified. People with chronic low back pain (N = 521) participated in a randomized controlled trial which compared cognitive therapy, mindfulness-based stress reduction, behavior therapy and treatment as usual. Hypotheses regarding predictors and/or moderators were based on the Limit, Activate, and Enhance model; developed to predict and explain moderators/predictors of psychosocial pain treatments. Results were: 1) low levels of cognitive/behavioral function at pre-treatment predicted favorable pre- to post-treatment outcomes; 2) favorable expectations of benefit from treatment and sound working alliances predicted favorable pre- to post-treatment outcomes; 3) women benefited more than men. These effects emerged without regard to treatment condition. Of note, high levels of cognitive/behavioral function at pre-treatment predicted favorable outcomes only for people in the treatment as usual condition. Analyses identified a set of psychosocial variables that may act as treatment predictors across cognitive therapy, mindfulness-based stress reduction and behavior therapy, as hypothesized by the Limit, Activate, and Enhance model if these 3 treatments operate via similar mechanisms. Findings point toward people who may and who may not benefit fully from the 3 psychosocial treatments studied here, and so may guide future research on matching people to these kinds of psychosocial approaches or to other (eg, forced-based interventions) non-psychosocial approaches. TRIAL REGISTRATION: The ClinicalTrials.gov Identifier is NCT02133976. PERSPECTIVE: This article examines potential predictors/moderators of response to psychosocial treatments for chronic pain. Results could guide efforts to match people to the most effective treatment type or kind.}, Doi = {10.1016/j.jpain.2024.01.003}, Key = {fds376088} } @article{fds372549, Author = {LaRowe, LR and Miaskowski, C and Miller, A and Mayfield, A and Keefe, FJ and Smith, AK and Cooper, BA and Wei, L-J and Ritchie, CS}, Title = {Chronic Pain and Pain Management in Older Adults: Protocol and Pilot Results.}, Journal = {Nurs Res}, Volume = {73}, Number = {1}, Pages = {81-88}, Year = {2024}, Month = {January}, url = {http://dx.doi.org/10.1097/NNR.0000000000000683}, Abstract = {BACKGROUND: Chronic pain occurs in 30% of older adults. This prevalence rate is expected to increase, given the growth in the older adult population and the associated growth of chronic conditions contributing to pain. No population-based studies have provided detailed, longitudinal information on the experience of chronic pain in older adults; the pharmacological and nonpharmacological strategies that older adults use to manage their chronic pain; and the effect of chronic pain on patient-reported outcomes. OBJECTIVES: This article aims to describe the protocol for a population-based, longitudinal study focused on understanding the experience of chronic pain in older adults. The objectives are to determine the prevalence and characteristics of chronic pain; identify the pharmacological and nonpharmacological pain treatments used; evaluate for longitudinal differences in biopsychosocial factors; and examine how pain types and pain trajectories affect important patient-reported outcomes. Also included are the results of a pilot study. METHODS: A population-based sample of approximately 1,888 older adults will be recruited from the National Opinion Research Center at the University of Chicago's AmeriSpeak Panel to complete surveys at three waves: enrollment (Wave 1), 6 months (Wave 2), and 12 months (Wave 3). To determine the feasibility, a pilot test of the enrollment survey was conducted among 123 older adults. RESULTS: In the pilot study, older adults with chronic pain reported a range of pain conditions, with osteoarthritis being the most common. Participants reported an array of pharmacological and nonpharmacological pain strategies. Compared to participants without chronic pain, those with chronic pain reported lower physical and cognitive function and poorer quality of life. Data collection for the primary, longitudinal study is ongoing. DISCUSSION: This project will be the first longitudinal population-based study to examine the experience and overall effect of chronic pain in older adults. Pilot study results provide evidence of the feasibility of study methods. Ultimately, this work will inform the development of tailored interventions for older patients targeted to decrease pain and improve function and quality of life.}, Doi = {10.1097/NNR.0000000000000683}, Key = {fds372549} } @article{fds372966, Author = {Kenney, MO and Wilson, S and Shah, N and Bortsov, A and Smith, WR and Little, J and Lanzkron, S and Kanter, J and Padrino, S and Owusu-Ansah, A and Cohen, A and Desai, P and Manwani, D and Rehman, SSU and Hagar, W and Keefe, F}, Title = {Biopsychosocial Factors Associated With Pain and Pain-Related Outcomes in Adults and Children With Sickle Cell Disease: A Multivariable Analysis of the GRNDaD Multicenter Registry.}, Journal = {J Pain}, Volume = {25}, Number = {1}, Pages = {153-164}, Year = {2024}, Month = {January}, url = {http://dx.doi.org/10.1016/j.jpain.2023.07.029}, Abstract = {Pain is the primary symptomatic manifestation of sickle cell disease (SCD), an inherited hemoglobinopathy. The characteristics that influence pain experiences and outcomes in SCD are not fully understood. The primary objective of this study was to use multivariable modeling to examine associations of biopsychosocial variables with a disease-specific measure of pain interference known as pain impact. We conducted a secondary analysis of data from the Global Research Network for Data and Discovery national SCD registry. A total of 657 children and adults with SCD were included in the analysis. This sample was 60% female with a median age of 34 (interquartile range 26-42 years) and a chronic pain prevalence of 64%. The model accounted for 58% of the variance in pain impact. Low social (P < .001) and emotional (P < .001) functioning, increasing age (P = .004), low income (P < .001), and high acute painful episodes (P = .007) were most strongly associated with high pain impact in our multivariable model. Additionally, multivariable modeling of pain severity and physical function in 2 comparable samples of registry participants revealed that increasing age and low social functioning were also strongly associated with higher pain severity and low physical functioning. Overall, the results suggest that social and emotional functioning are more strongly associated with pain impact in individuals with SCD than previously studied biological modifiers such as SCD genotype, hemoglobin, and percentage fetal hemoglobin. Future research using longitudinally collected data is needed to confirm these findings. PERSPECTIVE: This study reveals that psychosocial (ie, social and emotional functioning) and demographic (ie, age) variables may play an important role in predicting pain and pain-related outcomes in SCD. Our findings can inform future multicenter prospective longitudinal studies aimed at identifying modifiable psychosocial predictors of adverse pain outcomes in SCD.}, Doi = {10.1016/j.jpain.2023.07.029}, Key = {fds372966} } @article{fds375365, Author = {Dember, LM and Hsu, JY and Bernardo, L and Cavanaugh, KL and Charytan, DM and Crowley, ST and Cukor, D and Doorenbos, AZ and Edwards, DA and Esserman, D and Fischer, MJ and Jhamb, M and Joffe, S and Johansen, KL and Kalim, S and Keefe, FJ and Kimmel, PL and Krebs, EE and Kuzla, N and Mehrotra, R and Mishra, P and Pellegrino, B and Steel, JL and Unruh, ML and White, DM and Yabes, JG and Becker, WC and HOPE Consortium}, Title = {The design and baseline characteristics for the HOPE Consortium Trial to reduce pain and opioid use in hemodialysis.}, Journal = {Contemp Clin Trials}, Volume = {136}, Pages = {107409}, Year = {2024}, Month = {January}, url = {http://dx.doi.org/10.1016/j.cct.2023.107409}, Abstract = {The HOPE Consortium Trial to Reduce Pain and Opioid Use in Hemodialysis (HOPE Trial) is a multicenter randomized trial addressing chronic pain among patients receiving maintenance hemodialysis for end-stage kidney disease. The trial uses a sequential, multiple assignment design with a randomized component for all participants (Phase 1) and a non-randomized component for a subset of participants (Phase 2). During Phase 1, participants are randomized to Pain Coping Skills Training (PCST), an intervention designed to increase self-efficacy for managing pain, or Usual Care. PCST consists of weekly, live, coach-led cognitive behavioral therapy sessions delivered by video- or tele-conferencing for 12 weeks followed by daily interactive voice response sessions delivered by telephone for an additional 12 weeks. At 24 weeks (Phase 2), participants in both the PCST and Usual Care groups taking prescription opioid medications at an average dose of ≥20 morphine milligram equivalents per day are offered buprenorphine, a partial opioid agonist with a more favorable safety profile than full-agonist opioids. All participants are followed for 36 weeks. The primary outcome is pain interference ascertained, for the primary analysis, at 12 weeks. Secondary outcomes include additional patient-reported measures and clinical outcomes including falls, hospitalizations, and death. Exploratory outcomes include acceptability, tolerability, and efficacy of buprenorphine. The enrollment target of 640 participants was met 27 months after trial initiation. The findings of the trial will inform the management of chronic pain, a common and challenging issue for patients treated with maintenance hemodialysis. NCT04571619.}, Doi = {10.1016/j.cct.2023.107409}, Key = {fds375365} } @article{fds373557, Author = {Fisher, HM and Check, DK and Somers, TJ and Kelleher, SA and Majestic, C and Yu, JA and Reed, SD and Li, Y and Olsen, MK and Lerebours, R and Keefe, FJ and Steinhauser, KE and Breitbart, WS and Winger, JG}, Title = {Meaning-centered pain coping skills training for patients with metastatic cancer: Protocol for a randomized controlled efficacy trial.}, Journal = {Contemp Clin Trials}, Volume = {135}, Pages = {107363}, Year = {2023}, Month = {December}, url = {http://dx.doi.org/10.1016/j.cct.2023.107363}, Abstract = {BACKGROUND: Many patients with advanced cancer describe pain as a debilitating symptom that greatly interferes with daily activities and enjoyment of life. Psychosocial interventions can improve cancer-related pain but rarely address spiritual concerns (e.g., loss of meaning, peace), which can influence the pain experience for those facing life-threatening illness. To address these needs, we systematically developed and pilot tested a novel psychosocial intervention called Meaning-Centered Pain Coping Skills Training (MCPC). In this randomized controlled trial, we aim to determine MCPC's efficacy for reducing pain interference (primary outcome) and improving secondary outcomes. We will also estimate MCPC's cost-effectiveness. METHOD/DESIGN: Patients (target N = 210) with advanced solid tumor malignancies (Stage IV) and clinically-elevated pain interference will be enrolled and block randomized with equal allocation to MCPC + enhanced usual care or enhanced usual care alone. MCPC's four, videoconferenced, 45-60 min weekly sessions will be individually delivered by trained study therapists. Primary (pain interference) and secondary (pain severity, anxiety and depressive symptoms, pain self-efficacy, social support, spiritual well-being) patient-reported outcomes will be assessed at baseline, and 8-weeks (primary endpoint) and 12-weeks after baseline. CONCLUSION: Our MCPC intervention is the first to systematically address the biopsychosocial-spiritual aspects of pain in patients with advanced cancer. If MCPC demonstrates efficacy, next steps will involve hybrid efficacy-effectiveness and implementation work to broaden access to this brief, manualized, remotely-delivered intervention, with the goal of reducing suffering in patients with life-threatening illness.}, Doi = {10.1016/j.cct.2023.107363}, Key = {fds373557} } @article{fds374397, Author = {Myers, H and Keefe, FJ and George, SZ and Kennedy, J and Lake, AD and Martinez, C and Cook, CE}, Title = {Effect of a Patient Engagement, Education, and Restructuring of Cognitions (PEERC) approach on conservative care in rotator cuff related shoulder pain treatment: a randomized control trial.}, Journal = {BMC Musculoskelet Disord}, Volume = {24}, Number = {1}, Pages = {930}, Year = {2023}, Month = {December}, url = {http://dx.doi.org/10.1186/s12891-023-07044-y}, Abstract = {BACKGROUND: Despite similar outcomes for surgery and physical therapy (PT), the number of surgeries to treat rotator cuff related shoulder pain (RCRSP) is increasing. Interventions designed to enhance treatment expectations for PT have been shown to improve patient expectations, but no studies have explored whether such interventions influence patient reports of having had surgery, or being scheduled for surgery. The purpose of this randomized clinical trial was to examine the effect of a cognitive behavioral intervention aimed at changing expectations for PT on patient-report of having had or being scheduled for surgery and on the outcomes of PT. METHODS: The Patient Engagement, Education, and Restructuring of Cognitions (PEERC) intervention, was designed to change expectations regarding PT. PEERC was evaluated in a randomized, pragmatic "add-on" trial in by randomizing patients with RCRSP to receive either PT intervention alone (PT) or PT + PEERC. Fifty-four (54) individuals, recruited from an outpatient hospital-based orthopedic clinic, were enrolled in the trial (25 randomized to PT, 29 randomized to PT + PEERC). Outcomes assessed at enrollment, 6 weeks, discharge, and six months after discharge included the patient report of having had surgery, or being scheduled for surgery (primary) and satisfaction with PT outcome, pain, and function (secondary outcomes). RESULTS: The average age of the 54 participants was 51.81; SD = 12.54, and 63% were female. Chronicity of shoulder pain averaged 174.61 days; SD = 179.58. Study results showed that at the time of six months follow up, three (12%) of the participants in the PT alone group and one (3.4%) in the PT + PEERC group reported have had surgery or being scheduled for surgery (p = .32). There were no significant differences between groups on measures of satisfaction with the outcome of PT (p = .08), pain (p = .58) or function (p = .82). CONCLUSIONS: In patients with RCRSP, PT plus the cognitive behavioral intervention aimed at changing expectations for PT provided no additional benefit compared to PT alone with regard to patient report of having had surgery, or being scheduled to have surgery, patient reported treatment satisfaction with the outcome of PT, or improvements in pain, or function. TRIAL REGISTRATION: The trial is registered on ClinicalTrials.gov: NCT03353272 (27/11/2017).}, Doi = {10.1186/s12891-023-07044-y}, Key = {fds374397} } @article{fds374570, Author = {McDermott, K and Keefe, F and Vranceanu, A-M}, Title = {Bridging the gap: Utilizing insights from exposure therapy in the innovation of chronic musculoskeletal pain treatment.}, Journal = {J Consult Clin Psychol}, Volume = {91}, Number = {12}, Pages = {681-682}, Year = {2023}, Month = {December}, url = {http://dx.doi.org/10.1037/ccp0000855}, Abstract = {For some time, the gold standard treatment for anxiety disorders has been exposure therapy, defined as the repeated approach of anxiety-inducing situations, memories, or physiological sensations. Existing treatments to target fear and avoidance of pain can be augmented by innovations from exposure research in the anxiety disorders, including greater emphasis on safety learning, the utilization of imaginal exposure to catastrophic fears, and exposure to contrasting emotions. Given that treatments to target core, maintaining mechanisms of anxiety, including imaginal exposures, can be administered as self-directed treatments without therapist involvement, they represent important avenues for ensuring the millions of people with chronic musculosketal pain can gain access to psychosocial treatment and reduce the interference of pain in their lives. (PsycInfo Database Record (c) 2023 APA, all rights reserved).}, Doi = {10.1037/ccp0000855}, Key = {fds374570} } @article{fds372009, Author = {Rubenstein, D and McClernon, FJ and Powers, JM and Aston, ER and Keefe, FJ and Sweitzer, MM}, Title = {Pain is associated with exclusive use and co-use of tobacco and cannabis: Findings from Wave 5 (2018-2019) of the Population Assessment of Tobacco and Health Study.}, Journal = {Addict Behav}, Volume = {146}, Pages = {107814}, Year = {2023}, Month = {November}, url = {http://dx.doi.org/10.1016/j.addbeh.2023.107814}, Abstract = {INTRODUCTION: Rates of tobacco and cannabis use are disproportionately high among individuals with pain, and evidence suggests that pain may engender greater likelihood of substance co-use, yielding additive risk. This study examined national associations of pain with past-month tobacco use, cannabis use, and co-use of tobacco and cannabis. METHODS: Data came from a nationally representative US sample of adults in Wave 5 (2018-2019) of the Population Assessment of Tobacco and Health study (N = 32,014). The sample included civilian, non-institutionalized people who use tobacco and people who do not use tobacco. Past-week pain intensity (0-10) was dichotomized (0-4 no/low pain; 5-10 moderate/severe pain). Multinomial models adjusted for demographics examined substance use category membership (no tobacco or cannabis use, exclusive cannabis use, exclusive tobacco use, co-use) as a function of pain status. RESULTS: Moderate/severe pain was associated with increased relative risk of exclusive tobacco use (RRR [CI] 2.26 [2.05, 2.49], p <.001), exclusive cannabis use (1.49 [1.22, 1.82], p <.001), and co-use of tobacco and cannabis (2.79 [2.51, 3.10], p <.001), in comparison to no tobacco or cannabis use. Additionally, moderate/severe pain was associated with increased risk of co-use compared to exclusive tobacco use (1.23 [1.11, 1.37], p <.001) and exclusive cannabis use (1.88 [1.54, 2.29], p <.001). DISCUSSION: Findings suggest that not only is pain independently associated with greater risk of exclusively using tobacco or cannabis, but pain is also associated with heightened risk of co-using both products. Future work should examine the dynamic and potentially bidirectional relationships between pain and use of cannabis and tobacco.}, Doi = {10.1016/j.addbeh.2023.107814}, Key = {fds372009} } @article{fds373697, Author = {Basbaum, AI and Jensen, TS and Keefe, FJ}, Title = {Fifty years of pain research and clinical advances: highlights and key trends.}, Journal = {Pain}, Volume = {164}, Number = {11S}, Pages = {S11-S15}, Year = {2023}, Month = {November}, url = {http://dx.doi.org/10.1097/j.pain.0000000000003058}, Abstract = {This article highlights advances in basic science preclinical pain research, clinical research, and psychological research occurring over the 50 years since the International Association for the Study of Pain was founded. It presents important findings and key trends in these 3 areas of pain science: basic science preclinical research, clinical research, and psychological research.}, Doi = {10.1097/j.pain.0000000000003058}, Key = {fds373697} } @article{fds371045, Author = {Li, Y and Reed, SD and Winger, JG and Hyland, KA and Fisher, HM and Kelleher, SA and Miller, SN and Davidian, M and Laber, EB and Keefe, FJ and Somers, TJ}, Title = {Cost-Effectiveness Analysis Evaluating Delivery Strategies for Pain Coping Skills Training in Women With Breast Cancer.}, Journal = {J Pain}, Volume = {24}, Number = {9}, Pages = {1712-1720}, Year = {2023}, Month = {September}, url = {http://dx.doi.org/10.1016/j.jpain.2023.05.004}, Abstract = {Pain coping skills training (PCST) is efficacious in patients with cancer, but clinical access is limited. To inform implementation, as a secondary outcome, we estimated the cost-effectiveness of 8 dosing strategies of PCST evaluated in a sequential multiple assignment randomized trial among women with breast cancer and pain (N = 327). Women were randomized to initial doses and re-randomized to subsequent doses based on their initial response (ie, ≥30% pain reduction). A decision-analytic model was designed to incorporate costs and benefits associated with 8 different PCST dosing strategies. In the primary analysis, costs were limited to resources required to deliver PCST. Quality-adjusted life-years (QALYs) were modeled based on utility weights measured with the EuroQol-5 dimension 5-level at 4 assessments over 10 months. A probabilistic sensitivity analysis was performed to account for parameter uncertainty. Implementation of PCST initiated with the 5-session protocol was more costly ($693-853) than strategies initiated with the 1-session protocol ($288-496). QALYs for strategies beginning with the 5-session protocol were greater than for strategies beginning with the 1-session protocol. With the goal of implementing PCST as part of comprehensive cancer treatment and with willingness-to-pay thresholds ranging beyond $20,000 per QALY, the strategy most likely to provide the greatest number of QALYs at an acceptable cost was a 1-session PCST protocol followed by either 5 maintenance telephone calls for responders or 5 sessions of PCST for nonresponders. A PCST program with 1 initial session and subsequent dosing based on response provides good value and improved outcomes. PERSPECTIVE: This article presents the results of a cost analysis of the delivery of PCST, a nonpharmacological intervention, to women with breast cancer and pain. Results could potentially provide important cost-related information to health care providers and systems on the use of an efficacious and accessible nonmedication strategy for pain management. TRIALS REGISTRATION: ClinicalTrials.gov: NCT02791646, registered 6/2/2016.}, Doi = {10.1016/j.jpain.2023.05.004}, Key = {fds371045} } @article{fds371046, Author = {Somers, TJ and Winger, JG and Fisher, HM and Hyland, KA and Davidian, M and Laber, EB and Miller, SN and Kelleher, SA and Plumb Vilardaga and JC and Majestic, C and Shelby, RA and Reed, SD and Kimmick, GG and Keefe, FJ}, Title = {Behavioral cancer pain intervention dosing: results of a Sequential Multiple Assignment Randomized Trial.}, Journal = {Pain}, Volume = {164}, Number = {9}, Pages = {1935-1941}, Year = {2023}, Month = {September}, url = {http://dx.doi.org/10.1097/j.pain.0000000000002915}, Abstract = {Behavioral pain management interventions are efficacious for reducing pain in patients with cancer. However, optimal dosing of behavioral pain interventions for pain reduction is unknown, and this hinders routine clinical use. A Sequential Multiple Assignment Randomized Trial (SMART) was used to evaluate whether varying doses of Pain Coping Skills Training (PCST) and response-based dose adaptation can improve pain management in women with breast cancer. Participants (N = 327) had stage I-IIIC breast cancer and a worst pain score of > 5/10. Pain severity (a priori primary outcome) was assessed before initial randomization (1:1 allocation) to PCST-Full (5 sessions) or PCST-Brief (1 session) and 5 to 8 weeks later. Responders ( > 30% pain reduction) were rerandomized to a maintenance dose or no dose and nonresponders (<30% pain reduction) to an increased or maintenance dose. Pain severity was assessed again 5 to 8 weeks later (assessment 3) and 6 months later (assessment 4). As hypothesized, PCST-Full resulted in greater mean percent pain reduction than PCST-Brief (M [SD] = -28.5% [39.6%] vs M [SD]= -14.8% [71.8%]; P = 0.041). At assessment 3 after second dosing, all intervention sequences evidenced pain reduction from assessment 1 with no differences between sequences. At assessment 4, all sequences evidenced pain reduction from assessment 1 with differences between sequences ( P = 0.027). Participants initially receiving PCST-Full had greater pain reduction at assessment 4 ( P = 0.056). Varying PCST doses led to pain reduction over time. Intervention sequences demonstrating the most durable decreases in pain reduction included PCST-Full. Pain Coping Skills Training with intervention adjustment based on response can produce sustainable pain reduction.}, Doi = {10.1097/j.pain.0000000000002915}, Key = {fds371046} } @article{fds371049, Author = {Dorfman, CS and Shelby, RA and Stalls, JM and Somers, TJ and Keefe, FJ and Vilardaga, JP and Winger, JG and Mitchell, K and Ehren, C and Oeffinger, KC}, Title = {Improving Symptom Management for Survivors of Young Adult Cancer: Development of a Novel Intervention.}, Journal = {J Adolesc Young Adult Oncol}, Volume = {12}, Number = {4}, Pages = {472-487}, Year = {2023}, Month = {August}, url = {http://dx.doi.org/10.1089/jayao.2022.0100}, Abstract = {Purpose: Improved symptom management is a critical although unmet post-treatment need for young adult (YA) cancer survivors (aged 18-39 at diagnosis). This study aimed to develop and refine a behavioral symptom management intervention for YA survivors. Methods: Phase I: YA survivors (N = 21) and oncology providers (N = 11) completed individual interviews and an online, self-report assessment to examine symptom experiences, the need for a behavioral symptom management intervention for YAs, and perceptions about potential intervention components, structure, and format. Phase II: YA survivors (N = 10) completed user testing sessions, providing feedback on the prototype intervention materials (paper manual and mobile application), and completed an online assessment. Quantitative data were examined using descriptive statistics. Rapid qualitative analysis, a methodologically rigorous standardized approach, was used. Results: Pain, fatigue, and distress were ranked as top concerns by most YAs and providers. Phase I interviews underscored the need for a symptom management intervention for YAs. YAs and providers highlighted potential coping strategies and program format/structure suggestions (e.g., small group format) to best meet YAs' needs. A prototype intervention was developed combining the following: traditional behavioral symptom coping skills; home-based physical activity; strategies from Acceptance and Commitment Therapy and Meaning-Centered Psychotherapy; and strategies to foster self-compassion. Phase II user testing sessions highlighted strengths and suggestions for refining the prototype materials. Conclusion: Post-treatment symptoms are common for YAs. A tailored behavioral symptom management program was developed and refined with input from YAs and providers and will be examined for feasibility and acceptability in a pilot randomized controlled trial. Clinical Trial: Clinicaltrials.gov identifier NCT04035447.}, Doi = {10.1089/jayao.2022.0100}, Key = {fds371049} } @article{fds370880, Author = {Winger, JG and Kelleher, SA and Ramos, K and Check, DK and Yu, JA and Powell, VD and Lerebours, R and Olsen, MK and Keefe, FJ and Steinhauser, KE and Porter, LS and Breitbart, WS and Somers, TJ}, Title = {Meaning-centered pain coping skills training for patients with metastatic cancer: Results of a randomized controlled pilot trial.}, Journal = {Psychooncology}, Volume = {32}, Number = {7}, Pages = {1096-1105}, Year = {2023}, Month = {July}, url = {http://dx.doi.org/10.1002/pon.6151}, Abstract = {OBJECTIVE: For patients with advanced cancer, pain is a common and debilitating symptom that can negatively impact physical, emotional, and spiritual well-being. This trial examined the feasibility and initial effects of Meaning-Centered Pain Coping Skills Training (MCPC), a cognitive-behavioral pain management intervention with an emphasis on enhancing meaning (i.e., a personal sense of purpose, worth, and significance) and peace. METHODS: We enrolled 60 adults with stage IV solid tumor cancers and moderate-severe pain between February 2021 and February 2022. Participants were randomized 1:1 to MCPC + usual care or usual care alone. Meaning-Centered Pain Coping Skills Training consisted of four weekly 60-min individual sessions via videoconference or telephone, delivered by a trained therapist using a manualized protocol. Participants completed validated measures of pain severity, pain interference, pain self-efficacy, spiritual well-being (i.e., meaning, peace, and faith), and psychological distress at baseline and 5-week and 10-week follow-ups. RESULTS: All feasibility metrics exceeded prespecified benchmarks. Fifty-eight percent of screened patients were eligible, and 69% of eligible patients consented. Of those assigned to MCPC, 93% completed all sessions and 100% of those who completed follow-ups reported using coping skills weekly. Retention was strong at 5-week (85%) and 10-week (78%) follow-ups. Meaning-Centered Pain Coping Skills Training participants reported better scores than control participants across outcome measures, including moderate-to-large sized differences at 10-week follow-up in pain severity (Cohen's d = -0.75 [95% confidence interval: -1.36, -0.14]), pain interference (d = -0.82 [-1.45, -0.20]), and pain self-efficacy (d = 0.74 [0.13, 1.35]). CONCLUSIONS: MCPC is a highly feasible, engaging, and promising approach for improving pain management in advanced cancer. Future efficacy testing is warranted. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04431830, registered 16 June 2020.}, Doi = {10.1002/pon.6151}, Key = {fds370880} } @article{fds370237, Author = {Hyland, KA and Amaden, GH and Diachina, AK and Miller, SN and Dorfman, CS and Berchuck, SI and Winger, JG and Somers, TJ and Keefe, FJ and Uronis, HE and Kelleher, SA}, Title = {mHealth Coping Skills Training for Symptom Management (mCOPE) for colorectal cancer patients in early to mid-adulthood: Study protocol for a randomized controlled trial.}, Journal = {Contemp Clin Trials Commun}, Volume = {33}, Pages = {101126}, Year = {2023}, Month = {June}, url = {http://dx.doi.org/10.1016/j.conctc.2023.101126}, Abstract = {BACKGROUND: Colorectal cancer (CRC) patients in early to mid-adulthood (≤50 years) are challenged by high symptom burden (i.e., pain, fatigue, distress) and age-related stressors (e.g., managing family, work). Cognitive behavioral theory (CBT)-based coping skills training interventions reduce symptoms and improve quality of life in cancer patients. However, traditional CBT-based interventions are not accessible to these patients (e.g., in-person sessions, during work day), nor designed to address symptoms within the context of this stage of life. We developed a mobile health (mHealth) coping skills training program for pain, fatigue and distress (mCOPE) for CRC patients in early to mid-adulthood. We utilize a randomized controlled trial to test the extent to which mCOPE reduces pain, fatigue and distress (multiple primary outcomes) and improves quality of life and symptom self-efficacy (secondary outcomes). METHODS/DESIGN: Patients (N = 160) ≤50 years with CRC endorsing pain, fatigue and/or distress are randomized 1:1 to mCOPE or standard care. mCOPE is a five-session CBT-based coping skills training program (e.g., relaxation, activity pacing, cognitive restructuring) that was adapted for CRC patients in early to mid-adulthood. mCOPE utilizes mHealth technology (e.g., videoconference, mobile app) to deliver coping skills training, capture symptom and skills use data, and provide personalized support and feedback. Self-report assessments are completed at baseline, post-treatment (5-8 weeks post-baseline; primary endpoint), and 3- and 6-months later. CONCLUSIONS: mCOPE is innovative and potentially impactful for CRC patients in early to mid-adulthood. Hypothesis confirmation would demonstrate initial efficacy of a mHealth cognitive behavioral intervention to reduce symptom burden in younger CRC patients.}, Doi = {10.1016/j.conctc.2023.101126}, Key = {fds370237} } @article{fds371125, Author = {Hohenschurz-Schmidt, D and Vase, L and Scott, W and Annoni, M and Ajayi, OK and Barth, J and Bennell, K and Berna, C and Bialosky, J and Braithwaite, F and Finnerup, NB and Williams, ACDC and Carlino, E and Cerritelli, F and Chaibi, A and Cherkin, D and Colloca, L and Côté, P and Darnall, BD and Evans, R and Fabre, L and Faria, V and French, S and Gerger, H and Häuser, W and Hinman, RS and Ho, D and Janssens, T and Jensen, K and Johnston, C and Juhl Lunde and S and Keefe, F and Kerns, RD and Koechlin, H and Kongsted, A and Michener, LA and Moerman, DE and Musial, F and Newell, D and Nicholas, M and Palermo, TM and Palermo, S and Peerdeman, KJ and Pogatzki-Zahn, EM and Puhl, AA and Roberts, L and Rossettini, G and Tomczak Matthiesen and S and Underwood, M and Vaucher, P and Vollert, J and Wartolowska, K and Weimer, K and Werner, CP and Rice, ASC and Draper-Rodi, J}, Title = {Recommendations for the development, implementation, and reporting of control interventions in efficacy and mechanistic trials of physical, psychological, and self-management therapies: the CoPPS Statement.}, Journal = {BMJ}, Volume = {381}, Pages = {e072108}, Year = {2023}, Month = {May}, url = {http://dx.doi.org/10.1136/bmj-2022-072108}, Doi = {10.1136/bmj-2022-072108}, Key = {fds371125} } @article{fds371126, Author = {Bronfort, G and Delitto, A and Schneider, M and Heagerty, PJ and Chou, R and Connett, J and Evans, R and George, S and Glick, RM and Greco, C and Hanson, L and Keefe, F and Leininger, B and Licciardone, J and McFarland, C and Meier, E and Schulz, C and Turk, D}, Title = {Effectiveness of spinal manipulation and biopsychosocial self-management compared to medical care for low back pain: a randomized trial study protocol.}, Journal = {BMC Musculoskelet Disord}, Volume = {24}, Number = {1}, Pages = {415}, Year = {2023}, Month = {May}, url = {http://dx.doi.org/10.1186/s12891-023-06549-w}, Abstract = {BACKGROUND: Chronic low back pain (cLBP) is widespread, costly, and burdensome to patients and health systems. Little is known about non-pharmacological treatments for the secondary prevention of cLBP. There is some evidence that treatments addressing psychosocial factors in higher risk patients are more effective than usual care. However, most clinical trials on acute and subacute LBP have evaluated interventions irrespective of prognosis. METHODS: We have designed a phase 3 randomized trial with a 2 × 2 factorial design. The study is also a Hybrid type 1 trial with focus on intervention effectiveness while simultaneously considering plausible implementation strategies. Adults (n = 1000) with acute/subacute LBP at moderate to high risk of chronicity based on the STarT Back screening tool will be randomized in to 1 of 4 interventions lasting up to 8 weeks: supported self-management (SSM), spinal manipulation therapy (SMT), both SSM and SMT, or medical care. The primary objective is to assess intervention effectiveness; the secondary objective is to assess barriers and facilitators impacting future implementation. Primary effectiveness outcome measures are: (1) average pain intensity over 12 months post-randomization (pain, numerical rating scale); (2) average low back disability over 12 months post-randomization (Roland-Morris Disability Questionnaire); (3) prevention of cLBP that is impactful at 10-12 months follow-up (LBP impact from the PROMIS-29 Profile v2.0). Secondary outcomes include: recovery, PROMIS-29 Profile v2.0 measures to assess pain interference, physical function, anxiety, depression, fatigue, sleep disturbance, and ability to participate in social roles and activities. Other patient-reported measures include LBP frequency, medication use, healthcare utilization, productivity loss, STarT Back screening tool status, patient satisfaction, prevention of chronicity, adverse events, and dissemination measures. Objective measures include the Quebec Task Force Classification, Timed Up & Go Test, the Sit to Stand Test, and the Sock Test assessed by clinicians blinded to the patients' intervention assignment. DISCUSSION: By targeting those subjects at higher risk this trial aims to fill an important gap in the scientific literature regarding the effectiveness of promising non-pharmacological treatments compared to medical care for the management of patients with an acute episode of LBP and the prevention of progression to a severe chronic back problem. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03581123.}, Doi = {10.1186/s12891-023-06549-w}, Key = {fds371126} } @article{fds370043, Author = {Simon, CB and Hicks, GE and Pieper, CF and Byers Kraus and V and Keefe, FJ and Colón-Emeric, C}, Title = {A Novel Movement-Evoked Pain Provocation Test for Older Adults With Persistent Low Back Pain: Safety, Feasibility, and Associations With Self-reported Physical Function and Usual Gait Speed.}, Journal = {Clin J Pain}, Volume = {39}, Number = {4}, Pages = {166-174}, Year = {2023}, Month = {April}, url = {http://dx.doi.org/10.1097/AJP.0000000000001101}, Abstract = {OBJECTIVES: Low back pain (LBP) is highly prevalent and disabling for older adults. Movement-evoked pain is an emerging measure that may help to predict disability; but is not currently a part of geriatric LBP clinical care. This study tested the safety and feasibility of a new Movement-Evoked Provocation Test for Low Back Pain in Older Adults (MEPLO). We also compared associations between movement-evoked pain via 2 different scoring methods and disability-associated outcomes. MATERIALS AND METHODS: Thirty-nine older adults with persistent LBP provided baseline recalled and resting pain ratings, self-reported physical function, and usual gait speed. Participants then completed MEPLO, involving 4 tasks essential for functional independence: chair rises, trunk rotation, reaching, and walking. Movement-evoked pain was then quantified using the traditional change score (delta) method of pain premovement to postmovement; and also, a new aggregate method that combines pain ratings after the 4 tasks. RESULTS: No safety or feasibility issues were identified. Compared with the delta score, the aggregate score was more strongly associated with self-reported physical function (beta: -0.495 vs. -0.090) and usual gait speed (beta: -0.450 vs. -0.053). Similarly, the aggregate score was more strongly associated with self-reported physical function than recalled and resting pain (beta: -0.470, -0.283, and 0.136, respectively). DISCUSSION: This study shows the safety and feasibility of testing movement-evoked pain in older adults with persistent LBP, and its potential superiority to traditional pain measures. Future studies must validate these findings and test the extent to which MEPLO is implementable to change with geriatric LBP standard of care.}, Doi = {10.1097/AJP.0000000000001101}, Key = {fds370043} } @article{fds370161, Author = {Palermo, TM and Davis, KD and Bouhassira, D and Hurley, RW and Katz, JD and Keefe, FJ and Schatman, M and Turk, DC and Yarnitsky, D}, Title = {Promoting inclusion, diversity and equity in pain science.}, Journal = {Eur J Pain}, Volume = {27}, Number = {4}, Pages = {451-456}, Year = {2023}, Month = {April}, url = {http://dx.doi.org/10.1002/ejp.2087}, Doi = {10.1002/ejp.2087}, Key = {fds370161} } @article{fds371047, Author = {Kerns, RD and Davis, AF and Fritz, JM and Keefe, FJ and Peduzzi, P and Rhon, DI and Taylor, SL and Vining, R and Yu, Q and Zeliadt, SB and George, SZ}, Title = {Intervention Fidelity in Pain Pragmatic Trials for Nonpharmacologic Pain Management: Nuanced Considerations for Determining PRECIS-2 Flexibility in Delivery and Adherence.}, Journal = {J Pain}, Volume = {24}, Number = {4}, Pages = {568-574}, Year = {2023}, Month = {April}, url = {http://dx.doi.org/10.1016/j.jpain.2022.12.008}, Abstract = {Nonpharmacological treatments are considered first-line pain management strategies, but they remain clinically underused. For years, pain-focused pragmatic clinical trials (PCTs) have generated evidence for the enhanced use of nonpharmacological interventions in routine clinical settings to help overcome implementation barriers. The Pragmatic Explanatory Continuum Indicator Summary (PRECIS-2) framework describes the degree of pragmatism across 9 key domains. Among these, "flexibility in delivery" and "flexibility in adherence," address a key goal of pragmatic research by tailoring approaches to settings in which people receive routine care. However, to maintain scientific and ethical rigor, PCTs must ensure that flexibility features do not compromise delivery of interventions as designed, such that the results are ethically and scientifically sound. Key principles of achieving this balance include clear definitions of intervention core components, intervention monitoring and documentation that is sufficient but not overly burdensome, provider training that meets the demands of delivering an intervention in real-world settings, and use of an ethical lens to recognize and avoid potential trial futility when necessary and appropriate. PERSPECTIVE: This article presents nuances to be considered when applying the PRECIS-2 framework to describe pragmatic clinical trials. Trials must ensure that patient-centered treatment flexibility does not compromise delivery of interventions as designed, such that measurement and analysis of treatment effects is reliable.}, Doi = {10.1016/j.jpain.2022.12.008}, Key = {fds371047} } @article{fds370044, Author = {Mayhew, M and Balderson, BH and Cook, AJ and Dickerson, JF and Elder, CR and Firemark, AJ and Haller, IV and Justice, M and Keefe, FJ and McMullen, CK and O'Keeffe-Rosetti, MC and Owen-Smith, AA and Rini, C and Schneider, JL and Von Korff and M and Wandner, LD and DeBar, LL}, Title = {Comparing the clinical and cost-effectiveness of remote (telehealth and online) cognitive behavioral therapy-based treatments for high-impact chronic pain relative to usual care: study protocol for the RESOLVE multisite randomized control trial.}, Journal = {Trials}, Volume = {24}, Number = {1}, Pages = {196}, Year = {2023}, Month = {March}, url = {http://dx.doi.org/10.1186/s13063-023-07165-8}, Abstract = {BACKGROUND: Cognitive behavioral therapy for chronic pain (CBT-CP) is an effective but underused treatment for high-impact chronic pain. Increased access to CBT-CP services for pain is of critical public health importance, particularly for rural and medically underserved populations who have limited access due to these services being concentrated in urban and high income areas. Making CBT-CP widely available and more affordable could reduce barriers to CBT-CP use. METHODS: As part of the National Institutes of Health Helping to End Addiction Long-term® (NIH HEAL) initiative, we designed and implemented a comparative effectiveness, 3-arm randomized control trial comparing remotely delivered telephonic/video and online CBT-CP-based services to usual care for patients with high-impact chronic pain. The RESOLVE trial is being conducted in 4 large integrated healthcare systems located in Minnesota, Georgia, Oregon, and Washington state and includes demographically diverse populations residing in urban and rural areas. The trial compares (1) an 8-session, one-on-one, professionally delivered telephonic/video CBT-CP program; and (2) a previously developed and tested 8-session online CBT-CP-based program (painTRAINER) to (3) usual care augmented by a written guide for chronic pain management. Participants are followed for 1 year post-allocation and are assessed at baseline, and 3, 6, and 12 months post-allocation. The primary outcome is minimal clinically important difference (MCID; ≥ 30% reduction) in pain severity (composite of pain intensity and pain-related interference) assessed by a modified 11-item version of the Brief Pain Inventory-Short Form at 3 months. Secondary outcomes include pain severity, pain intensity, and pain-related interference scores, quality of life measures, and patient global impression of change at 3, 6, and 12 months. Cost-effectiveness is assessed by incremental cost per additional patient with MCID in primary outcome and by cost per quality-adjusted life year achieved. Outcome assessment is blinded to group assignment. DISCUSSION: This large-scale trial provides a unique opportunity to rigorously evaluate and compare the clinical and cost-effectiveness of 2 relatively low-cost and scalable modalities for providing CBT-CP-based treatments to persons with high-impact chronic pain, including those residing in rural and other medically underserved areas with limited access to these services. TRIAL REGISTRATION: ClinicalTrials.gov NCT04523714. This trial was registered on 24 August 2020.}, Doi = {10.1186/s13063-023-07165-8}, Key = {fds370044} } @article{fds370045, Author = {Burns, JW and Jensen, MP and Gerhart, J and Thorn, BE and Lillis, TA and Carmody, J and Keefe, F}, Title = {Cognitive therapy, mindfulness-based stress reduction, and behavior therapy for people with chronic low back pain: A comparative mechanisms study.}, Journal = {J Consult Clin Psychol}, Volume = {91}, Number = {3}, Pages = {171-187}, Year = {2023}, Month = {March}, url = {http://dx.doi.org/10.1037/ccp0000801}, Abstract = {OBJECTIVE: Cognitive therapy (CT), mindfulness-based stress reduction (MBSR), and behavior therapy (BT) for chronic pain treatment produce outcome improvements. Evidence also suggests that changes in putative therapeutic mechanisms are associated with changes in outcomes. Nonetheless, methodological limitations preclude clear understanding of how psychosocial chronic pain treatments work. In this comparative mechanism study, we examined evidence for specific and shared mechanism effects across the three treatments. METHOD: CT, MBSR, BT, and treatment as usual (TAU) were compared in people with chronic low back pain (N = 521). Eight individual sessions were administered with weekly assessments of "specific" mechanisms (pain catastrophizing, mindfulness, behavior activation) and outcomes. RESULTS: CT, MBSR, and BT produced similar pre- to posttreatment effects on all mechanism variables, and all three active treatments produced greater improvements than TAU. Participant ratings of expectations of benefit and working alliance were similar across treatments. Lagged and cross-lagged analyses revealed that prior week changes in both mechanism and outcome factors predicted next week changes in their counterparts. Analyses of variance contributions suggested that changes in pain catastrophizing and pain self-efficacy were consistent unique predictors of subsequent outcome changes. CONCLUSIONS: Findings support the operation of shared mechanisms over specific ones. Given significant lagged and cross-lagged effects, unidirectional conceptualizations-mechanism to outcome-need to be expanded to include reciprocal effects. Thus, prior week changes in pain-related cognitions could predict next week changes in pain interference which in turn could predict next week changes in pain-related cognitions, in what may be an upward spiral of improvement. (PsycInfo Database Record (c) 2023 APA, all rights reserved).}, Doi = {10.1037/ccp0000801}, Key = {fds370045} } @article{fds368120, Author = {Palermo, TM and Davis, KD and Bouhassira, D and Hurley, RW and Katz, JD and Keefe, FJ and Schatman, M and Turk, DC and Yarnitsky, D}, Title = {Promoting Inclusion, Diversity, and Equity in Pain Science.}, Journal = {J Pain}, Volume = {24}, Number = {2}, Pages = {187-191}, Year = {2023}, Month = {February}, url = {http://dx.doi.org/10.1016/j.jpain.2022.11.005}, Doi = {10.1016/j.jpain.2022.11.005}, Key = {fds368120} } @article{fds369116, Author = {Palermo, TM and Davis, KD and Bouhassira, D and Hurley, RW and Katz, JD and Keefe, FJ and Schatman, M and Turk, DC and Yarnitsky, D}, Title = {Promoting Inclusion, Diversity, and Equity in Pain Science.}, Journal = {Clin J Pain}, Volume = {39}, Number = {2}, Pages = {55-59}, Year = {2023}, Month = {February}, url = {http://dx.doi.org/10.1097/AJP.0000000000001094}, Doi = {10.1097/AJP.0000000000001094}, Key = {fds369116} } @article{fds369117, Author = {Palermo, TM and Davis, KD and Bouhassira, D and Hurley, RW and Katz, JD and Keefe, FJ and Schatman, M and Turk, DC and Yarnitsky, D}, Title = {Promoting Inclusion, Diversity, and Equity in Pain Science.}, Journal = {Pain Med}, Volume = {24}, Number = {2}, Pages = {105-109}, Year = {2023}, Month = {February}, url = {http://dx.doi.org/10.1093/pm/pnac204}, Doi = {10.1093/pm/pnac204}, Key = {fds369117} } @article{fds368585, Author = {Garland, EL and Roberts, RL and Hanley, AW and Zeidan, F and Keefe, FJ}, Title = {The Mindful Reappraisal of Pain Scale (MRPS): Validation of a New Measure of Psychological Mechanisms of Mindfulness-Based Analgesia.}, Journal = {Mindfulness (N Y)}, Volume = {14}, Number = {1}, Pages = {192-204}, Year = {2023}, Month = {January}, url = {http://dx.doi.org/10.1007/s12671-022-02034-y}, Abstract = {OBJECTIVES: Mindfulness is theorized to decrease the affective amplification of chronic pain by facilitating a shift from emotionally-laden, catastrophic pain appraisals of nociceptive input to reappraising chronic pain as an innocuous sensory signal that does not signify harm. Understanding of these hypothetical psychological mechanisms of mindfulness-based analgesia has been limited by a lack of direct measures. We conducted a series of psychometric and experimental studies to develop and validate the Mindful Reappraisal of Pain Sensations Scale (MPRS). METHODS: After item generation, we conducted exploratory and confirmatory factor analyses of the MRPS in samples of opioid-treated chronic pain patients both before (n=450; n=90) and after (n=222) participating in Mindfulness-Oriented Recovery Enhancement (MORE). We then examined the convergent and divergent validity of the MRPS. Finally, in data from a randomized clinical trial (n=250), the MRPS was tested as a mediator of the effects of MORE on reducing chronic pain severity. RESULTS: Exploratory and confirmatory factor analyses demonstrated the single-factor structure of the MRPS. The MRPS also evidenced convergent and divergent validity. Mindfulness training through MORE significantly increased MRPS scores relative to supportive psychotherapy (F4,425.03 = 16.15, p < .001). Changes in MRPS scores statistically mediated the effect of MORE on reducing chronic pain severity through 9-month follow-up. CONCLUSIONS: Taken together, these studies demonstrate that the MRPS is a psychometrically sound and valid measure of novel analgesic mechanisms of mindfulness including attentional disengagement from affective pain appraisals and interoceptive exposure to pain sensations.}, Doi = {10.1007/s12671-022-02034-y}, Key = {fds368585} } @article{fds369142, Author = {Palermo, TM and Davis, KD and Bouhassira, D and Hurley, RW and Katz, JD and Keefe, FJ and Schatman, M and Turk, DC and Yarnitsky, D}, Title = {Promoting inclusion, diversity, and equity in pain science.}, Journal = {Pain reports}, Volume = {8}, Number = {1}, Pages = {e1063}, Year = {2023}, Month = {January}, url = {http://dx.doi.org/10.1097/pr9.0000000000001063}, Doi = {10.1097/pr9.0000000000001063}, Key = {fds369142} } @article{fds369397, Author = {Palermo, TM and Davis, KD and Bouhassira, D and Hurley, RW and Katz, JD and Keefe, FJ and Schatman, ME and Turk, DC and Yarnitsky, D}, Title = {Promoting Inclusion, Diversity, and Equity in Pain Science.}, Journal = {J Pain Res}, Volume = {16}, Pages = {301-306}, Year = {2023}, url = {http://dx.doi.org/10.2147/JPR.S401985}, Doi = {10.2147/JPR.S401985}, Key = {fds369397} } @article{fds369895, Author = {Palermo, TM and Davis, KD and Bouhassira, D and Hurley, RW and Katz, JD and Keefe, FJ and Schatman, M and Turk, DC and Yarnitsky, D}, Title = {Promoting inclusion, diversity, and equity in pain science.}, Journal = {Can J Pain}, Volume = {7}, Number = {1}, Pages = {2161272}, Year = {2023}, url = {http://dx.doi.org/10.1080/24740527.2022.2161272}, Doi = {10.1080/24740527.2022.2161272}, Key = {fds369895} } @article{fds372550, Author = {Martin, S and Arthur, SS and Bovbjerg, DH and Huang, M and Keefe, FJ and Manculich, J and Soo, MSC and Zuley, ML and Shelby, RA}, Title = {The Role Of Psychological Factors As Predictors Of Mammography Pain Experienced By Breast Cancer Survivors During Their First Surveillance Screening After Breast-Conserving Surgery}, Journal = {JOURNAL OF PAIN}, Volume = {24}, Number = {4}, Pages = {100-100}, Year = {2023}, Key = {fds372550} } @article{fds373698, Author = {Winger, JG and Kelleher, SA and Ramos, K and Check, DK and Lerebours, RC and Olsen, MK and Keefe, FJ and Steinhauser, KE and Porter, LS and Somers, TJ}, Title = {MEANING-CENTERED PAIN COPING SKILLS TRAINING FOR PATIENTS WITH ADVANCED CANCER: RESULTS OF A RANDOMIZED CONTROLLED PILOT TRIAL}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {57}, Pages = {S285-S285}, Year = {2023}, Key = {fds373698} } @article{fds359927, Author = {Porter, LS and Weiner, DK and Ramos, K and Barnes, DE and Schmader, KE and Gwyther, L and Ritchie, CS and Keefe, FJ}, Title = {Partnering to cope with pain: A pilot study of a caregiver-assisted pain coping skills intervention for patients with cognitive impairment and dementia.}, Journal = {Palliat Support Care}, Volume = {20}, Number = {6}, Pages = {785-793}, Publisher = {Cambridge University Press (CUP)}, Year = {2022}, Month = {December}, url = {http://dx.doi.org/10.1017/S1478951521001747}, Abstract = {OBJECTIVE: To develop a new caregiver-assisted pain coping skills training protocol specifically tailored for community-dwelling persons with cognitive impairment and pain, and assess its feasibility and acceptability. METHOD: In Phase I, we conducted interviews with 10 patient-caregiver dyads to gather feedback about intervention content and delivery. Phase II was a single-arm pilot test to evaluate the intervention's feasibility and acceptability. Dyads in the pilot study (n = 11) completed baseline surveys, received five intervention sessions, and then completed post-intervention surveys. Analyses focused on feasibility and acceptability. RESULTS: Dyads responded positively to the pain coping skills presented in the interviews; their feedback was used to refine the intervention. Findings from the pilot study suggested that the intervention was feasible and acceptable. 69% of eligible dyads consented, 82% completed all five intervention sessions, and 100% completed the post-treatment assessment. Caregivers reported high satisfaction ratings. They also reported using the pain coping skills on a regular basis, and that they found most of the skills helpful and easy to use. SIGNIFICANCE OF RESULTS: These preliminary findings suggest that a caregiver-assisted pain coping skills intervention is feasible and acceptable, and that it may be a promising approach to managing pain in patients with cognitive impairment.}, Doi = {10.1017/S1478951521001747}, Key = {fds359927} } @article{fds371048, Author = {Benes, LL and Keefe, FJ and DeBar, LL}, Title = {Treating Persistent Pain: A Nurse Co-Led, Interdisciplinary Model for Primary Care.}, Journal = {Pain Manag Nurs}, Volume = {23}, Number = {6}, Pages = {728-736}, Year = {2022}, Month = {December}, url = {http://dx.doi.org/10.1016/j.pmn.2022.07.004}, Abstract = {The public health crisis of chronic pain has only increased in recognition since the Institute of Medicine's (IOM) Relieving Pain in America (2011) called for a cultural transformation in the way pain is viewed, treated, and put forward specific recommendations for action. The National Pain Strategy (NPS) provides a roadmap for putting these recommendations into practice. We implemented a program that placed nurses and behavioral specialists at the head of an interdisciplinary team utilizing best practices. In this program, nurses enacted the NPS recommendations to advance care for patients with persistent pain on long-term opioid treatment. This program promoted professional growth in nurses along with fostering success for patients. Compared with patients receiving usual care, patients in the program achieved greater reductions in pain severity, pain-related disability, and pain-related functional interference and reported greater satisfaction with pain-related care and primary care services. This article will detail the NPS-aligned practice approaches these nurses and their teams used, describe the training for the nurses, and speak to opportunities to enhance the nurse's capacity for this role in hopes of providing a model for the future implementation of an NPS-based approach by nurses.}, Doi = {10.1016/j.pmn.2022.07.004}, Key = {fds371048} } @article{fds367347, Author = {Stalls, JM and Bovbjerg, DH and Somers, TJ and Plumb Vilardaga and JC and Kimmick, GG and McAuliffe, PF and Keefe, FJ and Posluszny, DM and Sullivan, MJL and Erkanli, A and Reed, SD and Sutton, L and Owen, L and Massa, L and Shelby, RA}, Title = {Improving well-being for individuals with persistent pain after surgery for breast cancer, lobular carcinoma in situ, or ductal carcinoma in situ: A randomized clinical trial.}, Journal = {Contemp Clin Trials}, Volume = {122}, Pages = {106934}, Year = {2022}, Month = {November}, url = {http://dx.doi.org/10.1016/j.cct.2022.106934}, Abstract = {>276,000 Americans will be diagnosed with invasive breast cancer, lobular carcinoma in situ, or ductal carcinoma in situ this year and most will undergo breast surgery as part of their care. Although prognosis is excellent, many patients experience persistent post-surgical pain (PSP), which has no satisfactory pharmacological treatment. The causal contributions of pain-associated psychological factors (e.g., catastrophic thoughts about pain, psychological flexibility, self-efficacy) to the continuing burden of PSP have not yet been determined and may be opportune intervention targets. The randomized trial described here will compare the benefits of three manualized behavioral interventions for individuals with PSP. Participants will receive either: 1) self-guided health education (SGHE); 2) interventionist-guided health education (IGHE); or 3) interventionist-guided pain coping skills training with elements of acceptance and commitment therapy that specially target catastrophic thoughts about pain, self-efficacy, and psychological flexibility (CST-PSP). Participants will prospectively complete validated assessments of primary outcomes (PSP severity and interference) at baseline (pre-intervention) and 3-, 6-, and 12-months later. Validated measures of emotional distress and cancer-specific distress will be assessed as secondary outcomes. To test their roles as drivers of PSP, catastrophic thoughts about pain, self-efficacy, and psychological flexibility, will be assessed and statistically analyzed as mediators of hypothesized beneficial effects. The interventions' impacts on pain sensitivity and central sensitization will be investigated to test these physiological pathways as proximal drivers of PSP. To better characterize the patient experience, additional validated measures will be explored for associations with PSP, along with demographic and clinical factors. Trial registration: https://clinicaltrials.gov/ct2/show/NCT04225585, registered January 13, 2020.}, Doi = {10.1016/j.cct.2022.106934}, Key = {fds367347} } @article{fds367653, Author = {Gilron, I and Keefe, FJ}, Title = {An introduction to the biennial review of pain.}, Journal = {Pain}, Volume = {163}, Number = {Suppl 1}, Pages = {S1-S2}, Year = {2022}, Month = {November}, url = {http://dx.doi.org/10.1097/j.pain.0000000000002774}, Doi = {10.1097/j.pain.0000000000002774}, Key = {fds367653} } @article{fds367413, Author = {Post, KM and Smith, DA and Burns, JW and Porter, LS and Keefe, FJ}, Title = {A Dyadic Investigation of Depressed Affect and Interspousal Behavior in Couples With Chronic Back Pain.}, Journal = {Ann Behav Med}, Volume = {56}, Number = {10}, Pages = {1002-1013}, Year = {2022}, Month = {October}, url = {http://dx.doi.org/10.1093/abm/kaab100}, Abstract = {BACKGROUND: Depression and marital discord are characteristic not only of individuals with chronic low back pain (ICPs) but also of their spouses. PURPOSE: We examined actor-partner interdependence models to evaluate associations among depressed affect and criticism and support of partners at the same time point (concurrent effects) and 3 hr later (lagged effects). Fully dyadic models were used to account for both within-person and cross-spouse associations among depressed affect, criticism, and support for ICPs and spouses. We also examined the direction of the relationships (depressed affect predicting behavior and behavior predicting depressed affect) all while controlling for pain intensity, pain behavior, and the prior dependent variable. METHODS: ICPs (n = 105) and their spouses completed electronic diary measures of depressed affect and behavior (criticism and support) five times a day for 2 weeks. Hierarchical linear modeling with person-mean centering was used for data analysis. RESULTS: Within the same 3 hr epoch, more depressed affect was related to higher criticism and generally less support. Lagged analyses suggested bidirectional relationships between spouse's own depressed affect and spouse's own criticism of ICPs. Spouse depressed affect was also associated with decreased support received from ICPs. Pain behavior and pain intensity were also related to depressed affect, criticism, and support especially concurrently. CONCLUSIONS: Theories and interventions need to address not only ICP depressed affect but also spouse depressed affect, as spouse depressed affect may be a stress generating precursor to criticism and support.}, Doi = {10.1093/abm/kaab100}, Key = {fds367413} } @article{fds366144, Author = {Porter, LS and Ramos, K and Baucom, DH and Steinhauser, K and Erkanli, A and Strauman, TJ and Zafar, SY and Check, DK and Leo, K and Liu, E and Keefe, FJ}, Title = {Evaluating a couple communication skills training (CCST) intervention for advanced cancer: study protocol for a randomized controlled trial.}, Journal = {Trials}, Volume = {23}, Number = {1}, Pages = {712}, Year = {2022}, Month = {August}, url = {http://dx.doi.org/10.1186/s13063-022-06656-4}, Abstract = {BACKGROUND: For patients and their intimate partners, advanced cancer poses significant challenges that can negatively impact both individuals and their relationship. Prior studies have found evidence that couple-based communication skills interventions can to be beneficial for patients and partners. However, these studies have been limited by reliance on in-person treatment delivery and have not targeted couples at high risk for poor outcomes. This study tests the efficacy of a Couples Communication Skills Training (CCST) intervention delivered via videoconference for couples reporting high levels of holding back from discussing cancer-related concerns, a variable associated with poorer psychological and relationship functioning. METHODS: This RCT is designed to evaluate the efficacy of CCST in improving patient and partner relationship functioning (primary outcome). Secondary outcomes include patient and partner psychological functioning and patient symptoms and health care use. We also examine the role of objective and self-reported communication behaviors as mediators of treatment effects. Two hundred thirty patients with advanced lung, gastrointestinal, genitourinary, and breast cancer and their partners will be randomized to CCST or an education control intervention. Participants in both conditions complete self-reported outcome measures at baseline, mid-treatment, post-treatment, and 3 months post-treatment. Objective measures of communication are derived from video-recorded couple conversations collected at baseline and post-treatment. An implementation-related process evaluation (assessing implementation outcomes and potential barriers to/facilitators of implementation) will be conducted to inform future efforts to implement CCST in real-world settings. DISCUSSION: This trial can yield important new knowledge about effective ways to improve patient and partner adjustment to advanced cancer. TRIAL REGISTRATION: This study trial is registered at clinicaltrials.gov (Trial # NCT04590885); registration date: October 19, 2020.}, Doi = {10.1186/s13063-022-06656-4}, Key = {fds366144} } @article{fds362557, Author = {Kelleher, SA and Fisher, HM and Winger, JG and Miller, SN and Amaden, GH and Somers, TJ and Colloca, L and Uronis, HE and Keefe, FJ}, Title = {Virtual reality for improving pain and pain-related symptoms in patients with advanced stage colorectal cancer: A pilot trial to test feasibility and acceptability.}, Journal = {Palliat Support Care}, Volume = {20}, Number = {4}, Pages = {471-481}, Year = {2022}, Month = {August}, url = {http://dx.doi.org/10.1017/S1478951521002017}, Abstract = {OBJECTIVE: Virtual reality (VR) has the potential to improve pain and pain-related symptoms. We examined the feasibility, acceptability, safety, and impact of a 30-min virtual underwater/sea environment (VR Blue) for reducing pain and pain-related symptoms in advanced colorectal cancer patients. A qualitative exit interview was conducted to understand preferences, thoughts, and feelings about the VR session. METHOD: Participants (N = 20) had stage IV colorectal cancer and moderate-to-severe pain. Participants completed a 30-min VR Blue session that visually and aurally immersed them in virtual ocean scenarios. Feasibility was assessed by accrual (N = 20), protocol adherence (≥80% completing VR Blue), and completed data (≥80% assessment completion). Acceptability was determined by patients reporting ≥80% intervention satisfaction. Safety was determined by ≥80% of patients completing the session without self-reported side effects. Measures of pain, tension, relaxation, stress, anxiety, and mood were collected before, during, and after the VR Blue session. A semi-structured qualitative interview was conducted after VR Blue to assess participants' VR experiences. RESULTS: All participants (100%) completed the VR Blue session. There was 100% data collection at the pre- and post-assessments. Satisfaction with VR Blue was high M = 3.3 (SD = 0.4) (83%). No significant side effects were reported. Pain decreased by 59% (Pre-M = 3 [1]; Post-M = 1 [1]). Tension decreased by 74% (Pre-M = 30 [24]; Post-M = 8 [13]). Relaxation improved by 38% (Pre-M = 62 [21]); Post-M = 86 [17]). Stress decreased by 68% (Pre-M = 24 [24]; Post-M = 8 [14]). Anxiety decreased by 65% (Pre-M = 20 [23]; Post-M = 7 [13]). Mood improved by 70% (Pre-M = 13 [16]; Post-M = 4 [11]). Qualitative data suggested a positive response to the VR Blue protocol. SIGNIFICANCE OF RESULTS: This work supports the feasibility, acceptability, and safety of VR Blue for advanced colorectal cancer patients. Participants showed significant pre-post improvement in pain and pain-related symptoms hinting to the potential feasibility of VR interventions in this population. Larger, randomized trials with a control condition are needed to examine the efficacy of VR-based interventions for patients with advanced colorectal cancer and pain.}, Doi = {10.1017/S1478951521002017}, Key = {fds362557} } @article{fds364087, Author = {Parmelee, PA and Behrens, EA and Costlow Hill and K and Cox, BS and DeCaro, JA and Keefe, FJ and Smith, DM}, Title = {Momentary Associations of Osteoarthritis Pain and Affect: Depression as Moderator.}, Journal = {J Gerontol B Psychol Sci Soc Sci}, Volume = {77}, Number = {7}, Pages = {1240-1249}, Year = {2022}, Month = {July}, url = {http://dx.doi.org/10.1093/geronb/gbab221}, Abstract = {OBJECTIVES: This research examined main and moderating effects of global depressive symptoms upon in-the-moment associations of pain and affect among individuals with knee osteoarthritis (OA). Effects of depression on short-term change in pain and affect were also examined. METHOD: Older adults with physician-confirmed OA (N = 325) completed a baseline interview tapping global depressive symptoms, followed by an experience sampling protocol that captured momentary pain and affect 4 times daily for 7 days. Multilevel models controlling demographics and health conditions examined main and moderating effects of depression on momentary associations of pain with positive affect (PA) and negative affect (NA). Similar methods addressed short-term change in pain and affect. Auxiliary analyses explored broad associations of depressive symptoms with person-level averages and variability in pain and affect. RESULTS: Global depression predicted current pain, PA, and NA, as well as change in pain and affect over a 3- to 8-h period. Furthermore, both in the moment and over short periods, the association of pain and NA was stronger among persons higher in depressive symptoms. No moderating effect for the PA-pain association was found. Depressive symptoms were also associated with variability in pain and affect, particularly NA. DISCUSSION: Results confirm previous work on the relation of chronic pain with both global depressive symptoms and short-term affect. This research further demonstrates a unique moderating role of depression on the association of momentary pain with NA and suggests that the causal path may be stronger from pain to affect than vice versa.}, Doi = {10.1093/geronb/gbab221}, Key = {fds364087} } @article{fds363084, Author = {Keefe, FJ and Jensen, MP and Williams, ACDC and George, SZ}, Title = {The yin and yang of pragmatic clinical trials of behavioral interventions for chronic pain: balancing design features to maximize impact.}, Journal = {Pain}, Volume = {163}, Number = {7}, Pages = {1215-1219}, Year = {2022}, Month = {July}, url = {http://dx.doi.org/10.1097/j.pain.0000000000002546}, Doi = {10.1097/j.pain.0000000000002546}, Key = {fds363084} } @article{fds372010, Author = {Smith, DH and O'Keeffe-Rosetti, M and Leo, MC and Mayhew, M and Benes, L and Bonifay, A and Deyo, RA and Elder, CR and Keefe, FJ and McMullen, C and Owen-Smith, A and Trinacty, CM and Vollmer, WM and DeBar, L}, Title = {Economic Evaluation: A Randomized Pragmatic Trial of a Primary Care-based Cognitive Behavioral Intervention for Adults Receiving Long-term Opioids for Chronic Pain.}, Journal = {Medical care}, Volume = {60}, Number = {6}, Pages = {423-431}, Year = {2022}, Month = {June}, url = {http://dx.doi.org/10.1097/mlr.0000000000001713}, Abstract = {<h4>Background</h4>Chronic pain is prevalent and costly; cost-effective nonpharmacological approaches that reduce pain and improve patient functioning are needed.<h4>Objective</h4>Report the incremental cost-effectiveness ratio (ICER), compared with usual care, of cognitive behavioral therapy aimed at improving functioning and pain among patients with chronic pain on long-term opioid treatment.<h4>Design</h4>Economic evaluation conducted alongside a pragmatic cluster randomized trial.<h4>Subjects</h4>Adults with chronic pain on long-term opioid treatment (N=814).<h4>Intervention</h4>A cognitive behavioral therapy intervention teaching pain self-management skills in 12 weekly, 90-minute groups delivered by an interdisciplinary team (behaviorists, nurses) with additional support from physical therapists, and pharmacists.<h4>Outcome measures</h4>Cost per quality adjusted life year (QALY) gained, and cost per additional responder (≥30% improvement on standard scale assessment of Pain, Enjoyment, General Activity, and Sleep). Costs were estimated as-delivered, and replication.<h4>Results</h4>Per patient intervention replication costs were $2145 ($2574 as-delivered). Those costs were completely offset by lower medical care costs; inclusive of the intervention, total medical care over follow-up was $1841 lower for intervention patients. Intervention group patients also had greater QALY and responder gains than did controls. Supplemental analyses using pain-related medical care costs revealed ICERs of $35,000, and $53,000 per QALY (for replication, and as-delivered intervention costs, respectively); the ICER when excluding patients with outlier follow-up costs was $106,000.<h4>Limitations</h4>Limited to 1-year follow-up; identification of pain-related utilization potentially incomplete.<h4>Conclusion</h4>The intervention was the optimal choice at commonly accepted levels of willingness-to-pay for QALY gains; this finding was robust to sensitivity analyses.}, Doi = {10.1097/mlr.0000000000001713}, Key = {fds372010} } @article{fds364086, Author = {Hurka-Richardson, K and Platts-Mills, TF and McLean, SA and Weinberger, M and Stearns, SC and Bush, M and Quackenbush, E and Chari, S and Aylward, A and Kroenke, K and Kerns, RD and Weaver, MA and Keefe, FJ and Berkoff, D and Meyer, ML}, Title = {Brief Educational Video plus Telecare to Enhance Recovery for Older Emergency Department Patients with Acute Musculoskeletal Pain: an update to the study protocol for a randomized controlled trial.}, Journal = {Trials}, Volume = {23}, Number = {1}, Pages = {400}, Year = {2022}, Month = {May}, url = {http://dx.doi.org/10.1186/s13063-022-06310-z}, Abstract = {BACKGROUND: This update describes changes to the Brief Educational Tool to Enhance Recovery (BETTER) trial in response to the COVID-19 pandemic. METHODS/DESIGN: The original protocol was published in Trials. Due to the COVID-19 pandemic, the BETTER trial converted to remote recruitment in April 2020. All recruitment, consent, enrollment, and randomization now occur by phone within 24 h of the acute care visit. Other changes to the original protocol include an expansion of inclusion criteria and addition of new recruitment sites. To increase recruitment numbers, eligibility criteria were expanded to include individuals with chronic pain, non-daily opioid use within 2 weeks of enrollment, presenting musculoskeletal pain (MSP) symptoms for more than 1 week, hospitalization in past 30 days, and not the first time seeking medical treatment for presenting MSP pain. In addition, recruitment sites were expanded to other emergency departments and an orthopedic urgent care clinic. CONCLUSIONS: Recruiting from an orthopedic urgent care clinic and transitioning to remote operations not only allowed for continued participant enrollment during the pandemic but also resulted in some favorable outcomes, including operational efficiencies, increased enrollment, and broader generalizability. TRIAL REGISTRATION: ClinicalTrials.gov NCT04118595 . Registered on October 8, 2019.}, Doi = {10.1186/s13063-022-06310-z}, Key = {fds364086} } @article{fds360048, Author = {Scullin, MK and Jones, WE and Phenis, R and Beevers, S and Rosen, S and Dinh, K and Kiselica, A and Keefe, FJ and Benge, JF}, Title = {Using smartphone technology to improve prospective memory functioning: A randomized controlled trial.}, Journal = {J Am Geriatr Soc}, Volume = {70}, Number = {2}, Pages = {459-469}, Year = {2022}, Month = {February}, url = {http://dx.doi.org/10.1111/jgs.17551}, Abstract = {BACKGROUND: A decline in the ability to perform daily intentions-known as prospective memory-is a key driver of everyday functional impairment in dementia. In the absence of effective pharmacological treatments, there is a need for developing, testing, and optimizing behavioral interventions that can bolster daily prospective memory functioning. We investigated the feasibility and efficacy of smartphone-based strategies for prospective memory in persons with cognitive impairment. METHODS: Fifty-two older adults (74.79 ± 7.20 years) meeting diagnostic criteria for mild cognitive impairment or mild dementia were enrolled in a 4-week randomized controlled trial. Participants were trained to use a digital voice recorder app or a reminder app to off-load prospective memory intentions. Prospective memory was assessed using experimenter-assigned tasks (e.g., call the laboratory on assigned days), standardized questionnaires, and structured interviews. Secondary dependent measures included days of phone and app usage, acceptability ratings, quality of life, and independent activities of daily living. RESULTS: Participant ratings indicated that the intervention was acceptable and feasible. Furthermore, after the four-week intervention, participants reported improvements in daily prospective memory functioning on standardized questionnaires (p < 0.001, ηp2 = 0.285) and the structured interview (p < 0.001, d = 1.75). Participants performed relatively well on experimenter-assigned prospective memory tasks (51.7% ± 27.8%), with performance levels favoring the reminder app in Week 1, but reversing to favor the digital recorder app in Week 4 (p = 0.010, ηp2 = 0.079). Correlational analyses indicated that greater usage of the digital recorder or reminder app was associated with better prospective memory performance and greater improvements in instrumental activities of daily living (completed by care partners), even when controlling for condition, age, baseline cognitive functioning, and baseline smartphone experience. CONCLUSIONS: Older adults with cognitive disorders can learn smartphone-based memory strategies and doing so benefits prospective memory functioning and independence.}, Doi = {10.1111/jgs.17551}, Key = {fds360048} } @article{fds362179, Author = {Keefe, FJ}, Title = {Managing Acute Pain With Opioids in the Emergency Department: A Teachable Moment?}, Journal = {Am J Public Health}, Volume = {112}, Number = {S1}, Pages = {S9-S11}, Year = {2022}, Month = {February}, url = {http://dx.doi.org/10.2105/AJPH.2022.306748}, Doi = {10.2105/AJPH.2022.306748}, Key = {fds362179} } @article{fds362832, Author = {Burns, JW and Jensen, MP and Thorn, B and Lillis, TA and Carmody, J and Newman, AK and Keefe, F}, Title = {Cognitive therapy, mindfulness-based stress reduction, and behavior therapy for the treatment of chronic pain: randomized controlled trial.}, Journal = {Pain}, Volume = {163}, Number = {2}, Pages = {376-389}, Year = {2022}, Month = {February}, url = {http://dx.doi.org/10.1097/j.pain.0000000000002357}, Abstract = {Trials of cognitive therapy (CT), mindfulness-based stress reduction (MBSR), and behavior therapy (BT) suggest that all 3 treatments produce reductions in pain and improvements in physical function, mood, and sleep disturbance in people with chronic pain conditions. Fewer studies have compared the relative efficacies of these treatments. In this randomized controlled study, we compared CT, MBSR, BT, and treatment as usual (TAU) in a sample of people with chronic low back pain (N = 521). Eight individual sessions were administered with weekly assessments of outcomes. Consistent with the prior work, we found that CT, MBSR, and BT produced similar pretreatment to posttreatment effects on all outcomes and revealed similar levels of maintenance of treatment gains at 6-month follow-up. All 3 active treatments produced greater improvements than TAU. Weekly assessments allowed us to assess rates of change; ie, how quickly a given treatment produced significant differences, compared with TAU, on a given outcome. The 3 treatments differed significantly from TAU on average by session 6, and this rate of treatment effect was consistent across all treatments. Results suggest the possibility that the specific techniques included in CT, MBSR, and BT may be less important for producing benefits than people participating in any techniques rooted in these evidence-based psychosocial treatments for chronic pain.}, Doi = {10.1097/j.pain.0000000000002357}, Key = {fds362832} } @article{fds359697, Author = {Somers, TJ and Blumenthal, JA and Dorfman, CS and Huffman, KM and Edmond, SN and Miller, SN and Wren, AA and Caldwell, D and Keefe, FJ}, Title = {Effects of a Weight and Pain Management Program in Patients With Rheumatoid Arthritis With Obesity: A Randomized Controlled Pilot Investigation.}, Journal = {J Clin Rheumatol}, Volume = {28}, Number = {1}, Pages = {7-13}, Year = {2022}, Month = {January}, url = {http://dx.doi.org/10.1097/RHU.0000000000001793}, Abstract = {BACKGROUND: Obesity is associated with poor outcomes for patients with rheumatoid arthritis (RA). Effective weight management is imperative. Although traditional lifestyle behavioral weight loss programs have demonstrated efficacy for reducing weight, these interventions do not meet the pain-related weight loss challenges of RA patients with obesity. OBJECTIVE: A 12-session group program (90 minutes per session) was developed integrating pain coping skills training into a lifestyle behavioral weight loss intervention. In addition to the weekly group sessions, participants engaged in supervised exercise sessions 3 times per week. METHODS: Through a small, pilot randomized trial, 50 participants were randomized to receive the intervention (n = 29) or standard care of RA (n = 21). Feasibility data (i.e., accrual, attrition, adherence) was examined using descriptive statistics (e.g., percent). We examined patterns of change in study outcomes from baseline to follow-up separately for the intervention and standard care arms using descriptive statistics and paired t tests. Effect sizes are also presented. RESULTS: Of those randomized to the intervention group,79.3% initiated treatment, with participants attending 74.3% of group skills sessions and 64.2% of exercise sessions. Intervention participants evidenced reductions in weight (mean, -2.28 kg) and waist circumference (mean, -4.76 cm) and improvements in physical functioning, eating behaviors, pain, and self-efficacy for weight control. CONCLUSIONS: Findings suggest that incorporating a combined pain coping skills training and behavioral weight loss intervention into medical management of RA may improve outcomes. Study accrual and attrition, as well as intervention adherence, will inform future, larger randomized efficacy trials of the intervention.Retrospectively registered: January 29, 2020, NCT04246827.}, Doi = {10.1097/RHU.0000000000001793}, Key = {fds359697} } @article{fds362590, Author = {DeBar, L and Mayhew, M and Benes, L and Bonifay, A and Deyo, RA and Elder, CR and Keefe, FJ and Leo, MC and McMullen, C and Owen-Smith, A and Smith, DH and Trinacty, CM and Vollmer, WM}, Title = {A Primary Care-Based Cognitive Behavioral Therapy Intervention for Long-Term Opioid Users With Chronic Pain : A Randomized Pragmatic Trial.}, Journal = {Ann Intern Med}, Volume = {175}, Number = {1}, Pages = {46-55}, Year = {2022}, Month = {January}, url = {http://dx.doi.org/10.7326/M21-1436}, Abstract = {BACKGROUND: Chronic pain is common, disabling, and costly. Few clinical trials have examined cognitive behavioral therapy (CBT) interventions embedded in primary care settings to improve chronic pain among those receiving long-term opioid therapy. OBJECTIVE: To determine the effectiveness of a group-based CBT intervention for chronic pain. DESIGN: Pragmatic, cluster randomized controlled trial. (ClinicalTrials.gov: NCT02113592). SETTING: Kaiser Permanente health care systems in Georgia, Hawaii, and the Northwest. PARTICIPANTS: Adults (aged ≥18 years) with mixed chronic pain conditions receiving long-term opioid therapy. INTERVENTION: A CBT intervention teaching pain self-management skills in 12 weekly, 90-minute groups delivered by an interdisciplinary team (behaviorist, nurse, physical therapist, and pharmacist) versus usual care. MEASUREMENTS: Self-reported pain impact (primary outcome, as measured by the PEGS scale [pain intensity and interference with enjoyment of life, general activity, and sleep]) was assessed quarterly over 12 months. Pain-related disability, satisfaction with care, and opioid and benzodiazepine use based on electronic health care data were secondary outcomes. RESULTS: A total of 850 patients participated, representing 106 clusters of primary care providers (mean age, 60.3 years; 67.4% women); 816 (96.0%) completed follow-up assessments. Intervention patients sustained larger reductions on all self-reported outcomes from baseline to 12-month follow-up; the change in PEGS score was -0.434 point (95% CI, -0.690 to -0.178 point) for pain impact, and the change in pain-related disability was -0.060 point (CI, -0.084 to -0.035 point). At 6 months, intervention patients reported higher satisfaction with primary care (difference, 0.230 point [CI, 0.053 to 0.406 point]) and pain services (difference, 0.336 point [CI, 0.129 to 0.543 point]). Benzodiazepine use decreased more in the intervention group (absolute risk difference, -0.055 [CI, -0.099 to -0.011]), but opioid use did not differ significantly between groups. LIMITATION: The inclusion of only patients with insurance in large integrated health care systems limited generalizability, and the clinical effect of change in scores is unclear. CONCLUSION: Primary care-based CBT, using frontline clinicians, produced modest but sustained reductions in measures of pain and pain-related disability compared with usual care but did not reduce use of opioid medication. PRIMARY FUNDING SOURCE: National Institutes of Health.}, Doi = {10.7326/M21-1436}, Key = {fds362590} } @article{fds362793, Author = {Winger, JG and Ramos, K and Kelleher, SA and Somers, TJ and Steinhauser, KE and Porter, LS and Kamal, AH and Breitbart, WS and Keefe, FJ}, Title = {Meaning-Centered Pain Coping Skills Training: A Pilot Feasibility Trial of a Psychosocial Pain Management Intervention for Patients with Advanced Cancer.}, Journal = {J Palliat Med}, Volume = {25}, Number = {1}, Pages = {60-69}, Year = {2022}, Month = {January}, url = {http://dx.doi.org/10.1089/jpm.2021.0081}, Abstract = {Background: Pain from advanced cancer can greatly reduce patients' physical, emotional, and spiritual well-being. Objective: To examine the feasibility and acceptability of a behavioral pain management intervention, Meaning-Centered Pain Coping Skills Training (MCPC). Design: This trial used a single-arm feasibility design. Setting/Subjects: Thirty participants with stage IV solid tumor cancer, moderate-to-severe pain, and clinically elevated distress were enrolled from a tertiary cancer center in the United States. The manualized protocol was delivered across four 45- to 60-minute videoconference sessions. Measurements: Feasibility and acceptability were assessed through accrual, session/assessment completion, intervention satisfaction, and coping skills usage. Participants completed validated measures of primary outcomes (i.e., pain severity, pain interference, and spiritual well-being) and secondary outcomes at baseline, post-intervention, and four-week follow-up. Results: Eighty-eight percent (38/43) of patients who completed screening met inclusion criteria, and 79% (30/38) consented and completed baseline assessment. Sixty-seven percent (20/30) of participants were female (mean age = 57). Most participants were White/Caucasian (77%; 23/30) or Black/African American (17%; 5/30) with at least some college education (90%; 27/30). Completion rates for intervention sessions and both post-intervention assessments were 90% (27/30), 87% (26/30), and 77% (23/30), respectively. At the post-intervention assessment, participants reported a high degree of intervention satisfaction (mean = 3.53/4.00; SD = 0.46), and 81% (21/26) reported weekly use of coping skills that they learned. Participants also showed improvement from baseline on all primary outcomes and nearly all secondary outcomes at both post-intervention assessments. Conclusions: MCPC demonstrated strong feasibility and acceptability. Findings warrant further evaluation of MCPC in a randomized controlled trial. ClinicalTrials.gov Identifier: NCT03207360.}, Doi = {10.1089/jpm.2021.0081}, Key = {fds362793} } @article{fds363083, Author = {Dorfman, CS and Somers, TJ and Shelby, RA and Winger, JG and Patel, ML and Kimmick, G and Craighead, L and Keefe, FJ}, Title = {DEVELOPMENT, FEASIBILITY, AND ACCEPTABILITY OF A BEHAVIORAL WEIGHT AND SYMPTOM MANAGEMENT INTERVENTION FOR BREAST CANCER SURVIVORS AND INTIMATE PARTNERS.}, Journal = {J Cancer Rehabil}, Volume = {5}, Pages = {7-16}, Year = {2022}, url = {http://dx.doi.org/10.48252/JCR57}, Abstract = {BACKGROUND: Weight gain is common for breast cancer survivors and associated with disease progression, recurrence, and mortality. Traditional behavioral programs fail to address symptoms (i.e., pain, fatigue, distress) experienced by breast cancer survivors that may interfere with weight loss and fail to capitalize on the concordance in weight-related health behaviors of couples. This study aimed to develop and examine the feasibility and acceptability of a behavioral weight and symptom management intervention for breast cancer survivors and their intimate partners. MATERIALS AND METHODS: Interviews were conducted with N=14 couples with overweight/obesity to develop the intervention. Intervention feasibility and acceptability were examined through a single-arm pilot trial (N=12 couples). Patterns of change in intervention targets were examined for survivors and partners. RESULTS: Themes derived from interviews were used to develop the 12-session couple-based intervention, which included components from traditional behavioral weight management interventions, appetite awareness training, and cognitive and behavioral symptom management protocols. Couples also worked together to set goals, create plans for health behavior change, and adjust systemic and relationship barriers to weight loss. Examples were tailored to the experiences and symptom management needs of breast cancer survivors and partners. The intervention demonstrated feasibility (attrition: 8%; session completion: 88%) and acceptability (satisfaction). Survivors and partners experienced reductions in weight and improvements in physical activity, eating behaviors, emotional distress, and self-efficacy. Survivors evidenced improvements in fatigue and pain. CONCLUSIONS: A behavioral weight and symptom management intervention for breast cancer survivors and partners is feasible, acceptable, and is potentially efficacious.}, Doi = {10.48252/JCR57}, Key = {fds363083} } @article{fds371050, Author = {Colloca, L and Murthi, S and Keefe, FJ and Varshney, A}, Title = {VIRTUAL REALITY: FROM PAIN TO RACIAL BIASES}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {56}, Number = {SUPP 1}, Pages = {S604-S604}, Year = {2022}, Key = {fds371050} } @article{fds376459, Author = {Keefe, FJ}, Title = {VIRTUAL REALITY: AN APPROACH TAILORED TO SPECIFIC PAIN DISORDERS}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {56}, Number = {SUPP 1}, Pages = {S604-S604}, Year = {2022}, Key = {fds376459} } @article{fds361414, Author = {Eccleston, C and Keefe, FJ and de C Williams and AC}, Title = {Basic and applied psychology in PAIN: where we have been and where we are headed.}, Journal = {Pain}, Volume = {162}, Number = {12}, Pages = {2785-2788}, Year = {2021}, Month = {December}, url = {http://dx.doi.org/10.1097/j.pain.0000000000002414}, Doi = {10.1097/j.pain.0000000000002414}, Key = {fds361414} } @article{fds359696, Author = {Sterling, M and Keefe, FJ}, Title = {Physical rehabilitation research and pain science.}, Journal = {Pain}, Volume = {162}, Number = {11}, Pages = {2621-2624}, Year = {2021}, Month = {November}, url = {http://dx.doi.org/10.1097/j.pain.0000000000002326}, Doi = {10.1097/j.pain.0000000000002326}, Key = {fds359696} } @article{fds358053, Author = {Kelleher, SA and Fisher, HM and Winger, JG and Somers, TJ and Uronis, HE and Wright, AN and Keefe, FJ}, Title = {Feasibility, engagement, and acceptability of a behavioral pain management intervention for colorectal cancer survivors with pain and psychological distress: data from a pilot randomized controlled trial.}, Journal = {Support Care Cancer}, Volume = {29}, Number = {9}, Pages = {5361-5369}, Year = {2021}, Month = {September}, url = {http://dx.doi.org/10.1007/s00520-021-06126-8}, Abstract = {PURPOSE: Colorectal cancer survivors report pain and psychological distress to be burdensome long-term cancer consequences. Quality cancer survivorship care includes interventions for managing these symptoms. Yet, no studies have tested the efficacy of an accessible behavioral intervention for colorectal cancer survivors with pain and comorbid psychological distress. This paper reports on the feasibility (i.e., accrual, attrition, and adherence to study procedures), engagement, acceptability, and descriptive outcomes of a telephone-based coping skills training (CST) intervention. METHODS: This randomized pilot trial assigned colorectal cancer patients (N=31) to 5 sessions of CST or standard care. CST sessions focused on cognitive-behavioral theory-based coping skills tailored to colorectal cancer symptoms of pain and psychological distress. Participants completed assessments of pain severity, self-efficacy for pain management, health-related quality of life, and psychological distress at baseline, post-treatment, and 3-month follow-up. RESULTS: Data indicated strong feasibility, evidenced by high completion rates for intervention sessions and assessments (93% completed all sessions; M=48.7 days; baseline=100%; post-treatment=97%; 3-month follow-up=94%). Participants demonstrated robust engagement with CST (M days per week with reported skills use=3.8) and reported high protocol satisfaction (M=3.6/4.0). Descriptive statistics showed self-efficacy for pain management and health-related quality of life improved for all participants. CONCLUSION: Findings suggest that a telephone-based CST intervention has strong feasibility, evidenced by accrual, low attrition, and adherence to intervention sessions and assessments. Likewise, participant engagement and acceptability with CST were high. These data provide a foundation for larger randomized efficacy trials of the telephone-based CST intervention.}, Doi = {10.1007/s00520-021-06126-8}, Key = {fds358053} } @article{fds359064, Author = {Myers, H and Keefe, F and George, SZ and Kennedy, J and Lake, AD and Martinez, C and Cook, C}, Title = {The influence of a cognitive behavioural approach on changing patient expectations for conservative care in shoulder pain treatment: a protocol for a pragmatic randomized controlled trial.}, Journal = {BMC Musculoskelet Disord}, Volume = {22}, Number = {1}, Pages = {727}, Year = {2021}, Month = {August}, url = {http://dx.doi.org/10.1186/s12891-021-04588-9}, Abstract = {BACKGROUND: Despite similar outcomes for surgery and conservative care, the number of surgeries to treat rotator cuff related shoulder pain has increased. Interventions designed to enhance treatment expectations for conservative care have been shown to improve patient expectations, but no studies have yet explored whether such interventions influence patient decisions to pursue surgery. The purpose of this randomized clinical trial is to examine the effect of an intervention designed to improve expectations of conservative care on the decision to have surgery. METHODS: We will test the effectiveness of the Patient Engagement, Education, and Restructuring of Cognitions (PEERC) intervention which is intended to change expectations regarding conservative care. The PEERC intervention will be evaluated in a randomized, pragmatic "add-on" trial, to better understand the effect the intervention has on outcomes. Ninety-four (94) participants with rotator cuff related shoulder pain referred for physical therapy will be randomized to receive either impairment-based care or impairment-based care plus PEERC. Both groups will receive impairment-based conservative treatment created by compiling the evidence associated with established, effective interventions. Participants assigned to the impairment-based care plus PEERC condition will also receive the PEERC intervention. This intervention, informed by principles of cognitive behavioral therapy, involves three components: (1) strategies to enhance engagement, (2) education and (3) cognitive restructuring and behavioral activation. Outcomes will be assessed at multiple points between enrolment and six months after discharge. The primary outcome is patient reported decision to have surgery and the secondary outcomes are pain, function, expectations and satisfaction with conservative care. DISCUSSION: Rotator cuff related shoulder pain is highly prevalent, and because conservative and surgical treatments have similar outcomes, an intervention that changes expectations about conservative care could alter patient reports of their decision to have surgery and ultimately could lead to lower healthcare costs and decreased risk of surgical complications. TRIAL REGISTRATION: This study is registered as NCT03353272 at ClincialTrials.gov.}, Doi = {10.1186/s12891-021-04588-9}, Key = {fds359064} } @article{fds353293, Author = {Rini, C and Katz, AWK and Nwadugbo, A and Porter, LS and Somers, TJ and Keefe, FJ}, Title = {Changes in Identification of Possible Pain Coping Strategies by People with Osteoarthritis who Complete Web-based Pain Coping Skills Training.}, Journal = {Int J Behav Med}, Volume = {28}, Number = {4}, Pages = {488-498}, Year = {2021}, Month = {August}, url = {http://dx.doi.org/10.1007/s12529-020-09938-w}, Abstract = {BACKGROUND: We previously demonstrated that automated, Web-based pain coping skills training (PCST) can reduce osteoarthritis pain. The present secondary analyses examined whether this program also changed coping strategies participants identified for use in hypothetical pain-related situations. METHOD: People with hip/knee osteoarthritis (n = 107) were randomized to Web-based PCST or standard care control. At baseline and post-intervention, they reported their pain severity and impairment, then completed a task in which they described how they would cope with pain in four hypothetical pain-related situations, also reporting their perceived risk for pain and self-efficacy for managing it. We coded the generated coping strategies into counts of adaptive behavioral, maladaptive behavioral, adaptive cognitive, and discrete adaptive coping strategies (coping repertoire). RESULTS: Compared to the control arm, Web-based PCST decreased the number of maladaptive behavioral strategies generated (p = 0.002) while increasing the number of adaptive behavioral strategies generated (p = 0.006), likelihood of generating at least one adaptive cognitive strategy (p = 0.01), and the size of participants' coping repertoire (p = 0.009). Several of these changes were associated with changes in pain outcomes (ps = 0.01 to 0.65). Web-based PCST also reduced perceived risk for pain in the situations (p = 0.03) and increased self-efficacy for avoiding pain in similar situations (p < 0.001). CONCLUSION: Salutary changes found in this study appear to reflect intervention-concordant learning.}, Doi = {10.1007/s12529-020-09938-w}, Key = {fds353293} } @article{fds357342, Author = {Allen, KD and Beauchamp, T and Rini, C and Keefe, FJ and Bennell, KL and Cleveland, RJ and Grimm, K and Huffman, K and Hu, DG and Santana, A and Saxena Beem and S and Walker, J and Sheikh, SZ}, Title = {Pilot study of an internet-based pain coping skills training program for patients with systemic Lupus Erythematosus.}, Journal = {BMC Rheumatol}, Volume = {5}, Number = {1}, Pages = {20}, Year = {2021}, Month = {June}, url = {http://dx.doi.org/10.1186/s41927-021-00191-6}, Abstract = {BACKGROUND: Patients with Systemic Lupus Erythematosus (SLE) often experience pain and other symptoms that negatively impact quality of life. Interventions that enhance the use of behavioral and cognitive coping strategies may lead to improved outcomes among patients with SLE. Pain coping skills training (PCST) programs have been shown to improve outcomes among patients with other rheumatic conditions, but there have been no trials of PCST among patients with SLE. This study was a preliminary assessment of the feasibility and efficacy of painTRAINER, an automated, internet-based PCST program, among patients with SLE. METHODS: Participants (n = 60) with SLE from one health care system were randomly assigned with equal allocation to painTRAINER or a wait list control group. PainTRAINER involves 8 modules; participants were instructed to complete one module weekly, along with practice activities for each cognitive or behavioral coping skill. Outcome measures were assessed at baseline and 9-week follow-up, including the Pain Catastrophizing Scale, PROMIS Subscales (Pain Interference, Physical Function, Sleep Disturbance, Anxiety, Depression, Fatigue and Participation), and the LupusPRO questionnaire. Mean changes in outcomes from baseline to follow up and Cohen's d effect sizes were computed. RESULTS: Effect sizes for the painTRAINER group (relative to the wait list group) were small, with changes being greatest for the PROMIS Depression score (d = - 0.32). Among those randomized to the painTRAINER group, 50% accessed the program ("painTRAINER users"). Most of those who did not access the program stated that they did not receive instructions via email. Effect sizes for "painTRAINER users" (relative to wait list) were larger than for the whole painTRAINER group: Pain Catastrophizing d = - 0.60, PROMIS Pain Interference d = - 0.3., PROMIS Depression d = - 0.44, LupusPRO Health-Related Quality of Life d = 0.30. CONCLUSIONS: PainTRAINER users reported meaningful improvements in multiple physical and psychological outcomes, supporting the potential of PCST programs to benefit individuals with SLE. However, strategies are needed to improve engagement with the program and tailor content to comprehensively address key SLE symptoms and challenges. TRIAL REGISTRATION: NCT03933839 , May 1, 2019.}, Doi = {10.1186/s41927-021-00191-6}, Key = {fds357342} } @article{fds353294, Author = {Carson, JW and Carson, KM and Olsen, M and Sanders, L and Westbrook, K and Keefe, FJ and Porter, LS}, Title = {Yoga Practice Predicts Improvements in Day-to-Day Pain in Women With Metastatic Breast Cancer.}, Journal = {J Pain Symptom Manage}, Volume = {61}, Number = {6}, Pages = {1227-1233}, Year = {2021}, Month = {June}, url = {http://dx.doi.org/10.1016/j.jpainsymman.2020.10.009}, Abstract = {CONTEXT: Women with metastatic breast cancer (MBC) experience a significant symptom burden, including cancer pain. Yoga is a mind-body discipline that has shown promise for alleviating cancer pain, but few studies have included patients with metastatic disease or examined the acute effects of yoga practice. OBJECTIVES: To determine whether daily pain changed significantly during a randomized controlled trial of the Mindful Yoga program among women with MBC and whether time spent in yoga practice was related to daily pain. METHODS: On alternate weeks during the intervention period, we collected daily measures of pain from a subset of 48 women randomized to either yoga (n = 30) or a support group condition (n = 18). We also assessed daily duration of yoga practice among patients randomized to yoga. RESULTS: Pain levels were low for women in both conditions, and no differential treatment effects were found on daily pain. However, among women randomized to yoga, a dose/response relationship was found between yoga practice duration and daily pain. When patients had spent relatively more time practicing yoga across two consecutive days, they were more likely to experience lower pain on the next day. This finding is consistent with an earlier MBC study. Meditation practice showed the strongest association with lower daily pain. CONCLUSION: Findings suggest that yoga practice (meditation practice in particular) is associated with acute improvements in cancer pain, and that yoga interventions may be more impactful if tested in a sample of patients with advanced cancer in which pain is relatively elevated.}, Doi = {10.1016/j.jpainsymman.2020.10.009}, Key = {fds353294} } @article{fds356950, Author = {Riddle, DL and Slover, J and Keefe, FJ and Ang, DC and Dumenci, L and Perera, RA}, Title = {Racial Differences in Pain and Function Following Knee Arthroplasty: A Secondary Analysis From a Multicenter Randomized Clinical Trial.}, Journal = {Arthritis Care Res (Hoboken)}, Volume = {73}, Number = {6}, Pages = {810-817}, Year = {2021}, Month = {June}, url = {http://dx.doi.org/10.1002/acr.24177}, Abstract = {OBJECTIVE: The assessment of racial differences in pain and function outcome following knee arthroplasty (KA) has received little attention despite very substantial literature exploring a variety of other prognostic factors. The present study was undertaken to determine whether race was associated with KA outcome after accounting for potential confounding factors. METHODS: We conducted a secondary analysis of a randomized clinical trial of 384 participants with moderate-to-high pain catastrophizing who underwent KA. Preoperative measures included race/ethnicity status as well as a variety of potential confounders, including socioeconomic status, comorbidity, and bodily pain. Outcome measures were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scales as well as performance measures. Linear mixed-effects models compared outcomes over a 1-year follow-up period for African American versus non-African American participants. RESULTS: WOMAC pain scores differences for African American versus non-African American participants averaged ~2 points in unadjusted analyses and 1-1.5 points in adjusted analyses. In adjusted analyses, follow-up WOMAC function scores differed by 6 points for African Americans compared to non-African Americans (P = 0.002). CONCLUSION: African Americans generally had worse pain, function, and performance prior to KA and worse scores after surgery, but differences were small and attenuated by ~25-50% after adjustment for potential confounding. Only WOMAC function scores showed clinically important postsurgical differences in adjusted analyses. Clinicians should be aware that after adjustment for potential confounders, African Americans have approximately equivalent outcomes compared to others, with the exception of WOMAC function score.}, Doi = {10.1002/acr.24177}, Key = {fds356950} } @article{fds355883, Author = {Porter, LS and Steel, JL and Fairclough, DL and LeBlanc, TW and Bull, J and Hanson, LC and Fischer, S and Keefe, FJ}, Title = {Caregiver-guided pain coping skills training for patients with advanced cancer: Results from a randomized clinical trial.}, Journal = {Palliat Med}, Volume = {35}, Number = {5}, Pages = {952-961}, Year = {2021}, Month = {May}, url = {http://dx.doi.org/10.1177/02692163211004216}, Abstract = {BACKGROUND: Pain is a major concern among patients with advanced cancer and their family caregivers. Evidence suggests that pain coping skills training interventions can improve outcomes, however they have rarely been tested in this population. AIM: To test the efficacy of a caregiver-guided pain coping skills training intervention. The primary outcome was caregiver self-efficacy for helping the patient manage pain. DESIGN: A randomized controlled trial compared the intervention to an enhanced treatment-as-usual control. Dyads in both conditions received pain education, and those in the intervention received three sessions of pain coping skills training. Caregiver outcomes (self-efficacy; caregiver strain, caregiving satisfaction, psychological distress) and patient outcomes (self-efficacy, pain intensity and interference, psychological distress) were collected at baseline and post-intervention. SETTING/PARTICIPANTS: Two hundred two patients with stage III-IV cancer and pain and their family caregivers were enrolled from four outpatient oncology clinics and a free-standing hospice/palliative care organization. RESULTS: Compared to those in the control arm, caregivers in the intervention reported significant increases in caregiving satisfaction (p < 0.01) and decreased anxiety (p = 0.04). In both conditions, caregivers reported improvements in self-efficacy, and patients reported improvements in self-efficacy, pain severity and interference, and psychological distress. CONCLUSIONS: This is the first study to test a pain coping skills intervention targeted to patients and caregivers facing advanced cancer. Findings suggest that pain education provides benefits for patients and caregivers, and coping skills training may be beneficial for caregivers. Further research is needed to optimize the benefits of education and pain coping skills training for improving cancer pain outcomes.Trial registration: ClinicalTrials.gov NCT02430467, Caregiver-Guided Pain Management Training in Palliative Care.}, Doi = {10.1177/02692163211004216}, Key = {fds355883} } @article{fds358054, Author = {Kelleher, SA and Winger, JG and Fisher, HM and Miller, SN and Reed, SD and Thorn, BE and Spring, B and Samsa, GP and Majestic, CM and Shelby, RA and Sutton, LM and Keefe, FJ and Somers, TJ}, Title = {Behavioral cancer pain intervention using videoconferencing and a mobile application for medically underserved patients: Rationale, design, and methods of a prospective multisite randomized controlled trial.}, Journal = {Contemp Clin Trials}, Volume = {102}, Pages = {106287}, Year = {2021}, Month = {March}, url = {http://dx.doi.org/10.1016/j.cct.2021.106287}, Abstract = {BACKGROUND: Women with breast cancer in medically underserved areas are particularly vulnerable to persistent pain and disability. Behavioral pain interventions reduce pain and improve outcomes. Cancer patients in medically underserved areas receive limited adjunctive cancer care, as many lack access to pain therapists trained in behavioral interventions, face travel barriers to regional medical centers, and may have low literacy and limited resources. mHealth technologies have the potential to decrease barriers but must be carefully adapted for, and efficacy-tested with, medically underserved patients. We developed an mHealth behavioral pain coping skills training intervention (mPCST-Community). We now utilize a multisite randomized controlled trial to: 1) test the extent mPCST-Community reduces breast cancer patients' pain severity (primary outcome), pain interference, fatigue, physical disability, and psychological distress; 2) examine potential mediators of intervention effects; and 3) evaluate the intervention's cost and cost-effectiveness. METHODS/DESIGN: Breast cancer patients (N = 180) will be randomized to mPCST-Community or an attention control. mPCST-Community's four-session protocol will be delivered via videoconferencing at an underserved community clinic by a remote pain therapist at a major medical center. Videoconference sessions will be supplemented with a mobile application. Participants will complete self-report measures at baseline, post-intervention, and 3- and 6-month follow-ups. CONCLUSIONS: mPCST-Community has the potential to reduce pain and disability, and decrease barriers for cancer patients in medically underserved areas. This is one of the first trials to test an mHealth behavioral cancer pain intervention developed specifically for medically underserved communities. If successful, it could lead to widespread implementation and decreased health disparities.}, Doi = {10.1016/j.cct.2021.106287}, Key = {fds358054} } @article{fds355632, Author = {Griesemer, I and Hausmann, LR and Arbeeva, L and Campbell, LC and Cené, CW and Coffman, CJ and Keefe, FJ and Oddone, EZ and Somers, TJ and Allen, KD}, Title = {Discrimination Experiences and Depressive Symptoms among African Americans with Osteoarthritis Enrolled in a Pain Coping Skills Training Randomized Controlled Trial.}, Journal = {J Health Care Poor Underserved}, Volume = {32}, Number = {1}, Pages = {145-155}, Year = {2021}, url = {http://dx.doi.org/10.1353/hpu.2021.0014}, Abstract = {African Americans are more likely than members of other racial groups to report perceived discrimination in health care settings, and discrimination is linked to depression. Using data from a randomized controlled trial of pain coping skills training (PCST) for African Americans with osteoarthritis (N=164), we evaluated the interaction between discrimination experiences and experimental condition (PCST or control group) in linear regression models predicting depressive symptoms. There was a significant interaction between personal discrimination and experimental condition on depressive symptoms (interaction term coefficient: b=-3.2, 95% CI [- 6.4, - .02], p=.05). Discrimination was associated with depressive symptoms among those in the control group but not among those who received PCST. Participation in a PCST intervention may have reduced the association between discrimination experiences and depressive symptoms among participants in this sample. Future research should explore whether interventions aimed at teaching coping skills may be effective in ameliorating the harmful mental health effects of perceived discrimination.}, Doi = {10.1353/hpu.2021.0014}, Key = {fds355632} } @article{fds362376, Author = {Langer, SL and Romano, JM and Keefe, F and Baucom, DH and Strauman, T and Syrjala, KL and Bolger, N and Burns, J and Bricker, JB and Todd, M and Baucom, BRW and Fischer, MS and Ghosh, N and Gralow, J and Shankaran, V and Zafar, SY and Westbrook, K and Leo, K and Ramos, K and Weber, DM and Porter, LS}, Title = {Couple Communication in Cancer: Protocol for a Multi-Method Examination.}, Journal = {Front Psychol}, Volume = {12}, Pages = {769407}, Year = {2021}, url = {http://dx.doi.org/10.3389/fpsyg.2021.769407}, Abstract = {Cancer and its treatment pose challenges that affect not only patients but also their significant others, including intimate partners. Accumulating evidence suggests that couples' ability to communicate effectively plays a major role in the psychological adjustment of both individuals and the quality of their relationship. Two key conceptual models have been proposed to account for how couple communication impacts psychological and relationship adjustment: the social-cognitive processing (SCP) model and the relationship intimacy (RI) model. These models posit different mechanisms and outcomes, and thus have different implications for intervention. The purpose of this project is to test and compare the utility of these models using comprehensive and methodologically rigorous methods. Aims are: (1) to examine the overall fit of the SCP and RI models in explaining patient and partner psychological and relationship adjustment as they occur on a day-to-day basis and over the course of 1 year; (2) to examine the fit of the models for different subgroups (males vs. females, and patients vs. partners); and (3) to examine the utility of various methods of assessing communication by examining the degree to which baseline indices from different measurement strategies predict self-reported adjustment at 1-year follow up. The study employs a longitudinal, multi-method approach to examining communication processes including: standard self-report questionnaires assessing process and outcome variables collected quarterly over the course of 1 year; smartphone-based ecological momentary assessments to sample participant reports in real time; and laboratory-based couple conversations from which we derive observational measures of communicative behavior and affective expression, as well as vocal indices of emotional arousal. Participants are patients with stage II-IV breast, colon, rectal, or lung cancer and their spouses/partners, recruited from two NCI-designated comprehensive cancer centers. Results will be published in scientific journals, presented at scientific conferences, and conveyed to a larger audience through infographics and social media outlets. Findings will inform theory, measurement, and the design and implementation of efficacious interventions aimed at optimizing both patient and partner well-being.}, Doi = {10.3389/fpsyg.2021.769407}, Key = {fds362376} } @article{fds371051, Author = {Winger, JG and Somers, TJ and Steinhauser, KE and Porter, LS and Ramos, K and Kamal, AH and Breitbart, WS and Keefe, FJ}, Title = {MEANING-CENTERED PAIN COPING SKILLS TRAINING: A PILOT TRIAL OF A PSYCHOSOCIAL INTERVENTION FOR PATIENTS WITH ADVANCED CANCER}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {55}, Pages = {S302-S302}, Year = {2021}, Key = {fds371051} } @article{fds371052, Author = {Porter, LS and McDaniel, H and Keefe, FJ and Langer, S}, Title = {PARENTING CONCERNS IN COUPLES COPING WITH CANCER: ASSOCIATIONS WITH PSYCHOLOGICAL AND RELATIONSHIP FUNCTIONING}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {55}, Pages = {S540-S540}, Year = {2021}, Key = {fds371052} } @article{fds371053, Author = {Van Denburg and AN and Porter, LS and Somers, TJ and Keefe, FJ and Rini, CM}, Title = {SOCIAL SUPPORT AND HINDRANCE AMONG PATIENTS WITH OSTEOARTHRITIS COMPLETING WEB-BASED PAIN COPING SKILLS TRAINING}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {55}, Pages = {S424-S424}, Year = {2021}, Key = {fds371053} } @article{fds371054, Author = {Van Denburg and AN and Shelby, RA and Keefe, FJ and Soo, MS and McDaniel, H}, Title = {IMPACT OF CONTROLLED BREATHING AND MUSIC ON PAIN IN WOMEN UNDERGOING MRI-GUIDED BREAST BIOPSY: A RANDOMIZED CONTROLLED TRIAL}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {55}, Pages = {S269-S269}, Year = {2021}, Key = {fds371054} } @article{fds372551, Author = {Dorfman, CS and Stalls, J and Shelby, RA and Somers, TJ and Keefe, FJ and Oeffinger, KC}, Title = {DEVELOPMENT OF A BEHAVIORAL SYMPTOM MANAGEMENT INTERVENTION FOR SURVIVORS OF YOUNG ADULT CANCER}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {55}, Pages = {S144-S144}, Year = {2021}, Key = {fds372551} } @article{fds354531, Author = {George, SZ and Coffman, CJ and Allen, KD and Lentz, TA and Choate, A and Goode, AP and Simon, CB and Grubber, JM and King, H and Cook, CE and Keefe, FJ and Ballengee, LA and Naylor, J and Brothers, JL and Stanwyck, C and Alkon, A and Hastings, SN}, Title = {Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial.}, Journal = {Pain Med}, Volume = {21}, Number = {Suppl 2}, Pages = {S62-S72}, Year = {2020}, Month = {December}, url = {http://dx.doi.org/10.1093/pm/pnaa348}, Abstract = {BACKGROUND: Coordinated efforts between the National Institutes of Health, the Department of Defense, and the Department of Veterans Affairs have built the capacity for large-scale clinical research investigating the effectiveness of nonpharmacologic pain treatments. This is an encouraging development; however, what constitutes best practice for nonpharmacologic management of low back pain (LBP) is largely unknown. DESIGN: The Improving Veteran Access to Integrated Management of Back Pain (AIM-Back) trial is an embedded pragmatic cluster-randomized trial that will examine the effectiveness of two different care pathways for LBP. Sixteen primary care clinics will be randomized 1:1 to receive training in delivery of 1) an integrated sequenced-care pathway or 2) a coordinated pain navigator pathway. Primary outcomes are pain interference and physical function (Patient-Reported Outcomes Measurement Information System Short Form [PROMIS-SF]) collected in the electronic health record at 3 months (n=1,680). A subset of veteran participants (n=848) have consented to complete additional surveys at baseline and at 3, 6, and 12 months for supplementary pain and other measures. SUMMARY: AIM-Back care pathways will be tested for effectiveness, and treatment heterogeneity will be investigated to identify which veterans may respond best to a given pathway. Health care utilization patterns (including opioid use) will also be compared between care pathways. Therefore, the AIM-Back trial will provide important information that can inform the future delivery of nonpharmacologic treatment of LBP.}, Doi = {10.1093/pm/pnaa348}, Key = {fds354531} } @article{fds353849, Author = {Lawford, BJ and Hinman, RS and Nelligan, RK and Keefe, F and Rini, C and Bennell, KL}, Title = {"I Could Do It in My Own Time and When I Really Needed It": Perceptions of Online Pain Coping Skills Training For People With Knee Osteoarthritis.}, Journal = {Arthritis Care Res (Hoboken)}, Volume = {72}, Number = {12}, Pages = {1736-1746}, Year = {2020}, Month = {December}, url = {http://dx.doi.org/10.1002/acr.24093}, Abstract = {OBJECTIVE: To qualitatively explore the perceptions and experiences of people with knee osteoarthritis (OA) who used an online automated pain coping skills training program (PCST). METHODS: This was a descriptive qualitative study (based on interpretivist methodology) embedded within a randomized controlled trial. Individual semistructured interviews were conducted with 12 people with knee OA who had participated in an 8-week automated online PCST program while also receiving exercise advice and support from a physical therapist via Skype. Interviews in this study focused specifically on the online PCST program, rather than the physical therapy component. Interviews were audiorecorded, transcribed verbatim, and thematically analyzed. RESULTS: Five themes arose: 1) easy to understand and follow (clearly explained, presented well), 2) better able to cope with pain (controlling pain, helping relax, pacing self, incorporating skills into exercise program), 3) anonymity and flexibility (no judgement by clinician, work at own pace, accessibility), 4) not always relatable or engaging (some techniques not useful, Americanization of the program, annoying character examples, time consuming and slow-paced), and 5) support from clinician desirable (follow-up from a clinician would be beneficial, worked in tandem with physical therapist-prescribed exercise, desire referral to the program by a trusted source). CONCLUSION: People with knee OA had generally positive experiences using an online PCST program, suggesting that online PCST is a broadly acceptable and accessible way to help people with OA to manage their pain. User engagement may be enhanced by redesigning some aspects of the program and by provision of support from a clinician.}, Doi = {10.1002/acr.24093}, Key = {fds353849} } @article{fds350569, Author = {Dumenci, L and Kroenke, K and Keefe, FJ and Ang, DC and Slover, J and Perera, RA and Riddle, DL}, Title = {Disentangling trait versus state characteristics of the Pain Catastrophizing Scale and the PHQ-8 Depression Scale.}, Journal = {Eur J Pain}, Volume = {24}, Number = {8}, Pages = {1624-1634}, Year = {2020}, Month = {September}, url = {http://dx.doi.org/10.1002/ejp.1619}, Abstract = {BACKGROUND: Research on the role of trait versus state characteristics of a variety of measures among persons experiencing pain has been a focus for the past few decades. Studying the trait versus state nature of the Pain Catastrophizing Scale (PCS) and the Patient Health Questionnaire (PHQ-8) depression scale would be highly informative given both are commonly measured in pain populations and neither scale has been studied for trait/state contributions. METHODS: The PHQ-8 and PCS were obtained on persons undergoing knee arthroplasty at baseline, 2-, 6- and 12-month post-surgery (N = 402). The multi-trait generalization of the latent trait-state model was used to partition trait and state variability in PCS and PHQ-8 item responses simultaneously. A set of variables were used to predict trait catastrophizing and trait depression. RESULTS: For total scores, the latent traits and latent states explain 63.2% (trait = 43.2%; state = 20.0%) and 50.2% (trait = 29.4%; state = 20.8%) of the variability in PCS and PHQ-8, respectively. Patients with a high number of bodily pain sites, high levels of anxiety, young patients and African-American patients had high levels of trait catastrophizing and trait depression. The PCS and the PHQ-8 consist of both enduring trait and dynamic state characteristics, with trait characteristics dominating for both measures. CONCLUSION: Clinicians and researchers using these scales should not assume the obtained measurements solely reflect either trait- or state-based characteristics. SIGNIFICANCE: Clinicians and researchers using the PCS or PHQ-8 scales are measuring both state and trait characteristics and not just trait- or state-based characteristics.}, Doi = {10.1002/ejp.1619}, Key = {fds350569} } @article{fds352322, Author = {Ramos, K and Langer, SL and Todd, M and Romano, JM and Ghosh, N and Keefe, FJ and Baucom, DH and Syrjala, KL and Porter, LS}, Title = {Attachment Style, Partner Communication, and Physical Well-Being among Couples Coping with Cancer.}, Journal = {Pers Relatsh}, Volume = {27}, Number = {3}, Pages = {526-549}, Year = {2020}, Month = {September}, url = {http://dx.doi.org/10.1111/pere.12330}, Abstract = {Attachment styles may influence interpersonal strategies used to cope with stress. We examined links between attachment style, communicative behaviors, and physical well-being among 166 couples coping with cancer. Results of actor-partner interdependence mediation models indicated that insecure attachment styles were associated with greater self-report of two different and seemingly contradictory communicative behaviors (disclosure and holding back), which in turn were associated with poorer physical well-being. These effects were intrapersonal for both patients and spouses, with the exception of anxious attachment and holding back for spouses. They were also interpersonal in that spouse insecure attachment was associated with poorer patient physical well-being through spouse communication (greater holding back and disclosure). Couple-based communication interventions to support adjustment should consider attachment style.}, Doi = {10.1111/pere.12330}, Key = {fds352322} } @article{fds352470, Author = {Aaron, RV and Finan, PH and Wegener, ST and Keefe, FJ and Lumley, MA}, Title = {Emotion regulation as a transdiagnostic factor underlying co-occurring chronic pain and problematic opioid use.}, Journal = {Am Psychol}, Volume = {75}, Number = {6}, Pages = {796-810}, Year = {2020}, Month = {September}, url = {http://dx.doi.org/10.1037/amp0000678}, Abstract = {Chronic pain is a common and costly condition, and some people with chronic pain engage in problematic opioid use. There is a critical need to identify factors underlying this co-occurrence, so that treatment can be targeted to improve outcomes. We propose that difficulty with emotion regulation (ER) is a transdiagnostic factor that underlies the co-occurrence of chronic pain and problematic opioid use (CP-POU). In this narrative review, we draw from prominent models of ER to summarize the literature characterizing ER in chronic pain and CP-POU. We conclude that chronic pain is associated with various ER difficulties, including emotion identification and the up- and down-regulation of both positive and negative emotion. Little research has examined ER specifically in CP-POU; however, initial evidence suggests CP-POU is characterized by difficulties with ER that are similar to those found in chronic pain more generally. There is great potential to expand the treatment of ER to improve pain-related outcomes in chronic pain and CP-POU. More research is needed, however, to elucidate ER in CP-POU and to determine which types of ER strategies are optimal for different clinical presentations and categories of problematic opioid use. (PsycInfo Database Record (c) 2020 APA, all rights reserved).}, Doi = {10.1037/amp0000678}, Key = {fds352470} } @article{fds353024, Author = {Rice, ASC and Keefe, FJ}, Title = {An introduction to the Biennial Review of Pain.}, Journal = {Pain}, Volume = {161 Suppl 1}, Pages = {S1-S2}, Year = {2020}, Month = {September}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001979}, Doi = {10.1097/j.pain.0000000000001979}, Key = {fds353024} } @article{fds355225, Author = {Raja, SN and Carr, DB and Cohen, M and Finnerup, NB and Flor, H and Gibson, S and Keefe, FJ and Mogil, JS and Ringkamp, M and Sluka, KA and Song, X-J and Stevens, B and Sullivan, MD and Tutelman, PR and Ushida, T and Vader, K}, Title = {The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises.}, Journal = {Pain}, Volume = {161}, Number = {9}, Pages = {1976-1982}, Year = {2020}, Month = {September}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001939}, Abstract = {The current International Association for the Study of Pain (IASP) definition of pain as "An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage" was recommended by the Subcommittee on Taxonomy and adopted by the IASP Council in 1979. This definition has become accepted widely by health care professionals and researchers in the pain field and adopted by several professional, governmental, and nongovernmental organizations, including the World Health Organization. In recent years, some in the field have reasoned that advances in our understanding of pain warrant a reevaluation of the definition and have proposed modifications. Therefore, in 2018, the IASP formed a 14-member, multinational Presidential Task Force comprising individuals with broad expertise in clinical and basic science related to pain, to evaluate the current definition and accompanying note and recommend whether they should be retained or changed. This review provides a synopsis of the critical concepts, the analysis of comments from the IASP membership and public, and the committee's final recommendations for revisions to the definition and notes, which were discussed over a 2-year period. The task force ultimately recommended that the definition of pain be revised to "An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage," and that the accompanying notes be updated to a bulleted list that included the etymology. The revised definition and notes were unanimously accepted by the IASP Council early this year.}, Doi = {10.1097/j.pain.0000000000001939}, Key = {fds355225} } @article{fds371055, Author = {Miaskowski, C and Blyth, F and Nicosia, F and Haan, M and Keefe, F and Smith, A and Ritchie, C}, Title = {A Biopsychosocial Model of Chronic Pain for Older Adults.}, Journal = {Pain Med}, Volume = {21}, Number = {9}, Pages = {1793-1805}, Year = {2020}, Month = {September}, url = {http://dx.doi.org/10.1093/pm/pnz329}, Abstract = {POPULATION: Comprehensive evaluation of chronic pain in older adults is multifaceted. OBJECTIVE AND METHODS: Research on chronic pain in older adults needs to be guided by sound conceptual models. The purpose of this paper is to describe an adaptation of the Biopsychosocial Model (BPS) of Chronic Pain for older adults. The extant literature was reviewed, and selected research findings that provide the empiric foundation for this adaptation of the BPS model of chronic pain are summarized. The paper concludes with a discussion of specific recommendations for how this adapted model can be used to guide future research. CONCLUSIONS: This adaptation of the BPS model of chronic pain for older adults provides a comprehensive framework to guide future research in this vulnerable population.}, Doi = {10.1093/pm/pnz329}, Key = {fds371055} } @article{fds351497, Author = {Dharmasri, CJ and Griesemer, I and Arbeeva, L and Campbell, LC and Cené, CW and Keefe, FJ and Oddone, EZ and Somers, TJ and Allen, KD}, Title = {Acceptability of telephone-based pain coping skills training among African Americans with osteoarthritis enrolled in a randomized controlled trial: a mixed methods analysis.}, Journal = {BMC Musculoskelet Disord}, Volume = {21}, Number = {1}, Pages = {545}, Year = {2020}, Month = {August}, url = {http://dx.doi.org/10.1186/s12891-020-03578-7}, Abstract = {BACKGROUND: Osteoarthritis (OA) disproportionately impacts African Americans compared to Caucasians, including greater pain severity. The Pain Coping Skills Training for African Americans with Osteoarthritis (STAART) study examined a culturally enhanced Pain Coping Skills Training (CST) program among African Americans with OA. This mixed methods study evaluated the acceptability of the Pain CST program among STAART participants. METHODS: STAART was a randomized controlled trial evaluating the effectiveness of an 11-session, telephone-based pain CST program, compared to a usual care control group. Participants were from the University of North Carolina and Durham Veterans Affairs Healthcare Systems. The present analyses included 93 participants in the CST group who completed a questionnaire about experiences with the program. Descriptive statistics of the questionnaire responses were calculated using SAS software. Thematic analysis was applied to open-response data using Dedoose software. RESULTS: Participants' mean rating of overall helpfulness of the pain CST program for managing arthritis symptoms was 8.0 (SD = 2.2) on a scale of 0-10. A majority of participants reported the program made a positive difference in their experience with arthritis (83.1%). Mean ratings of helpfulness of the specific skills ranged from 7.7 to 8.8 (all scales 0-10). Qualitative analysis of the open-response data identified four prominent themes: Improved Pain Coping, Mood and Emotional Benefits, Improved Physical Functioning, and experiences related to Intervention Delivery. CONCLUSIONS: The high ratings of helpfulness demonstrate acceptability of this culturally enhanced pain CST program by African Americans with OA. Increasing access to cognitive-behavioral therapy-based programs may be a promising strategy to address racial disparities in OA-related pain and associated outcomes. TRIAL REGISTRATION: NCT02560922 , registered September 25, 2015.}, Doi = {10.1186/s12891-020-03578-7}, Key = {fds351497} } @article{fds350254, Author = {Gilam, G and Gross, JJ and Wager, TD and Keefe, FJ and Mackey, SC}, Title = {What Is the Relationship between Pain and Emotion? Bridging Constructs and Communities.}, Journal = {Neuron}, Volume = {107}, Number = {1}, Pages = {17-21}, Year = {2020}, Month = {July}, url = {http://dx.doi.org/10.1016/j.neuron.2020.05.024}, Abstract = {Although pain is defined as a sensory and emotional experience, it is traditionally researched and clinically treated separately from emotion. Conceptual and mechanistic relationships between these constructs highlight the need for better understanding of their bi-directional influences and the value of bridging the pain and emotion research and clinical communities.}, Doi = {10.1016/j.neuron.2020.05.024}, Key = {fds350254} } @article{fds350815, Author = {Platts-Mills, TF and McLean, SA and Weinberger, M and Stearns, SC and Bush, M and Teresi, BB and Hurka-Richardson, K and Kroenke, K and Kerns, RD and Weaver, MA and Keefe, FJ}, Title = {Brief educational video plus telecare to enhance recovery for older emergency department patients with acute musculoskeletal pain: study protocol for the BETTER randomized controlled trial.}, Journal = {Trials}, Volume = {21}, Number = {1}, Pages = {615}, Year = {2020}, Month = {July}, url = {http://dx.doi.org/10.1186/s13063-020-04552-3}, Abstract = {BACKGROUND: Chronic musculoskeletal pain (MSP) affects more than 40% of adults aged 50 years and older and is the leading cause of disability in the USA. Older adults with chronic MSP are at risk for analgesic-related side effects, long-term opioid use, and functional decline. Recognizing the burden of chronic MSP, reducing the transition from acute to chronic pain is a public health priority. In this paper, we report the protocol for the Brief EducaTional Tool to Enhance Recovery (BETTER) trial. This trial compares two versions of an intervention to usual care for preventing the transition from acute to chronic MSP among older adults in the emergency department (ED). METHODS: Three hundred sixty patients from the ED will be randomized to one of three arms: full intervention (an interactive educational video about pain medications and recovery-promoting behaviors, a telecare phone call from a nurse 48 to 72 h after discharge from the ED, and an electronic communication containing clinical information to the patient's primary care provider); video-only intervention (the interactive educational video but no telecare or primary care provider communication); or usual care. Data collection will occur at baseline and at 1 week and 1, 3, 6, and 12 months after study enrollment. The primary outcome is a composite measure of pain severity and interference. Secondary outcomes include physical function, overall health, opioid use, healthcare utilization, and an assessment of the economic value of the intervention. DISCUSSION: This trial is the first patient-facing ED-based intervention aimed at helping older adults to better manage their MSP and reduce their risk of developing chronic pain. If effective, future studies will examine the effectiveness of implementation strategies. TRIAL REGISTRATION: ClinicalTrials.gov NCT04118595 . Registered on 8 October 2019.}, Doi = {10.1186/s13063-020-04552-3}, Key = {fds350815} } @article{fds348807, Author = {Winger, JG and Ramos, K and Steinhauser, KE and Somers, TJ and Porter, LS and Kamal, AH and Breitbart, WS and Keefe, FJ}, Title = {Enhancing meaning in the face of advanced cancer and pain: Qualitative evaluation of a meaning-centered psychosocial pain management intervention.}, Journal = {Palliat Support Care}, Volume = {18}, Number = {3}, Pages = {263-270}, Year = {2020}, Month = {June}, url = {http://dx.doi.org/10.1017/S1478951520000115}, Abstract = {OBJECTIVES: The objectives of this study were to obtain patient evaluations of the content, structure, and delivery modality of Meaning-Centered Pain Coping Skills Training (MCPC), a novel psychosocial intervention for patients with advanced cancer and pain. MCPC aims to help patients connect with valued sources of meaning in their lives (e.g., family relationships), while providing training in evidence-based cognitive and behavioral skills (e.g., guided imagery) to reduce pain. METHODS: Semi-structured interviews were conducted with 12 patients with stage IV solid tumor cancers and persistent pain. Transcripts were analyzed using methods from applied thematic analysis. RESULTS: When evaluating MCPC's educational information and skills training descriptions, participants described ways in which this content resonated with their experience. Many coped with their pain and poor prognosis by relying on frameworks that provided them with a sense of meaning, often involving their personally held religious or spiritual beliefs. They also expressed a need for learning ways to cope with pain in addition to taking medication. A few participants offered helpful suggestions for refining MCPC's content, such as addressing common co-occurring symptoms of sleep disturbance and fatigue. Concerning MCPC's structure and delivery modality, most participants preferred that sessions include their family caregiver and described remote delivery (i.e., telephone or videoconference) as being more feasible than attending in-person sessions. SIGNIFICANCE OF RESULTS: Participants were interested in an intervention that concurrently focuses on learning pain coping skills and enhancing a sense of meaning. Using remote delivery modalities may reduce access barriers (e.g., travel) that would otherwise prevent many patients from utilizing psychosocial services.}, Doi = {10.1017/S1478951520000115}, Key = {fds348807} } @article{fds348808, Author = {Winger, JG and Nunez, C and Kelleher, SA and Ingle, KK and Gandhi, V and Keefe, FJ and Somers, TJ}, Title = {Predictors of Intervention Session Completion in a Randomized Clinical Trial of a Behavioral Cancer Pain Intervention.}, Journal = {J Pain Symptom Manage}, Volume = {59}, Number = {6}, Pages = {1268-1277}, Year = {2020}, Month = {June}, url = {http://dx.doi.org/10.1016/j.jpainsymman.2020.01.020}, Abstract = {CONTEXT: Some patients with cancer are able to complete psychosocial pain management intervention sessions, and others find it difficult to do so. OBJECTIVES: Conduct a secondary analysis of a randomized clinical trial (N = 178) that compared delivery formats (in-person vs. videoconference) of a pain coping skills training (PCST) intervention for patients with cancer to examine if intervention session completion predicts postintervention outcomes of pain severity and interference, psychological distress, physical well-being, and pain self-efficacy; and identify predictors (i.e., demographics, medical characteristics, baseline outcome scores) of session completion. METHODS: Session completion (i.e., completing all four sessions vs. missing at least one session) was tested as a predictor of postintervention outcomes. Predictors of session completion were then examined. RESULTS: In both study conditions combined, PCST session completion predicted improvement from baseline to postintervention in pain severity (β = -0.27; P = 0.03), pain interference (β = -0.25; P = 0.048), and pain self-efficacy (β = 0.23; P = 0.07). Participants in the videoconference condition were significantly more likely than those in the in-person condition to complete all sessions (83% vs. 65%; P = 0.006). Participants with at least some college education (odds ratio [OR] 4.36; P = 0.04), a diagnosis of breast cancer (OR 6.73; P = 0.04), and higher levels of pain self-efficacy (OR 2.32; P = 0.02) were more likely to complete videoconference sessions. Participants who lived closer to the medical center (OR 0.64; P = 0.07), had early stage cancer (OR 3.82; P = 0.07), and fewer medical comorbidities (OR 0.59; P = 0.04) were more likely to complete in-person sessions. CONCLUSION: Completing PCST sessions is important for improving pain outcomes. Efforts to increase session completion (e.g., videoconference delivery) should be considered.}, Doi = {10.1016/j.jpainsymman.2020.01.020}, Key = {fds348808} } @article{fds349319, Author = {Eccleston, C and Blyth, FM and Dear, BF and Fisher, EA and Keefe, FJ and Lynch, ME and Palermo, TM and Reid, MC and Williams, ACDC}, Title = {Managing patients with chronic pain during the COVID-19 outbreak: considerations for the rapid introduction of remotely supported (eHealth) pain management services.}, Journal = {Pain}, Volume = {161}, Number = {5}, Pages = {889-893}, Year = {2020}, Month = {May}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001885}, Doi = {10.1097/j.pain.0000000000001885}, Key = {fds349319} } @article{fds349349, Author = {Shelby, RA and Dorfman, CS and Arthur, SS and Bosworth, HB and Corsino, L and Sutton, L and Owen, L and Erkanli, A and Keefe, F and Corbett, C and Kimmick, G}, Title = {Improving health engagement and lifestyle management for breast cancer survivors with diabetes.}, Journal = {Contemp Clin Trials}, Volume = {92}, Pages = {105998}, Year = {2020}, Month = {May}, url = {http://dx.doi.org/10.1016/j.cct.2020.105998}, Abstract = {Breast cancer survivors with type 2 diabetes are at high risk for cancer recurrence, serious health complications, more severe symptoms, psychological distress, and premature death relative to breast cancer survivors without diabetes. Maintaining glycemic control is critical for decreasing symptoms and preventing serious health problems. Many breast cancer survivors with type 2 diabetes have difficulty maintaining diabetes self-management behaviors and achieving glycemic control. Both cancer and diabetes-related symptoms (e.g., physical symptoms and psychological distress) are often barriers to engaging in diabetes self-management strategies. This study evaluates a novel diabetes coping skills training (DCST) intervention for improving breast cancer survivors' abilities to manage symptoms and adhere to recommended diabetes self-management behaviors. The telephone-based DCST protocol integrates three key theory-based strategies: coping skills training for managing symptoms, adherence skills training, and healthy lifestyle skills training. A randomized clinical trial will test the DCST intervention plus diabetes education by comparing it to diabetes education alone. Symptoms, distress, diabetes self-management behaviors, and self-efficacy will be assessed at baseline and 3, 6, and 12 months. Glycosylated hemoglobin (HbA1c) will be assessed at baseline, 6, and 12 months. This study addresses a critical gap in the care of breast cancer survivors by evaluating a novel behavioral intervention to improve the management of symptoms, adherence, and glycemic control in breast cancer survivors with type 2 diabetes. Special considerations for this medically underserved population are also provided. The findings of this study could lead to significant improvements in clinical care and beneficial outcomes for breast cancer survivors. Trials registration: ClinicalTrials.gov, NCT02970344, registered 11/22/2016.}, Doi = {10.1016/j.cct.2020.105998}, Key = {fds349349} } @article{fds348878, Author = {Bennell, KL and Keating, C and Lawford, BJ and Kimp, AJ and Egerton, T and Brown, C and Kasza, J and Spiers, L and Proietto, J and Sumithran, P and Quicke, JG and Hinman, RS and Better Knee and Better Me™ study team and Harris, A and Briggs, AM and Page, C and Choong, PF and Dowsey, MM and Keefe, F and Rini, C}, Title = {Better Knee, Better Me™: effectiveness of two scalable health care interventions supporting self-management for knee osteoarthritis - protocol for a randomized controlled trial.}, Journal = {BMC Musculoskelet Disord}, Volume = {21}, Number = {1}, Pages = {160}, Year = {2020}, Month = {March}, url = {http://dx.doi.org/10.1186/s12891-020-3166-z}, Abstract = {BACKGROUND: Although education, exercise, and weight loss are recommended for management of knee osteoarthritis, the additional benefits of incorporating weight loss strategies into exercise interventions have not been well investigated. The aim of this study is to compare, in a private health insurance setting, the clinical- and cost-effectiveness of a remotely-delivered, evidence- and theory-informed, behaviour change intervention targeting exercise and self-management (Exercise intervention), with the same intervention plus active weight management (Exercise plus weight management intervention), and with an information-only control group for people with knee osteoarthritis who are overweight or obese. METHODS: Three-arm, pragmatic parallel-design randomised controlled trial involving 415 people aged ≥45 and ≤ 80 years, with body mass index ≥28 kg/m2 and < 41 kg/m2 and painful knee osteoarthritis. Recruitment is Australia-wide amongst Medibank private health insurance members. All three groups receive access to a bespoke website containing information about osteoarthritis and self-management. Participants in the Exercise group also receive six consultations with a physiotherapist via videoconferencing over 6 months, including prescription of a strengthening exercise and physical activity program, advice about management, and additional educational resources. The Exercise plus weight management group receive six consultations with a dietitian via videoconferencing over 6 months, which include a very low calorie ketogenic diet with meal replacements and resources to support behaviour change, in addition to the interventions of the Exercise group. Outcomes are measured at baseline, 6 and 12 months. Primary outcomes are self-reported knee pain and physical function at 6 months. Secondary outcomes include weight, physical activity levels, quality of life, global rating of change, satisfaction with care, knee surgery and/or appointments with an orthopaedic surgeon, and willingness to undergo surgery. Additional measures include adherence, adverse events, self-efficacy, and perceived usefulness of intervention components. Cost-effectiveness of each intervention will also be assessed. DISCUSSION: This pragmatic study will determine whether a scalable remotely-delivered service combining weight management with exercise is more effective than a service with exercise alone, and with both compared to an information-only control group. Findings will inform development and implementation of future remotely-delivered services for people with knee osteoarthritis. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12618000930280 (01/06/2018).}, Doi = {10.1186/s12891-020-3166-z}, Key = {fds348878} } @article{fds349544, Author = {Blumenthal, JA and Smith, PJ and Sherwood, A and Mabe, S and Snyder, L and Frankel, C and McKee, DC and Hamilton, N and Keefe, FJ and Shearer, S and Schwartz, J and Palmer, S}, Title = {Remote Therapy to Improve Outcomes in Lung Transplant Recipients: Design of the INSPIRE-III Randomized Clinical Trial.}, Journal = {Transplant Direct}, Volume = {6}, Number = {3}, Pages = {e535}, Year = {2020}, Month = {March}, url = {http://dx.doi.org/10.1097/TXD.0000000000000979}, Abstract = {BACKGROUND: Impaired functional capacity and emotional distress are associated with lower quality of life (QoL) and worse clinical outcomes in post lung transplant patients. Strategies to increase physical activity and reduce distress are needed. METHODS: The Investigational Study of Psychological Interventions in Recipients of Lung Transplant-III study is a single site, parallel group randomized clinical trial in which 150 lung transplant recipients will be randomly assigned to 3 months of telephone-delivered coping skills training combined with aerobic exercise (CSTEX) or to a Standard of Care plus Education control group. The primary endpoints are a global measure of distress and distance walked on the 6-Minute Walk Test. Secondary outcomes include measures of transplant-specific QoL, frailty, health behaviors, and chronic lung allograft dysfunction-free survival. RESULTS: Participants will be evaluated at baseline, at the conclusion of 3 months of weekly treatment, at 1-year follow-up, and followed annually thereafter for clinical events for up to 4 years (median = 2 y). We also will determine whether functional capacity, distress, and health behaviors (eg, physical activity, medication adherence, and volume of air forcefully exhaled in 1 second (FEV1), mediate the effects of the CSTEX intervention on clinical outcomes. CONCLUSIONS: Should the CSTEX intervention result in better outcomes compared with the standard of care plus post-transplant education, the remotely delivered CSTEX intervention can be made available to all lung transplant recipients as a way of enhancing their QoL and improving clinical outcomes.}, Doi = {10.1097/TXD.0000000000000979}, Key = {fds349544} } @article{fds366292, Author = {Von Korff and M and DeBar, LL and Krebs, EE and Kerns, RD and Deyo, RA and Keefe, FJ}, Title = {Graded chronic pain scale revised: mild, bothersome, and high-impact chronic pain.}, Journal = {Pain}, Volume = {161}, Number = {3}, Pages = {651-661}, Year = {2020}, Month = {March}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001758}, Abstract = {Drawing on advances in chronic pain metrics, a simplified Graded Chronic Pain Scale-Revised was developed to differentiate mild, bothersome, and high-impact chronic pain. Graded Chronic Pain Scale-Revised was validated among adult enrollees of 2 health plans (N = 2021). In this population, the prevalence of chronic pain (pain present most or every day, prior 3 months) was 40.5%: 15.4% with mild chronic pain (lower pain intensity and interference); 10.1% bothersome chronic pain (moderate to severe pain intensity with lower interference with life activities); and 15.0% high-impact chronic pain (sustained pain-related activity limitations). Persons with mild chronic pain vs those without chronic pain showed small differences on 10 health status indicators (unfavorable health perceptions, activity limitations, and receiving long-term opioid therapy), with nonsignificant differences for 7 of 10 indicators. Persons with bothersome vs mild chronic pain differed significantly on 6 of 10 indicators (eg, negative pain coping beliefs, psychological distress, unfavorable health perceptions, and pain-related interference with overall activities). Persons with high-impact chronic pain differed significantly from those with mild chronic pain on all 10 indicators. Persons with high-impact chronic pain, relative to those with bothersome chronic pain, were more likely to have substantial activity limitations (significant differences for 4 of 5 disability indicators) and more often received long-term opioid therapy. Graded Chronic Pain Scale-Revised strongly predicted 5 activity-limitation indicators with area under receiver operating characteristic curve coefficients of 0.76 to 0.89. We conclude that the 5-item Graded Chronic Pain Scale-Revised and its scoring rules provide a brief, simple, and valid method for assessing chronic pain.}, Doi = {10.1097/j.pain.0000000000001758}, Key = {fds366292} } @article{fds346728, Author = {Plumb Vilardaga and JC and Winger, JG and Teo, I and Owen, L and Sutton, LM and Keefe, FJ and Somers, TJ}, Title = {Coping Skills Training and Acceptance and Commitment Therapy for Symptom Management: Feasibility and Acceptability of a Brief Telephone-Delivered Protocol for Patients With Advanced Cancer.}, Journal = {J Pain Symptom Manage}, Volume = {59}, Number = {2}, Pages = {270-278}, Year = {2020}, Month = {February}, url = {http://dx.doi.org/10.1016/j.jpainsymman.2019.09.005}, Abstract = {CONTEXT: Patients with advanced cancer face a life-limiting condition that brings a high symptom burden that often includes pain, fatigue, and psychological distress. Psychosocial interventions have promise for managing symptoms but need additional tailoring for these patients' specific needs. Patients with advanced cancer in the community also face persistent barriers-availability of interventions in community clinics as well as financial and illness-related factors-to accessing psychosocial interventions. OBJECTIVES: The aim of the present study was to assess the feasibility and acceptability of telephone implementation of Engage, a novel brief combined Coping Skills Training and Acceptance and Commitment Therapy protocol, for reducing symptoms and increasing quality of life in community patients with advanced cancer. METHODS: Adult patients with advanced cancer receiving care in the community received Engage, four 60-minute manualized telephone sessions delivered by a trained psychotherapist and completed pretreatment and post-treatment assessments. RESULTS: Engage was feasible, achieving 100% accrual (N = 24) of a heterogeneous sample of patients with advanced cancer, with good retention (88% completed). Acceptability was demonstrated via satisfaction (mean 29 of 32; SD 2), engagement (95% attendance), and use of skills. Secondary analyses pointed to reductions in pain interference, fatigue, psychological distress, and improvements in psychological acceptance and engagement in value-guided activity after treatment. CONCLUSION: Engage, our brief novel combined Coping Skills and Acceptance and Commitment Therapy intervention, demonstrated initial feasibility and acceptability when delivered over the telephone and increased access for community clinic patients with advanced cancer. Future research will assess the comparative efficacy of Engage in larger randomized trials.}, Doi = {10.1016/j.jpainsymman.2019.09.005}, Key = {fds346728} } @article{fds346903, Author = {Zimmaro, LA and Carson, JW and Olsen, MK and Sanders, LL and Keefe, FJ and Porter, LS}, Title = {Greater mindfulness associated with lower pain, fatigue, and psychological distress in women with metastatic breast cancer.}, Journal = {Psychooncology}, Volume = {29}, Number = {2}, Pages = {263-270}, Year = {2020}, Month = {February}, url = {http://dx.doi.org/10.1002/pon.5223}, Abstract = {OBJECTIVE: Women with metastatic breast cancer (MBC) report high levels of disease-related symptoms including pain, fatigue, psychological distress, and sleep disturbance. Mindfulness may be particularly relevant to women with MBC given the high symptom burden and psychological toll of this disease; however, the topic is understudied among this patient population. Therefore, we aimed to test the associations between mindfulness and patient-reported symptoms among a sample of women with MBC. METHODS: Sixty-four women with MBC completed baseline questionnaires of mindfulness (Five Facet Mindfulness Questionnaire-Short Form [FFMQ-SF]) and symptoms of pain severity and interference, fatigue, psychological distress, and sleep disturbance as part of a randomized controlled trial of a Mindful Yoga intervention. Correlational analyses of data collected at baseline tested associations between the five mindfulness facets (observing, describing, acting with awareness, nonjudging, and nonreactivity) and patient-reported measures of symptoms. RESULTS: Overall, higher mindfulness was associated with lower symptom levels including lower pain severity, pain interference, fatigue, anxiety, depression, and sleep disturbance. However, degree of association varied by mindfulness facet. Nonreactivity, nonjudging, and describing showed the most frequent associations and largest effect sizes across symptoms, while observing showed the least frequent associations and lowest effect sizes. CONCLUSIONS: Mindfulness-and in particular nonreactivity, nonjudging, and describing-may be a personal resource for women with MBC in coping with complex symptoms of this life-threatening illness. Findings are discussed relative to their implications for interventions aimed at increasing mindfulness in this vulnerable population.}, Doi = {10.1002/pon.5223}, Key = {fds346903} } @article{fds347049, Author = {Garland, EL and Brintz, CE and Hanley, AW and Roseen, EJ and Atchley, RM and Gaylord, SA and Faurot, KR and Yaffe, J and Fiander, M and Keefe, FJ}, Title = {Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis.}, Journal = {JAMA Intern Med}, Volume = {180}, Number = {1}, Pages = {91-105}, Year = {2020}, Month = {January}, url = {http://dx.doi.org/10.1001/jamainternmed.2019.4917}, Abstract = {IMPORTANCE: Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients. OBJECTIVE: To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain. DATA SOURCES: For this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched. STUDY SELECTION: Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also prescribed opioids for clinical pain. DATA EXTRACTION AND SYNTHESIS: Independent reviewers screened citations, extracted data, and assessed risk of bias. Meta-analyses were conducted using standardized mean differences in pain and opioid dose to obtain aggregate estimates of effect size with 95% CIs. MAIN OUTCOMES AND MEASURES: The primary outcome was pain intensity. The secondary outcomes were opioid dose, opioid misuse, opioid craving, disability, or function. RESULTS: Of 4212 citations reviewed, 60 reports with 6404 participants were included in the meta-analysis. Overall, MBTs were associated with pain reduction (Cohen d = -0.51; 95% CI, -0.76 to -0.26) and reduced opioid dose (Cohen d = -0.26; 95% CI, -0.44 to -0.08). Studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and cognitive behavioral therapy (n = 7) interventions. Moderate to large effect size improvements in pain outcomes were found for meditation (Cohen d = -0.70), hypnosis (Cohen d = -0.54), suggestion (Cohen d = -0.68), and cognitive behavioral therapy (Cohen d = -0.43) but not for other MBTs. Although most meditation (n = 4 [80%]), cognitive-behavioral therapy (n = 4 [57%]), and hypnosis (n = 12 [63%]) studies found improved opioid-related outcomes, fewer studies of suggestion, guided imagery, and relaxation reported such improvements. Most MBT studies used active or placebo controls and were judged to be at low risk of bias. CONCLUSIONS AND RELEVANCE: The findings suggest that MBTs are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse. Future studies should carefully quantify opioid dosing variables to determine the association of mind-body therapies with opioid-related outcomes.}, Doi = {10.1001/jamainternmed.2019.4917}, Key = {fds347049} } @article{fds352471, Author = {Greenberg, J and Mace, RA and Popok, PJ and Kulich, RJ and Patel, KV and Burns, JW and Somers, TJ and Keefe, FJ and Schatman, ME and Vranceanu, A-M}, Title = {Psychosocial Correlates of Objective, Performance-Based, and Patient-Reported Physical Function Among Patients with Heterogeneous Chronic Pain.}, Journal = {J Pain Res}, Volume = {13}, Pages = {2255-2265}, Year = {2020}, url = {http://dx.doi.org/10.2147/JPR.S266455}, Abstract = {BACKGROUND: Improving all aspects of physical function is an important goal of chronic pain management. Few studies follow recent guidelines to comprehensively assess physical function via patient-reported, performance-based, and objective/ambulatory measures. PURPOSE: To test 1) the interrelation between the 3 types of physical function measurement and 2) the association between psychosocial factors and each type of physical function measurement. METHODS: Patients with chronic pain (N=79) completed measures of: 1) physical function (patient-reported disability; performance-based 6-minute walk-test; objective accelerometer step count); 2) pain and non-adaptive coping (pain during rest and activity, pain-catastrophizing, kinesiophobia); 3) adaptive coping (mindfulness, general coping, pain-resilience); and 4) social-emotional dysfunction (anxiety, depression, social isolation and emotional support). First, we tested the interrelation among the 3 aspects of physical function. Second, we used structural equation modeling to test associations between psychosocial factors (pain and non-adaptive coping, adaptive coping, and social-emotional dysfunction) and each measurement of physical function. RESULTS: Performance-based and objective physical function were significantly interrelated (r=0.48, p<0.001) but did not correlate with patient-reported disability. Pain and non-adaptive coping (β=0.68, p<0.001), adaptive coping (β=-0.65, p<0.001) and social-emotional dysfunction (β=0.65, p<0.001) were associated with patient-reported disability but not to performance-based or objective physical function (ps>0.1). CONCLUSION: Results suggest that patient-reported physical function may provide limited information about patients' physical capacity or ambulatory activity. While pain and non-adaptive reactions to it, adaptive coping, and social-emotional dysfunction may potentially improve patient-reported physical function, additional targets may be needed to improve functional capacity and ambulatory activity. TRIAL REGISTRATION: ClinicalTrials.gov NCT03412916.}, Doi = {10.2147/JPR.S266455}, Key = {fds352471} } @article{fds372552, Author = {Pita, MG and Coleman, JN and Kimmick, G and Keefe, FJ and Bosworth, HB and Sutton, LM and Owen, L and Gandhi, V and Shelby, RA}, Title = {ASSOCIATION BETWEEN PERCEIVED DISCRIMINATION IN MEDICAL CARE AND SELF-EFFICACY FOR PURSUING BREAST CANCER FOLLOW-UP CARE}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {54}, Pages = {S702-S702}, Year = {2020}, Key = {fds372552} } @article{fds372553, Author = {Coleman, JN and Kimmick, G and Keefe, FJ and Bosworth, HB and Sutton, LM and Owen, L and Gandhi, V and Shelby, RA}, Title = {PERCEPTIONS OF FOLLOW-UP CARE AMONG BREAST CANCER SURVIVORS: ASSOCIATIONS WITH COMMUNICATION AND TRUST IN MEDICAL CARE}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {54}, Pages = {S279-S279}, Year = {2020}, Key = {fds372553} } @article{fds372554, Author = {Rini, CM and Kashikar-Zuck, S and DeBar, L and Keefe, FJ}, Title = {NEW EVIDENCE FOR PSYCHOLOGICAL AND OTHER NON-PHARMACOLOGIC APPROACHES FOR MANAGING CHRONIC PAIN}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {54}, Pages = {S203-S203}, Year = {2020}, Key = {fds372554} } @article{fds372555, Author = {Arthur, SS and Bovbjerg, DH and Keefe, FJ and Kimmick, G and Sutton, LM and Owen, L and Hwang, E-SS and Raybon, KB and Coleman, JN and Shelby, RA}, Title = {FEASIBILITY TRIAL OF TARGETED PAIN COPING SKILLS TRAINING FOR PERSISTENT PAIN AFTER BREAST CANCER SURGERY}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {54}, Pages = {S548-S548}, Year = {2020}, Key = {fds372555} } @article{fds372556, Author = {Langer, S and Todd, M and Romano, JM and Bolger, N and Bricker, J and Syrjala, KL and Burns, J and Keefe, FJ and Strauman, T and Gralow, J and Westbrook, K and Shankaran, V and Zafar, SY and Martins, R and Ghosh, N and Porter, LS}, Title = {THE RELATIONSHIP INTIMACY MODEL OF COUPLE ADAPTATION TO CANCER: SUPPORT FROM A PROSPECTIVE, LONGITUDINAL, SMARTPHONE-ENABLED ECOLOGICAL MOMENTARY ASSESSMENT STUDY}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {54}, Pages = {S142-S142}, Year = {2020}, Key = {fds372556} } @article{fds372557, Author = {Rini, CM and Katz, A and Nwadugbo, A and Porter, LS and Somers, T and Keefe, FJ}, Title = {WEB-BASED PAIN COPING SKILLS TRAINING CHANGES COPING STRATEGIES PEOPLE WOULD USE IN HYPOTHETICAL SITUATIONS LIKELY TO INCREASE PAIN}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {54}, Pages = {S203-S203}, Year = {2020}, Key = {fds372557} } @article{fds342180, Author = {Porter, LS and Carson, JW and Olsen, M and Carson, KM and Sanders, L and Jones, L and Westbrook, K and Keefe, FJ}, Title = {Feasibility of a mindful yoga program for women with metastatic breast cancer: results of a randomized pilot study.}, Journal = {Support Care Cancer}, Volume = {27}, Number = {11}, Pages = {4307-4316}, Year = {2019}, Month = {November}, url = {http://dx.doi.org/10.1007/s00520-019-04710-7}, Abstract = {PURPOSE: Patients with metastatic breast cancer (MBC) experience high levels of symptoms. Yoga interventions have shown promise for improving cancer symptoms but have rarely been tested in patients with advanced disease. This study examined the acceptability of a comprehensive yoga program for MBC and the feasibility of conducting a randomized trial testing the intervention. METHODS: Sixty-three women with MBC were randomized with a 2:1 allocation to yoga or a support group comparison condition. Both interventions involved eight weekly group sessions. Feasibility was quantified using rates of accrual, attrition, and session attendance. Acceptability was assessed with a standardized self-report measure. Pain, fatigue, sleep quality, psychological distress, mindfulness, and functional capacity were assessed at baseline, post-intervention, and 3 and 6 months post-intervention. RESULTS: We met goals for accrual and retention, with 50% of eligible patients enrolled and 87% of randomized participants completing post-intervention surveys. Sixty-five percent of women in the yoga condition and 90% in the support group attended ≥ 4 sessions. Eighty percent of participants in the yoga condition and 65% in the support group indicated that they were highly satisfied with the intervention. Following treatment, women in the yoga intervention had modest improvements in some outcomes; however, overall symptom levels were low for women in both conditions. CONCLUSIONS: Findings suggest that the yoga intervention content was highly acceptable to patients with MBC, but that there are challenges to implementing an intervention involving eight group-based in-person sessions. Alternative modes of delivery may be necessary to reach patients most in need of intervention.}, Doi = {10.1007/s00520-019-04710-7}, Key = {fds342180} } @article{fds346729, Author = {Winger, JG and Plumb Vilardaga and JC and Keefe, FJ}, Title = {Indices of pain variability: a paradigm shift.}, Journal = {Pain}, Volume = {160}, Number = {11}, Pages = {2411-2412}, Year = {2019}, Month = {November}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001627}, Doi = {10.1097/j.pain.0000000000001627}, Key = {fds346729} } @article{fds344584, Author = {Hung, A and Li, Y and Keefe, FJ and Ang, DC and Slover, J and Perera, RA and Dumenci, L and Reed, SD and Riddle, DL}, Title = {Ninety-day and one-year healthcare utilization and costs after knee arthroplasty.}, Journal = {Osteoarthritis Cartilage}, Volume = {27}, Number = {10}, Pages = {1462-1469}, Year = {2019}, Month = {October}, url = {http://dx.doi.org/10.1016/j.joca.2019.05.019}, Abstract = {OBJECTIVES: This study examined ninety-day and one-year postoperative healthcare utilization and costs following total knee arthroplasty (TKA) from the health sector and patient perspectives. DESIGN: This study relied on: 1) patient-reported medical resource utilization data from diaries in the Knee Arthroplasty Pain Coping Skills Training (KASTPain) trial; and 2) Medicare fee schedules. Medicare payments, patient cost-sharing, and patient time costs were estimated. Generalized linear mixed models were used to identify baseline predictors of costs. RESULTS: In the first ninety days following TKA, patients had an average of 29.7 outpatient visits and 6% were hospitalized. Mean total costs during this period summed to $3,720, the majority attributed to outpatient visit costs (84%). Over the year following TKA, patients had an average of 48.9 outpatient visits, including 33.2 for physical therapy. About a quarter (24%) of patients were hospitalized. Medical costs were incurred at a decreasing rate, from $2,428 in the first six weeks to $648 in the last six weeks. Mean total medical costs across all patients over the year were $8,930, including $5,328 in outpatient costs. Total costs were positively associated with baseline Charlson comorbidity score (P < 0.01). Outpatient costs were positively associated with baseline Charlson comorbidity score (P = 0.03) and a bodily pain burden summary score (P < 0.01). Mean patient cost-sharing summed to $1,342 and time costs summed to $1,346. CONCLUSIONS: Costs in the ninety days and year after TKA can be substantial for both healthcare payers and patients. These costs should be considered as payers continue to explore alternative payment models.}, Doi = {10.1016/j.joca.2019.05.019}, Key = {fds344584} } @article{fds342792, Author = {Burns, JW and Post, KM and Smith, DA and Porter, LS and Buvanendran, A and Fras, AM and Keefe, FJ}, Title = {Spouse and Patient Beliefs and Perceptions About Chronic Pain: Effects on Couple Interactions and Patient Pain Behavior.}, Journal = {J Pain}, Volume = {20}, Number = {10}, Pages = {1176-1186}, Year = {2019}, Month = {October}, url = {http://dx.doi.org/10.1016/j.jpain.2019.04.001}, Abstract = {Patient beliefs and perceptions about the causes and meaning of their chronic pain are related to their psychosocial functioning. Beliefs and perceptions about chronic pain held by spouses may also be related to patient functioning. We used a laboratory procedure to evaluate whether spouse beliefs about and perceptions of chronic pain were related to spouse negative responses toward patients with chronic low back pain during a conflictual discussion and to their attributions about patient pain behavior during a subsequent pain-induction task. Patients (n = 71) and their spouses (n = 71) participated in a 10-minute discussion followed by the patient undergoing a 10-minute structured pain behavior task. Findings were that a) spouse perceptions that patient's pain was a mystery were significantly related to greater patient perceived spouse critical/invalidating responses toward the patient during the discussion; and b) spouse perceptions that patient's pain was a mystery were related to internal and negative attributions spouses made while observing patients display pain behaviors during the structured pain behavior task. Inasmuch as both spouse critical/invalidating speech toward patients and negative attributions regarding the cause of patient behavior are related to poor patient functioning, spouse uncertainty about the source and potential legitimacy of their partner's pain may play crucial roles in affecting patient well-being. PERSPECTIVE: Spouse beliefs about and perceptions of patient chronic pain were related to spouse behavior toward patients during a discussion and to attributions explaining patient pain during physical activity. If spouse confusion and doubt about patient pain is related to negative behavior and attributions, then modifying these perceptions may be a fundamental intervention target.}, Doi = {10.1016/j.jpain.2019.04.001}, Key = {fds342792} } @article{fds341763, Author = {Wren, AA and Shelby, RA and Soo, MS and Huysmans, Z and Jarosz, JA and Keefe, FJ}, Title = {Preliminary efficacy of a lovingkindness meditation intervention for patients undergoing biopsy and breast cancer surgery: A randomized controlled pilot study.}, Journal = {Support Care Cancer}, Volume = {27}, Number = {9}, Pages = {3583-3592}, Year = {2019}, Month = {September}, url = {http://dx.doi.org/10.1007/s00520-019-4657-z}, Abstract = {PURPOSE: Despite more women undergoing treatment for breast cancer and increased survival rates, many women suffer from anxiety and physical symptoms (e.g., pain, fatigue) surrounding diagnosis and surgery. Research investigating the efficacy of psychosocial interventions for breast cancer patients during this period is limited. This randomized controlled pilot study examined the effect of a brief lovingkindness meditation intervention on these key outcomes. METHODS: Participants were 60 women who underwent core needle breast biopsy, received an abnormal biopsy result, and underwent breast surgery (White = 73.6%; African American = 22.6%; Asian American = 3.8%; Age M = 56). Participants were randomly assigned to one of three treatment conditions at breast biopsy: (1) lovingkindness meditation, (2) music, and (3) usual care. Assessments of anxiety, pain, fatigue, physiologic reactivity, and self-compassion occurred prior to patients' biopsy, following biopsy, 1 week after receipt of biopsy results, and 1 week following breast surgery. RESULTS: Multilevel modeling analyses demonstrated that lovingkindness meditation significantly improved pain (p = 0.02), self-compassion (p = 0.004), and heart rate (p = 0.02) over time compared to control conditions. There was a trend for anxiety (p = 0.05). Music significantly improved pain (p = 0.04) compared to usual care. CONCLUSIONS: These findings provide preliminary evidence for the feasibility and efficacy of a lovingkindness meditation intervention for breast cancer patients during the diagnostic and surgical period. Improving psychological and physical well-being during this time frame has the potential to improve longer-term health outcomes during adjuvant treatment and survivorship. Interventions that cultivate positive adjustment during the diagnostic and surgical period of breast cancer are an important area of future research.}, Doi = {10.1007/s00520-019-4657-z}, Key = {fds341763} } @article{fds344585, Author = {Kelleher, SA and Winger, JG and Dorfman, CS and Ingle, KK and Moskovich, AA and Abernethy, AP and Keefe, FJ and Samsa, GP and Kimmick, GG and Somers, TJ}, Title = {A behavioral cancer pain intervention: A randomized noninferiority trial comparing in-person with videoconference delivery.}, Journal = {Psychooncology}, Volume = {28}, Number = {8}, Pages = {1671-1678}, Year = {2019}, Month = {August}, url = {http://dx.doi.org/10.1002/pon.5141}, Abstract = {OBJECTIVE: Behavioral cancer pain interventions are efficacious for improving important pain outcomes; yet, traditional in-person delivery limits patient access. This study compared videoconference-delivered mobile health pain coping skills training (mPCST) to in-person pain coping skills training (PCST-traditional). METHODS: This study was a randomized, noninferiority trial with cancer patients. Participants (N = 178) were randomly assigned to four, 45-minute sessions of mPCST or PCST-traditional. Session content focused on evidence-based cognitive and behavioral pain management skills. Assessments were completed at baseline, posttreatment, and 3-month posttreatment, and included measures of primary intervention outcomes (ie, pain severity and pain interference) and secondary intervention outcomes (ie, physical symptoms, psychological distress, physical well-being, and self-efficacy). The main study aim tested whether mPCST was more accessible (defined as feasibility, acceptability, patient burden, and engagement) than PCST-traditional. The second aim tested whether mPCST was noninferior to PCST-traditional. RESULTS: mPCST demonstrated significantly greater feasibility (ie, attrition, adherence, and time to completion) than PCST-traditional. Both groups reported similar patient burden and engagement as well as a high degree of acceptability. All intervention outcomes demonstrated noninferiority at posttreatment and, with the exception of physical symptoms, 3-month posttreatment. Concerning the primary intervention outcomes, 95% CIs for the mean differences (d) were below the noninferiority margin of 1 for pain severity (posttreatment d = 0.09, 95% CI, -0.63-0.81; 3 months d = -0.43 95% CI, -1.22-0.36) and pain interference (posttreatment d = -0.11, 95% CI, -0.99-0.76; 3 months d = -0.26 95% CI, -1.14-0.62). CONCLUSION: mPCST is highly accessible and noninferior to PCST-traditional.}, Doi = {10.1002/pon.5141}, Key = {fds344585} } @article{fds345843, Author = {Simmons, LA and Williams, H and Silva, S and Keefe, F and Tanabe, P}, Title = {Acceptability and Feasibility of a Mindfulness-Based Intervention for Pain Catastrophizing among Persons with Sickle Cell Disease.}, Journal = {Pain Manag Nurs}, Volume = {20}, Number = {3}, Pages = {261-269}, Year = {2019}, Month = {June}, url = {http://dx.doi.org/10.1016/j.pmn.2018.10.002}, Abstract = {BACKGROUND: Few investigators have developed and tested nonpharmacological interventions for helping persons with sickle cell disease (SCD) manage persistent pain. AIMS: The purpose of this pilot study was to examine the feasibility and acceptability of a mindfulness-based intervention (MBI) in adults with SCD and chronic pain and to gather preliminary data on its efficacy. DESIGN: Data on feasibility and acceptability, including recruitment, retention, and attendance rates, were collected during a single-site, randomized control trial. Participants were randomly assigned to either a 6-session group telephonic MBI or a wait-listed control. Pain catastrophizing was assessed at baseline and at weeks 1, 3, and 6. SETTING: Outpatient, comprehensive, interdisciplinary sickle cell disease center in the Southeast. PARTICIPANTS/SUBJECTS: Adults at least 18 years of age with a self-reported diagnosis of sickle cell disease who self-identified as having chronic, non-cancer pain that persisted on most days for at least 6 months and adversely affected function and/or well-being. METHODS: Seventy-eight adults were recruited; 18 (23%) declined to participate; 60 were randomly assigned to either the MBI (N = 40) or control (N = 20). Of those, 14 (35%) from the MBI and 12 (60%) from the control group withdrew immediately after random allocation, resulting in 34 evaluable cases (MBI: N = 26; control: N = 8). RESULTS: Among the 26 assigned to MBI, the median number of sessions attended per person was 4; 7 (27%) attended all six sessions. Qualitative findings indicated that MBI participants viewed the program as acceptable and liked the telephonic format, community, and content. Reductions in pain catastrophizing outcomes were identified after intervention. CONCLUSIONS: An MBI is feasible and acceptable for persons with SCD experiencing chronic pain. A larger randomized controlled trial to establish MBI efficacy on pain and related outcomes for SCD will provide nonpharmacologic, behavioral pain management options for nurses and other clinicians caring for persons with SCD and chronic pain.}, Doi = {10.1016/j.pmn.2018.10.002}, Key = {fds345843} } @article{fds341764, Author = {Dumenci, L and Perera, RA and Keefe, FJ and Ang, DC and Slover, J and Jensen, MP and Riddle, DL}, Title = {Model-based pain and function outcome trajectory types for patients undergoing knee arthroplasty: a secondary analysis from a randomized clinical trial.}, Journal = {Osteoarthritis Cartilage}, Volume = {27}, Number = {6}, Pages = {878-884}, Year = {2019}, Month = {June}, url = {http://dx.doi.org/10.1016/j.joca.2019.01.004}, Abstract = {OBJECTIVE: Knee arthroplasty (KA) is an effective surgical procedure. However, clinical studies suggest that a considerable number of patients continue to experience substantial pain and functional loss following surgical recovery. We aimed to estimate pain and function outcome trajectory types for persons undergoing KA, and to determine the relationship between pain and function trajectory types, and pre-surgery predictors of trajectory types. DESIGN: Participants were 384 patients who took part in the KA Skills Training randomized clinical trial. Pain and function were assessed at 2-week pre- and 2-, 6-, and 12-months post-surgery. Piecewise latent class growth models were used to estimate pain and function trajectories. Pre-surgery variables were used to predict trajectory types. RESULTS: There was strong evidence for two trajectory types, labeled as good and poor, for both Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain and Function scores. Model estimated rates of the poor trajectory type were 18% for pain and function. Dumenci's latent kappa between pain and function trajectory types was 0.71 (95% CI: 0.61-0.80). Pain catastrophizing and number of painful body regions were significant predictors of poor pain and function outcomes. Outcome-specific predictors included low income for poor pain and baseline pain and younger age for poor function. CONCLUSIONS: Among adults undergoing KA, approximately one-fifth continue to have persistent pain, poor function, or both. Although the poor pain and function trajectory types tend to go together within persons, a significant number experience either poor pain or function but not both, suggesting heterogeneity among persons who do not fully benefit from KA.}, Doi = {10.1016/j.joca.2019.01.004}, Key = {fds341764} } @article{fds343560, Author = {Allen, KD and Somers, TJ and Campbell, LC and Arbeeva, L and Coffman, CJ and Cené, CW and Oddone, EZ and Keefe, FJ}, Title = {Pain coping skills training for African Americans with osteoarthritis: results of a randomized controlled trial.}, Journal = {Pain}, Volume = {160}, Number = {6}, Pages = {1297-1307}, Year = {2019}, Month = {June}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001525}, Abstract = {African Americans bear a disproportionate burden of osteoarthritis (OA), but they have been underrepresented in trials of behavioral interventions for pain. This trial examined a culturally tailored pain coping skills training (CST) program, compared to a wait list control group, among 248 African Americans with knee or hip OA. The pain CST program involved 11 telephone-based sessions over 3 months. Outcomes were assessed at baseline, 3 months (primary), and 9 months, and included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (primary outcome), WOMAC total score and function subscale, PROMIS Pain Interference, Short-Form 12 Mental and Physical Composite Subscales, Coping Strategies Questionnaire-Total Coping Attempts, Pain Catastrophizing Scale, Patient Health Questionnaire-8, Arthritis Self-Efficacy Scale, and Patient Global Impression of Arthritis Symptom Change. Linear mixed models were fit for all outcomes. There were no significant between-group differences in WOMAC pain score at 3 months (-0.63 [95% confidence interval -1.45, 0.18]; P = 0.128) or 9 months (-0.84 [95% confidence interval -1.73, 0.06]; P = 0.068). Among secondary outcomes, at 3 months, there were significant differences, in favor of the CST group, for Coping Strategies Questionnaire Total Coping Attempts, Pain Catastrophizing Scale, Arthritis Self-Efficacy, and Patient Global Impression of Arthritis Symptom Change (P < 0.01). Coping Strategies Questionnaire Total Coping Attempts, Arthritis Self-Efficacy, and Patient Global Assessment Change were also significantly improved at 9 months in the CST group, compared with wait list (P < 0.01). The culturally tailored pain CST program did not significantly reduce pain severity but did improve key measures of pain coping and perceived ability to manage pain among African Americans with OA.}, Doi = {10.1097/j.pain.0000000000001525}, Key = {fds343560} } @article{fds341832, Author = {Porter, LS and Samsa, G and Steel, JL and Hanson, LC and LeBlanc, TW and Bull, J and Fischer, S and Keefe, FJ}, Title = {Caregiver-guided pain coping skills training for patients with advanced cancer: Background, design, and challenges for the CaringPals study.}, Journal = {Clin Trials}, Volume = {16}, Number = {3}, Pages = {263-272}, Year = {2019}, Month = {June}, url = {http://dx.doi.org/10.1177/1740774519829695}, Abstract = {BACKGROUND/AIMS: Pain is a major concern of patients with advanced cancer and their caregivers. There is strong evidence that pain coping skills training interventions based on cognitive-behavioral principles can reduce pain severity and pain interference. However, few such interventions have been tested for patients with advanced cancer and their family caregivers. This study aims to test the efficacy of a caregiver-guided pain coping skills training protocol on patient and caregiver outcomes. METHODS: A total of 214 patients age ≥18 with Stage III-Stage IV cancer and moderate to severe pain, along with their family caregivers, are being identified and randomized with a 1:1 allocation to the caregiver-guided pain coping skills training intervention or enhanced treatment-as-usual. Dyads in both conditions receive educational resources on pain management, and the caregiver-guided pain coping skills training intervention includes three weekly 60-min sessions conducted with the patient-caregiver dyad via videoconference. Measures of caregiver outcomes (self-efficacy for helping the patient manage pain, caregiver strain, caregiving satisfaction, psychological distress) and patient outcomes (self-efficacy for pain management, pain intensity and interference, psychological distress) are collected at baseline and post-intervention. Caregiver outcomes are also collected 3 and 6 months following the patient's death. The study is enrolling patients from four tertiary care academic medical centers and one free-standing hospice and palliative care organization. The primary outcome is caregiver self-efficacy for helping the patient manage pain. RESULTS: This article describes challenges in the design and implementation of the CaringPals trial. Key issues for trial design include the identification and recruitment of patients with advanced cancer and pain, and the follow-up and collection of data from caregivers following the patient's death. CONCLUSION: The CaringPals trial addresses a gap in research in pain coping skills training interventions by addressing the unique needs of patients with advanced cancer and their caregivers. Findings from this study may lead to advances in the clinical care of patients with advanced cancer and pain, as well as a better understanding of the effects of training family caregivers to help patients cope with pain.}, Doi = {10.1177/1740774519829695}, Key = {fds341832} } @article{fds341561, Author = {Bovbjerg, DH and Keefe, FJ and Soo, MS and Manculich, J and Van Denburg, A and Zuley, ML and Ahrendt, GM and Skinner, CS and Edmond, SN and Shelby, RA}, Title = {Persistent breast pain in post-surgery breast cancer survivors and women with no history of breast surgery or cancer: associations with pain catastrophizing, perceived breast cancer risk, breast cancer worry, and emotional distress.}, Journal = {Acta Oncol}, Volume = {58}, Number = {5}, Pages = {763-768}, Year = {2019}, Month = {May}, url = {http://dx.doi.org/10.1080/0284186X.2019.1574023}, Abstract = {Background: Persistent breast pain (PBP) is prevalent among breast cancer survivors and has powerful negative psychological consequences. The present study provided a first test of the hypothesis that: (a) pain catastrophizing, (b) heightened perceived risk of cancer, and (c) worry that pain indicates cancer may be independent mediating links between breast cancer survivors' experiences of PBP and heightened emotional distress. Methodology: We assessed levels of PBP and psychological factors in breast cancer survivors (Survivor Group: n = 417; Stages I-IIIA; White = 88.7%; Age M = 59.4 years) at their first surveillance mammogram post-surgery (6-15 months). A comparison group of women without histories of breast surgery or cancer (Non-cancer Group: n = 587; White = 78.7%; Age M = 57.4 years) was similarly assessed at the time of a routine screening mammogram. All women completed measures of breast pain, pain catastrophizing, perceived breast cancer risk, and worry that breast pain indicates cancer, as well as measures of emotional distress (symptoms of anxiety, symptoms of depression, and mammography-specific distress). Analyses included race, age, BMI, education, and menopausal status as covariates, with significance set at 0.05. Results: As expected, PBP prevalence was significantly higher in the Survivor Group than in the Non-cancer Group (50.6% vs. 17.5%). PBP+ survivors also had significantly higher levels of emotional distress, pain catastrophizing, mammography-specific distress, and worry that breast pain indicates cancer, compared to PBP- survivors. Structural equation modeling results were significant for all hypothesized mediational pathways. Interestingly, comparisons of PBP+ to PBP- women in the Non-cancer Group showed similar results. Conclusion: These findings suggest the importance of (a) pain catastrophizing, (b) perceived breast cancer risk and, (c) worry that breast pain may indicate cancer, as potential targets for interventions aimed at reducing the negative psychological impact of PBP in post-surgery breast cancer survivors, as well as in unaffected women with PBP due to unknown reasons.}, Doi = {10.1080/0284186X.2019.1574023}, Key = {fds341561} } @article{fds372558, Author = {Hung, A and Li, Y and Keefe, FJ and Ang, D and Slover, J and Jensen, MP and Bair, MJ and Kroenke, K and Perera, RA and McKee, D and Dumenci, L and Reed, SD and Riddle, DL}, Title = {PMS17 ONE-YEAR HEALTHCARE UTILIZATION AND COSTS AFTER KNEE ARTHROPLASTY}, Journal = {Value in Health}, Volume = {22}, Pages = {S241-S241}, Publisher = {Elsevier BV}, Year = {2019}, Month = {May}, url = {http://dx.doi.org/10.1016/j.jval.2019.04.1127}, Doi = {10.1016/j.jval.2019.04.1127}, Key = {fds372558} } @article{fds372559, Author = {Allen, KD and Arbeeva, L and Campbell, L and Cené, C and Keefe, FJ and Oddone, E and Somers, T and Coffman, C}, Title = {Identifying subgroups of African American patients with differential improvement following a pain coping skills training program for osteoarthritis}, Journal = {Osteoarthritis and Cartilage}, Volume = {27}, Pages = {S489-S489}, Publisher = {Elsevier BV}, Year = {2019}, Month = {April}, url = {http://dx.doi.org/10.1016/j.joca.2019.02.543}, Doi = {10.1016/j.joca.2019.02.543}, Key = {fds372559} } @article{fds372560, Author = {Dumenci, L and Perera, RA and Keefe, FJ and Ang, DC and Slover, J and Jensen, MP and Riddle, DL}, Title = {Pain and function trajectory types of knee arthroplasty patients}, Journal = {Osteoarthritis and Cartilage}, Volume = {27}, Pages = {S401-S402}, Publisher = {Elsevier BV}, Year = {2019}, Month = {April}, url = {http://dx.doi.org/10.1016/j.joca.2019.02.403}, Doi = {10.1016/j.joca.2019.02.403}, Key = {fds372560} } @article{fds340442, Author = {Sitlinger, A and Shelby, RA and Van Denburg and AN and White, H and Edmond, SN and Marcom, PK and Bosworth, HB and Keefe, FJ and Kimmick, GG}, Title = {Higher symptom burden is associated with lower function in women taking adjuvant endocrine therapy for breast cancer.}, Journal = {J Geriatr Oncol}, Volume = {10}, Number = {2}, Pages = {317-321}, Year = {2019}, Month = {March}, url = {http://dx.doi.org/10.1016/j.jgo.2018.11.008}, Abstract = {OBJECTIVE: To explore the impact of symptoms on physical function in women on adjuvant endocrine therapy for breast cancer. METHODS: Eligible women were postmenopausal, had hormone receptor positive, stage I-IIIA breast cancer, completed surgery, chemotherapy, radiation, and on adjuvant endocrine therapy. At a routine follow-up visit, women (N = 107) completed standardized symptom measures: Brief Fatigue Inventory, Brief Pain Inventory, Menopause Specific Quality of Life Questionnaire, Functional Assessment of Cancer Therapy Neurotoxicity scales. Two performance measures assessed function: grip strength (Jamar dynamometer; n = 71) and timed get-up-and-go (TUG; n = 103). Analyses were performed with an overall symptom composite score. Correlations and multiple linear regression analyses were performed to test adverse effects on physical function. RESULTS: The mean age was 64 years (range 45-84), 81% white, 84% on an aromatase inhibitor, and on endocrine therapy for mean 35 months (range 1-130 months). Dominant hand grip strength was inversely correlated with symptom composite scores (r = -0.29, p = .02). Slower TUG was positively correlated with higher Charlson comorbidity level (r = 0.36, p < .001) and higher symptom composite scores (r = 0.24, p = .01). In multivariate analyses, weaker dominant and non-dominant hand grip strength were significantly associated with greater symptom composite scores (β = -0.27, t = 2.43, p = .02 and β = -0.36, t = 3.15, p = .003, respectively) and slower TUG was associated with higher symptom composite scores (β = 0.18, t = 1.97, p = .05). CONCLUSIONS: Higher symptom burden is associated with worse physical function, as measured by hand grip strength and TUG. Further study to determine the impact of endocrine therapy and its side effects on function is warranted.}, Doi = {10.1016/j.jgo.2018.11.008}, Key = {fds340442} } @article{fds372561, Author = {Winger, JG and Dorfman, CS and Steinhauser, KE and Kamal, AH and Keefe, FJ and Somers, TJ and Breitbart, WS}, Title = {QUALITATIVE FEEDBACK ON A PSYCHOSOCIAL PAIN MANAGEMENT INTERVENTION FOR PATIENTS WITH ADVANCED CANCER}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {53}, Pages = {S264-S264}, Publisher = {OXFORD UNIV PRESS INC}, Year = {2019}, Month = {March}, Key = {fds372561} } @article{fds372562, Author = {Dorfman, CS and Winger, JG and Somers, T and Shelby, RA and Kimmick, G and Craighead, L and Patel, ML and Keefe, FJ}, Title = {WEIGHT-RELATED BEHAVIORS OF CANCER SURVIVORS & PARTNERS: INTERVENTION DEVELOPMENT AND RESULTS OF A PILOT DYADIC INTERVENTION}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {53}, Pages = {S709-S709}, Publisher = {OXFORD UNIV PRESS INC}, Year = {2019}, Month = {March}, Key = {fds372562} } @article{fds372563, Author = {Porter, LS and Todd, M and Keefe, FJ and Strauman, T and Baucom, D and Bricker, JB and Burns, J and Ghosh, N and Puleo, B and Langer, S}, Title = {COUPLE COMMUNICATION IN CANCER: A COMPARISON OF GLOBAL AND ECOLOGICAL MOMENTARY ASSESSMENT REPORTS}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {53}, Pages = {S268-S268}, Publisher = {OXFORD UNIV PRESS INC}, Year = {2019}, Month = {March}, Key = {fds372563} } @article{fds341762, Author = {Riddle, DL and Keefe, FJ and Ang, DC and Slover, J and Jensen, MP and Bair, MJ and Kroenke, K and Perera, RA and Reed, SD and McKee, D and Dumenci, L}, Title = {Pain Coping Skills Training for Patients Who Catastrophize About Pain Prior to Knee Arthroplasty: A Multisite Randomized Clinical Trial.}, Journal = {J Bone Joint Surg Am}, Volume = {101}, Number = {3}, Pages = {218-227}, Year = {2019}, Month = {February}, url = {http://dx.doi.org/10.2106/JBJS.18.00621}, Abstract = {BACKGROUND: Pain catastrophizing has been identified as a prognostic indicator of poor outcome following knee arthroplasty. Interventions to address pain catastrophizing, to our knowledge, have not been tested in patients undergoing knee arthroplasty. The purpose of this study was to determine whether pain coping skills training in persons with moderate to high pain catastrophizing undergoing knee arthroplasty improves outcomes 12 months postoperatively compared with usual care or arthritis education. METHODS: A multicenter, 3-arm, single-blinded, randomized comparative effectiveness trial was performed involving 5 university-based medical centers in the United States. There were 402 randomized participants. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Scale, measured at baseline, 2 months, 6 months, and 12 months following the surgical procedure. RESULTS: Participants were recruited from January 2013 to June 2016. In 402 participants, 66% were women and the mean age of the participants (and standard deviation) was 63.2 ± 8.0 years. Three hundred and forty-six participants (90% of those who underwent a surgical procedure) completed a 12-month follow-up. All 3 treatment groups had large improvements in 12-month WOMAC pain scores with no significant differences (p > 0.05) among the 3 treatment arms. No differences were found between WOMAC pain scores at 12 months for the pain coping skills and arthritis education groups (adjusted mean difference, 0.3 [95% confidence interval (CI), -0.9 to 1.5]) or between the pain coping and usual-care groups (adjusted mean difference, 0.4 [95% CI, -0.7 to 1.5]). Secondary outcomes also showed no significant differences (p > 0.05) among the 3 groups. CONCLUSIONS: Among adults with pain catastrophizing undergoing knee arthroplasty, cognitive behaviorally based pain coping skills training did not confer pain or functional benefit beyond the large improvements achieved with usual surgical and postoperative care. Future research should develop interventions for the approximately 20% of patients undergoing knee arthroplasty who experience persistent function-limiting pain. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.}, Doi = {10.2106/JBJS.18.00621}, Key = {fds341762} } @article{fds341765, Author = {Shelby, RA and Dorfman, CS and Bosworth, HB and Keefe, F and Sutton, L and Owen, L and Corsino, L and Erkanli, A and Reed, SD and Arthur, SS and Somers, T and Barrett, N and Huettel, S and Gonzalez, JM and Kimmick, G}, Title = {Testing a behavioral intervention to improve adherence to adjuvant endocrine therapy (AET).}, Journal = {Contemp Clin Trials}, Volume = {76}, Pages = {120-131}, Year = {2019}, Month = {January}, url = {http://dx.doi.org/10.1016/j.cct.2018.11.010}, Abstract = {Adjuvant endocrine therapy (AET) is used to prevent recurrence and reduce mortality for women with hormone receptor positive breast cancer. Poor adherence to AET is a significant problem and contributes to increased medical costs and mortality. A variety of problematic symptoms associated with AET are related to non-adherence and early discontinuation of treatment. The goal of this study is to test a novel, telephone-based coping skills training that teaches patients adherence skills and techniques for coping with problematic symptoms (CST-AET). Adherence to AET will be assessed in real-time for 18 months using wireless smart pill bottles. Symptom interference (i.e., pain, vasomotor symptoms, sleep problems, vaginal dryness) and cost-effectiveness of the intervention protocol will be examined as secondary outcomes. Participants (N = 400) will be recruited from a tertiary care medical center or community clinics in medically underserved or rural areas. Participants will be randomized to receive CST-AET or a general health education intervention (comparison condition). CST-AET includes ten nurse-delivered calls delivered over 6 months. CST-AET provides systematic training in coping skills for managing symptoms that interfere with adherence. Interactive voice messaging provides reinforcement for skills use and adherence that is tailored based on real-time adherence data from the wireless smart pill bottles. Given the high rates of non-adherence and recent recommendations that women remain on AET for 10 years, we describe a timely trial. If effective, the CST-AET protocol may not only reduce the burden of AET use but also lead to cost-effective changes in clinical care and improve breast cancer outcomes. Trials registration: ClinicalTrials.gov, NCT02707471, registered 3/3/2016.}, Doi = {10.1016/j.cct.2018.11.010}, Key = {fds341765} } @article{fds336942, Author = {Whitney, CA and Dorfman, CS and Shelby, RA and Keefe, FJ and Gandhi, V and Somers, TJ}, Title = {Reminders of cancer risk and pain catastrophizing: relationships with cancer worry and perceived risk in women with a first-degree relative with breast cancer.}, Journal = {Fam Cancer}, Volume = {18}, Number = {1}, Pages = {9-18}, Year = {2019}, Month = {January}, url = {http://dx.doi.org/10.1007/s10689-018-0082-6}, Abstract = {First-degree relatives of women with breast cancer may experience increased worry or perceived risk when faced with reminders of their own cancer risk. Worry and risk reminders may include physical symptoms (e.g., persistent breast pain) and caregiving experiences. Women who engage in pain catastrophizing may be particularly likely to experience increased distress when risk reminders are present. We examined the degree to which persistent breast pain and experience as a cancer caregiver were related to cancer worry and perceived risk in first-degree relatives of women with breast cancer (N = 85) and how catastrophic thoughts about breast pain could impact these relationships. There was a significant interaction between persistent breast pain and pain catastrophizing in predicting cancer worry (p = .03); among women who engaged in pain catastrophizing, cancer worry remained high even in the absence of breast pain. Pain catastrophizing also moderated the relationships between caregiving involvement and cancer worry (p = .003) and perceived risk (p = .03). As the degree of caregiving responsibility increased, cancer worry and perceived risk increased for women who engaged in pain catastrophizing; levels of cancer worry and perceived risk remained low and stable for women who did not engage in pain catastrophizing regardless of caregiving experience. The results suggest that first-degree relatives of breast cancer survivors who engage in pain catastrophizing may experience greater cancer worry and perceived risk and may benefit from interventions aimed at reducing catastrophic thoughts about pain.}, Doi = {10.1007/s10689-018-0082-6}, Key = {fds336942} } @article{fds371056, Author = {Merlin, JS and Patel, K and Thompson, N and Kapo, J and Keefe, F and Liebschutz, J and Paice, J and Somers, T and Starrels, J and Childers, J and Schenker, Y and Ritchie, CS}, Title = {Managing Chronic Pain in Cancer Survivors Prescribed Long-Term Opioid Therapy: A National Survey of Ambulatory Palliative Care Providers.}, Journal = {J Pain Symptom Manage}, Volume = {57}, Number = {1}, Pages = {20-27}, Year = {2019}, Month = {January}, url = {http://dx.doi.org/10.1016/j.jpainsymman.2018.10.493}, Abstract = {CONTEXT: Chronic pain, or pain lasting more than three months, is common among cancer survivors, who are often prescribed long-term opioid therapy (LTOT). OBJECTIVE: Our objective was to explore palliative care providers' experiences with managing chronic pain in cancer survivors prescribed LTOT, specifically in ambulatory palliative care settings, and their strategies for overcoming challenges. METHODS: We recruited providers through leading national palliative care organizations who manage chronic pain in cancer survivors. Asked to consider only cancer survivors with chronic pain when responding, participants completed an online survey that included questions about use of opioid risk mitigation tools, confidence in addressing opioid misuse behaviors and discussing/recommending management approaches, and access to addiction treatment. RESULTS: Of 157 participants, most were physicians (83%) or nurse practitioners (15%). Most reported using opioid risk mitigation tools such as urine drug testing (71%), opioid treatment agreements (85%), and practitioner database monitoring programs (94%). Participants were confident (7-8/10) managing the most commonly encountered opioid misuse behaviors (missing appointments, marijuana use, and using more opioids than prescribed) and in their ability to recommend nonpharmacologic and nonopioid pharmacologic treatments for chronic pain (10/10). They were least confident prescribing naloxone or managing addiction (5/10); only 27% reported having training or systems in place to address addiction. Only 13% had a waiver to prescribe buprenorphine. CONCLUSION: Palliative care providers are comfortable with many aspects of managing chronic pain in cancer survivors on LTOT, although challenges persist, including the lack of systems-based approaches and training in addiction treatment.}, Doi = {10.1016/j.jpainsymman.2018.10.493}, Key = {fds371056} } @article{fds340525, Author = {Dorfman, CS and Kelleher, SA and Winger, JG and Shelby, RA and Thorn, BE and Sutton, LM and Keefe, FJ and Gandhi, V and Manohar, P and Somers, TJ}, Title = {Development and pilot testing of an mHealth behavioral cancer pain protocol for medically underserved communities.}, Journal = {J Psychosoc Oncol}, Volume = {37}, Number = {3}, Pages = {335-349}, Year = {2019}, url = {http://dx.doi.org/10.1080/07347332.2018.1479327}, Abstract = {The purpose of this study was to refine and test a mobile-health behavioral cancer pain coping skills training protocol for women with breast cancer and pain from medically underserved areas. Three focus groups (Phase 1) were used to refine the initial protocol. A single-arm pilot trial (Phase 2) was conducted to assess feasibility, acceptability, and changes in outcomes. The intervention was delivered at a community-based clinic via videoconferencing technology. Participants were women (N = 19 for Phase 1 and N = 20 for Phase 2) with breast cancer and pain in medically underserved areas. Major themes from focus groups were used to refine the intervention. The refined intervention demonstrated feasibility and acceptability. Participants reported significant improvement in pain severity, pain interference, and self-efficacy for pain management. Our intervention is feasible, acceptable, and likely to lead to improvement in pain-related outcomes for breast cancer patients in medically underserved areas. Implications for Psychosocial Oncology Practice Breast cancer patients being treated in medically underserved areas have a dearth of exposure to behavioral interventions that may improve their ability to manage pain. Evidence from this single-arm pilot trial suggests that our mobile-health behavioral cancer pain coping skills training protocol is acceptable and feasible in this vulnerable population. Appropriately adapted mobile-health technologies may provide an avenue to reach underserved patients and implement behavioral interventions to improve pain management.}, Doi = {10.1080/07347332.2018.1479327}, Key = {fds340525} } @article{fds345914, Author = {Gewandter, JS and Eisenach, JC and Gross, RA and Jensen, MP and Keefe, FJ and Lee, DA and Turk, DC}, Title = {Checklist for the preparation and review of pain clinical trial publications: a pain-specific supplement to CONSORT.}, Journal = {Pain Rep}, Volume = {4}, Number = {3}, Pages = {e621}, Year = {2019}, url = {http://dx.doi.org/10.1097/PR9.0000000000000621}, Abstract = {INTRODUCTION: Randomized clinical trials (RCTs) are considered the gold standard when assessing the efficacy of interventions because randomization of treatment assignment minimizes bias in treatment effect estimates. However, if RCTs are not performed with methodological rigor, many opportunities for bias in treatment effect estimates remain. Clear and transparent reporting of RCTs is essential to allow the reader to consider the opportunities for bias when critically evaluating the results. To promote such transparent reporting, the Consolidated Standards of Reporting Trials (CONSORT) group has published a series of recommendations starting in 1996. However, a decade after the publication of the first CONSORT guidelines, systematic reviews of clinical trials in the pain field identified a number of common deficiencies in reporting (e.g., failure to identify primary outcome measures and analyses, indicate clearly the numbers of participants who completed the trial and were included in the analyses, or report harms adequately). METHODS: Qualitative review of a diverse set of published recommendations and systematic reviews that addressed the reporting of clinical trials, including those related to all therapeutic indications (e.g., CONSORT) and those specific to pain clinical trials. RESULTS: A checklist designed to supplement the content covered in the CONSORT checklist with added details relating to challenges specific to pain trials or found to be poorly reported in recent pain trials was developed. CONCLUSIONS: Authors and reviewers of analgesic RCTs should consult the CONSORT guidelines and this checklist to ensure that the issues most pertinent to pain RCTs are reported with transparency.}, Doi = {10.1097/PR9.0000000000000621}, Key = {fds345914} } @article{fds337361, Author = {Burns, JW and Gerhart, J and Post, KM and Smith, DA and Porter, LS and Buvanendran, A and Fras, AM and Keefe, FJ}, Title = {Spouse Criticism/Hostility Toward Partners With Chronic Pain: The Role of Spouse Attributions for Patient Control Over Pain Behaviors.}, Journal = {J Pain}, Volume = {19}, Number = {11}, Pages = {1308-1317}, Year = {2018}, Month = {November}, url = {http://dx.doi.org/10.1016/j.jpain.2018.05.007}, Abstract = {Spouse attributions regarding displays of pain behaviors by their partners with chronic pain may account for subsequent increases in spouse critical/hostile responses toward their partners. People with chronic low back pain (n = 105) and their pain-free spouses (n = 105) completed electronic diary measures 5 times per day for 14 consecutive days. Key items assessed spouse observations of patient pain behavior, attributions regarding these behaviors, and spouse critical/hostile responses toward patients. Results were 1) spouse observations of patient pain behavior at time 1 predicted high levels of spouse critical/hostile responses toward the patient at time 2. 2) "Internal" attributions (eg, the patient was attempting to influence spouse's feelings) at time 1 predicted high levels of spouse critical/hostile responses toward the patient at time 2. 3) Internal attributions mediated links between spouse-observed pain behaviors at time 1 and levels of spouse critical/hostile responses at time 2. Spouse observations of patient pain behavior was also related to an "external" attribution (ie, patient pain behavior was due to pain condition), but this attribution was not a significant mediator. A vital factor linking spouse scrutiny to spouse critical/hostile responses may be the spouse's ascribed reasons for the patient's grimacing, bracing, complaining, and so forth. Perspective: Results indicate that spouse internal and negative attributions for pain behaviors of their partners with chronic pain may influence subsequent spouse critical/hostile reactions to them. Findings suggest that replacing spouse internal and negative attributions with external, compassionate, and accepting explanations may be useful therapeutic targets for couples coping with chronic pain.}, Doi = {10.1016/j.jpain.2018.05.007}, Key = {fds337361} } @article{fds339861, Author = {Cole, LJ and Bennell, KL and Ahamed, Y and Bryant, C and Keefe, F and Moseley, GL and Hodges, P and Farrell, MJ}, Title = {Determining Brain Mechanisms that Underpin Analgesia Induced by the Use of Pain Coping Skills.}, Journal = {Pain Med}, Volume = {19}, Number = {11}, Pages = {2177-2190}, Year = {2018}, Month = {November}, url = {http://dx.doi.org/10.1093/pm/pnx301}, Abstract = {OBJECTIVE: Cognitive behavioral therapies decrease pain and improve mood and function in people with osteoarthritis. This study assessed the effects of coping strategies on the central processing of knee pain in people with osteoarthritis of the knees. METHODS: Mechanical pressure was applied to exacerbate knee pain in 28 people with osteoarthritis of the knee. Reports of pain intensity and functional magnetic resonance imaging measures of pain-related brain activity were recorded with and without the concurrent use of pain coping skills. RESULTS: Coping skills led to a significant reduction in pain report (Coping = 2.64 ± 0.17, Not Coping = 3.28 ± 0.15, P < 0.001). These strategies were associated with increased activation in pain modulatory regions of the brain (medial prefrontal and rostral anterior cingulate cortices, Pcorrected < 0.05) and decreased pain-related activation in regions that process noxious input (midcingulate cortex, supplementary motor area, secondary somatosensory cortex, and anterior parietal lobule, Pcorrected < 0.05). The magnitude of the decrease in pain report during the use of pain coping strategies was found to be proportional to the decrease in pain-related activation in brain regions that code the aversive/emotional dimension of pain (anterior insula, inferior frontal gyrus, orbitofrontal cortex, Pcorrected < 0.05) but did not differ between groups with and without training in coping skills. However, training in coping skills reduced the extent to which brain responses to noxious input were influenced by anxiety. CONCLUSIONS: The results of this study support previous reports of pain modulation by cognitive pain coping strategies and contribute to the current understanding of how analgesia associated with the use of pain coping strategies is represented in the brain.}, Doi = {10.1093/pm/pnx301}, Key = {fds339861} } @article{fds338437, Author = {Allen, KD and Arbeeva, L and Cené, CW and Coffman, CJ and Grimm, KF and Haley, E and Keefe, FJ and Nagle, CT and Oddone, EZ and Somers, TJ and Watkins, Y and Campbell, LC}, Title = {Pain coping skills training for African Americans with osteoarthritis study: baseline participant characteristics and comparison to prior studies.}, Journal = {BMC Musculoskelet Disord}, Volume = {19}, Number = {1}, Pages = {337}, Year = {2018}, Month = {September}, url = {http://dx.doi.org/10.1186/s12891-018-2249-6}, Abstract = {BACKGROUND: The Pain Coping Skills Training for African Americans with OsteoaRTthritis (STAART) trial is examining the effectiveness of a culturally enhanced pain coping skills training (CST) program for African Americans with osteoarthritis (OA). This disparities-focused trial aimed to reach a population with greater symptom severity and risk factors for poor pain-related outcomes than previous studies. This paper compares characteristics of STAART participants with prior studies of CST or cognitive behavioral therapy (CBT)-informed training in pain coping strategies for OA. METHODS: A literature search identified 10 prior trials of pain CST or CBT-informed pain coping training among individuals with OA. We descriptively compared characteristics of STAART participants with other studies, in 3 domains of the National Institutes of Minority Health and Health Disparities' Research Framework: Sociocultural Environment (e.g., age, education, marital status), Biological Vulnerability and Mechanisms (e.g, pain and function, body mass index), and Health Behaviors and Coping (e.g., pain catastrophizing). Means and standard deviations (SDs) or proportions were calculated for STAART participants and extracted from published manuscripts for comparator studies. RESULTS: The mean age of STAART participants, 59 years (SD = 10.3), was lower than 9 of 10 comparator studies; the proportion of individuals with some education beyond high school, 75%, was comparable to comparator studies (61-86%); and the proportion of individuals who are married or living with a partner, 42%, was lower than comparator studies (62-66%). Comparator studies had less than about 1/3 African American participants. Mean scores on the Western Ontario and McMaster Universities Osteoarthritis Index pain and function scales were higher (worse) for STAART participants than for other studies, and mean body mass index of STAART participants, 35.2 kg/m2 (SD = 8.2), was higher than all other studies (30-34 kg/m2). STAART participants' mean score on the Pain Catastrophizing scale, 19.8 (SD = 12.3), was higher (worse) than other studies reporting this measure (7-17). CONCLUSIONS: Compared with prior studies with predominantly white samples, STAART participants have worse pain and function and more risk factors for negative pain-related outcomes across several domains. Given STAART participants' high mean pain catastrophizing scores, this sample may particularly benefit from the CST intervention approach. TRIAL REGISTRATION: NCT02560922.}, Doi = {10.1186/s12891-018-2249-6}, Key = {fds338437} } @article{fds336943, Author = {Van Denburg and AN and Shelby, RA and Caldwell, DS and O'Sullivan, ML and Keefe, FJ}, Title = {Self-Efficacy for Pain Communication Moderates the Relation Between Ambivalence Over Emotional Expression and Pain Catastrophizing Among Patients With Osteoarthritis.}, Journal = {J Pain}, Volume = {19}, Number = {9}, Pages = {1006-1014}, Year = {2018}, Month = {September}, url = {http://dx.doi.org/10.1016/j.jpain.2018.04.001}, Abstract = {UNLABELLED: Pain catastrophizing (ie, the tendency to focus on and magnify pain sensations and feel helpless in the face of pain) is one of the most important and consistent psychological predictors of the pain experience. The present study examined, in 60 patients with osteoarthritis pain who were married or partnered: 1) the degree to which ambivalence over emotional expression and negative network orientation were associated with pain catastrophizing, and 2) whether self-efficacy for pain communication moderated these relations. Hierarchical multiple linear regression analyses revealed a significant main effect for the association between ambivalence over emotional expression and pain catastrophizing; as ambivalence over emotional expression increased, the degree of pain catastrophizing increased. In addition, the interaction between ambivalence over emotional expression and self-efficacy for pain communication was significant, such that as self-efficacy for pain communication increased, the association between ambivalence over emotional expression and pain catastrophizing became weaker. Negative network orientation was not significantly associated with pain catastrophizing. Findings suggest that higher levels of self-efficacy for pain communication may help weaken the effects of ambivalence over emotional expression on pain catastrophizing. In light of these results, patients may benefit from interventions that target pain communication processes and emotion regulation. PERSPECTIVE: This article examines interpersonal processes involved in pain catastrophizing. This study has the potential to lead to better understanding of maladaptive pain coping strategies and possibly better prevention and treatment strategies.}, Doi = {10.1016/j.jpain.2018.04.001}, Key = {fds336943} } @article{fds341013, Author = {Bennell, KL and Nelligan, RK and Rini, C and Keefe, FJ and Kasza, J and French, S and Forbes, A and Dobson, F and Abbott, JH and Dalwood, A and Harris, A and Vicenzino, B and Hodges, PW and Hinman, RS}, Title = {Effects of internet-based pain coping skills training before home exercise for individuals with hip osteoarthritis (HOPE trial): a randomised controlled trial.}, Journal = {Pain}, Volume = {159}, Number = {9}, Pages = {1833-1842}, Year = {2018}, Month = {September}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001281}, Abstract = {This assessor-, therapist-, and participant-blinded randomised controlled trial evaluated the effects of an automated internet-based pain coping skills training (PCST) program before home exercise for people with clinically diagnosed hip osteoarthritis. One hundred forty-four people were randomised to either the PCST group or the comparator group. In the first 8 weeks, the PCST group received online education and PCST, whereas the comparison group received online education only. From weeks 8 to 24, both groups visited a physiotherapist 5 times for home exercise prescription. Assessments were performed at baseline, 8, 24, and 52 weeks. Primary outcomes were hip pain on walking (11-point numerical rating scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) at 24 weeks. Secondary outcomes were other measures of pain, quality-of-life, global change, self-efficacy, pain coping, pain catastrophizing, depression, anxiety, stress, physical activity, and adverse events. Primary outcomes were completed by 137 (95%), 131 (91%), and 127 (88%) participants at 8, 24, and 52 weeks, respectively. There were no significant between-group differences in primary outcomes at week 24 (change in: walking pain [mean difference 0.5 units; 95% confidence interval, -0.3 to 1.3] and function [-0.9 units; 95% confidence interval, -4.8 to 2.9]), with both groups showing clinically relevant improvements. At week 8, the PCST group had greater improvements in function, pain coping, and global improvement than comparison. Greater pain coping improvements persisted at 24 and 52 weeks. In summary, online PCST immediately improved pain coping and function but did not confer additional benefits to a subsequent exercise program, despite sustained pain coping improvements.}, Doi = {10.1097/j.pain.0000000000001281}, Key = {fds341013} } @article{fds336940, Author = {Cook, CE and George, SZ and Keefe, F}, Title = {Different interventions, same outcomes? Here are four good reasons.}, Journal = {Br J Sports Med}, Volume = {52}, Number = {15}, Pages = {951-952}, Year = {2018}, Month = {August}, url = {http://dx.doi.org/10.1136/bjsports-2017-098978}, Doi = {10.1136/bjsports-2017-098978}, Key = {fds336940} } @article{fds337107, Author = {Parmelee, PA and Scicolone, MA and Cox, BS and DeCaro, JA and Keefe, FJ and Smith, DM}, Title = {Global Versus Momentary Osteoarthritis Pain and Emotional Distress: Emotional Intelligence as Moderator.}, Journal = {Ann Behav Med}, Volume = {52}, Number = {8}, Pages = {713-723}, Year = {2018}, Month = {July}, url = {http://dx.doi.org/10.1093/abm/kax044}, Abstract = {BACKGROUND: Pain and emotional well-being are complexly associated both globally and in the moment. Emotional regulation strategies may contribute to that complexity by shaping the pain-well-being association. PURPOSE: Using emotional intelligence (EI) as an integrative conceptual framework, this study probed the role of emotional regulation in the associations of osteoarthritis pain with emotional well-being in varying time frames. Perceived attention to, clarity, and regulation of emotions were examined as predictors of well-being, and as moderators of the well-being-pain association, at global and momentary (within-day) levels. METHODS: In a microlongitudinal study, 218 older adults with physician-diagnosed knee osteoarthritis self-reported global pain, depressive symptoms, and EI (mood attention, clarity, and repair). Momentary pain and positive and negative affect were then assessed four times daily for 7 days. EI subscales were examined as moderators of the pain-well-being association at global and momentary levels, controlling demographics and general health. RESULTS: Global and momentary pain were positively associated with mood clarity and negatively with attention, but not with repair. Clarity and repair negatively predicted depression, and buffered effects of pain on depression. Momentary negative affect was negatively predicted by mood clarity and repair; again, clarity and mood repair buffered effects of momentary pain on negative affect. Only mood repair predicted positive affect, with no interactions emerging. CONCLUSIONS: Attention to mood states exacerbates the experience of pain in both short and long terms. In contrast, both mood clarity and ability to repair moods appear important to both momentary and longer-term emotional well-being.}, Doi = {10.1093/abm/kax044}, Key = {fds337107} } @article{fds336945, Author = {Lawford, BJ and Hinman, RS and Kasza, J and Nelligan, R and Keefe, F and Rini, C and Bennell, KL}, Title = {Moderators of Effects of Internet-Delivered Exercise and Pain Coping Skills Training for People With Knee Osteoarthritis: Exploratory Analysis of the IMPACT Randomized Controlled Trial.}, Journal = {J Med Internet Res}, Volume = {20}, Number = {5}, Pages = {e10021}, Publisher = {JMIR Publications Inc.}, Year = {2018}, Month = {May}, url = {http://dx.doi.org/10.2196/10021}, Abstract = {BACKGROUND: Internet-delivered exercise, education, and pain coping skills training is effective for people with knee osteoarthritis, yet it is not clear whether this treatment is better suited to particular subgroups of patients. OBJECTIVE: The aim was to explore demographic and clinical moderators of the effect of an internet-delivered intervention on changes in pain and physical function in people with knee osteoarthritis. METHODS: Exploratory analysis of data from 148 people with knee osteoarthritis who participated in a randomized controlled trial comparing internet-delivered exercise, education, and pain coping skills training to internet-delivered education alone. Primary outcomes were changes in knee pain while walking (11-point Numerical Rating Scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index function subscale) at 3 and 9 months. Separate regression models were fit with moderator variables (age, gender, expectations of outcomes, self-efficacy [pain], education, employment status, pain catastrophizing, body mass index) and study group as covariates, including an interaction between the two. RESULTS: Participants in the intervention group who were currently employed had significantly greater reductions in pain at 3 months than similar participants in the control group (between-group difference: mean 2.38, 95% CI 1.52-3.23 Numerical Rating Scale units; interaction P=.02). Additionally, within the intervention group, pain at 3 months reduced by mean 0.53 (95% CI 0.28-0.78) Numerical Rating Scale units per unit increase in baseline self-efficacy for managing pain compared to mean 0.11 Numerical Rating Scale units (95% CI -0.13 to 0.35; interaction P=.02) for the control group. CONCLUSIONS: People who were employed and had higher self-efficacy at baseline were more likely to experience greater improvements in pain at 3 months after an internet-delivered exercise, education, and pain coping skills training program. There was no evidence of a difference in the effect across gender, educational level, expectation of treatment outcome, or across age, body mass index, or tendency to catastrophize pain. Findings support the effectiveness of internet-delivered care for a wide range of people with knee osteoarthritis, but future confirmatory research is needed. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12614000243617; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365812&isReview=true (Archived by WebCite at http://www.webcitation.org/6z466oTPs).}, Doi = {10.2196/10021}, Key = {fds336945} } @article{fds331439, Author = {Porter, LS and Keefe, FJ}, Title = {Couple-based communication interventions for cancer: moving beyond a 'one size fits all' approach.}, Journal = {Acta Oncol}, Volume = {57}, Number = {5}, Pages = {693-695}, Year = {2018}, Month = {May}, url = {http://dx.doi.org/10.1080/0284186X.2017.1400687}, Doi = {10.1080/0284186X.2017.1400687}, Key = {fds331439} } @article{fds337030, Author = {Keefe, FJ and Main, CJ and George, SZ}, Title = {Advancing Psychologically Informed Practice for Patients With Persistent Musculoskeletal Pain: Promise, Pitfalls, and Solutions.}, Journal = {Phys Ther}, Volume = {98}, Number = {5}, Pages = {398-407}, Year = {2018}, Month = {May}, url = {http://dx.doi.org/10.1093/ptj/pzy024}, Abstract = {There has been growing interest in psychologically oriented pain management over the past 3 to 4 decades, including a 2011 description of psychologically informed practice (PIP) for low back pain. PIP requires a broader focus than traditional biomechanical and pathology-based approaches that have been traditionally used to manage musculoskeletal pain. A major focus of PIP is addressing the behavioral aspects of pain (ie, peoples' responses to pain) by identifying individual expectations, beliefs, and feelings as prognostic factors for clinical and occupational outcomes indicating progression to chronicity. Since 2011, the interest in PIP seems to be growing, as evidenced by its use in large trials, inclusion in scientific conferences, increasing evidence base, and expansion to other musculoskeletal pain conditions. Primary care physicians and physical therapists have delivered PIP as part of a stratified care approach involving screening and targeting of treatment for people at high risk for continued pain-associated disability. Furthermore, PIP is consistent with recent national priorities emphasizing nonpharmacological pain management options. In this perspective, PIP techniques that range in complexity are described, considerations for implementation in clinical practice are offered, and future directions that will advance the understanding of PIP are outlined.}, Doi = {10.1093/ptj/pzy024}, Key = {fds337030} } @article{fds336941, Author = {Jensen, MP and Thorn, BE and Carmody, J and Keefe, FJ and Burns, JW}, Title = {The Role of Cognitive Content and Cognitive Processes in Chronic Pain: An Important Distinction?}, Journal = {Clin J Pain}, Volume = {34}, Number = {5}, Pages = {391-401}, Year = {2018}, Month = {May}, url = {http://dx.doi.org/10.1097/AJP.0000000000000559}, Abstract = {OBJECTIVES: Pain-related cognitive content (what people think about pain) and cognitive processes (how people think about pain; what they do with their pain-related thoughts) and their interaction are hypothesized to play distinct roles in patient function. However, questions have been raised regarding whether it is possible or practical to assess cognitive content and cognitive process as distinct domains. The aim of this study was to determine the extent to which measures that seem to assess mostly pain-related cognitive content, cognitive processes, and content and process, are relatively independent from each other and contribute unique variance to the prediction of patient function. MATERIALS AND METHODS: Individuals with chronic low back pain (N=165) participating in an ongoing RCT were administered measures of cognitions, pain, and function (depressive symptoms and pain interference) pretreatment. RESULTS: Analyses provided support for the hypothesis that cognitive content and cognitive process, while related, can be assessed as distinct components. However, the measure assessing a cognitive process-mindfulness-evidenced relatively weak associations with function, especially compared with the stronger and more consistent findings for the measures of content (catastrophizing and self-efficacy). DISCUSSION: The results provide preliminary evidence for the possibility that mindfulness could have both benefits and costs. Research to evaluate this possibility is warranted.}, Doi = {10.1097/AJP.0000000000000559}, Key = {fds336941} } @article{fds330575, Author = {O'Sullivan, ML and Shelby, RA and Dorfman, CS and Kelleher, SA and Fisher, HM and Rowe Nichols and KA and Keefe, FJ and Sung, AD and Somers, TJ}, Title = {The effect of pre-transplant pain and chronic disease self-efficacy on quality of life domains in the year following hematopoietic stem cell transplantation.}, Journal = {Support Care Cancer}, Volume = {26}, Number = {4}, Pages = {1243-1252}, Year = {2018}, Month = {April}, url = {http://dx.doi.org/10.1007/s00520-017-3947-6}, Abstract = {PURPOSE: Pain is common for hematopoietic stem cell transplant (HSCT) patients and may be experienced pre-transplant, acutely post-transplant, and for months or years following transplant. HSCT patients with persistent pain may be at risk for poor quality of life following transplant; however, the impact of pre-transplant pain on quality of life post-transplant is not well understood. Self-efficacy for chronic disease management is associated with quality of life among cancer patients and may impact quality of life for HSCT patients. The primary aim was to examine the effect of pre-transplant pain and self-efficacy on quality of life domains in the year following transplant. METHODS: One hundred sixty-six HSCT patients completed questionnaires providing information on pain, self-efficacy, and quality of life prior to transplant, at discharge, and 3-, 6-, and 12-months post-transplant as part of a longitudinal, observational study. Linear mixed modeling examined the trajectories of these variables and the effect of pre-transplant pain and self-efficacy on post-transplant quality of life. RESULTS: Pain and social and emotional quality of life remained stable in the year following transplant while self-efficacy and physical and functional quality of life improved. Pre-transplant pain was significantly related to lower physical well-being post-transplant. Lower pre-transplant self-efficacy was related to lower quality of life across all domains post-transplant. CONCLUSION: Above and beyond the effect of pre-transplant pain, self-efficacy for managing chronic disease is important in understanding quality of life following transplant. Identifying patients with pain and/or low self-efficacy pre-transplant may allow for early intervention with self-management strategies.}, Doi = {10.1007/s00520-017-3947-6}, Key = {fds330575} } @article{fds330868, Author = {Rini, C and Vu, MB and Lerner, H and Bloom, C and Carda-Auten, J and Wood, WA and Basch, EM and Voorhees, PM and Reeder-Hayes, KE and Keefe, FJ}, Title = {A qualitative study of patient and provider perspectives on using web-based pain coping skills training to treat persistent cancer pain.}, Journal = {Palliat Support Care}, Volume = {16}, Number = {2}, Pages = {155-169}, Year = {2018}, Month = {April}, url = {http://dx.doi.org/10.1017/S1478951517000086}, Abstract = {OBJECTIVE: Persistent pain is common and inadequately treated in cancer patients. Behavioral pain interventions are a recommended part of multimodal pain treatments, but they are underused in clinical care due to barriers such as a lack of the resources needed to deliver them in person and difficulties coordinating their use with clinical care. Pain coping skills training (PCST) is an evidence-based behavioral pain intervention traditionally delivered in person. Delivering this training via the web would increase access to it by addressing barriers that currently limit its use. We conducted a patient pilot study of an 8-week web-based PCST program to determine the acceptability of this approach to patients and the program features needed to meet their needs. Focus groups with healthcare providers identified strategies for coordinating the use of web-based PCST in clinical care. METHOD: Participants included 7 adults with bone pain due to multiple myeloma or metastasized breast or prostate cancer and 12 healthcare providers (4 physicians and 8 advanced practice providers) who treat cancer-related bone pain. Patients completed web-based PCST at home and then took part in an in-depth qualitative interview. Providers attended focus groups led by a trained moderator. Qualitative analyses identified themes in the patient and provider data. RESULTS: Patients reported strongly favorable responses to web-based PCST and described emotional and physical benefits. They offered suggestions for adapting the approach to better fit their needs and to overcome barriers to completion. Focus groups indicated a need to familiarize healthcare providers with PCST and to address concerns about overburdening patients. Providers would recommend the program to patients they felt could benefit. They suggested applying a broad definition of cancer pain and having various types of providers help coordinate program its use with clinical care. SIGNIFICANCE OF RESULTS: Web-based PCST was acceptable to patients and providers. Our findings suggest that patients could benefit from this approach, especially if patient and provider barriers are addressed.}, Doi = {10.1017/S1478951517000086}, Key = {fds330868} } @article{fds333734, Author = {DeBar, L and Benes, L and Bonifay, A and Deyo, RA and Elder, CR and Keefe, FJ and Leo, MC and McMullen, C and Mayhew, M and Owen-Smith, A and Smith, DH and Trinacty, CM and Vollmer, WM}, Title = {Interdisciplinary team-based care for patients with chronic pain on long-term opioid treatment in primary care (PPACT) - Protocol for a pragmatic cluster randomized trial.}, Journal = {Contemp Clin Trials}, Volume = {67}, Pages = {91-99}, Year = {2018}, Month = {April}, url = {http://dx.doi.org/10.1016/j.cct.2018.02.015}, Abstract = {BACKGROUND: Chronic pain is one of the most common, disabling, and expensive public health problems in the United States. Interdisciplinary pain management treatments that employ behavioral approaches have been successful in helping patients with chronic pain reduce symptoms and regain functioning. However, most patients lack access to such treatments. We are conducting a pragmatic clinical trial to test the hypothesis that patients who receive an interdisciplinary biopsychosocial intervention, the Pain Program for Active Coping and Training (PPACT), at their primary care clinic will have a greater reduction in pain impact in the year following than patients receiving usual care. METHODS/DESIGN: This is an effectiveness-implementation hybrid pragmatic clinical trial in which we randomize clusters of primary care providers and their patients with chronic pain who are on long-term opioid therapy to 1) receive an interdisciplinary behavioral intervention in conjunction with their current health care or 2) continue with current health care services. Our primary outcome is pain impact (a composite of pain intensity and pain-related interference) measured using the PEG, a validated three-item assessment. Secondary outcomes include pain-related disability, patient satisfaction, opioids dispensed and health care utilization. An economic evaluation assesses the resources and costs necessary to deliver the intervention and its cost-effectiveness compared with usual care. A formative evaluation employs mixed methods to understand the context for implementation in the participating health care systems. DISCUSSION: This trial will inform the feasibility of implementing interdisciplinary behavioral approaches to pain management in the primary care setting, potentially providing a more effective, safer, and more satisfactory alternative to opioid-based chronic pain treatment. Clinical Trials Registration Number: NCT02113592.}, Doi = {10.1016/j.cct.2018.02.015}, Key = {fds333734} } @article{fds336944, Author = {Somers, TJ and Kelleher, SA and Dorfman, CS and Shelby, RA and Fisher, HM and Rowe Nichols and K and Sullivan, KM and Chao, NJ and Samsa, GP and Abernethy, AP and Keefe, FJ}, Title = {An mHealth Pain Coping Skills Training Intervention for Hematopoietic Stem Cell Transplantation Patients: Development and Pilot Randomized Controlled Trial.}, Journal = {JMIR Mhealth Uhealth}, Volume = {6}, Number = {3}, Pages = {e66}, Year = {2018}, Month = {March}, url = {http://dx.doi.org/10.2196/mhealth.8565}, Abstract = {BACKGROUND: Pain is a challenge for patients following hematopoietic stem cell transplantation (HCT). OBJECTIVE: This study aimed to develop and test the feasibility, acceptability, and initial efficacy of a Web-based mobile pain coping skills training (mPCST) protocol designed to address the needs of HCT patients. METHODS: Participants had undergone HCT and reported pain following transplant (N=68). To guide intervention development, qualitative data were collected from focus group participants (n=25) and participants who completed user testing (n=7). After their input was integrated into the mPCST intervention, a pilot randomized controlled trial (RCT, n=36) was conducted to examine the feasibility, acceptability, and initial efficacy of the intervention. Measures of acceptability, pain severity, pain disability, pain self-efficacy, fatigue, and physical disability (self-report and 2-min walk test [2MWT]) were collected. RESULTS: Participants in the focus groups and user testing provided qualitative data that were used to iteratively refine the mPCST protocol. Focus group qualitative data included participants' experiences with pain following transplant, perspectives on ways to cope with pain, and suggestions for pain management for other HCT patients. User testing participants provided feedback on the HCT protocol and information on the use of videoconferencing. The final version of the mPCST intervention was designed to bridge the intensive outpatient (1 in-person session) and home settings (5 videoconferencing sessions). A key component of the intervention was a website that provided personalized messages based on daily assessments of pain and activity. The website also provided intervention materials (ie, electronic handouts, short videos, and audio files). The intervention content included pain coping advice from other transplant patients and instructions on how to apply pain coping skills while engaging in meaningful and leisure activities. In the RCT phase of this research, HCT patients (n=36) were randomized to receive the mPCST intervention or to proceed with the treatment as usual. Results revealed that the mPCST participants completed an average of 5 out of 6 sessions. The participants reported that the intervention was highly acceptable (mean 3/4), and they found the sessions to be helpful (mean 8/10) and easy to understand (mean 7/7). The mPCST participants demonstrated significant improvements in pre- to post-treatment pain, self-efficacy (P=.03, d=0.61), and on the 2MWT (P=.03, d=0.66), whereas the patients in the treatment-as-usual group did not report any such improvements. Significant changes in pain disability and fatigue were found in both groups (multiple P<.02); the magnitudes of the effect sizes were larger for the mPCST group than for the control group (pain disability: d=0.79 vs 0.69; fatigue: d=0.94 vs 0.81). There were no significant changes in pain severity in either group. CONCLUSIONS: Using focus groups and user testing, we developed an mPCST protocol that was feasible, acceptable, and beneficial for HCT patients with pain. TRIAL REGISTRATION: ClinicalTrials.gov NCT01984671; https://clinicaltrials.gov/ct2/show/NCT01984671 (Archived by WebCite at http://www.webcitation.org/6xbpx3clZ).}, Doi = {10.2196/mhealth.8565}, Key = {fds336944} } @article{fds342507, Author = {Van Denburg and AN and Vilardaga, JP and Shelby, RA and Keefe, FJ}, Title = {Opioid therapy and persistent pain: can cognitive behavioral therapy help?}, Journal = {Pain}, Volume = {159}, Number = {3}, Pages = {411-415}, Year = {2018}, Month = {March}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001091}, Doi = {10.1097/j.pain.0000000000001091}, Key = {fds342507} } @article{fds342508, Author = {Keefe, FJ and Ballantyne, J and Blyth, F and Coghill, RC and Dickenson, A and Dionne, CE and Eccleston, C and Finnerup, NB and Kuner, R and Seminowicz, DA and Sluka, K}, Title = {Publishing the best basic and applied pain science: open science and PAIN.}, Journal = {Pain}, Volume = {159}, Number = {3}, Pages = {405-406}, Year = {2018}, Month = {March}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001166}, Doi = {10.1097/j.pain.0000000000001166}, Key = {fds342508} } @article{fds337362, Author = {Janke, EA and Cheatle, M and Keefe, FJ and Dhingra, L and Society of Behavioral Medicine Health Policy Committee}, Title = {Society of Behavioral Medicine (SBM) position statement: improving access to psychosocial care for individuals with persistent pain: supporting the National Pain Strategy's call for interdisciplinary pain care.}, Journal = {Transl Behav Med}, Volume = {8}, Number = {2}, Pages = {305-308}, Year = {2018}, Month = {March}, url = {http://dx.doi.org/10.1093/tbm/ibx043}, Abstract = {Policy makers have articulated a need for clear, evidence-based guidance to help inform pain policy. Persistent pain is common, expensive, and debilitating, and requires comprehensive assessment and treatment planning. Recently released opioid prescribing guidelines by the CDC (2016) emphasize the importance of using nonopioid therapies before considering opioid treatment for those without a malignant illness. The National Pain Strategy (2016) underscores the importance of comprehensive, interdisciplinary pain care. Unfortunately, despite persuasive evidence supporting the efficacy of psychosocial approaches, these interventions are inaccessible to the majority of Americans. Psychosocial approaches to pain management should be available for all individuals with persistent pain and in all health care settings and contexts as part of the comprehensive, interdisciplinary approach to pain care as outlined in the National Pain Strategy. To achieve this, we must prioritize reimbursement of evidence-based psychosocial approaches for pain assessment and management and improve provider training and competencies to implement these approaches.}, Doi = {10.1093/tbm/ibx043}, Key = {fds337362} } @article{fds333735, Author = {Gerhart, JI and Burns, JW and Bruehl, S and Smith, DA and Post, KM and Porter, LS and Schuster, E and Buvanendran, A and Fras, AM and Keefe, FJ}, Title = {Variability in negative emotions among individuals with chronic low back pain: relationships with pain and function.}, Journal = {Pain}, Volume = {159}, Number = {2}, Pages = {342-350}, Year = {2018}, Month = {February}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001102}, Abstract = {Chronic pain is associated with elevated negative emotions, and resources needed to adaptively regulate these emotions can be depleted during prolonged pain. Studies of links between pain, function, and negative emotions in people with chronic pain, however, have focused almost exclusively on relationships among mean levels of these factors. Indexes that may reflect aspects of emotion regulation have typically not been analyzed. We propose that 1 index of emotion regulation is variability in emotion over time as opposed to average emotion over time. The sample was 105 people with chronic low back pain and 105 of their pain-free spouses. They completed electronic diary measures 5x/d for 14 consecutive days, producing 70 observations per person from which we derived estimates of within-subject variance in negative emotions. Location-scale models were used to simultaneously model predictors of both mean level and variance in patient negative emotions over time. Patients reported significantly more variability in negative emotions compared to their spouses. Patients who reported higher average levels of pain, pain interference, and downtime reported significantly higher levels of variability in negative emotions. Spouse-observed pain and pain behaviors were also associated with greater variability in patients' negative emotions. Test of the inverse associations between negative emotion level and variability in pain and function were significant but weaker in magnitude. These findings support the notion that chronic pain may erode negative emotion regulation resources, to the potential detriment of intra- and inter-personal function.}, Doi = {10.1097/j.pain.0000000000001102}, Key = {fds333735} } @article{fds333736, Author = {Burns, JW and Post, KM and Smith, DA and Porter, LS and Buvanendran, A and Fras, AM and Keefe, FJ}, Title = {Spouse criticism and hostility during marital interaction: effects on pain intensity and behaviors among individuals with chronic low back pain.}, Journal = {Pain}, Volume = {159}, Number = {1}, Pages = {25-32}, Year = {2018}, Month = {January}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001037}, Abstract = {Individuals with chronic pain may experience negative responses from spouse, family, and friends. Responses such as overt criticism and hostility may be associated with worsening pain and function for chronic pain sufferers. We used a laboratory procedure to evaluate whether variability in spouse criticism/hostility exhibited toward chronic low back pain (CLBP) patients during a conflictual discussion predicted variability in patient pain and function during a subsequent pain-induction task. Chronic low back pain patients (n = 71) and their spouses (n = 71) participated in a 10-minute discussion followed by the patient undergoing a 10-minute structured pain behavior task (SPBT). Spouse criticism/hostility perceived by patients and patient Beck Depression Inventory-II (BDI) scores correlated significantly and positively with pain intensity during the SPBT, whereas perceived spouse hostility, patient BDI scores, and spouse trait hostility correlated significantly and positively with observed pain behaviors during the SPBT. Spouse criticism/hostility coded by raters from video recordings interacted significantly with patient BDI scores, such that observed spouse criticism/hostility was related significantly and positively with pain behaviors only for patients with high BDI scores. Patient sex interacted significantly with observed spouse criticism/hostility, such that observed spouse criticism/hostility was related significantly and positively with pain behaviors only for female patients. Results support the hypothesis that spouse criticism and hostility-actually expressed or perceived-may worsen CLBP patient symptoms. Further, women patients and patients high in depressive symptoms appeared most vulnerable to spouse criticism/hostility. Thus, negative marital communication patterns may be appropriate targets for intervention, especially among these 2 at risk groups.}, Doi = {10.1097/j.pain.0000000000001037}, Key = {fds333736} } @article{fds332333, Author = {Lumley, MA and Anderson, T and Ankawi, B and Goldman, G and Perri, LM and Bianco, JA and Keefe, FJ}, Title = {The working alliance and Clinician-assisted Emotional Disclosure for rheumatoid arthritis.}, Journal = {J Psychosom Res}, Volume = {104}, Pages = {9-15}, Year = {2018}, Month = {January}, url = {http://dx.doi.org/10.1016/j.jpsychores.2017.11.004}, Abstract = {OBJECTIVES: The working alliance predicts improvement following general psychotherapy, but how it operates in brief interventions conducted with medically ill patients is unknown. Also, the role of the working alliance may differ in emotion-focused versus educational interventions. METHODS: We report secondary analyses of a randomized clinical trial (Keefe et al.) [35], in which patients with rheumatoid arthritis (RA) received four nurse-provided sessions of either a) Clinician-assisted Emotional Disclosure (CAED), which emphasized the disclosure, expression, and processing of emotions related to stressful events; or b) Arthritis Education (AE), which provided basic education about RA. The Working Alliance Inventory was completed by both patient and nurse after each session. Patients were evaluated on multiple health measures at baseline and 1, 3, and 12months post-treatment. RESULTS: Analyses compared the alliance between interventions and related the alliance to outcomes within interventions. Patients in CAED reported a lower alliance than patients in AE. Interestingly, in CAED, lower alliance ratings predicted better outcomes (improved functioning, lower pain behaviors, lower inflammation, lower daily stress), whereas in AE, the working alliance was largely not predictive of outcomes. CONCLUSION: Having nurses encourage emotional disclosure among patients with RA reduced the patients' working alliance, but a lower alliance nonetheless predicted better patient outcomes, perhaps reflecting successful engagement in an intervention that is emotionally and relationally challenging. The level and predictive validity of the working alliance likely depends on patient, provider, and intervention factors, and further study of the working alliance in psychosocial interventions in the medical context is needed.}, Doi = {10.1016/j.jpsychores.2017.11.004}, Key = {fds332333} } @article{fds339268, Author = {Langer, SL and Romano, JM and Todd, M and Strauman, TJ and Keefe, FJ and Syrjala, KL and Bricker, JB and Ghosh, N and Burns, JW and Bolger, N and Puleo, BK and Gralow, JR and Shankaran, V and Westbrook, K and Zafar, SY and Porter, LS}, Title = {Links Between Communication and Relationship Satisfaction Among Patients With Cancer and Their Spouses: Results of a Fourteen-Day Smartphone-Based Ecological Momentary Assessment Study.}, Journal = {Front Psychol}, Volume = {9}, Number = {OCT}, Pages = {1843}, Year = {2018}, url = {http://dx.doi.org/10.3389/fpsyg.2018.01843}, Abstract = {Cancer treatment poses significant challenges not just for those diagnosed with the disease but also for their intimate partners. Evidence suggests that couples' communication plays a major role in the adjustment of both individuals and in the quality of their relationship. Most descriptive studies linking communication to adjustment have relied on traditional questionnaire methodologies and cross-sectional designs, limiting external validity and discernment of temporal patterns. Using the systemic-transactional model of dyadic coping as a framework, we examined intra- and inter-personal associations between communication (both enacted and perceived) and relationship satisfaction (RS) among patients with stage II-IV breast or colorectal cancer and their spouses (N = 107 couples). Participants (mean age = 51, 64.5% female patients, and 37.4% female spouses) independently completed twice-daily ecological momentary assessments (EMA) via smartphone for 14 consecutive days. Items assessed RS and communication (expression of feelings, holding back from expression, support and criticism of partner, and parallel ratings of partner behavior). Linear mixed models employing an Actor Partner Interdependence Model were used to examine concurrent, time-lagged, and cross-lagged associations between communication and RS. Expressing one's feelings was unassociated with RS. Holding back from doing so, in contrast, was associated with lower RS for both patients and spouses in concurrent models. These effects were both intrapersonal and interpersonal, meaning that when individuals held back from expressing their feelings, they reported lower RS and so too did their partner. Giving and receiving support were associated with one's own higher RS for both patients and spouses in concurrent models, and for patients in lagged models. Conversely, criticizing one's partner and feeling criticized were maladaptive, associated with lower RS (own and in some cases, partner's). Cross-lagged analyses (evening RS to next-day afternoon communication) yielded virtually no effects, suggesting that communication may have a stronger influence on short-term RS than the reverse. Findings underscore the importance of responsive communication, more so than expression per se, in explaining both concurrent and later relationship adjustment. In addition, a focus on holding back from expressing feelings may enhance the understanding of RS for couples coping with cancer.}, Doi = {10.3389/fpsyg.2018.01843}, Key = {fds339268} } @article{fds371057, Author = {Vlaeyen, JW and Keefe, FJ and Main, CJ and Eccleston, C and Williams, ACDC}, Title = {In memoriam: Professor Stephen J. Morley (1950-2017).}, Journal = {Pain}, Volume = {158}, Number = {11}, Pages = {2057-2058}, Year = {2017}, Month = {November}, url = {http://dx.doi.org/10.1097/j.pain.0000000000001017}, Doi = {10.1097/j.pain.0000000000001017}, Key = {fds371057} } @article{fds371058, Author = {Main, CJ and Burton, AK and Keefe, FJ and Nicholas, MK and Watson, PJ}, Title = {In memoriam: Gordon Waddell 1942 to 2017}, Journal = {Pain}, Volume = {158}, Number = {9}, Pages = {1625-1626}, Publisher = {Ovid Technologies (Wolters Kluwer Health)}, Year = {2017}, Month = {September}, url = {http://dx.doi.org/10.1097/j.pain.0000000000000958}, Doi = {10.1097/j.pain.0000000000000958}, Key = {fds371058} } @article{fds330576, Author = {Lefebvre, JC and Jensen, MP and Waters, SJ and Molton, IR and Keefe, FJ and Caldwell, DS}, Title = {The development and assessment of the Worry About Pain Questionnaire.}, Journal = {Eur J Pain}, Volume = {21}, Number = {7}, Pages = {1154-1164}, Year = {2017}, Month = {August}, url = {http://dx.doi.org/10.1002/ejp.1015}, Abstract = {BACKGROUND: Worry can be conceptualized as a cognitive-affective automatic process initiated in order to address uncertainty and potential personal inadequacies that could result in negative outcomes. The purpose of the current study was to develop a measure of pain-specific worry - the Worry About Pain Questionnaire (WAPQ). METHOD: In study 1, responses of 335 pain-free participants were used to complete an item analysis and exploratory factors analysis to develop and assess the internal structure of the WAPQ. Study 2 included 224 pain-free participants who completed the WAPQ in order to confirm its factor structure, and to examine its relation to the experience of acute experimental pain. In study 3, 137 individuals with persistent pain were asked to complete the WAPQ as well as measures of pain and depressive symptoms. RESULTS: The resulting 15-item measure assesses uncertainties and potential negative outcomes related to the experience of pain. The results of the exploratory and confirmatory factor analyses showed a two-factor structure. Across all studies, the WAPQ was found to be related to measures of pain in clinical and non-clinical samples, acute experimental pain stimuli, as well as pain anxiety, pain catastrophizing, fear of pain, rumination and depressive symptomatology. CONCLUSIONS: The results suggest that the WAPQ is a reliable and valid measure for the assessment of worry about pain that can be used to understand how pain-specific worries are related to the experience and impact of pain across different populations. SIGNIFICANCE: Worry has been assessed in pain populations using measures that assess worry in general. The current study shows a relationship between pain-specific worry and the experience of pain. Further, worry about pain is related to but not synonymous with pain catastrophizing.}, Doi = {10.1002/ejp.1015}, Key = {fds330576} } @article{fds371059, Author = {Somers, TJ and Kelleher, SA and Dorfman, CS and Shelby, RA and Fisher, HM and Rowe Nichols and K and Sullivan, KM and Chao, NJ and Samsa, GP and Abernethy, AP and Keefe, FJ}, Title = {An mHealth Pain Coping Skills Training Intervention for Hematopoietic Stem Cell Transplantation Patients: Development and Pilot Randomized Controlled Trial (Preprint)}, Year = {2017}, Month = {July}, url = {http://dx.doi.org/10.2196/preprints.8565}, Abstract = {<sec> <title>BACKGROUND</title> <p>Pain is a challenge for patients following hematopoietic stem cell transplantation (HCT).</p> </sec> <sec> <title>OBJECTIVE</title> <p>This study aimed to develop and test the feasibility, acceptability, and initial efficacy of a Web-based mobile pain coping skills training (mPCST) protocol designed to address the needs of HCT patients.</p> </sec> <sec> <title>METHODS</title> <p>Participants had undergone HCT and reported pain following transplant (N=68). To guide intervention development, qualitative data were collected from focus group participants (n=25) and participants who completed user testing (n=7). After their input was integrated into the mPCST intervention, a pilot randomized controlled trial (RCT, n=36) was conducted to examine the feasibility, acceptability, and initial efficacy of the intervention. Measures of acceptability, pain severity, pain disability, pain self-efficacy, fatigue, and physical disability (self-report and 2-min walk test [2MWT]) were collected.</p> </sec> <sec> <title>RESULTS</title> <p>Participants in the focus groups and user testing provided qualitative data that were used to iteratively refine the mPCST protocol. Focus group qualitative data included participants’ experiences with pain following transplant, perspectives on ways to cope with pain, and suggestions for pain management for other HCT patients. User testing participants provided feedback on the HCT protocol and information on the use of videoconferencing. The final version of the mPCST intervention was designed to bridge the intensive outpatient (1 in-person session) and home settings (5 videoconferencing sessions). A key component of the intervention was a website that provided personalized messages based on daily assessments of pain and activity. The website also provided intervention materials (ie, electronic handouts, short videos, and audio files). The intervention content included pain coping advice from other transplant patients and instructions on how to apply pain coping skills while engaging in meaningful and leisure activities. In the RCT phase of this research, HCT patients (n=36) were randomized to receive the mPCST intervention or to proceed with the treatment as usual. Results revealed that the mPCST participants completed an average of 5 out of 6 sessions. The participants reported that the intervention was highly acceptable (mean 3/4), and they found the sessions to be helpful (mean 8/10) and easy to understand (mean 7/7). The mPCST participants demonstrated significant improvements in pre- to post-treatment pain, self-efficacy (P=.03, d=0.61), and on the 2MWT (P=.03, d=0.66), whereas the patients in the treatment-as-usual group did not report any such improvements. Significant changes in pain disability and fatigue were found in both groups (multiple P<.02); the magnitudes of the effect sizes were larger for the mPCST group than for the control group (pain disability: d=0.79 vs 0.69; fatigue: d=0.94 vs 0.81). There were no significant changes in pain severity in either group.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>Using focus groups and user testing, we developed an mPCST protocol that was feasible, acceptable, and beneficial for HCT patients with pain.</p> </sec> <sec> <title>CLINICALTRIAL</title> <p>ClinicalTrials.gov NCT01984671; https://clinicaltrials.gov/ct2/show/NCT01984671 (Archived by WebCite at http://www.webcitation.org/6xbpx3clZ)</p> </sec>}, Doi = {10.2196/preprints.8565}, Key = {fds371059} } @article{fds319635, Author = {Porter, LS and Keefe, FJ and Baucom, DH and Olsen, M and Zafar, SY and Uronis, H}, Title = {A randomized pilot trial of a videoconference couples communication intervention for advanced GI cancer.}, Journal = {Psychooncology}, Volume = {26}, Number = {7}, Pages = {1027-1035}, Year = {2017}, Month = {July}, url = {http://dx.doi.org/10.1002/pon.4121}, Abstract = {OBJECTIVE: This study aims to test the feasibility and preliminary efficacy of a couple-based communication intervention for advanced GI cancer delivered via videoconference. METHODS: Thirty-two couples were randomly assigned to either couples communication skills training (CCST) or an education comparison intervention, both delivered via videoconference. Participation was limited to couples who reported communication difficulties at screening. Patients and partners completed measures of relationship functioning and individual functioning at baseline and post-intervention. RESULTS: Eighty-eight percent of randomized dyads completed all six sessions and reported high levels of satisfaction with the intervention. Between-group effect sizes suggested that the CCST intervention led to improvements in relationship satisfaction for patients and partners and to improvements in intimacy and communication for patients. CONCLUSIONS: A couples-based communication intervention delivered via videoconference is feasible and acceptable in the context of advanced cancer. Preliminary findings suggest that the intervention shows promise in contributing to enhanced relationship functioning. Copyright © 2016 John Wiley & Sons, Ltd.}, Doi = {10.1002/pon.4121}, Key = {fds319635} } @article{fds330867, Author = {Parmelee, PA and Cox, BS and DeCaro, JA and Keefe, FJ and Smith, DM}, Title = {Racial/ethnic differences in sleep quality among older adults with osteoarthritis.}, Journal = {Sleep Health}, Volume = {3}, Number = {3}, Pages = {163-169}, Year = {2017}, Month = {June}, url = {http://dx.doi.org/10.1016/j.sleh.2017.03.010}, Abstract = {OBJECTIVE: To examine racial/ethnic differences in sleep quality and the pain-sleep association among older adults with osteoarthritis of the knee. DESIGN: Baseline interview followed by a 7-day microlongitudinal study using accelerometry and self-reports. SETTING: Participants were community residents in western Alabama and Long Island, NY. PARTICIPANTS: Ninety-six African Americans (AAs) and 128 non-Hispanic whites (NHWs) with physician-diagnosed knee osteoarthritis, recruited from a variety of clinical and community settings. MEASUREMENTS: Self-reports yielded demographics, body mass index, physical health problems, and depressive symptoms. Sleep quality was measured for 3 to 7 nights using wrist-worn accelerometers; pain was self-reported daily over the same period. RESULTS: With demographics and health controlled, AAs displayed poorer sleep efficiency, greater time awake after sleep onset and sleep fragmentation, and marginally more awakenings during the night, but no differences in total sleep time. AAs also showed greater night-to-night variability in number of awakenings and sleep fragmentation, and marginally greater variability in total sleep time and sleep efficiency. Sleep quality was not associated with pain either the day before sleep or the day after. Average daily pain interacted with race, whereas AAs displayed no effect of pain on sleep efficiency, NHWs exhibited better sleep efficiency at higher levels of average pain. CONCLUSIONS: These data corroborate previous studies documenting poorer sleep among AAs vs NHWs. The findings of greater night-to-night variability in sleep among AAs, as well as a negative association of pain with sleep quality among NHWs, are unique. Further study is needed to elucidate these findings.}, Doi = {10.1016/j.sleh.2017.03.010}, Key = {fds330867} } @article{fds330577, Author = {Gerhart, JI and Burns, JW and Post, KM and Smith, DA and Porter, LS and Burgess, HJ and Schuster, E and Buvanendran, A and Fras, AM and Keefe, FJ}, Title = {Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects.}, Journal = {Ann Behav Med}, Volume = {51}, Number = {3}, Pages = {365-375}, Year = {2017}, Month = {June}, url = {http://dx.doi.org/10.1007/s12160-016-9860-2}, Abstract = {BACKGROUND: Poor sleep quality among people with chronic low back pain appears to be related to worse pain, affect, poor physical function, and pain catastrophizing. The causal direction between poor sleep and pain remains an open question, however, as does whether sleep quality exerts effects on low back pain differently across the course of the day. PURPOSE: This daily diary study examined lagged temporal associations between prior night sleep quality and subsequent day pain, affect, physical function and pain catastrophizing, the reverse lagged temporal associations between prior day pain-related factors and subsequent night sleep quality, and whether the time of day during which an assessment was made moderated these temporal associations. METHODS: Chronic low back pain patients (n = 105) completed structured electronic diary assessments five times per day for 14 days. Items included patient ratings of their pain, affect, physical function, and pain catastrophizing. RESULTS: Collapsed across all observations, poorer sleep quality was significantly related to higher pain ratings, higher negative affect, lower positive affect, poorer physical function, and higher pain catastrophizing. Lagged analyses averaged across the day revealed that poorer prior night sleep quality significantly predicted greater next day patient ratings of pain, and poorer physical function and higher pain catastrophizing. Prior poorer night sleep quality significantly predicted greater reports of pain, and poorer physical function, and higher pain catastrophizing, especially during the early part of the day. Sleep quality × time of day interactions showed that poor sleepers reported high pain, and negative mood and low function uniformly across the day, whereas good sleepers reported relatively good mornings, but showed pain, affect and function levels comparable to poor sleepers by the end of the day. Analyses of the reverse causal pathway were mostly nonsignificant. CONCLUSIONS: Sleep quality appears related not only to pain intensity but also to a wide range of patient mood and function factors. A good night's sleep also appears to offer only temporary respite, suggesting that comprehensive interventions for chronic low back pain not only should include attention to sleep problems but also focus on problems with pain appraisals and coping.}, Doi = {10.1007/s12160-016-9860-2}, Key = {fds330577} } @article{fds372564, Author = {Kimmick, GG and Bosworth, HB and Keefe, FJ and Sutton, L and Owen, L and Erkanli, A and Reed, SD and Staley, SA and Pak, S and Barrett, N and Huettel, S and Shelby, RA}, Title = {Testing a behavioral intervention to improve adherence to adjuvant endocrine therapy (AET).}, Journal = {Journal of Clinical Oncology}, Volume = {35}, Number = {15_suppl}, Pages = {TPS10128-TPS10128}, Publisher = {American Society of Clinical Oncology (ASCO)}, Year = {2017}, Month = {May}, url = {http://dx.doi.org/10.1200/jco.2017.35.15_suppl.tps10128}, Abstract = {<jats:p> TPS10128 </jats:p><jats:p> Background: Adjuvant endocrine therapy (AET) is a crucial component of treatment used to prevent recurrence and reduce mortality for women with hormone receptor positive breast cancer. Poor adherence to AET is a significant problem, with rates of non-adherence ranging from 28% to 59%. Non-adherence to AET contributes to increased medical costs and increased mortality. Symptoms (e.g., pain, hot flashes, sleep problems, vaginal dryness) associated with AET are related to non-adherence and early discontinuation of treatment. Our goal is to test the efficacy of a novel self-management intervention (SMAET) that teaches patients skills for enhancing adherence to AET and coping with AET-related symptoms. Methods: Trial participants will be recruited from a tertiary care medical center and community clinics that are located in medically underserved areas. Target enrollment is 400 patients. Prospective participants must meet the following criteria: diagnosis of Stage I to III breast cancer; hormone receptor positive tumor; local definitive cancer treatment complete; within 12 months of beginning AET; have at least 18 months of AET recommended; and at least 21 years of age. We will test the effects of the SMAET intervention (n = 200) by comparing it to a general health education intervention (n = 200; attention control). The SMAET protocol includes 7 sessions providing systematic training in coping skills for managing symptoms that interfere with adherence and 3 maintenance calls delivered over 6 months by a nurse via the phone. The intervention also includes interactive voice messaging that is tailored based on real-time adherence data. The primary study outcome, adherence to AET, will be assessed in real-time for 18 months using wireless smart pill bottles (i.e., bottle opening and percent of pills remaining). Symptom interference will be examined as a secondary outcome and will be assessed over 18 months. If effective, the intervention may reduce the burden of AET use. Clinical trial information: NCT02707471. </jats:p>}, Doi = {10.1200/jco.2017.35.15_suppl.tps10128}, Key = {fds372564} } @article{fds331440, Author = {Bennell, KL and Nelligan, R and Dobson, F and Rini, C and Keefe, F and Kasza, J and French, S and Bryant, C and Dalwood, A and Abbott, JH and Hinman, RS}, Title = {Internet-delivered exercise and pain-coping skills training for chronic knee pain}, Journal = {Annals of Internal Medicine}, Volume = {166}, Number = {7}, Pages = {I13}, Publisher = {American College of Physicians}, Year = {2017}, Month = {April}, url = {http://dx.doi.org/10.7326/P17-9031}, Doi = {10.7326/P17-9031}, Key = {fds331440} } @article{fds333024, Author = {Bennell, KL and Nelligan, R and Dobson, F and Rini, C and Keefe, F and Kasza, J and French, S and Bryant, C and Dalwood, A and Abbott, JH and Hinman, RS}, Title = {Effectiveness of an Internet-Delivered Exercise and Pain-Coping Skills Training Intervention for Persons With Chronic Knee Pain: A Randomized Trial.}, Journal = {Ann Intern Med}, Volume = {166}, Number = {7}, Pages = {453-462}, Year = {2017}, Month = {April}, url = {http://dx.doi.org/10.7326/M16-1714}, Abstract = {BACKGROUND: Effective, accessible biopsychosocial treatments are needed to manage chronic knee pain on a population level. OBJECTIVE: To evaluate the effectiveness of Internet-delivered, physiotherapist-prescribed home exercise and pain-coping skills training (PCST). DESIGN: Pragmatic parallel-group randomized, controlled trial. (Australian New Zealand Clinical Trials Registry: ACTRN12614000243617). SETTING: Community (Australia). PATIENTS: 148 persons aged 50 years or older with chronic knee pain. INTERVENTION: The intervention was delivered via the Internet and included educational material, 7 videoconferencing (Skype [Microsoft]) sessions with a physiotherapist for home exercise, and a PCST program over 3 months. The control was Internet-based educational material. MEASUREMENTS: Primary outcomes were pain during walking (11-point numerical rating scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index) at 3 months. Secondary outcomes were knee pain, quality of life, global change (overall, pain, and functional status), arthritis self-efficacy, coping, and pain catastrophizing. Outcomes were also measured at 9 months. RESULTS: Of participants enrolled, 139 (94%) completed primary outcome measures at 3 months and 133 (90%) completed secondary outcome measures at 9 months; multiple imputation was used for missing data. The intervention group reported significantly more improvement in pain (mean difference, 1.6 units [95% CI, 0.9 to 2.3 units]) and physical function (mean difference, 9.3 units [CI, 5.9 to 12.7 units]) than the control group at 3 months, and improvements were sustained at 9 months (mean differences, 1.1 units [CI, 0.4 to 1.8 units] and 7.0 units [CI, 3.4 to 10.5 units], respectively). Intervention participants showed significantly more improvement in most secondary outcomes than control participants. At both time points, significantly more intervention participants reported global improvements. LIMITATION: Participants were unblinded. CONCLUSION: For persons with chronic knee pain, Internet-delivered, physiotherapist-prescribed exercise and PCST provide clinically meaningful improvements in pain and function that are sustained for at least 6 months. PRIMARY FUNDING SOURCE: National Health and Medical Research Council.}, Doi = {10.7326/M16-1714}, Key = {fds333024} } @article{fds333023, Author = {Keefe, FJ and Sommer, C}, Title = {An introduction to the Biennial Review of Pain.}, Journal = {Pain}, Volume = {158 Suppl 1}, Pages = {S1}, Year = {2017}, Month = {April}, url = {http://dx.doi.org/10.1097/j.pain.0000000000000877}, Doi = {10.1097/j.pain.0000000000000877}, Key = {fds333023} } @article{fds330906, Author = {Edmond, SN and Shelby, RA and Keefe, FJ and Fisher, HM and Schmidt, JE and Soo, MS and Skinner, CS and Ahrendt, GM and Manculich, J and Sumkin, JH and Zuley, ML and Bovbjerg, DH}, Title = {Persistent Breast Pain Among Women With Histories of Breast-conserving Surgery for Breast Cancer Compared With Women Without Histories of Breast Surgery or Cancer.}, Journal = {Clin J Pain}, Volume = {33}, Number = {1}, Pages = {51-56}, Year = {2017}, Month = {January}, url = {http://dx.doi.org/10.1097/AJP.0000000000000377}, Abstract = {OBJECTIVES: This study compared persistent breast pain among women who received breast-conserving surgery for breast cancer and women without a history of breast cancer. METHODS: Breast cancer survivors (n=200) were recruited at their first postsurgical surveillance mammogram (6 to 15 mo postsurgery). Women without a breast cancer history (n=150) were recruited at the time of a routine screening mammogram. All women completed measures of breast pain, pain interference with daily activities and intimacy, worry about breast pain, anxiety symptoms, and depression symptoms. Demographic and medical information were also collected. RESULTS: Persistent breast pain (duration ≥6 mo) was reported by 46.5% of breast cancer survivors and 12.7% of women without a breast cancer history (P<0.05). Breast cancer survivors also had significantly higher rates of clinically significant persistent breast pain (pain intensity score ≥3/10), as well as higher average breast pain intensity and unpleasantness scores. Breast cancer survivors with persistent breast pain had significantly higher levels of depressive symptoms, as well as pain worry and interference, compared with survivors without persistent breast pain or women without a breast cancer history. Anxiety symptoms were significantly higher in breast cancer survivors with persistent breast pain compared with women without a breast cancer history. DISCUSSION: Results indicate that persistent breast pain negatively impacts women with a history of breast-conserving cancer surgery compared with women without that history. Strategies to ameliorate persistent breast pain and to improve adjustment among women with persistent breast pain should be explored for incorporation into standard care for breast cancer survivors.}, Doi = {10.1097/AJP.0000000000000377}, Key = {fds330906} } @article{fds333025, Author = {Paice, JA and Portenoy, R and Lacchetti, C and Campbell, T and Cheville, A and Citron, M and Constine, LS and Cooper, A and Glare, P and Keefe, F and Koyyalagunta, L and Levy, M and Miaskowski, C and Otis-Green, S and Sloan, P and Bruera, E}, Title = {Management of Chronic Pain in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline.}, Journal = {J Clin Oncol}, Volume = {34}, Number = {27}, Pages = {3325-3345}, Year = {2016}, Month = {September}, url = {http://dx.doi.org/10.1200/JCO.2016.68.5206}, Abstract = {PURPOSE: To provide evidence-based guidance on the optimum management of chronic pain in adult cancer survivors. METHODS: An ASCO-convened expert panel conducted a systematic literature search of studies investigating chronic pain management in cancer survivors. Outcomes of interest included symptom relief, pain intensity, quality of life, functional outcomes, adverse events, misuse or diversion, and risk assessment or mitigation. RESULTS: A total of 63 studies met eligibility criteria and compose the evidentiary basis for the recommendations. Studies tended to be heterogeneous in terms of quality, size, and populations. Primary outcomes also varied across the studies, and in most cases, were not directly comparable because of different outcomes, measurements, and instruments used at different time points. Because of a paucity of high-quality evidence, many recommendations are based on expert consensus. RECOMMENDATIONS: Clinicians should screen for pain at each encounter. Recurrent disease, second malignancy, or late-onset treatment effects in any patient who reports new-onset pain should be evaluated, treated, and monitored. Clinicians should determine the need for other health professionals to provide comprehensive pain management care in patients with complex needs. Systemic nonopioid analgesics and adjuvant analgesics may be prescribed to relieve chronic pain and/or to improve function. Clinicians may prescribe a trial of opioids in carefully selected patients with cancer who do not respond to more conservative management and who continue to experience distress or functional impairment. Risks of adverse effects of opioids should be assessed. Clinicians should clearly understand terminology such as tolerance, dependence, abuse, and addiction as it relates to the use of opioids and should incorporate universal precautions to minimize abuse, addiction, and adverse consequences. Additional information is available at www.asco.org/chronic-pain-guideline and www.asco.org/guidelineswiki.}, Doi = {10.1200/JCO.2016.68.5206}, Key = {fds333025} } @article{fds330869, Author = {Yarnitsky, D and Keefe, FJ}, Title = {Access to PAIN Reports is now open: IASP inaugurates a new journal.}, Journal = {Pain}, Volume = {157}, Number = {9}, Pages = {1835}, Year = {2016}, Month = {September}, url = {http://dx.doi.org/10.1097/j.pain.0000000000000645}, Doi = {10.1097/j.pain.0000000000000645}, Key = {fds330869} } @article{fds322119, Author = {Huebner, JL and Landerman, LR and Somers, TJ and Keefe, FJ and Guilak, F and Blumenthal, JA and Caldwell, DS and Kraus, VB}, Title = {Exploratory secondary analyses of a cognitive-behavioral intervention for knee osteoarthritis demonstrate reduction in biomarkers of adipocyte inflammation.}, Journal = {Osteoarthritis Cartilage}, Volume = {24}, Number = {9}, Pages = {1528-1534}, Year = {2016}, Month = {September}, url = {http://dx.doi.org/10.1016/j.joca.2016.04.002}, Abstract = {OBJECTIVE: To investigate the effects of pain coping skills training (PCST) and a lifestyle behavioral weight management (BWM) program on inflammatory markers and biomarker associations with pain and function in the OA LIFE study. METHOD: Serum samples were available from a subset (N = 169) of the overweight or obese knee OA participants in the OA LIFE study that evaluated: PCST, BWM, combined PCST + BWM, or standard care (SC). Inflammatory markers (hsCRP, IL-1ra, IL-1β, IL-6, IL-8, TNF-α, TNFRI, TNFRII, and hyaluronic acid (HA)), and adipokines (leptin and adiponectin) were measured before and after the 24-week treatment period. Biomarkers were assessed for effects of treatment and for associations with change in weight, pain and disability (unadjusted and adjusted for age, race, sex, baseline body mass index (BMI), and baseline biomarker concentration). RESULTS: PCST + BWM was associated with significant reductions in hsCRP (P = 0.0014), IL-6 (P = 0.0075), and leptin (P = 0.0001). After adjustment, there was a significant effect of PCST + BWM on changes in leptin (b = -0.19, P = 0.01) and IL-6 (b = -0.25, P = 0.02) relative to SC. Reductions in leptin and IL-6 were significantly correlated with reductions in weight, BMI and Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain; reductions in IL-6 were correlated with improvements in WOMAC and Arthritis Impact Measurement Scales (AIMS) physical function. By mediation analyses, weight loss was responsible for 54% of the change in IL-6 and all of the change in leptin. CONCLUSIONS: OA-related inflammatory markers were reduced by a 24-week combined PCST + BWM intervention. This suggests that the inflammatory state can be successfully modified in the context of a readily instituted clinical intervention with a positive clinical outcome.}, Doi = {10.1016/j.joca.2016.04.002}, Key = {fds322119} } @article{fds319633, Author = {Broderick, JE and Keefe, FJ and Schneider, S and Junghaenel, DU and Bruckenthal, P and Schwartz, JE and Kaell, AT and Caldwell, DS and McKee, D and Gould, E}, Title = {Cognitive behavioral therapy for chronic pain is effective, but for whom?}, Journal = {Pain}, Volume = {157}, Number = {9}, Pages = {2115-2123}, Year = {2016}, Month = {September}, url = {http://dx.doi.org/10.1097/j.pain.0000000000000626}, Abstract = {Moderator analyses are reported for posttreatment outcomes in a large, randomized, controlled effectiveness trial for chronic pain for hip and knee osteoarthritis (N = 256). Pain Coping Skills Training, a form of cognitive behavioral therapy, was compared to usual care. Treatment was delivered by nurse practitioners in patients' community doctors' offices. Consistent with meta-analyses of pain cognitive behavioral therapy efficacy, treatment effects in this trial were significant for several primary and secondary outcomes, but tended to be small. This study was designed to examine differential response to treatment for patient subgroups to guide clinical decision-making for treatment. Based on existing literature, demographic (age, sex, race/ethnicity, and education) and clinical variables (disease severity, body mass index, patient treatment expectations, depression, and patient pain coping style) were specified a priori as potential moderators. Trial outcome variables (N = 15) included pain, fatigue, self-efficacy, quality of life, catastrophizing, and use of pain medication. Results yielded 5 significant moderators for outcomes at posttreatment: pain coping style, patient expectation for treatment response, radiographically assessed disease severity, age, and education. Thus, sex, race/ethnicity, body mass index, and depression at baseline were not associated with level of treatment response. In contrast, patients with interpersonal problems associated with pain coping did not benefit much from the treatment. Although most patients projected positive expectations for the treatment prior to randomization, only those with moderate to high expectations benefited. Patients with moderate to high osteoarthritis disease severity showed stronger treatment effects. Finally, the oldest and most educated patients showed strong treatment effects, while younger and less educated did not.}, Doi = {10.1097/j.pain.0000000000000626}, Key = {fds319633} } @article{fds322120, Author = {Schrubbe, LA and Ravyts, SG and Benas, BC and Campbell, LC and Cené, CW and Coffman, CJ and Gunn, AH and Keefe, FJ and Nagle, CT and Oddone, EZ and Somers, TJ and Stanwyck, CL and Taylor, SS and Allen, KD}, Title = {Pain coping skills training for African Americans with osteoarthritis (STAART): study protocol of a randomized controlled trial.}, Journal = {BMC Musculoskelet Disord}, Volume = {17}, Number = {1}, Pages = {359}, Year = {2016}, Month = {August}, url = {http://dx.doi.org/10.1186/s12891-016-1217-2}, Abstract = {BACKGROUND: African Americans bear a disproportionate burden of osteoarthritis (OA), with higher prevalence rates, more severe pain, and more functional limitations. One key barrier to addressing these disparities has been limited engagement of African Americans in the development and evaluation of behavioral interventions for management of OA. Pain Coping Skills Training (CST) is a cognitive-behavioral intervention with shown efficacy to improve OA-related pain and other outcomes. Emerging data indicate pain CST may be a promising intervention for reducing racial disparities in OA symptom severity. However, there are important gaps in this research, including incorporation of stakeholder perspectives (e.g. cultural appropriateness, strategies for implementation into clinical practice) and testing pain CST specifically among African Americans with OA. This study will evaluate the effectiveness of a culturally enhanced pain CST program among African Americans with OA. METHODS/DESIGN: This is a randomized controlled trial among 248 participants with symptomatic hip or knee OA, with equal allocation to a pain CST group and a wait list (WL) control group. The pain CST program incorporated feedback from patients and other stakeholders and involves 11 weekly telephone-based sessions. Outcomes are assessed at baseline, 12 weeks (primary time point), and 36 weeks (to assess maintenance of treatment effects). The primary outcome is the Western Ontario and McMaster Universities Osteoarthritis Index, and secondary outcomes include self-efficacy, pain coping, pain interference, quality of life, depressive symptoms, and global assessment of change. Linear mixed models will be used to compare the pain CST group to the WL control group and explore whether participant characteristics are associated with differential improvement in the pain CST program. This research is in compliance with the Helsinki Declaration and was approved by the Institutional Review Boards of the University of North Carolina at Chapel Hill, Durham Veterans Affairs Medical Center, East Carolina University, and Duke University Health System. DISCUSSION: This culturally enhanced pain CST program could have a substantial impact on outcomes for African Americans with OA and may be a key strategy in the reduction of racial health disparities. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02560922 , registered 9/22/2015.}, Doi = {10.1186/s12891-016-1217-2}, Key = {fds322120} } @article{fds273587, Author = {Waters, SJ and Strauman, TJ and McKee, DC and Campbell, LC and Shelby, RA and Dixon, KE and Fras, AM and Keefe, FJ}, Title = {Self-system therapy for distress associated with persistent low back pain: A randomized clinical trial.}, Journal = {Psychother Res}, Volume = {26}, Number = {4}, Pages = {472-483}, Year = {2016}, Month = {July}, ISSN = {1050-3307}, url = {http://dx.doi.org/10.1080/10503307.2015.1040485}, Abstract = {OBJECTIVE: Persistent low back pain (PLBP) is associated with vulnerability to depression. PLBP frequently requires major changes in occupation and lifestyle, which can lead to a sense of failing to attain one's personal goals (self-discrepancy). METHOD: We conducted a clinical trial to examine the efficacy of self-system therapy (SST), a brief structured therapy for depression based on self-discrepancy theory. A total of 101 patients with PLBP and clinically significant depressive symptoms were randomized either to SST, pain education, or standard care. RESULTS: Patients receiving SST showed significantly greater improvement in depressive symptoms. Reduction in self-discrepancy predicted reduction in depressive symptoms only within the SST condition. CONCLUSIONS: Findings support the utility of SST for individuals facing persistent pain and associated depression.}, Doi = {10.1080/10503307.2015.1040485}, Key = {fds273587} } @article{fds362180, Author = {Yarnitsky, D and Keefe, FJ}, Title = {Access to PAIN Reports is now open: IASP inaugurates a new journal.}, Journal = {Pain Rep}, Volume = {1}, Number = {1}, Pages = {e563}, Year = {2016}, Month = {July}, url = {http://dx.doi.org/10.1097/PR9.0000000000000563}, Doi = {10.1097/PR9.0000000000000563}, Key = {fds362180} } @article{fds319634, Author = {Soo, MS and Jarosz, JA and Wren, AA and Soo, AE and Mowery, YM and Johnson, KS and Yoon, SC and Kim, C and Hwang, ES and Keefe, FJ and Shelby, RA}, Title = {Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue.}, Journal = {J Am Coll Radiol}, Volume = {13}, Number = {5}, Pages = {526-534}, Year = {2016}, Month = {May}, url = {http://dx.doi.org/10.1016/j.jacr.2015.12.004}, Abstract = {PURPOSE: To evaluate the impact of guided meditation and music interventions on patient anxiety, pain, and fatigue during imaging-guided breast biopsy. METHODS: After giving informed consent, 121 women needing percutaneous imaging-guided breast biopsy were randomized into three groups: (1) guided meditation; (2) music; (3) standard-care control group. During biopsy, the meditation and music groups listened to an audio-recorded, guided, loving-kindness meditation and relaxing music, respectively; the standard-care control group received supportive dialogue from the biopsy team. Immediately before and after biopsy, participants completed questionnaires measuring anxiety (State-Trait Anxiety Inventory Scale), biopsy pain (Brief Pain Inventory), and fatigue (modified Functional Assessment of Chronic Illness Therapy-Fatigue). After biopsy, participants completed questionnaires assessing radiologist-patient communication (modified Questionnaire on the Quality of Physician-Patient Interaction), demographics, and medical history. RESULTS: The meditation and music groups reported significantly greater anxiety reduction (P values < .05) and reduced fatigue after biopsy than the standard-care control group; the standard-care control group reported increased fatigue after biopsy. The meditation group additionally showed significantly lower pain during biopsy, compared with the music group (P = .03). No significant difference in patient-perceived quality of radiologist-patient communication was noted among groups. CONCLUSIONS: Listening to guided meditation significantly lowered biopsy pain during imaging-guided breast biopsy; meditation and music reduced patient anxiety and fatigue without compromising radiologist-patient communication. These simple, inexpensive interventions could improve women's experiences during core-needle breast biopsy.}, Doi = {10.1016/j.jacr.2015.12.004}, Key = {fds319634} } @article{fds311139, Author = {Bennell, KL and Ahamed, Y and Jull, G and Bryant, C and Hunt, MA and Forbes, AB and Kasza, J and Akram, M and Metcalf, B and Harris, A and Egerton, T and Kenardy, JA and Nicholas, MK and Keefe, FJ}, Title = {Physical Therapist-Delivered Pain Coping Skills Training and Exercise for Knee Osteoarthritis: Randomized Controlled Trial.}, Journal = {Arthritis Care Res (Hoboken)}, Volume = {68}, Number = {5}, Pages = {590-602}, Year = {2016}, Month = {May}, ISSN = {2151-464X}, url = {http://dx.doi.org/10.1002/acr.22744}, Abstract = {OBJECTIVE: To investigate whether a 12-week physical therapist-delivered combined pain coping skills training (PCST) and exercise (PCST/exercise) is more efficacious and cost effective than either treatment alone for knee osteoarthritis (OA). METHODS: This was an assessor-blinded, 3-arm randomized controlled trial in 222 people (73 PCST/exercise, 75 exercise, and 74 PCST) ages ≥50 years with knee OA. All participants received 10 treatments over 12 weeks plus a home program. PCST covered pain education and training in cognitive and behavioral pain coping skills, exercise comprised strengthening exercises, and PCST/exercise integrated both. Primary outcomes were self-reported average knee pain (visual analog scale, range 0-100 mm) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index, range 0-68) at week 12. Secondary outcomes included other pain measures, global change, physical performance, psychological health, physical activity, quality of life, and cost effectiveness. Analyses were by intent-to-treat methodology with multiple imputation for missing data. RESULTS: A total of 201 participants (91%), 181 participants (82%), and 186 participants (84%) completed week 12, 32, and 52 measurements, respectively. At week 12, there were no significant between-group differences for reductions in pain comparing PCST/exercise versus exercise (mean difference 5.8 mm [95% confidence interval (95% CI) -1.4, 13.0]) and PCST/exercise versus PCST (6.7 mm [95% CI -0.6, 14.1]). Significantly greater improvements in function were found for PCST/exercise versus exercise (3.7 units [95% CI 0.4, 7.0]) and PCST/exercise versus PCST (7.9 units [95% CI 4.7, 11.2]). These differences persisted at weeks 32 (both) and 52 (PCST). Benefits favoring PCST/exercise were seen on several secondary outcomes. Cost effectiveness of PCST/exercise was not demonstrated. CONCLUSION: This model of care could improve access to psychological treatment and augment patient outcomes from exercise in knee OA, although it did not appear to be cost effective.}, Doi = {10.1002/acr.22744}, Key = {fds311139} } @article{fds323405, Author = {Platts-Mills, TF and Nicholson, RJ and Richmond, NL and Patel, KV and Simonsick, EM and Domeier, RM and Swor, RA and Hendry, PL and Peak, DA and Rathlev, NK and Jones, JS and Lee, DC and Weaver, MA and Keefe, FJ and McLean, SA}, Title = {Restricted activity and persistent pain following motor vehicle collision among older adults: a multicenter prospective cohort study.}, Journal = {BMC Geriatr}, Volume = {16}, Pages = {86}, Year = {2016}, Month = {April}, url = {http://dx.doi.org/10.1186/s12877-016-0260-z}, Abstract = {BACKGROUND: Restricted physical activity commonly occurs following acute musculoskeletal pain in older adults and may influence long-term outcomes. We sought to examine the relationship between restricted physical activity after motor vehicle collision (MVC) and the development of persistent pain. METHODS: We examined data from a prospective study of adults ≥65 years of age presenting to the emergency department (ED) after MVC without life-threatening injuries. Restricted physical activity 6 weeks after MVC was defined in three different ways: 1) by a ≥25 point decrease in Physical Activity Scale in the Elderly (PASE) score, 2) by the answer "yes" to the question, "during the past two weeks, have you stayed in bed for at least half a day?", and 3) by the answer "yes" to the question, "during the past two weeks, have you cut down on your usual activities as compared to before the accident?" We examined relationships between each definition of restricted activity and pain severity, pain interference, and functional capacity at 6 months with adjustment for confounders. RESULTS: Within the study sample (N = 164), adjusted average pain severity scores at 6 months did not differ between patients with and without restricted physical activity based on decreased PASE score (2.54 vs. 2.07, p = 0.32). In contrast, clinically and statistically important differences in adjusted average pain severity at 6 months were observed for patients who reported spending half a day in bed vs. those who did not (3.56 vs. 1.91, p < 0.01). In adjusted analyses, both decreased PASE score and cutting down on activity were associated with functional capacity at 6 months, but only decreased PASE score was associated with increased ADL difficulty at 6 months (0.70 vs. -0.01, p = 0.02). CONCLUSIONS: Among older adults experiencing MVC, those reporting bed rest or reduced activity 6 weeks after the collision reported higher pain and pain interference scores at 6 months. More research is needed to determine if interventions to promote activity can improve outcomes after MVC in older adults.}, Doi = {10.1186/s12877-016-0260-z}, Key = {fds323405} } @article{fds273588, Author = {Platts-Mills, TF and Flannigan, SA and Bortsov, AV and Smith, S and Domeier, RM and Swor, RA and Hendry, PL and Peak, DA and Rathlev, NK and Jones, JS and Lee, DC and Keefe, FJ and Sloane, PD and McLean, SA}, Title = {Persistent Pain Among Older Adults Discharged Home From the Emergency Department After Motor Vehicle Crash: A Prospective Cohort Study.}, Journal = {Ann Emerg Med}, Volume = {67}, Number = {2}, Pages = {166-176.e1}, Year = {2016}, Month = {February}, ISSN = {0196-0644}, url = {http://dx.doi.org/10.1016/j.annemergmed.2015.05.003}, Abstract = {STUDY OBJECTIVE: Motor vehicle crashes are the second most common form of trauma among older adults. We seek to describe the incidence, risk factors, and consequences of persistent pain among older adults evaluated in the emergency department (ED) after a motor vehicle crash. METHODS: We conducted a prospective longitudinal study of patients aged 65 years or older who presented to one of 8 EDs after motor vehicle crash between June 2011 and June 2014 and were discharged home after evaluation. ED evaluation was done through in-person interview; follow-up data were obtained through mail-in survey or telephone call. Pain severity (0 to 10 scale) overall and for 15 parts of the body were assessed at each follow-up point. Principal component analysis was used to assess the dimensionality of the locations of pain data. Participants reporting pain severity greater than or equal to 4 attributed to the motor vehicle crash at 6 months were defined as having persistent pain. RESULTS: Of the 161 participants, 72% reported moderate to severe pain at the ED evaluation. At 6 months, 26% of participants reported moderate to severe motor vehicle crash-related pain. ED characteristics associated with persistent pain included acute pain severity; pain located in the head, neck, and jaw or lower back and legs; poor self-rated health; less formal education; pre-motor vehicle crash depressive symptoms; and patient's expected time to physical recovery more than 30 days. Compared with individuals without persistent pain, those with persistent pain were substantially more likely at 6-month follow-up to have also experienced a decline in their capacity for physical function (73% versus 36%; difference=37%; 95% confidence interval [CI] 19% to 52%), a new difficulty with activities of daily living (42% versus 17%; difference=26%; 95% CI 10% to 43%), a 1-point or more reduction in overall self-rated health on a 5-point scale (54% versus 30%; difference=24%; 95% CI 6% to 41%), and a change in their living situation to obtain additional help (23% versus 8%; difference=15%; 95% CI 2% to 31%). CONCLUSION: Among older adults discharged home from the ED post-evaluation after a motor vehicle crash, persistent pain is common and frequently associated with functional decline and disability.}, Doi = {10.1016/j.annemergmed.2015.05.003}, Key = {fds273588} } @article{fds273568, Author = {Burns, JW and Gerhart, JI and Bruehl, S and Post, KM and Smith, DA and Porter, LS and Schuster, E and Buvanendran, A and Fras, AM and Keefe, FJ}, Title = {Anger arousal and behavioral anger regulation in everyday life among people with chronic low back pain: Relationships with spouse responses and negative affect.}, Journal = {Health Psychol}, Volume = {35}, Number = {1}, Pages = {29-40}, Year = {2016}, Month = {January}, ISSN = {0278-6133}, url = {http://dx.doi.org/10.1037/hea0000221}, Abstract = {OBJECTIVE: To determine the degree to which anger arousal and anger regulation (expression, inhibition) in the daily lives of people with chronic pain were related to spouse support, criticism, and hostility as perceived by patients and as reported by spouses. METHOD: Married couples (N = 105, 1 spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. On these diaries, patients completed items on their own anger arousal, anger expression, and inhibition, and on perceived spouse support, criticism, and hostility. Spouses reported on their responses toward patients and their negative affect. Hierarchical linear modeling tested concurrent and lagged relationships. RESULTS: Patient-reported increases in anger arousal and anger expression were predominantly related to concurrent decreases in patient-perceived and spouse-reported spouse support, concurrent increases in patient-perceived and spouse-reported spouse criticism and hostility, and increases in spouse-reported negative affect. Relationships for anger expression remained significant with anger arousal controlled. These effects were especially strong for male patients. Spouses reported greater negative affect when patients were present than when they were not. CONCLUSIONS: Social support may facilitate adjustment to chronic pain, with declining support and overt criticism and hostility possibly adversely impacting pain and function. Results suggest that patient anger arousal and expression may be related to a negative interpersonal environment for married couples coping with chronic low back pain.}, Doi = {10.1037/hea0000221}, Key = {fds273568} } @article{fds273586, Author = {Hendrix, CC and Bailey, DE and Steinhauser, KE and Olsen, MK and Stechuchak, KM and Lowman, SG and Schwartz, AJ and Riedel, RF and Keefe, FJ and Porter, LS and Tulsky, JA}, Title = {Effects of enhanced caregiver training program on cancer caregiver's self-efficacy, preparedness, and psychological well-being.}, Journal = {Support Care Cancer}, Volume = {24}, Number = {1}, Pages = {327-336}, Year = {2016}, Month = {January}, ISSN = {0941-4355}, url = {http://dx.doi.org/10.1007/s00520-015-2797-3}, Abstract = {PURPOSE: We examined the effects of an enhanced informal caregiver training (Enhanced-CT) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients. METHODS: We recruited adult patients in oncology units and their informal caregivers. We utilized a two-armed, randomized controlled trial design with data collected at baseline, post-training, and at 2 and 4 weeks after hospital discharge. Primary outcomes were self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving. Secondary outcomes were caregiver depression, anxiety, and burden. The education comparison (EDUC) group received information about community resources. We used general linear models to test for differences in the Enhanced-CT relative to the EDUC group. RESULTS: We consented and randomized 138 dyads: Enhanced-CT = 68 and EDUC = 70. The Enhanced-CT group had a greater increase in caregiver self-efficacy for cancer symptom management and stress management and preparation for caregiving at the post-training assessment compared to the EDUC group but not at 2- and 4-week post-discharge assessments. There were no intervention group differences in depression, anxiety, and burden. CONCLUSION: An Enhanced-CT protocol resulted in short-term improvements in self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving but not in caregivers' psychological well-being. The lack of sustained effects may be related to the single-dose nature of our intervention and the changing needs of informal caregivers after hospital discharge.}, Doi = {10.1007/s00520-015-2797-3}, Key = {fds273586} } @article{fds273589, Author = {Naylor, JC and Kilts, JD and Szabo, ST and Dunn, CE and Keefe, FJ and Tupler, LA and Shampine, LJ and Morey, RA and Strauss, JL and Hamer, RM and Wagner, HR and MIRECC Workgroup, and Marx, CE}, Title = {Allopregnanolone Levels Are Inversely Associated with Self-Reported Pain Symptoms in U.S. Iraq and Afghanistan-Era Veterans: Implications for Biomarkers and Therapeutics.}, Journal = {Pain Med}, Volume = {17}, Number = {1}, Pages = {25-32}, Year = {2016}, Month = {January}, ISSN = {1526-2375}, url = {http://hdl.handle.net/10161/10962 Duke open access}, Abstract = {BACKGROUND AND OBJECTIVES: Pain symptoms are common among Iraq/Afghanistan-era veterans, many of whom continue to experience persistent pain symptoms despite multiple pharmacological interventions. Preclinical data suggest that neurosteroids such as allopregnanolone demonstrate pronounced analgesic properties, and thus represent logical biomarker candidates and therapeutic targets for pain. Allopregnanolone is also a positive GABAA receptor modulator with anxiolytic, anticonvulsant, and neuroprotective actions in rodent models. We previously reported inverse associations between serum allopregnanolone levels and self-reported pain symptom severity in a pilot study of 82 male veterans. METHODS: The current study investigates allopregnanolone levels in a larger cohort of 485 male Iraq/Afghanistan-era veterans to attempt to replicate these initial findings. Pain symptoms were assessed by items from the Symptom Checklist-90-R (SCL-90-R) querying headache, chest pain, muscle soreness, and low back pain over the past 7 days. Allopregnanolone levels were quantified by gas chromatography/mass spectrometry. RESULTS: Associations between pain ratings and allopregnanolone levels were examined with Poisson regression analyses, controlling for age and smoking. Bivariate nonparametric Mann–Whitney analyses examining allopregnanolone levels across high and low levels of pain were also conducted. Allopregnanolone levels were inversely associated with muscle soreness [P = 0.0028], chest pain [P = 0.032], and aggregate total pain (sum of all four pain items) [P = 0.0001]. In the bivariate analyses, allopregnanolone levels were lower in the group reporting high levels of muscle soreness [P = 0.001]. CONCLUSIONS: These findings are generally consistent with our prior pilot study and suggest that allopregnanolone may function as an endogenous analgesic. Thus, exogenous supplementation with allopregnanolone could have therapeutic potential. The characterization of neurosteroid profiles may also have biomarker utility.}, Doi = {10.1111/pme.12860}, Key = {fds273589} } @article{fds273590, Author = {Buchheit, T and Van de Ven and T and Hsia, H-LJ and McDuffie, M and MacLeod, DB and White, W and Chamessian, A and Keefe, FJ and Buckenmaier, CT and Shaw, AD}, Title = {Pain Phenotypes and Associated Clinical Risk Factors Following Traumatic Amputation: Results from Veterans Integrated Pain Evaluation Research (VIPER).}, Journal = {Pain Med}, Volume = {17}, Number = {1}, Pages = {149-161}, Year = {2016}, Month = {January}, ISSN = {1526-2375}, url = {http://dx.doi.org/10.1111/pme.12848}, Abstract = {OBJECTIVE: To define clinical phenotypes of postamputation pain and identify markers of risk for the development of chronic pain. DESIGN: Cross-sectional study of military service members enrolled 3-18 months after traumatic amputation injury. SETTING: Military Medical Center. SUBJECTS: 124 recent active duty military service members. METHODS: Study subjects completed multiple pain and psychometric questionnaires to assess the qualities of phantom and residual limb pain. Medical records were reviewed to determine the presence/absence of a regional catheter near the time of injury. Subtypes of residual limb pain (somatic, neuroma, and complex regional pain syndrome) were additionally analyzed and associated with clinical risk factors. RESULTS: A majority of enrolled patients (64.5%) reported clinically significant pain (pain score ≥ 3 averaged over previous week). 61% experienced residual limb pain and 58% experienced phantom pain. When analysis of pain subtypes was performed in those with residual limb pain, we found evidence of a sensitized neuroma in 48.7%, somatic pain in 40.8%, and complex regional pain syndrome in 19.7% of individuals. The presence of clinically significant neuropathic residual limb pain was associated with symptoms of PTSD and depression. Neuropathic pain of any severity was associated with symptoms of all four assessed clinical risk factors: depression, PTSD, catastrophizing, and the absence of regional analgesia catheter. CONCLUSIONS: Most military service members in this cohort suffered both phantom and residual limb pain following amputation. Neuroma was a common cause of neuropathic pain in this group. Associated risk factors for significant neuropathic pain included PTSD and depression. PTSD, depression, catastrophizing, and the absence of a regional analgesia catheter were associated with neuropathic pain of any severity.}, Doi = {10.1111/pme.12848}, Key = {fds273590} } @article{fds291329, Author = {Balderson, BH and McCurry, SM and Vitiello, MV and Shortreed, SM and Rybarczyk, BD and Keefe, FJ and Korff, MV}, Title = {Information without Implementation: A Practical Example for Developing a Best Practice Education Control Group.}, Journal = {Behav Sleep Med}, Volume = {14}, Number = {5}, Pages = {514-527}, Year = {2016}, ISSN = {1540-2002}, url = {http://dx.doi.org/10.1080/15402002.2015.1036271}, Abstract = {This article considers methodology for developing an education-only control group and proposes a simple approach to designing rigorous and well-accepted control groups. This approach is demonstrated in a large randomized trial. The Lifestyles trial (n = 367) compared three group interventions: (a) cognitive-behavioral treatment (CBT) for osteoarthritis pain, (b) CBT for osteoarthritis pain and insomnia, and (c) education-only control (EOC). EOC emulated the interventions excluding hypothesized treatment components and controlling for nonspecific treatment effects. Results showed this approach resulted in a control group that was highly credible and acceptable to patients. This approach can be an effective and practical guide for developing high-quality control groups in trials of behavioral interventions.}, Doi = {10.1080/15402002.2015.1036271}, Key = {fds291329} } @article{fds330870, Author = {Askew, RL and Cook, KF and Keefe, FJ and Nowinski, CJ and Cella, D and Revicki, DA and Morgan DeWitt and EM and Michaud, K and Trence, DL and Amtmann, D}, Title = {A PROMIS Measure of Neuropathic Pain Quality.}, Journal = {Value Health}, Volume = {19}, Number = {5}, Pages = {623-630}, Year = {2016}, url = {http://dx.doi.org/10.1016/j.jval.2016.02.009}, Abstract = {OBJECTIVES: Neuropathic pain (NP) is a consequence of many chronic conditions. This study aimed to develop an unidimensional NP scale with scores that represent levels of NP and distinguish between individuals with NP and non-NP conditions. METHODS: A candidate item pool of 42 pain quality descriptors was administered to participants with osteoarthritis, rheumatoid arthritis, diabetic neuropathy, and cancer chemotherapy-induced peripheral neuropathy. A subset of pain quality descriptors (items) that best distinguished between participants with and those without NP conditions were identified. Dimensionality of pain descriptors was evaluated in a development sample and cross-validated in a holdout sample. Item responses were calibrated using an item response theory model, and scores were generated on a T-score metric. NP scale scores were evaluated in terms of the reliability, validity, and ability to distinguish between participants with and without conditions typically associated with NP. RESULTS: Of the 42 initial items, 5 were identified for the Patient-Reported Outcome Measurement Information System (PROMIS) Neuropathic Pain Quality Scale. T scores exhibited good discriminatory ability on the basis of receiver-operator characteristic analysis. Score thresholds that optimize sensitivity and specificity were identified. Construct, criterion, and discriminant validity, and reliability of scale scores were supported. CONCLUSIONS: The five-item Patient-Reported Outcome Measurement Information System (PROMIS PQ-Neuro) Neuropathic Pain Quality Scale is a short and practical measure that can be used to identify patients more likely to have NP and to distinguish levels of NP. The data collected will support future research that targets other unidimensional pain quality domains (e.g., nociceptive pain).}, Doi = {10.1016/j.jval.2016.02.009}, Key = {fds330870} } @article{fds322121, Author = {Somers, TJ and Kelleher, SA and Westbrook, KW and Kimmick, GG and Shelby, RA and Abernethy, AP and Keefe, FJ}, Title = {A Small Randomized Controlled Pilot Trial Comparing Mobile and Traditional Pain Coping Skills Training Protocols for Cancer Patients with Pain.}, Journal = {Pain Res Treat}, Volume = {2016}, Pages = {2473629}, Year = {2016}, url = {http://dx.doi.org/10.1155/2016/2473629}, Abstract = {Psychosocial pain management interventions are efficacious for cancer pain but are underutilized. Recent advances in mobile health (mHealth) technologies provide new opportunities to decrease barriers to access psychosocial pain management interventions. The objective of this study was to gain information about the accessibility and efficacy of mobile pain coping skills training (mPCST) intervention delivered to cancer patients with pain compared to traditional in-person pain coping skills training intervention. This study randomly assigned participants (N = 30) to receive either mobile health pain coping skills training intervention delivered via Skype or traditional pain coping skills training delivered face-to-face (PCST-trad). This pilot trial suggests that mPCST is feasible, presents low burden to patients, may lead to high patient engagement, and appears to be acceptable to patients. Cancer patients with pain in the mPCST group reported decreases in pain severity and physical symptoms as well as increases in self-efficacy for pain management that were comparable to changes in the PCST-trad group (p's < 0.05). These findings suggest that mPCST, which is a highly accessible intervention, may provide benefits similar to an in-person intervention and shows promise for being feasible, acceptable, and engaging to cancer patients with pain.}, Doi = {10.1155/2016/2473629}, Key = {fds322121} } @article{fds273592, Author = {Bastian, LA and Fish, LJ and Gierisch, JM and Stechuchak, KM and Grambow, SC and Keefe, FJ}, Title = {Impact of Smoking Cessation on Subsequent Pain Intensity Among Chronically Ill Veterans Enrolled in a Smoking Cessation Trial.}, Journal = {J Pain Symptom Manage}, Volume = {50}, Number = {6}, Pages = {822-829}, Year = {2015}, Month = {December}, ISSN = {0885-3924}, url = {http://dx.doi.org/10.1016/j.jpainsymman.2015.06.012}, Abstract = {CONTEXT: Prior cross-sectional studies have reported greater pain intensity among persistent smokers compared with nonsmokers or former smokers; yet, few prospective studies have examined how smoking abstinence affects pain intensity. OBJECTIVES: To determine the impact of smoking cessation on subsequent pain intensity in smokers with chronic illness enrolled in a smoking cessation trial. METHODS: We recruited veteran smokers with chronic illness (heart disease, cancer, chronic obstructive pulmonary disease, diabetes, or hypertension) for a randomized controlled smoking cessation trial and prospectively examined pain intensity and smoking status. Participants (n = 380) were asked to rate their pain in the past week from 0 to 10 at baseline and the five-month follow-up. The primary outcome measure was self-reported pain intensity at the five-month follow-up survey. Self-reported smoking status was categorized as an abstainer if patients reported no cigarettes in the seven days before the follow-up survey. RESULTS: In unadjusted analyses, abstainers reported significantly lower pain levels at the five-month follow-up compared with patients who continued to smoke (parameter estimate = -1.07; 95% CI = -1.77, -0.36). In multivariable modeling, abstaining from cigarettes was not associated with subsequent pain intensity at five-month follow-up (parameter estimate = -0.27; 95% CI = -0.79, 0.25). CONCLUSION: Participants who were classified as abstainers did not report significantly different levels of pain intensity than patients who continued to smoke. Future studies should expand on our findings and monitor pain intensity in smoking cessation trials. TRIAL REGISTRATION: ClinicalTrials.govNCT00448344.}, Doi = {10.1016/j.jpainsymman.2015.06.012}, Key = {fds273592} } @article{fds311140, Author = {Burns, JW and Gerhart, JI and Post, KM and Smith, DA and Porter, LS and Schuster, E and Buvanendran, A and Fras, AM and Keefe, FJ}, Title = {The Communal Coping Model of Pain Catastrophizing in Daily Life: A Within-Couples Daily Diary Study.}, Journal = {J Pain}, Volume = {16}, Number = {11}, Pages = {1163-1175}, Year = {2015}, Month = {November}, ISSN = {1526-5900}, url = {http://dx.doi.org/10.1016/j.jpain.2015.08.005}, Abstract = {UNLABELLED: The Communal Coping Model characterizes pain catastrophizing as a coping tactic whereby pain expression elicits assistance and empathic responses from others. Married couples (N = 105 couples; 1 spouse with chronic low back pain) completed electronic daily diary assessments 5 times/day for 14 days. In these diaries, patients reported pain catastrophizing, pain, and function, and perceived spouse support, perceived criticism, and perceived hostility. Non-patient spouses reported on their support, criticism, and hostility directed toward patients, as well as their observations of patient pain and pain behaviors. Hierarchical linear modeling tested concurrent and lagged (3 hours later) relationships. Principal findings included the following: a) within-person increases in pain catastrophizing were positively associated with spouse reports of patient pain behavior in concurrent and lagged analyses; b) within-person increases in pain catastrophizing were positively associated with patient perceptions of spouse support, criticism, and hostility in concurrent analyses; c) within-person increases in pain catastrophizing were negatively associated with spouse reports of criticism and hostility in lagged analyses. Spouses reported patient behaviors that were tied to elevated pain catastrophizing, and spouses changed their behavior during and after elevated pain catastrophizing episodes. Pain catastrophizing may affect the interpersonal environment of patients and spouses in ways consistent with the Communal Coping Model. PERSPECTIVE: Pain catastrophizing may represent a coping response by which individuals' pain expression leads to assistance or empathic responses from others. Results of the present study support this Communal Coping Model, which emphasizes interpersonal processes by which pain catastrophizing, pain, pain behavior, and responses of significant others are intertwined.}, Doi = {10.1016/j.jpain.2015.08.005}, Key = {fds311140} } @article{fds372565, Title = {PAIN AND EMOTIONAL WELL-BEING AS VARIABILITY PREDICTORS AND THE ROLE OF MINDFULNESS IN COMMUNITY-DWELLING OLDER ADULTS}, Journal = {The Gerontologist}, Volume = {55}, Number = {Suppl_2}, Pages = {491-491}, Publisher = {Oxford University Press (OUP)}, Year = {2015}, Month = {November}, url = {http://dx.doi.org/10.1093/geront/gnv210.02}, Doi = {10.1093/geront/gnv210.02}, Key = {fds372565} } @article{fds273565, Author = {Bennell, KL and Rini, C and Keefe, F and French, S and Nelligan, R and Kasza, J and Forbes, A and Dobson, F and Abbott, JH and Dalwood, A and Vicenzino, B and Harris, A and Hinman, RS}, Title = {Effects of Adding an Internet-Based Pain Coping Skills Training Protocol to a Standardized Education and Exercise Program for People With Persistent Hip Pain (HOPE Trial): Randomized Controlled Trial Protocol.}, Journal = {Phys Ther}, Volume = {95}, Number = {10}, Pages = {1408-1422}, Year = {2015}, Month = {October}, ISSN = {0031-9023}, url = {http://dx.doi.org/10.2522/ptj.20150119}, Abstract = {BACKGROUND: Persistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability, and psychological dysfunction. OBJECTIVE: The purpose of this study is to evaluate whether adding an Internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist-instructed home exercise leads to greater reductions in pain and improvements in function. DESIGN: An assessor-, therapist-, and participant-blinded randomized controlled trial will be conducted. SETTING: The study will be conducted in a community setting. PARTICIPANTS: The participants will be 142 people over 50 years of age with self-reported hip pain consistent with hip OA. INTERVENTION: Participants will be randomly allocated to: (1) a control group receiving a 24-week standardized intervention comprising an 8-week Internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or (2) a PCST group receiving an 8-week Internet-based PCST protocol in addition to the control intervention. MEASUREMENTS: Outcomes will be measured at baseline and 8, 24, and 52 weeks, with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant-perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing, and physical activity. Measurements of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost-effectiveness will be assessed at 52 weeks. LIMITATIONS: A self-reported diagnosis of persistent hip pain will be used. CONCLUSIONS: The findings will help determine whether adding an Internet-based PCST protocol to standardized education and physical therapist-instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice toward innovative modes of psychosocial health care provision.}, Doi = {10.2522/ptj.20150119}, Key = {fds273565} } @article{fds273585, Author = {Somers, TJ and Abernethy, AP and Edmond, SN and Kelleher, SA and Wren, AA and Samsa, GP and Keefe, FJ}, Title = {A Pilot Study of a Mobile Health Pain Coping Skills Training Protocol for Patients With Persistent Cancer Pain.}, Journal = {J Pain Symptom Manage}, Volume = {50}, Number = {4}, Pages = {553-558}, Year = {2015}, Month = {October}, ISSN = {0885-3924}, url = {http://dx.doi.org/10.1016/j.jpainsymman.2015.04.013}, Abstract = {CONTEXT: Pain coping skills training (PCST) interventions have shown efficacy for reducing pain and providing other benefits in patients with cancer. However, their reach is often limited because of a variety of barriers (e.g., travel, physical burden, cost, time). OBJECTIVES: This study examined the feasibility and acceptability of a brief PCST intervention delivered to patients in their homes using mobile health (mHealth) technology. Pre-to-post intervention changes in pain, physical functioning, physical symptoms, psychological distress, self-efficacy for pain management, and pain catastrophizing also were examined. METHODS: Patients with a diagnosis of breast, lung, prostate, or colorectal cancer who reported persistent pain (N = 25) participated in a four-session intervention delivered using mHealth technology (videoconferencing on a tablet computer). Participants completed measures of pain, physical functioning, physical symptoms, psychological distress, self-efficacy for pain management, and pain catastrophizing. We also assessed patient satisfaction. RESULTS: Participants completed an average of 3.36 (SD = 1.11) of the four intervention sessions for an overall session completion rate of 84%. Participants reported that the program was of excellent quality and met their needs. Significant preintervention to postintervention differences were found in pain, physical symptoms, psychological distress, and pain catastrophizing. CONCLUSION: The use of mHealth technology is a feasible and acceptable option for delivery of PCST for patients with cancer. This delivery mode is likely to dramatically increase intervention access for cancer patients with pain compared to traditional in-person delivery. Preliminary data also suggest that the program is likely to produce pretreatment to post-treatment decreases in pain and other important outcomes.}, Doi = {10.1016/j.jpainsymman.2015.04.013}, Key = {fds273585} } @article{fds273591, Author = {Kimmick, G and Edmond, SN and Bosworth, HB and Peppercorn, J and Marcom, PK and Blackwell, K and Keefe, FJ and Shelby, RA}, Title = {Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy.}, Journal = {Breast}, Volume = {24}, Number = {5}, Pages = {630-636}, Year = {2015}, Month = {October}, ISSN = {0960-9776}, url = {http://dx.doi.org/10.1016/j.breast.2015.06.010}, Abstract = {PURPOSE: To explore how symptoms and psychosocial factors are related to intentional and unintentional non-adherent medication taking behaviors. METHODS: Included were postmenopausal women with hormone receptor positive, stage I-IIIA breast cancer, who had completed surgery, chemotherapy, and radiation, and were taking endocrine therapy. Self-administered, standardized measures were completed during a routine clinic visit: Brief Fatigue Inventory, Brief Pain Inventory, Menopause Specific Quality of Life Questionnaire, Functional Assessment of Cancer Therapy General and Neurotoxicity scales, and Self-Efficacy for Appropriate Medication Use Scale. Regression analyses were performed to determine the degree to which demographic, medical, symptom, and psychosocial variables, explain intentional, such as changing one's doses or stopping medication, and unintentional, such as forgetting to take one's medication, non-adherent behaviors. RESULTS: Participants were 112 women: mean age 64 (SD = 9) years; 81% white; mean time from surgery 40 (SD = 28) months; 49% received chemotherapy (39% including a taxane); mean time on endocrine therapy, 35 (SD = 29.6) months; 82% taking an aromatase inhibitor. Intentional and unintentional non-adherent behaviors were described in 33.9% and 58.9% of participants, respectively. Multivariate analysis showed that higher self-efficacy for taking medication was associated with lower levels of unintentional (p = 0.002) and intentional (p = 0.004) non-adherent behaviors. The presence of symptoms (p = 0.03) and lower self-efficacy for physician communication (p = 0.009) were associated with higher levels of intentional non-adherent behaviors. CONCLUSIONS: These results suggest that women who report greater symptoms, lower self-efficacy for communicating with their physician, and lower self-efficacy for taking their medication are more likely to engage in both intentional and unintentional non-adherent behaviors.}, Doi = {10.1016/j.breast.2015.06.010}, Key = {fds273591} } @article{fds273639, Author = {Dalton, JA and Higgins, MK and Miller, AH and Keefe, FJ and Khuri, FR}, Title = {Pain Intensity and Pain Interference in Patients With Lung Cancer: A Pilot Study of Biopsychosocial Predictors.}, Journal = {Am J Clin Oncol}, Volume = {38}, Number = {5}, Pages = {457-464}, Year = {2015}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24064756}, Abstract = {OBJECTIVE: To explore biopsychosocial factors (beliefs, depression, catastrophizing cytokines) in individuals newly diagnosed with lung cancer and no pain to determine their relationship at diagnosis and across time and to determine whether these factors contribute to pain intensity or pain interference with function at pain onset. MATERIALS AND METHODS: A longitudinal, exploratory, pilot study was implemented in a private medical center and a VA medical center in the southeast. Twelve subjects not experiencing pain related to cancer of the lung or its treatment were recruited. A Karnofsky status of 40% and hemoglobin of 8 g were required. Five questionnaires were completed and 10 mL of blood was drawn at baseline; 4 questionnaires and blood draws were repeated monthly for 5 months. One baseline questionnaire and a pain assessment were added at final. Demographic, clinical, and questionnaire data were summarized; standardized scale scores were calculated. RESULTS: Biopsychosocial scores that were low at baseline increased from T1-T4 but decreased slightly T5-T6. Individuals with higher pain intensity and higher pain interference at final had higher psychosocial scores at baseline than individuals with lower pain intensity and lower pain interference at final. CONCLUSIONS: Unrelated to disease stage, metastasis, or treatment, unique levels of biopsychosocial factors are observed in patients newly diagnosed with lung cancer who report higher levels of pain intensity and higher levels of pain interference at the time pain occurs. Replication studies are needed to validate this response pattern and determine the value of repeated individual assessments.}, Doi = {10.1097/COC.0b013e3182a79009}, Key = {fds273639} } @article{fds273571, Author = {Tsai, P-F and Chang, JY and Beck, C and Kuo, Y-F and Keefe, FJ and Rosengren, K}, Title = {A supplemental report to a randomized cluster trial of a 20-week Sun-style Tai Chi for osteoarthritic knee pain in elders with cognitive impairment.}, Journal = {Complement Ther Med}, Volume = {23}, Number = {4}, Pages = {570-576}, Year = {2015}, Month = {August}, ISSN = {0965-2299}, url = {http://dx.doi.org/10.1016/j.ctim.2015.06.001}, Abstract = {OBJECTIVE: This was a secondary data analysis of a cluster-randomized clinical trial that tested the efficacy of a 20-week Sun-style Tai Chi (TC) program in reducing pain in community-dwelling elders with cognitive impairment and knee osteoarthritis (OA). The study also examined whether elders' level of cognitive function was related to the outcomes of the TC program. METHOD: Elders (N=55) were recruited from 8 study sites. Each site was randomly assigned to participate in either a 20-week TC or an education program. Verbal report of pain was measured by a Verbal Descriptor Scale (VDS) at weeks 1, 5, 9, 13, 17 and 21 (designated as times 1-6). Pain behaviors and analgesic intake were also recorded at times 1-6. RESULTS: At post-test, scores on the VDS and observed pain behaviors were significantly better in the TC group than in the control group (p=0.008-0.048). The beneficial effects of TC were not associated with cognitive ability. CONCLUSION: These results suggest that TC can be used as an adjunct to pharmacological intervention to relieve OA pain in elders with cognitive impairment. TRIAL REGISTRATION: Clinical Trial.gov NCT01528566.}, Doi = {10.1016/j.ctim.2015.06.001}, Key = {fds273571} } @article{fds273576, Author = {Campbell, L and Stalls-Jernigan, J and Thornton, S and Keefe, FJ and McKee, D}, Title = {Relationship Intimacy and Quality of Life in Black Prostate Cancer Survivors and Partners}, Journal = {PSYCHO-ONCOLOGY}, Volume = {24}, Pages = {330-330}, Publisher = {WILEY-BLACKWELL}, Year = {2015}, Month = {July}, ISSN = {1057-9249}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000358255000601&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds273576} } @article{fds372566, Author = {Sitlinger, AP and Shelby, RA and White, HK and Edmond, SN and Bosworth, HB and Keefe, FJ and Kimmick, GG}, Title = {Grip strength and timed get-up-and-go: Associations with symptoms among women taking adjuvant endocrine therapy.}, Journal = {Journal of Clinical Oncology}, Volume = {33}, Number = {15_suppl}, Pages = {e11564-e11564}, Publisher = {American Society of Clinical Oncology (ASCO)}, Year = {2015}, Month = {May}, url = {http://dx.doi.org/10.1200/jco.2015.33.15_suppl.e11564}, Doi = {10.1200/jco.2015.33.15_suppl.e11564}, Key = {fds372566} } @article{fds273584, Author = {Messier, SP and Callahan, LF and Golightly, YM and Keefe, FJ}, Title = {OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of lifestyle diet and exercise interventions for osteoarthritis.}, Journal = {Osteoarthritis Cartilage}, Volume = {23}, Number = {5}, Pages = {787-797}, Year = {2015}, Month = {May}, ISSN = {1063-4584}, url = {http://dx.doi.org/10.1016/j.joca.2015.03.008}, Abstract = {The objective was to develop a set of "best practices" for use as a primer for those interested in entering the clinical trials field for lifestyle diet and/or exercise interventions in osteoarthritis (OA), and as a set of recommendations for experienced clinical trials investigators. A subcommittee of the non-pharmacologic therapies committee of the OARSI Clinical Trials Working Group was selected by the Steering Committee to develop a set of recommended principles for non-pharmacologic diet/exercise OA randomized clinical trials. Topics were identified for inclusion by co-authors and reviewed by the subcommittee. Resources included authors' expert opinions, traditional search methods including MEDLINE (via PubMed), and previously published guidelines. Suggested steps and considerations for study methods (e.g., recruitment and enrollment of participants, study design, intervention and assessment methods) were recommended. The recommendations set forth in this paper provide a guide from which a research group can design a lifestyle diet/exercise randomized clinical trial in patients with OA.}, Doi = {10.1016/j.joca.2015.03.008}, Key = {fds273584} } @article{fds273597, Author = {Burns, JW and Gerhart, JI and Bruehl, S and Peterson, KM and Smith, DA and Porter, LS and Schuster, E and Kinner, E and Buvanendran, A and Fras, AM and Keefe, FJ}, Title = {Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: Relationships to patient pain and function.}, Journal = {Health Psychol}, Volume = {34}, Number = {5}, Pages = {547-555}, Year = {2015}, Month = {May}, ISSN = {0278-6133}, url = {http://dx.doi.org/10.1037/hea0000091}, Abstract = {OBJECTIVE: The objective of this study was to determine the degree to which patient anger arousal and behavioral anger regulation (expression, inhibition) occurring in the course of daily life was related to patient pain and function as rated by patients and their spouses. METHOD: Married couples (N = 105) (one spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. Patients completed items on their own state anger, behavioral anger expression and inhibition, and pain-related factors. Spouses completed items on their observations of patient pain-related factors. Hierarchical linear modeling was used to test concurrent and lagged relationships. RESULTS: Patient-reported increases in state anger were related to their reports of concurrent increases in pain and pain interference and to spouse reports of patient pain and pain behavior. Patient-reported increases in behavioral anger expression were related to lagged increases in pain intensity and interference and decreases in function. Most of these relationships remained significant with state anger controlled. Patient-reported increases in behavioral anger inhibition were related to concurrent increases in pain interference and decreases in function, which also remained significant with state anger controlled. Patient-reported increases in state anger were related to lagged increases in spouse reports of patient pain intensity and pain behaviors. CONCLUSIONS: Results indicate that in patients with chronic pain, anger arousal and behavioral anger expression and inhibition in everyday life are related to elevated pain intensity and decreased function as reported by patients. Spouse ratings show some degree of concordance with patient reports.}, Doi = {10.1037/hea0000091}, Key = {fds273597} } @article{fds311141, Author = {Rini, C and Porter, LS and Somers, TJ and McKee, DC and DeVellis, RF and Smith, M and Winkel, G and Ahern, DK and Goldman, R and Stiller, JL and Mariani, C and Patterson, C and Jordan, JM and Caldwell, DS and Keefe, FJ}, Title = {Automated Internet-based pain coping skills training to manage osteoarthritis pain: a randomized controlled trial.}, Journal = {Pain}, Volume = {156}, Number = {5}, Pages = {837-848}, Year = {2015}, Month = {May}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1097/j.pain.0000000000000121}, Abstract = {Osteoarthritis (OA) places a significant burden on worldwide public health because of the large and growing number of people affected by OA and its associated pain and disability. Pain coping skills training (PCST) is an evidence-based intervention targeting OA pain and disability. To reduce barriers that currently limit access to PCST, we developed an 8-week, automated, Internet-based PCST program called PainCOACH and evaluated its potential efficacy and acceptability in a small-scale, 2-arm randomized controlled feasibility trial. Participants were 113 men and women with clinically confirmed hip or knee OA and associated pain. They were randomized to a group completing PainCOACH or an assessment-only control group. Osteoarthritis pain, pain-related interference with functioning, pain-related anxiety, self-efficacy for pain management, and positive and negative affect were measured before intervention, midway through the intervention, and after intervention. Findings indicated high acceptability and adherence: 91% of participants randomized to complete PainCOACH finished all 8 modules over 8 to 10 weeks. Linear mixed models showed that, after treatment, women who received the PainCOACH intervention reported significantly lower pain than that in women in the control group (Cohen d = 0.33). Intervention effects could not be tested in men because of their low pain and small sample size. Additionally, both men and women demonstrated increases in self-efficacy from baseline to after intervention compared with the control group (d = 0.43). Smaller effects were observed for pain-related anxiety (d = 0.20), pain-related interference with functioning (d = 0.13), negative affect (d = 0.10), and positive affect (d = 0.24). Findings underscore the value of continuing to develop an automated Internet-based approach to disseminate this empirically supported intervention.}, Doi = {10.1097/j.pain.0000000000000121}, Key = {fds311141} } @article{fds273579, Author = {Raja, SN and Keefe, FJ}, Title = {An introduction to the biennial review of pain.}, Journal = {Pain}, Volume = {156 Suppl 1}, Pages = {S1}, Year = {2015}, Month = {April}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1097/j.pain.0000000000000112}, Doi = {10.1097/j.pain.0000000000000112}, Key = {fds273579} } @article{fds371060, Author = {Somers, TJ and Kelleher, SA and Edmond, SN and Wren, AA and Fisher, HM and Abernethy, AP and Keefe, FJ}, Title = {TWO PHASES OF PILOTING A MHEALTH BEHAVIORAL INTERVENTION FOR CANCER PAIN}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {49}, Pages = {S217-S217}, Publisher = {SPRINGER}, Year = {2015}, Month = {April}, Key = {fds371060} } @article{fds371061, Author = {Kelleher, SA and Fisher, HM and Shelby, RA and Sullivan, KM and Abernethy, AP and Keefe, FJ and Somers, TJ}, Title = {A HYBRID IN-PERSON AND MHEALTH PAIN COPING SKILLS INTERVENTION FOR STEM CELL TRANSPLANT PATIENTS}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {49}, Pages = {S216-S216}, Publisher = {SPRINGER}, Year = {2015}, Month = {April}, Key = {fds371061} } @article{fds371062, Author = {Edmond, SN and Shelby, RA and Keefe, FJ and Soo, MS and Skinner, CS and Ahrendt, G and Manculich, J and Sumkin, JH and Zuley, M and Bovbjerg, DH}, Title = {ANXIETY AND NEGATIVE MOOD FOLLOWING MAMMOGRAPHY SCREENING FOR BREAST CANCER}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {49}, Pages = {S6-S6}, Publisher = {SPRINGER}, Year = {2015}, Month = {April}, Key = {fds371062} } @article{fds372567, Author = {Nicholson, RJ and Hunold, KM and Weaver, MA and Lytle, LA and Keefe, FJ and McLean, SA and Plans-Mills, TF}, Title = {Effect of Reduced Physical Activity on the Development of Persistent Pain After Motor Vehicle Collision in Older Adults: a Propensity Score-Matched Analysis}, Journal = {JOURNAL OF THE AMERICAN GERIATRICS SOCIETY}, Volume = {63}, Pages = {S102-S102}, Publisher = {WILEY-BLACKWELL}, Year = {2015}, Month = {April}, Key = {fds372567} } @article{fds372568, Author = {Nilsen, W and Stirrat, M and Atienza, AA and Elwood, W and Fitzsimmons, S and Davidson, KW and Keefe, FJ and Spruijt-Metz, D}, Title = {NIH GRANTWRITING WORKSHOP}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {49}, Pages = {S1-S1}, Publisher = {SPRINGER}, Year = {2015}, Month = {April}, Key = {fds372568} } @article{fds372569, Author = {Burns, J and Gerhart, J and Bruehl, S and Smith, D and Post, K and Keefe, FJ}, Title = {SLEEP QUALITY, PAIN AND FUNCTION IN PEOPLE WITH CHRONIC LOW BACK PAIN: A DAILY DIARY STUDY}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {49}, Pages = {S168-S168}, Publisher = {SPRINGER}, Year = {2015}, Month = {April}, Key = {fds372569} } @article{fds372570, Author = {Butryn, ML and Forman, E and Keefe, FJ and Sherwood, NE and Stevens, VJ}, Title = {BUILDING AND MANAGING A CLINICAL RESEARCH TEAM}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {49}, Pages = {S53-S53}, Publisher = {SPRINGER}, Year = {2015}, Month = {April}, Key = {fds372570} } @article{fds273583, Author = {Edmond, SN and Keefe, FJ}, Title = {Validating pain communication: current state of the science.}, Journal = {Pain}, Volume = {156}, Number = {2}, Pages = {215-219}, Year = {2015}, Month = {February}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1097/01.j.pain.0000460301.18207.c2}, Doi = {10.1097/01.j.pain.0000460301.18207.c2}, Key = {fds273583} } @article{fds273615, Author = {Golightly, YM and Allen, KD and Stechuchak, KM and Coffman, CJ and Keefe, FJ}, Title = {Associations of coping strategies with diary based pain variables among Caucasian and African American patients with osteoarthritis.}, Journal = {Int J Behav Med}, Volume = {22}, Number = {1}, Pages = {101-108}, Year = {2015}, Month = {February}, ISSN = {1070-5503}, url = {http://dx.doi.org/10.1007/s12529-013-9365-3}, Abstract = {PURPOSE: The purposes of this study are to examine the associations between pain coping strategies and daily diary-based pain measures and to determine whether these associations differed by race (African American and Caucasian). METHODS: Primary care patients from the Durham Veterans Affairs and Duke University Medical Centers (N = 153) with hand, hip, or knee osteoarthritis (OA) completed electronic pain diaries on a one-weekend day and one weekday. The maximum, range (maximum minus minimum pain), and area under the curve (AUC) of joint pain ratings were calculated. Pain coping (Coping Strategies Questionnaire (CSQ) coping attempts, catastrophizing, and praying/hoping subscale scores) was assessed prior to diary entries and at the end of each diary day (total, problem-focused, and emotion-focused scores from Stone and Neale's Daily Coping Inventory). Pearson correlations between pain variables and coping measures were examined. Linear mixed models were fit including age, race, weekend/weekday, study enrollment site, education level, pain medication use, self-rated health, Arthritis Impact Measurement Scales affect and function subscales, and interactions of coping measures with race and weekend day/weekday status. RESULTS: Correlations between coping and pain measures were 0.12-0.45. In adjusted models, maximum pain and pain range were associated with all three diary-based coping measures; maximum pain was associated with CSQ coping attempts; and AUC was associated with CSQ praying/hoping. Interactions were not significant. CONCLUSIONS: Among participants with OA, pain coping strategies were related to important aspects of the pain experience, particularly pain range and maximum pain. However, race did not modify associations of pain coping strategy use and the pain experience.}, Doi = {10.1007/s12529-013-9365-3}, Key = {fds273615} } @article{fds273582, Author = {Coghill, RC and Keefe, FJ}, Title = {Quantitative sensory testing in predicting persistent pain after joint replacement surgery: promise and challenges.}, Journal = {Pain}, Volume = {156}, Number = {1}, Pages = {4-5}, Year = {2015}, Month = {January}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.0000000000000025}, Doi = {10.1016/j.pain.0000000000000025}, Key = {fds273582} } @article{fds322762, Author = {Keefe, FJ}, Title = {PAIN®: our "new look".}, Journal = {Pain}, Volume = {156}, Number = {1}, Pages = {1-2}, Year = {2015}, Month = {January}, url = {http://dx.doi.org/10.1016/j.pain.0000000000000029}, Doi = {10.1016/j.pain.0000000000000029}, Key = {fds322762} } @article{fds330872, Author = {Trost, Z and Zielke, M and Guck, A and Nowlin, L and Zakhidov, D and France, CR and Keefe, F}, Title = {The promise and challenge of virtual gaming technologies for chronic pain: the case of graded exposure for low back pain.}, Journal = {Pain Manag}, Volume = {5}, Number = {3}, Pages = {197-206}, Year = {2015}, url = {http://dx.doi.org/10.2217/pmt.15.6}, Abstract = {Virtual reality (VR) technologies have been successfully applied to acute pain interventions and recent reviews have suggested their potential utility in chronic pain. The current review highlights the specific relevance of VR interactive gaming technologies for pain-specific intervention, including their current use across a variety of physical conditions. Using the example of graded-exposure treatment for pain-related fear and disability in chronic low back pain, we discuss ways that VR gaming can be harnessed to optimize existing chronic pain therapies and examine the potential limitations of traditional VR interfaces in the context of chronic pain. We conclude by discussing directions for future research on VR-mediated applications in chronic pain.}, Doi = {10.2217/pmt.15.6}, Key = {fds330872} } @article{fds330578, Author = {Rini, C and Porter, LS and Somers, TJ and McKee, DC and Keefe, FJ}, Title = {Retaining critical therapeutic elements of behavioral interventions translated for delivery via the Internet: recommendations and an example using pain coping skills training.}, Journal = {J Med Internet Res}, Volume = {16}, Number = {12}, Pages = {e245}, Year = {2014}, Month = {December}, url = {http://dx.doi.org/10.2196/jmir.3374}, Abstract = {Evidence supporting the efficacy of behavioral interventions based on principles of cognitive behavioral therapies has spurred interest in translating these interventions for delivery via the Internet. However, the benefits of this dissemination method cannot be realized unless the translated interventions are as effective as possible. We describe a challenge that must be overcome to ensure this occurs--Internet interventions must retain therapeutic components and processes underlying the success of face-to-face interventions on which they are based. These components and processes vary in the ease with which they can be translated to the online environment. Moreover, some are subtle and may be overlooked, despite being recognized as essential to the success of face-to-face interventions. We provide preliminary guidance for retaining critical therapeutic components and processes in the translation process, using Pain Coping Skills Training for osteoarthritis pain to illustrate methods. Directions for future research are also discussed.}, Doi = {10.2196/jmir.3374}, Key = {fds330578} } @article{fds273612, Author = {Gere, J and Martire, LM and Keefe, FJ and Stephens, MAP and Schulz, R}, Title = {Spouse confidence in self-efficacy for arthritis management predicts improved patient health.}, Journal = {Ann Behav Med}, Volume = {48}, Number = {3}, Pages = {337-346}, Year = {2014}, Month = {December}, ISSN = {0883-6612}, url = {http://dx.doi.org/10.1007/s12160-014-9608-9}, Abstract = {BACKGROUND: In addition to patient self-efficacy, spouse confidence in patient efficacy may also independently predict patient health outcomes. However, the potential influence of spouse confidence has received little research attention. PURPOSE: The current study examined the influence of patient and spouse efficacy beliefs for arthritis management on patient health. METHODS: Patient health (i.e., arthritis severity, perceived health, depressive symptoms, lower extremity function), patient self-efficacy, and spouse confidence in patients' efficacy were assessed in a sample of knee osteoarthritis patients (N = 152) and their spouses at three time points across an 18-month period. Data were analyzed using structural equation models. RESULTS: Consistent with predictions, spouse confidence in patient efficacy for arthritis management predicted improvements in patient depressive symptoms, perceived health, and lower extremity function over 6 months and in arthritis severity over 1 year. CONCLUSIONS: Our findings add to a growing literature that highlights the important role of spouse perceptions in patients' long-term health.}, Doi = {10.1007/s12160-014-9608-9}, Key = {fds273612} } @article{fds273578, Author = {Musey, PI and Linnstaedt, SD and Platts-Mills, TF and Miner, JR and Bortsov, AV and Safdar, B and Bijur, P and Rosenau, A and Tsze, DS and Chang, AK and Dorai, S and Engel, KG and Feldman, JA and Fusaro, AM and Lee, DC and Rosenberg, M and Keefe, FJ and Peak, DA and Nam, CS and Patel, RG and Fillingim, RB and McLean, SA}, Title = {Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section.}, Journal = {Acad Emerg Med}, Volume = {21}, Number = {12}, Pages = {1421-1430}, Year = {2014}, Month = {December}, ISSN = {1069-6563}, url = {http://dx.doi.org/10.1111/acem.12529}, Abstract = {Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender differences in the assessment and treatment of pain conditions in emergency care settings.}, Doi = {10.1111/acem.12529}, Key = {fds273578} } @article{fds273581, Author = {Blumenthal, JA and Emery, CF and Smith, PJ and Keefe, FJ and Welty-Wolf, K and Mabe, S and Martinu, T and Johnson, JJ and Babyak, MA and O'Hayer, VF and Diaz, PT and Durheim, M and Baucom, D and Palmer, SM}, Title = {The effects of a telehealth coping skills intervention on outcomes in chronic obstructive pulmonary disease: primary results from the INSPIRE-II study.}, Journal = {Psychosom Med}, Volume = {76}, Number = {8}, Pages = {581-592}, Year = {2014}, Month = {October}, ISSN = {0033-3174}, url = {http://dx.doi.org/10.1097/PSY.0000000000000101}, Abstract = {OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is associated with increased morbidity and mortality and reduced quality of life (QoL). Novel interventions are needed to improve outcomes in COPD patients. The present study assessed the effects of a telephone-based coping skills intervention on psychological and somatic QoL and on the combined medical end point of COPD-related hospitalizations and all-cause mortality. METHODS: We conducted a dual-site, randomized clinical trial with assessments at baseline and after 16 weeks of treatment. The study population comprised 326 outpatients with COPD aged 38 to 81 years, randomized to coping skills training (CST) or to COPD education (COPD-ED). Patients completed a battery of QoL instruments, pulmonary function tests, and functional measures and were followed up for up to 4.4 years to assess medical outcomes. RESULTS: The CST group exhibited greater improvements in psychological QoL compared with controls (p = .001), including less depression (Cohen d = 0.22 [95% confidence interval, or CI = 0.08-0.36]) and anxiety (d = 0.17 [95% CI = 0.02-0.33]), and better overall mental health (d = 0.17 [95% CI = 0.03-0.32]), emotional role functioning (d = 0.29 [95% CI = 0.10-0.48]), vitality (d = 0.27 [95% CI = 0.11, 0.42]), and social functioning (d = 0.21 [95% CI = 0.03-0.38]). A significant baseline psychological QoL by treatment group interaction revealed that CST with lower QoL at baseline achieved even greater improvements in psychological QoL compared with COPD-ED. CST participants also exhibited greater improvements in somatic QoL (p = .042), including greater improvements in pulmonary QoL (d = 0.13 [95% CI = 0.01-0.24]), less fatigue (d = 0.34 [95% CI = 0.18-0.50]), and less shortness of breath (d = 0.11 [95% CI = -0.01 to 0.23]) and greater improvement in distance walked on the Six-Minute Walk test (d = 0.09 [95% CI = 0.01-0.16]). However, there was no significant difference in risk of time to COPD-related hospitalization or all-cause mortality between CST (34 events) and COPD-ED (32 events; p = 0.430). CONCLUSIONS: A telehealth CST intervention produced clinically meaningful improvements in QoL and functional capacity, but no overall improvement in risk of COPD-related hospitalization and all-cause mortality. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00736268.}, Doi = {10.1097/PSY.0000000000000101}, Key = {fds273581} } @article{fds273595, Author = {Boeding, SE and Pukay-Martin, ND and Baucom, DH and Porter, LS and Kirby, JS and Gremore, TM and Keefe, FJ}, Title = {Couples and breast cancer: women's mood and partners' marital satisfaction predicting support perception.}, Journal = {J Fam Psychol}, Volume = {28}, Number = {5}, Pages = {675-683}, Year = {2014}, Month = {October}, ISSN = {0893-3200}, url = {http://dx.doi.org/10.1037/fam0000019}, Abstract = {Women who are diagnosed with breast cancer can experience an array of psychosocial difficulties; however, social support, particularly from a spouse, has been shown to have a protective function during this time. This study examined the ways in which a woman's daily mood, pain, and fatigue, and her spouse's marital satisfaction predict the woman's report of partner support in the context of breast cancer. Pretest data from a larger intervention study and multilevel modeling were used to examine the effects of women's daily mood, pain, and fatigue and average levels of mood, pain, and fatigue on women's report of social support received from her partner, as well as how the effects of mood interacted with partners' marital satisfaction. Results show that on days in which women reported higher levels of negative or positive mood, as well as on days they reported more pain and fatigue, they reported receiving more support. Women who, on average, reported higher levels of positive mood tended to report receiving more support than those who, on average, reported lower positive mood. However, average levels of negative mood were not associated with support. Higher average levels of fatigue but not pain were associated with higher support. Finally, women whose husbands reported higher levels of marital satisfaction reported receiving more partner support, but husbands' marital satisfaction did not moderate the effect of women's mood on support. Implications of these findings are discussed relative to assisting couples during this difficult time in their lives.}, Doi = {10.1037/fam0000019}, Key = {fds273595} } @article{fds273605, Author = {Bryant, C and Lewis, P and Bennell, KL and Ahamed, Y and Crough, D and Jull, GA and Kenardy, J and Nicholas, MK and Keefe, FJ}, Title = {Can physical therapists deliver a pain coping skills program? An examination of training processes and outcomes.}, Journal = {Phys Ther}, Volume = {94}, Number = {10}, Pages = {1443-1454}, Year = {2014}, Month = {October}, ISSN = {0031-9023}, url = {http://dx.doi.org/10.2522/ptj.20130444}, Abstract = {BACKGROUND: Physical therapists are well established as providers of treatments for common, painful, and disabling conditions, such as knee osteoarthritis (OA). Thus, they are well placed to deliver treatments that integrate physical and psychosocial elements. Attention is usually given to outcomes of such programs, but few studies have examined the processes and outcomes of training physical therapists to deliver such treatments. OBJECTIVE: The aim of this study was to describe the processes in training physical therapists: (1) to deliver a standardized pain coping skills treatment and (2) to evaluate the effectiveness of that training. DESIGN: This study was an analysis of data relating to therapist performance in a randomized clinical trial. METHODS: Eleven physical therapists were trained to deliver a 10-session pain coping skills training program for people with knee OA as part of a randomized controlled trial (N=222). The initial training was provided in a workshop format and included extensive, ongoing supervision by a psychologist and rigorous use of well-defined performance criteria to assess competence. Adherence to the program, ratings of performance, and use of advanced skills were all measured against these criteria in a sample (n=74, 10%) of the audio recordings of the intervention sessions. RESULTS: Overall, the physical therapists achieved a very high standard of treatment delivery, with 96.6% adherence to the program and mean performance ratings all in the satisfactory range. These results were maintained throughout the intervention and across all sessions. LIMITATIONS: Only 10% of the delivered sessions were analyzed, and the physical therapists who took part in the study were a self-selected group. CONCLUSIONS: This study demonstrated that a systematic approach to training and accrediting physical therapists to deliver a standardized pain coping skills program can result in high and sustained levels of adherence to the program. Training fidelity was achieved in this group of motivated clinicians, but the supervision provided was time intensive. The data provide a promising indicator of greater potential for psychologically informed practice to be a feature of effective health care.}, Doi = {10.2522/ptj.20130444}, Key = {fds273605} } @article{fds273608, Author = {Shelby, RA and Edmond, SN and Wren, AA and Keefe, FJ and Peppercorn, JM and Marcom, PK and Blackwell, KL and Kimmick, GG}, Title = {Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy.}, Journal = {Support Care Cancer}, Volume = {22}, Number = {10}, Pages = {2851-2859}, Year = {2014}, Month = {October}, ISSN = {0941-4355}, url = {http://dx.doi.org/10.1007/s00520-014-2269-1}, Abstract = {PURPOSE: This study examined the relationships between physical symptoms, self-efficacy for coping with symptoms, and functional, emotional, and social well-being in women who were taking adjuvant endocrine therapy for breast cancer. METHODS: One hundred and twelve women who were taking adjuvant endocrine therapy (tamoxifen or an aromatase inhibitor) for breast cancer completed measures of physical symptoms, self-efficacy for coping with symptoms, and functional, social, and emotional well-being at the time of routine medical follow-up (women were on average 3.4 years post-surgery; range 3 months to 11 years). RESULTS: Multiple linear regression analyses showed that higher self-efficacy for coping with symptoms was associated with greater functional, emotional, and social well-being after controlling for physical symptoms (p < 0.05). Self-efficacy for coping with symptoms moderated the relationship between physical symptoms and functional (B = 0.05, SE = 0.02, t = 2.67, p = 0.009) and emotional well-being (B = 0.03, SE = 0.01, t = 2.45, p = 0.02). As self-efficacy increased, the relationship between greater physical symptoms and lower well-being became weaker. Among women with high levels of self-efficacy, physical symptoms were not related to functional and emotional well-being. CONCLUSIONS: Self-efficacy for coping with symptoms may reduce the negative impact of physical symptoms and contribute to well-being in breast cancer survivors taking adjuvant endocrine therapy. Future studies could examine whether psychosocial interventions aimed at increasing self-efficacy for managing symptoms help women better cope with treatment side effects and improve quality of life.}, Doi = {10.1007/s00520-014-2269-1}, Key = {fds273608} } @article{fds273596, Author = {Barsky Reese and J and Porter, LS and Regan, KR and Keefe, FJ and Azad, NS and Diaz, LA and Herman, JM and Haythornthwaite, JA}, Title = {A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer.}, Journal = {Psychooncology}, Volume = {23}, Number = {9}, Pages = {1005-1013}, Year = {2014}, Month = {September}, ISSN = {1057-9249}, url = {http://dx.doi.org/10.1002/pon.3508}, Abstract = {BACKGROUND: We previously developed and piloted a telephone-based intimacy enhancement (IE) intervention addressing sexual concerns of colorectal cancer patients and their partners in an uncontrolled study. The current study tested the feasibility, acceptability, and preliminary efficacy of the IE intervention in a randomized, controlled trial. METHODS: Twenty-three couples were randomized to either the four-session IE condition or to a wait list control condition and completed sexual and relationship outcomes measures. The IE intervention teaches skills for coping with sexual concerns and improving intimacy. Feasibility and acceptability were assessed through enrollment and post-treatment program evaluations, respectively. Effect sizes were calculated by comparing differences in average pre/post change scores across completers in the two groups (n = 18 couples). RESULTS: Recruitment and attrition data supported feasibility. Program evaluations for process (e.g., ease of participation) and content (e.g., relevance) demonstrated acceptability. Engaging in intimacy-building activities and communication were the skills rated as most commonly practiced and most helpful. For patients, positive effects of the IE intervention were found for female and male sexual function, medical impact on sexual function, and self-efficacy for enjoying intimacy (≥.58); no effects were found on sexual distress or intimacy and small negative effects for sexual communication, and two self-efficacy items. For partners, positive IE effects were found for all outcomes; the largest were for sexual distress (.69), male sexual function (1.76), communication (.97), and two self-efficacy items (≥.87). CONCLUSIONS: The telephone-based IE intervention shows promise for couples facing colorectal cancer. Larger multi-site intervention studies are necessary to replicate findings.}, Doi = {10.1002/pon.3508}, Key = {fds273596} } @article{fds273606, Author = {Broderick, JE and Keefe, FJ and Bruckenthal, P and Junghaenel, DU and Schneider, S and Schwartz, JE and Kaell, AT and Caldwell, DS and McKee, D and Reed, S and Gould, E}, Title = {Nurse practitioners can effectively deliver pain coping skills training to osteoarthritis patients with chronic pain: A randomized, controlled trial.}, Journal = {Pain}, Volume = {155}, Number = {9}, Pages = {1743-1754}, Year = {2014}, Month = {September}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2014.05.024}, Abstract = {A multisite, randomized, controlled clinical effectiveness trial was conducted for osteoarthritis patients with chronic pain of the knee or hip. Adult health nurse practitioners provided a 10-session intervention, pain coping skills training (PCST), in patients' doctors' offices (N=129 patients); the control group received usual care (N=127 patients). Primary outcomes assessed at baseline, posttreatment, 6-month follow-up, and 12-month follow-up were: pain intensity, physical functioning, psychological distress, self-efficacy, catastrophizing, use of coping strategies, and quality of life. Secondary measures included fatigue, social functioning, health satisfaction, and use of pain medication. Methods favoring external validity, consistent with pragmatic, effectiveness research, were utilized. Primary ITT and secondary per-protocol analyses were conducted. Attrition was within the expected range: 11% at posttreatment and 29% at 12-month follow-up; rates did not differ between groups. Omnibus ITT analyses across all assessment points indicated significant improvement for the PCST group compared with the control group for pain intensity, physical functioning, psychological distress, use of pain coping strategies, and self-efficacy, as well as fatigue, satisfaction with health, and reduced use of pain medication. Treatment effects were robust to covariates (demographics and clinical sites). Trends in the outcomes across the assessments were examined. All outcomes, except for self-efficacy, were maintained through the 12-month follow-up; effects for self-efficacy degraded over time. Per-protocol analyses did not yield greater effect sizes. Comparisons of PCST patients who were more vs less treatment adherent suggested greater effectiveness for patients with high adherence. Results support the effectiveness of nurse practitioner delivery of PCST for chronic osteoarthritis pain.}, Doi = {10.1016/j.pain.2014.05.024}, Key = {fds273606} } @article{fds273618, Author = {Bartley, EJ and Edmond, SN and Wren, AA and Somers, TJ and Teo, I and Zhou, S and Rowe, KA and Abernethy, AP and Keefe, FJ and Shelby, RA}, Title = {Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation.}, Journal = {J Pain Symptom Manage}, Volume = {48}, Number = {3}, Pages = {374-384}, Year = {2014}, Month = {September}, ISSN = {0885-3924}, url = {http://dx.doi.org/10.1016/j.jpainsymman.2013.09.019}, Abstract = {CONTEXT: Holding back, or withholding discussion of disease-related thoughts and emotions, is associated with negative outcomes including lower quality of life, diminished well-being, and relational distress. For patients undergoing hematopoietic stem cell transplantation (HSCT), the degree to which one holds back from discussing illness-related concerns may be an important determinant of social well-being and health; however, this has not been systematically assessed in this population. OBJECTIVES: The purpose of the present study was to assess the moderating effects of holding back discussion of disease-related concerns on the relationship between health-related symptoms and social well-being in adult patients undergoing HSCT. METHODS: Seventy autologous (n = 55) and allogeneic (n = 15) HSCT patients completed measures of holding back, social well-being, and health symptoms (i.e., pain, fatigue, sleep problems, cognitive problems) both before and after transplantation (i.e., three months after transplantation and six months after transplantation). RESULTS: In patients with average to high levels of holding back, health symptoms were significantly related to lower levels of social well-being; however, for patients with low levels of holding back, the relationship between health symptoms and social well-being was not significant. CONCLUSION: The results of the present study suggest that the level of holding back may be important in understanding how health-related symptoms relate to social well-being in patients undergoing HSCT. These findings underscore the importance of addressing how patients undergoing HSCT communicate about their disease with others as this may be related to their adjustment to illness and treatment.}, Doi = {10.1016/j.jpainsymman.2013.09.019}, Key = {fds273618} } @article{fds273593, Author = {Dobson, F and Hinman, RS and French, S and Rini, C and Keefe, F and Nelligan, R and Abbott, JH and Bryant, C and Staples, MP and Dalwood, A and Bennell, KL}, Title = {Internet-mediated physiotherapy and pain coping skills training for people with persistent knee pain (IMPACT - knee pain): a randomised controlled trial protocol.}, Journal = {BMC Musculoskelet Disord}, Volume = {15}, Number = {1}, Pages = {279}, Year = {2014}, Month = {August}, ISSN = {1471-2474}, url = {http://dx.doi.org/10.1186/1471-2474-15-279}, Abstract = {BACKGROUND: Persistent knee pain in people over 50 years of age is often attributable to knee osteoarthritis (OA), a common joint condition that causes physical and psychological dysfunction. Exercise and pain coping skills training (PCST) can help reduce the impact of persistent knee pain, however, access to health professionals who deliver these services can be challenging. With increasing access to the Internet, remotely delivered Internet-based treatment approaches may provide alternatives for healthcare delivery. This pragmatic randomised controlled trial will investigate whether an Internet-delivered intervention that combines PCST and physiotherapist-guided exercise (PCST + Ex) is more effective than online educational material (educational control) in people with persistent knee pain. METHODS/DESIGN: We will recruit 148 people over 50 years of age with self-reported persistent knee pain consistent with knee OA from the Australian community. Following completion of baseline questionnaires, participants will be randomly allocated to access a 3-month intervention of either (i) online educational material, or (ii) the same online material plus an 8-module (once per week) Internet-based PCST program and seven Internet-delivered physiotherapy sessions with a home exercise programs to be performed 3 times per week. Outcomes will be measured at baseline, 3 months and 9 months with the primary time point at 3 months. Primary outcomes are average knee pain on walking (11-point numeric rating scale) and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index subscale). Secondary outcomes include additional measures of knee pain, health-related quality-of-life, perceived global change in symptoms, and potential moderators and mediators of outcomes including self-efficacy for pain management and function, pain coping attempts and pain catastrophising. Other measures of adherence, adverse events, harms, use of health services/co-interventions, and process measures including appropriateness and satisfaction of the intervention, will be collected at 3, 6 and 9 months. DISCUSSION: The findings will help determine the effectiveness and acceptability of Internet access to a combination of interventions that are known to be beneficial to people with persistent knee pain. This study has the potential to guide clinical practice towards innovative modes of healthcare provision. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry reference: ACTRN12614000243617.}, Doi = {10.1186/1471-2474-15-279}, Key = {fds273593} } @article{fds273600, Author = {Lumley, MA and Keefe, FJ and Mosley-Williams, A and Rice, JR and McKee, D and Waters, SJ and Partridge, RT and Carty, JN and Coltri, AM and Kalaj, A and Cohen, JL and Neely, LC and Pahssen, JK and Connelly, MA and Bouaziz, YB and Riordan, PA}, Title = {The effects of written emotional disclosure and coping skills training in rheumatoid arthritis: a randomized clinical trial.}, Journal = {J Consult Clin Psychol}, Volume = {82}, Number = {4}, Pages = {644-658}, Year = {2014}, Month = {August}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037/a0036958}, Abstract = {OBJECTIVE: Two psychological interventions for rheumatoid arthritis (RA) are cognitive-behavioral coping skills training (CST) and written emotional disclosure (WED). These approaches have developed independently, and their combination may be more effective than either one alone. Furthermore, most studies of each intervention have methodological limitations, and each needs further testing. METHOD: We randomized 264 adults with RA in a 2 × 2 factorial design to 1 of 2 writing conditions (WED vs. control writing) followed by 1 of 2 training conditions (CST vs. arthritis education control training). Patient-reported pain and functioning, blinded evaluations of disease activity and walking speed, and an inflammatory marker (C-reactive protein) were assessed at baseline and 1-, 4-, and 12-month follow-ups. RESULTS: Completion of each intervention was high (>90% of patients), and attrition was low (10.2% at 12-month follow-up). Hierarchical linear modeling of treatment effects over the follow-up period, and analyses of covariance at each assessment point, revealed no interactions between writing and training; however, both interventions had main effects on outcomes, with small effect sizes. Compared with control training, CST decreased pain and psychological symptoms through 12 months. The effects of WED were mixed: Compared with control writing, WED reduced disease activity and physical disability at 1 month only, but WED had more pain than control writing on 1 of 2 measures at 4 and 12 months. CONCLUSIONS: The combination of WED and CST does not improve outcomes, perhaps because each intervention has unique effects at different time points. CST improves health status in RA and is recommended for patients, whereas WED has limited benefits and needs strengthening or better targeting to appropriate patients.}, Doi = {10.1037/a0036958}, Key = {fds273600} } @article{fds273601, Author = {Somers, TJ and Wren, AA and Blumenthal, JA and Caldwell, D and Huffman, KM and Keefe, FJ}, Title = {Pain, physical functioning, and overeating in obese rheumatoid arthritis patients: do thoughts about pain and eating matter?}, Journal = {J Clin Rheumatol}, Volume = {20}, Number = {5}, Pages = {244-250}, Year = {2014}, Month = {August}, ISSN = {1076-1608}, url = {http://dx.doi.org/10.1097/RHU.0000000000000124}, Abstract = {BACKGROUND: Obese rheumatoid arthritis (RA) patients have higher levels of pain, disability, and disease activity than do nonobese patients with RA. Patients' health-related thoughts about arthritis and weight may be important to consider in obese patients with RA who face the dual challenge of managing RA and weight. OBJECTIVES: The objective of this study was to examine the relationships of pain catastrophizing, self-efficacy (ie, confidence) for arthritis management and self-efficacy for weight management to important outcomes in obese patients with RA. We expected that after controlling for demographic and medical variables, higher levels of pain catastrophizing and lower levels of confidence would account for significant and unique variance in pain, physical functioning, and overeating. METHODS: Participants had a diagnosis of RA and a body mass index of 28 kg/m or greater and completed self-report questionnaires assessing pain, physical functioning, overeating, pain catastrophizing, self-efficacy for arthritis management, self-efficacy for weight management, and a 6-minute walk test. RESULTS: Pain catastrophizing, self-efficacy for arthritis, and self-efficacy for weight management were significantly and uniquely related to RA-related outcomes. Pain catastrophizing was a significant independent predictor of pain severity (β = 0.38); self-efficacy for arthritis was a significant independent predictor of self-report physical functioning (β = -0.37) and the 6-minute walk performance (β = 0.44), and self-efficacy for weight management was a significant independent predictor of overeating (β = -0.58). CONCLUSIONS: Pain catastrophizing, self-efficacy for arthritis, and self-efficacy for weight management each contributed uniquely to relate to key outcomes in obese patients with RA. Clinicians should consider assessment of thought processes when assessing and intervening with patients who face dual health challenges; unique intervention approaches may be needed for addressing the challenges of arthritis and weight.}, Doi = {10.1097/RHU.0000000000000124}, Key = {fds273601} } @article{fds273604, Author = {Alexander, AM and Flynn, KE and Hahn, EA and Jeffery, DD and Keefe, FJ and Reeve, BB and Schultz, W and Reese, JB and Shelby, RA and Weinfurt, KP}, Title = {Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function.}, Journal = {J Sex Med}, Volume = {11}, Number = {8}, Pages = {1991-1998}, Year = {2014}, Month = {August}, ISSN = {1743-6095}, url = {http://dx.doi.org/10.1111/jsm.12599}, Abstract = {INTRODUCTION: There is a significant gap in research regarding the readability and comprehension of existing sexual function measures. Patient-reported outcome measures may use terms not well understood by respondents with low literacy. AIM: This study aims to test comprehension of words and phrases typically used in sexual function measures to improve validity for all individuals, including those with low literacy. METHODS: We recruited 20 men and 28 women for cognitive interviews on version 2.0 of the Patient-Reported Outcome Measurement Information System(®) (PROMIS(®) ) Sexual Function and Satisfaction measures. We assessed participants' reading level using the word reading subtest of the Wide Range Achievement Test. Sixteen participants were classified as having low literacy. MAIN OUTCOME MEASURES: In the first round of cognitive interviews, each survey item was reviewed by five or more people, at least two of whom had lower than a ninth-grade reading level (low literacy). Patient feedback was incorporated into a revised version of the items. In the second round of interviews, an additional three or more people (at least one with low literacy) reviewed each revised item. RESULTS: Participants with low literacy had difficulty comprehending terms such as aroused, orgasm, erection, ejaculation, incontinence, and vaginal penetration. Women across a range of literacy levels had difficulty with clinical terms like labia and clitoris. We modified unclear terms to include parenthetical descriptors or slang equivalents, which generally improved comprehension. CONCLUSIONS: Common words and phrases used across measures of self-reported sexual function are not universally understood. Researchers should appreciate these misunderstandings as a potential source of error in studies using self-reported measures of sexual function. This study also provides evidence for the importance of including individuals with low literacy in cognitive pretesting during the measure development.}, Doi = {10.1111/jsm.12599}, Key = {fds273604} } @article{fds273610, Author = {Vitiello, MV and McCurry, SM and Shortreed, SM and Baker, LD and Rybarczyk, BD and Keefe, FJ and Von Korff and M}, Title = {Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia.}, Journal = {Pain}, Volume = {155}, Number = {8}, Pages = {1547-1554}, Year = {2014}, Month = {August}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2014.04.032}, Abstract = {UNLABELLED: In a primary care population of 367 older adults (aged ⩾60 years) with osteoarthritis (OA) pain and insomnia, we examined the relationship between short-term improvement in sleep and long-term sleep, pain, and fatigue outcomes through secondary analyses of randomized controlled trial data. Study participants, regardless of experimental treatment received, were classified either as improvers (⩾30% baseline to 2-month reduction on the Insomnia Severity Index [ISI]) or as nonimprovers. After controlling for treatment arm and potential confounders, improvers showed significant, sustained improvements across 18 months compared with nonimprovers in pain severity (P<0.001, adjusted mean difference=-0.51 [95% CI: -0.80, -0.21), arthritis symptoms (P<0.001, 0.63 [0.26, 1.00]), and fear avoidance (P=0.009, -2.27 [-3.95, -0.58]) but not in catastrophizing or depression. Improvers also showed significant, sustained improvements in ISI (P<0.001, -3.03 [-3.74, -2.32]), Pittsburgh Sleep Quality Index Total (P<0.001, -1.45 [-1.97, -0.93]) and general sleep quality (P<0.001, -0.28 [-0.39, -0.16]) scores, Flinders Fatigue Scale (P<0.001, -1.99 [-3.01, -0.98]), and Dysfunctional Beliefs About Sleep Scale (P=0.037, -2.44 [-4.74, -0.15]), but no improvements on the Functional Outcomes of Sleep Questionnaire or the Epworth Sleepiness Scale. We conclude that short-term (2-month) improvements in sleep predicted long-term (9- and 18-month) improvements for multiple measures of sleep, chronic pain, and fatigue. These improvements were not attributable to nonspecific benefits for psychological well-being, such as reduced depression. These findings are consistent with benefits of improved sleep for chronic pain and fatigue among older persons with osteoarthritis pain and comorbid insomnia if robust improvements in sleep are achieved and sustained. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01142349.}, Doi = {10.1016/j.pain.2014.04.032}, Key = {fds273610} } @article{fds273602, Author = {Soo, AE and Shelby, RA and Miller, LS and Balmadrid, MH and Johnson, KS and Wren, AA and Yoon, SC and Keefe, FJ and Soo, MS}, Title = {Predictors of pain experienced by women during percutaneous imaging-guided breast biopsies.}, Journal = {J Am Coll Radiol}, Volume = {11}, Number = {7}, Pages = {709-716}, Year = {2014}, Month = {July}, ISSN = {1546-1440}, url = {http://dx.doi.org/10.1016/j.jacr.2014.01.013}, Abstract = {PURPOSE: The purpose of this study was to evaluate pain experienced during imaging-guided core-needle breast biopsies and to identify factors that predict increased pain perception during procedures. METHODS: In this institutional review board-approved, HIPAA-compliant protocol, 136 women undergoing stereotactically or ultrasound-guided breast biopsy or cyst aspiration were recruited and provided written informed consent. Participants filled out questionnaires assessing anticipated biopsy pain, ongoing breast pain, pain experienced during biopsy, catastrophic thoughts about pain during biopsy, anxiety, perceived communication with the radiologist, chronic life stress, and demographic and medical information. Procedure type, experience level of the radiologist performing the biopsy, number of biopsies, breast density, histology, and tumor size were recorded for each patient. Data were analyzed using Spearman's ρ correlations and a probit regression model. RESULTS: No pain (0 out of 10) was reported by 39.7% of women, mild pain (1-3 out of 10) by 48.5%, and moderate to severe pain (≥4 out of 10) by 11.8% (n = 16). Significant (P < .05) predictors of greater biopsy pain in the probit regression model included younger age, greater prebiopsy breast pain, higher anticipated biopsy pain, and undergoing a stereotactic procedure. Anticipated biopsy pain correlated most strongly with biopsy pain (β = .27, P = .004). CONCLUSIONS: Most patients report minimal pain during imaging-guided biopsy procedures. Women experiencing greater pain levels tended to report higher anticipated pain before the procedure. Communication with patients before biopsy regarding minimal average pain reported during biopsy and encouragement to make use of coping strategies may reduce patient anxiety and anticipated pain.}, Doi = {10.1016/j.jacr.2014.01.013}, Key = {fds273602} } @article{fds273609, Author = {Syrjala, KL and Jensen, MP and Mendoza, ME and Yi, JC and Fisher, HM and Keefe, FJ}, Title = {Psychological and behavioral approaches to cancer pain management.}, Journal = {J Clin Oncol}, Volume = {32}, Number = {16}, Pages = {1703-1711}, Year = {2014}, Month = {June}, ISSN = {0732-183X}, url = {http://dx.doi.org/10.1200/JCO.2013.54.4825}, Abstract = {This review examines evidence for psychological factors that affect pain across the cancer continuum from diagnosis through treatment and long-term survivorship or end of life. Evidence is convincing that emotional distress, depression, anxiety, uncertainty, and hopelessness interact with pain. Unrelieved pain can increase a desire for hastened death. Patients with cancer use many strategies to manage pain, with catastrophizing associated with increased pain and self-efficacy associated with lower pain reports. A variety of psychological and cognitive behavioral treatments can reduce pain severity and interference with function, as indicated in multiple meta-analyses and high-quality randomized controlled trials. Effective methods include education (with coping skills training), hypnosis, cognitive behavioral approaches, and relaxation with imagery. Exercise has been tested extensively in patients with cancer and long-term survivors, but few exercise studies have evaluated pain outcomes. In survivors post-treatment, yoga and hypnosis as well as exercise show promise for controlling pain. Although some of these treatments effectively reduce pain for patients with advanced disease, few have been tested in patients at the end of life. Given the clear indicators that psychological factors affect cancer pain and that psychological and behavioral treatments are effective in reducing varying types of pain for patients with active disease, these methods need further testing in cancer survivors post-treatment and in patients with end-stage disease. Multidisciplinary teams are essential in oncology settings to integrate analgesic care and expertise in psychological and behavioral interventions in standard care for symptom management, including pain.}, Doi = {10.1200/JCO.2013.54.4825}, Key = {fds273609} } @article{fds273611, Author = {Sparling, TL and Schmitt, D and Miller, CE and Guilak, F and Somers, TJ and Keefe, FJ and Queen, RM}, Title = {Energy recovery in individuals with knee osteoarthritis.}, Journal = {Osteoarthritis Cartilage}, Volume = {22}, Number = {6}, Pages = {747-755}, Year = {2014}, Month = {June}, ISSN = {1063-4584}, url = {http://hdl.handle.net/10161/8901 Duke open access}, Abstract = {OBJECTIVE: Pathological gaits have been shown to limit transfer between potential (PE) and kinetic (KE) energy during walking, which can increase locomotor costs. The purpose of this study was to examine whether energy exchange would be limited in people with knee osteoarthritis (OA). METHODS: Ground reaction forces during walking were collected from 93 subjects with symptomatic knee OA (self-selected and fast speeds) and 13 healthy controls (self-selected speed) and used to calculate their center of mass (COM) movements, PE and KE relationships, and energy recovery during a stride. Correlations and linear regressions examined the impact of energy fluctuation phase and amplitude, walking velocity, body mass, self-reported pain, and radiographic severity on recovery. Paired t-tests were run to compare energy recovery between cohorts. RESULTS: Symptomatic knee OA subjects displayed lower energetic recovery during self-selected walking speeds than healthy controls (P = 0.0018). PE and KE phase relationships explained the majority (66%) of variance in recovery. Recovery had a complex relationship with velocity and its change across speeds was significantly influenced by the self-selected walking speed of each subject. Neither radiographic OA scores nor subject self-reported measures demonstrated any relationship with energy recovery. CONCLUSIONS: Knee OA reduces effective exchange of PE and KE, potentially increasing the muscular work required to control movements of the COM. Gait retraining may return subjects to more normal patterns of energy exchange and allow them to reduce fatigue.}, Doi = {10.1016/j.joca.2014.04.004}, Key = {fds273611} } @article{fds372571, Author = {Edmond, SN and Shelby, RA and Keefe, FJ and Soo, MS and Skinner, CS and Stinnett, S and Ahrendt, GM and Manculich, J and Sumkin, JH and Zuley, ML and Bovbjerg, DH}, Title = {Persistent pain following breast cancer surgery: A case-control study.}, Journal = {Journal of Clinical Oncology}, Volume = {32}, Number = {15_suppl}, Pages = {9579-9579}, Publisher = {American Society of Clinical Oncology (ASCO)}, Year = {2014}, Month = {May}, url = {http://dx.doi.org/10.1200/jco.2014.32.15_suppl.9579}, Doi = {10.1200/jco.2014.32.15_suppl.9579}, Key = {fds372571} } @article{fds273617, Author = {Keefe, FJ}, Title = {The changing face of PAIN: New opportunities and new directions.}, Journal = {Pain}, Volume = {155}, Number = {5}, Pages = {839-840}, Year = {2014}, Month = {May}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2014.02.010}, Doi = {10.1016/j.pain.2014.02.010}, Key = {fds273617} } @article{fds371063, Author = {Huysmans, ZZ and Wren, AA and Shelby, RA and Keefe, FJ and Soo, MS}, Title = {IMPACT OF EXPERIENCES AT THE TIME OF BREAST BIOPSY ON KNOWLEDGE OF RECOMMENDED FOLLOW-UP, PERCEIVED CANCER RISK, BELIEFS ABOUT MAMMOGRAPHY, AND PREFERENCES FOR SUPPORT}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {47}, Pages = {S190-S190}, Publisher = {SPRINGER}, Year = {2014}, Month = {April}, Key = {fds371063} } @article{fds371064, Author = {Shelby, RA and Edmond, SN and Soo, MS and Keefe, FJ and Ahrendt, GM and Sumkin, J and Zuley, M and Bovbjerg, DH}, Title = {PERSISTENT POST-SURGICAL PAIN FOLLOWING BREAST CONSERVING SURGERY: LEVELS OF PAIN AND PSYCHOSOCIAL FACTORS}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {47}, Pages = {S189-S189}, Publisher = {SPRINGER}, Year = {2014}, Month = {April}, Key = {fds371064} } @article{fds273616, Author = {Nielsen, M and Keefe, FJ and Bennell, K and Jull, GA}, Title = {Physical therapist-delivered cognitive-behavioral therapy: a qualitative study of physical therapists' perceptions and experiences.}, Journal = {Phys Ther}, Volume = {94}, Number = {2}, Pages = {197-209}, Year = {2014}, Month = {February}, ISSN = {0031-9023}, url = {http://dx.doi.org/10.2522/ptj.20130047}, Abstract = {BACKGROUND: The importance of the biopsychosocial model in assessment and management of chronic musculoskeletal conditions is recognized. Physical therapists have been encouraged to develop psychologically informed practice. Little is known about the process of physical therapists' learning and delivering of psychological interventions within the practice context. OBJECTIVE: The aim of this study was to investigate physical therapists' experiences and perspectives of a cognitive-behavioral-informed training and intervention process as part of a randomized controlled trial (RCT) involving adults with painful knee osteoarthritis. DESIGN: A qualitative design was used. Participants were physical therapists trained to deliver pain coping skills training (PCST). METHODS: Eight physical therapists trained to deliver PCST were interviewed by telephone at 4 time points during the 12-month RCT period. Interviews were audiorecorded, transcribed verbatim into computer-readable files, and analyzed using Framework Analysis. RESULTS: Thematic categories identified were: training, experience delivering PCST, impact on general clinical practice, and perspectives on PCST and physical therapist practice. Physical therapists reported positive experiences with PCST and program delivery. They thought that their participation in the RCT had enhanced their general practice. Although some components of the PCST program were familiar, the therapists found delivering the program was quite different from regular practice. Physical therapists believed the PCST program, a 3- to 4-day workshop followed by formal mentoring and performance feedback from a psychologist for 3 to 6 months and during the RCT, was critical to their ability to effectively deliver the PCST intervention. They identified a number of challenges in delivering PCST in their normal practice. CONCLUSION: Physical therapists can be trained to confidently deliver a PCST program. The physical therapists in this study believed that training enhanced their clinical practice. Comprehensive training and mentoring by psychologists was crucial to ensure treatment fidelity.}, Doi = {10.2522/ptj.20130047}, Key = {fds273616} } @article{fds273625, Author = {Keefe, FJ and Mogil, JS}, Title = {Introducing Pain Classics: a special review series for PAIN®.}, Journal = {Pain}, Volume = {155}, Number = {2}, Pages = {207}, Year = {2014}, Month = {February}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24342466}, Doi = {10.1016/j.pain.2013.12.019}, Key = {fds273625} } @article{fds273642, Author = {Revicki, DA and Cook, KF and Amtmann, D and Harnam, N and Chen, W-H and Keefe, FJ}, Title = {Exploratory and confirmatory factor analysis of the PROMIS pain quality item bank.}, Journal = {Qual Life Res}, Volume = {23}, Number = {1}, Pages = {245-255}, Year = {2014}, Month = {February}, ISSN = {0962-9343}, url = {http://dx.doi.org/10.1007/s11136-013-0467-9}, Abstract = {PURPOSE: The assessment of pain sensation and quality is a key component in understanding the experience of individuals with chronic pain. This study evaluated the factor structure of the patient-reported outcome measurement information system (PROMIS) pain quality item bank. METHODS: As part of the PROMIS project, we developed a pool of 37 pain quality items, based on a review of existing pain questionnaires and development of new items. A web-based survey was designed and completed by 845 members of the general population and 967 individuals with different types of chronic pain. Exploratory factor analysis (EFA) was conducted on a random split-half sample of the data to examine the factor structure of the 37 PROMIS pain quality items in the general population and in a chronic pain sample. A confirmatory factor analysis was conducted in the holdout sample. RESULTS: The EFA of the pain quality items resulted in comparable six-factor solutions for the general and chronic pain samples: (1) pulling/tugging pain; (2) tingling/numbness pain; (3) sharp/stabbing pain; (4) dull/aching pain; (5) pounding/pulsing pain; and (6) affective pain. The confirmatory factor analysis in the holdout sample supported this factor structure. CONCLUSIONS: Further research is needed to evaluate the psychometric characteristics of the derived scales based on their factor scores.}, Doi = {10.1007/s11136-013-0467-9}, Key = {fds273642} } @article{fds273637, Author = {Keefe, FJ}, Title = {Introducing Bridging the Gaps: a new form of special commentary for PAIN®.}, Journal = {Pain}, Volume = {155}, Number = {1}, Pages = {1}, Year = {2014}, Month = {January}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24157893}, Doi = {10.1016/j.pain.2013.10.019}, Key = {fds273637} } @article{fds273577, Author = {Choi, KW and Somers, TJ and Babyak, MA and Sikkema, KJ and Blumenthal, JA and Keefe, FJ}, Title = {The relationship between pain and eating among overweight and obese individuals with osteoarthritis: an ecological momentary study.}, Journal = {Pain Res Manag}, Volume = {19}, Number = {6}, Pages = {e159-e163}, Year = {2014}, ISSN = {1203-6765}, url = {http://dx.doi.org/10.1155/2014/598382}, Abstract = {BACKGROUND: Osteoarthritis (OA) patients who are overweight or obese report higher levels of pain compared with their normal-weight OA counterparts. Evidence suggests that overweight or obese OA patients also experience pain relief from eating foods high in calories, fat or sugar. Eating to alleviate pain may be problematic because it can lead to additional weight gain, which may contribute to heightened pain. OBJECTIVES: To investigate the relationship between pain and food intake using ecological momentary assessments in a sample of 71 overweight and obese OA patients. METHODS: Participants completed two consecutive days of diary entries in which they recorded their levels of pain, mood and food intake throughout the day. Data were analyzed using generalized estimating equations that modelled pain as a predictor of calorie, fat and sugar intake. All models were adjusted for sex, body mass index, negative mood, time and treatment history. RESULTS: Pain significantly predicted calorie (Z=2.57; P=0.01) and fat intake (Z=1.99; P=0.05). CONCLUSIONS: Using ecological momentary assessments as a novel approach, the present study provides preliminary data supporting a relationship between pain and food intake among overweight and obese OA patients. Continued advances in our understanding of the relationship between pain and eating behaviour may help to optimize intervention strategies for these patients.}, Doi = {10.1155/2014/598382}, Key = {fds273577} } @article{fds273594, Author = {Shpaner, M and Kelly, C and Lieberman, G and Perelman, H and Davis, M and Keefe, FJ and Naylor, MR}, Title = {Unlearning chronic pain: A randomized controlled trial to investigate changes in intrinsic brain connectivity following Cognitive Behavioral Therapy.}, Journal = {Neuroimage Clin}, Volume = {5}, Pages = {365-376}, Year = {2014}, ISSN = {2213-1582}, url = {http://dx.doi.org/10.1016/j.nicl.2014.07.008}, Abstract = {Chronic pain is a complex physiological and psychological phenomenon. Implicit learning mechanisms contribute to the development of chronic pain and to persistent changes in the central nervous system. We hypothesized that these central abnormalities can be remedied with Cognitive Behavioral Therapy (CBT). Specifically, since regions of the anterior Default Mode Network (DMN) are centrally involved in emotional regulation via connections with limbic regions, such as the amygdala, remediation of maladaptive behavioral and cognitive patterns as a result of CBT for chronic pain would manifest itself as a change in the intrinsic functional connectivity (iFC) between these prefrontal and limbic regions. Resting-state functional neuroimaging was performed in patients with chronic pain before and after 11-week CBT (n = 19), as well as a matched (ages 19-59, both sexes) active control group of patients who received educational materials (n = 19). Participants were randomized prior to the intervention. To investigate the differential impact of treatment on intrinsic functional connectivity (iFC), we compared pre-post differences in iFC between groups. In addition, we performed exploratory whole brain analyses of changes in fractional amplitude of low frequency fluctuations (fALFF). The course of CBT led to significant improvements in clinical measures of pain and self-efficacy for coping with chronic pain. Significant group differences in pre-post changes in both iFC and fALFF were correlated with clinical outcomes. Compared to control patients, iFC between the anterior DMN and the amygdala/periaqueductal gray decreased following CBT, whereas iFC between the basal ganglia network and the right secondary somatosensory cortex increased following CBT. CBT patients also had increased post-therapy fALFF in the bilateral posterior cingulate and the cerebellum. By delineating neuroplasticity associated with CBT-related improvements, these results add to mounting evidence that CBT is a valuable treatment option for chronic pain.}, Doi = {10.1016/j.nicl.2014.07.008}, Key = {fds273594} } @article{fds273614, Author = {Reese, JB and Porter, LS and Regan, KR and Keefe, FJ and Azad, NS and Diaz, LA and Herman, JM and Haythornthwaite, JA}, Title = {A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer}, Journal = {Psycho-Oncology}, Volume = {23}, Number = {9}, Pages = {1005-1013}, Publisher = {WILEY}, Year = {2014}, ISSN = {1057-9249}, url = {http://dx.doi.org/10.1002/pon.3508}, Doi = {10.1002/pon.3508}, Key = {fds273614} } @article{fds273626, Author = {Tracey, I and Keefe, F}, Title = {Introducing the Biennial Review of Pain.}, Journal = {Pain}, Volume = {154 Suppl 1}, Pages = {S1}, Year = {2013}, Month = {December}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2013.10.017}, Doi = {10.1016/j.pain.2013.10.017}, Key = {fds273626} } @article{fds273632, Author = {Seminowicz, DA and Shpaner, M and Keaser, ML and Krauthamer, GM and Mantegna, J and Dumas, JA and Newhouse, PA and Filippi, CG and Keefe, FJ and Naylor, MR}, Title = {Cognitive-behavioral therapy increases prefrontal cortex gray matter in patients with chronic pain.}, Journal = {J Pain}, Volume = {14}, Number = {12}, Pages = {1573-1584}, Year = {2013}, Month = {December}, ISSN = {1526-5900}, url = {http://dx.doi.org/10.1016/j.jpain.2013.07.020}, Abstract = {UNLABELLED: Several studies have reported reduced cerebral gray matter (GM) volume or density in chronic pain conditions, but there is limited research on the plasticity of the human cortex in response to psychological interventions. We investigated GM changes after cognitive-behavioral therapy (CBT) in patients with chronic pain. We used voxel-based morphometry to compare anatomic magnetic resonance imaging scans of 13 patients with mixed chronic pain types before and after an 11-week CBT treatment and to 13 healthy control participants. CBT led to significant improvements in clinical measures. Patients did not differ from healthy controls in GM anywhere in the brain. After treatment, patients had increased GM in the bilateral dorsolateral prefrontal, posterior parietal, subgenual anterior cingulate/orbitofrontal, and sensorimotor cortices, as well as hippocampus, and reduced GM in supplementary motor area. In most of these areas showing GM increases, GM became significantly higher than in controls. Decreased pain catastrophizing was associated with increased GM in the left dorsolateral prefrontal and ventrolateral prefrontal cortices, right posterior parietal cortex, somatosensory cortex, and pregenual anterior cingulate cortex. Although future studies with additional control groups will be needed to determine the specific roles of CBT on GM and brain function, we propose that increased GM in the prefrontal and posterior parietal cortices reflects greater top-down control over pain and cognitive reappraisal of pain, and that changes in somatosensory cortices reflect alterations in the perception of noxious signals. PERSPECTIVE: An 11-week CBT intervention for coping with chronic pain resulted in increased GM volume in prefrontal and somatosensory brain regions, as well as increased dorsolateral prefrontal volume associated with reduced pain catastrophizing. These results add to mounting evidence that CBT can be a valuable treatment option for chronic pain.}, Doi = {10.1016/j.jpain.2013.07.020}, Key = {fds273632} } @article{fds273633, Author = {Burns, JW and Peterson, KM and Smith, DA and Keefe, FJ and Porter, LS and Schuster, E and Kinner, E}, Title = {Temporal associations between spouse criticism/hostility and pain among patients with chronic pain: a within-couple daily diary study.}, Journal = {Pain}, Volume = {154}, Number = {12}, Pages = {2715-2721}, Year = {2013}, Month = {December}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2013.07.053}, Abstract = {Chronic musculoskeletal pain can strain marriages, perhaps even to the point of engendering spouse criticism and hostility directed toward patients. Such negative spouse responses may have detrimental effects on patient well-being. While results of cross-sectional studies support this notion, we extended these efforts by introducing expressed emotion (EE) and interpersonal theoretical perspectives, and by using electronic diary methods to capture both patient and spouse reports in a prospective design. Patients with chronic low back pain (CLBP) and their spouses (N = 105 couples) reported on perceived spouse behavior and patient pain 5 times/day for 14 days using Personal Data Assistants (PDAs). Concurrent and lagged within-couple associations between patient's perceptions of spouse criticism/hostility and patient self-reported pain and spouses' observations of patient pain behaviors revealed that (1) patient perceived spouse criticism and hostility were correlated significantly with pain intensity, and spouse observed patient pain behavior was related significantly with patient perceived hostility at the same time point; (2) patient perceived spouse hostility significantly predicted patient pain intensity 3 hours later, and spouse observed pain behaviors significantly predicted patient perceived spouse hostility 3 hours later. Results support both EE and interpersonal models, and imply that a comprehensive model would combine these conceptualizations to fully illustrate how spouse criticism/hostility and patient pain interact to produce a negative spiral. Given that marital interactions are amenable to clinical intervention, improved insight into how spouse behavior and patient pain are tightly linked will encourage productive translational efforts to target this neglected area.}, Doi = {10.1016/j.pain.2013.07.053}, Key = {fds273633} } @article{fds273634, Author = {Cook, KF and Keefe, F and Jensen, MP and Roddey, TS and Callahan, LF and Revicki, D and Bamer, AM and Kim, J and Chung, H and Salem, R and Amtmann, D}, Title = {Development and validation of a new self-report measure of pain behaviors.}, Journal = {Pain}, Volume = {154}, Number = {12}, Pages = {2867-2876}, Year = {2013}, Month = {December}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2013.08.024}, Abstract = {Pain behaviors that are maintained beyond the acute stage after injury can contribute to subsequent psychosocial and physical disability. Critical to the study of pain behaviors is the availability of psychometrically sound pain behavior measures. In this study we developed a self-report measure of pain behaviors, the Pain Behaviors Self Report (PaB-SR). PaB-SR scores were developed using item response theory and evaluated using a rigorous, multiple-witness approach to validity testing. Participants included 661 survey participants with chronic pain and with multiple sclerosis, back pain, or arthritis; 618 survey participants who were significant others of a chronic pain participant; and 86 participants in a videotaped pain behavior observation protocol. Scores on the PaB-SR were found to be measurement invariant with respect to clinical condition. PaB-SR scores, observer reports, and the videotaped protocol yielded distinct, but convergent views of pain behavior, supporting the validity of the new measure. The PaB-SR is expected to be of substantial utility to researchers wishing to explore the relationship between pain behaviors and constructs such as pain intensity, pain interference, and disability.}, Doi = {10.1016/j.pain.2013.08.024}, Key = {fds273634} } @article{fds273641, Author = {Wilson, SJ and Martire, LM and Keefe, FJ and Mogle, JA and Stephens, MAP and Schulz, R}, Title = {Daily verbal and nonverbal expression of osteoarthritis pain and spouse responses.}, Journal = {Pain}, Volume = {154}, Number = {10}, Pages = {2045-2053}, Year = {2013}, Month = {October}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2013.06.023}, Abstract = {The current study applied a model of pain communication to examine the distinction between verbal and nonverbal pain expression in their prediction of punishing, empathic, and solicitous spouse responses to patient pain. It was hypothesized that on days when patients engaged in more nonverbal expression, spouses would respond more positively (ie, with less punishing and more solicitous and empathic behavior). The same pattern was predicted for verbal expression. In addition, it was expected that associations between patient nonverbal pain expression and positive spouse responses would be strengthened, and that the association with punishing responses would be weakened, on days when levels of verbal pain expression were higher than usual, regardless of daily pain severity. In a 22-day diary study, 144 individuals with knee osteoarthritis and their spouses completed daily measures of pain expression, spouse responses, health, and affect. The predicted positive main effect of nonverbal expression on empathic and solicitous responses was supported by the data, as was the positive main effect for verbal pain expression. Results from moderation analyses partially supported our hypothesis in that patients' nonverbal pain expression was even more strongly related to empathic and solicitous spouse responses on days of high verbal pain expression, and patients were buffered from spouse punishing responses on days when both nonverbal and verbal expression were high. These findings suggest that pain expression in both verbal and nonverbal modes of communication is important for positive and negative spousal responses.}, Doi = {10.1016/j.pain.2013.06.023}, Key = {fds273641} } @article{fds371065, Author = {Weinfurt, KP and Lin, L and Reese, JB and Bruner, DW and Dombeck, C and Keefe, FJ and Moore, A and Porter, L and Flynn, KE}, Title = {Reasons for sexual inactivity in a US national survey of adults}, Journal = {QUALITY OF LIFE RESEARCH}, Volume = {22}, Pages = {1 pages}, Publisher = {SPRINGER}, Year = {2013}, Month = {October}, Key = {fds371065} } @article{fds371066, Author = {Flynn, KE and Lin, L and Keefe, FJ and Reese, JB and Weinfurt, KP}, Title = {The vulvar discomfort domain of the PROMIS (R) sexual function and satisfaction measure}, Journal = {QUALITY OF LIFE RESEARCH}, Volume = {22}, Pages = {1 pages}, Publisher = {SPRINGER}, Year = {2013}, Month = {October}, Key = {fds371066} } @article{fds273640, Author = {Martire, LM and Keefe, FJ and Schulz, R and Parris Stephens and MA and Mogle, JA}, Title = {The impact of daily arthritis pain on spouse sleep.}, Journal = {Pain}, Volume = {154}, Number = {9}, Pages = {1725-1731}, Year = {2013}, Month = {September}, ISSN = {0304-3959}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000323600000030&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Abstract = {Although chronic pain has been linked to poorer psychosocial well-being in the spouse, the extent to which patient pain affects spouse sleep is unknown. The aim of the present study was to test the hypothesis that greater daily knee pain would be associated with poorer sleep for the spouse that evening. We also tested the hypothesis that this pain contagion is exacerbated in couples who have a close relationship. A total of 138 knee osteoarthritis (OA) patients and their spouses completed baseline interviews and a 22-day diary assessment. Multilevel lagged models indicated that greater knee OA pain at the end of the day was associated with spouses' poorer overall sleep quality that night and feeling less refreshed after sleep. In contrast, there was no evidence that spouse sleep was related to greater patient pain the next day. The effects of patient pain on spouse sleep were not due to disturbances in patient sleep and were also independent of spouse sex, depressive symptoms, and physical comorbidities; both partners' negative affect; and the quality of marital interactions throughout the day. As predicted, we also found that patient pain was more strongly related to less refreshing sleep for spouses who were in a close relationship. Findings illustrate that chronic pain may place the spouse's health at risk and suggest an important target for couple-oriented interventions.}, Doi = {10.1016/j.pain.2013.05.020}, Key = {fds273640} } @article{fds273646, Author = {Lefebvre, JC and Keefe, FJ}, Title = {The effect of neuroticism on the recall of persistent low-back pain and perceived activity interference.}, Journal = {J Pain}, Volume = {14}, Number = {9}, Pages = {948-956}, Year = {2013}, Month = {September}, ISSN = {1526-5900}, url = {http://dx.doi.org/10.1016/j.jpain.2013.03.006}, Abstract = {UNLABELLED: The assessment of persistent pain often relies on recalling and then summarizing the entire pain experience using a single rating. Newer methodologies, such as the Original Pain Recall Assessment, ask people to recall the pain they experienced over a specific period of time by tracing a single line in a graph to represent their pain levels. One advantage of this approach is that one can compare recalled levels of pain with actual daily diary pain ratings. This methodology was used to investigate the effects of neuroticism on the recall of levels and patterns of persistent pain. The study involved 70 participants who completed a measure of neuroticism, depressive symptoms, and up to 15 daily diaries that asked for ratings of pain intensity, pain unpleasantness, and activity interference due to pain. Following completion of the daily diary period, the participants were asked to recall the entire diary period using the Original Pain Recall Assessment methodology. The analyses revealed that higher levels of neuroticism were related to significantly better recall of the variability of pain unpleasantness over time. Furthermore, individuals who reported higher levels of depressive symptoms were less accurate in the recall of pain in general. PERSPECTIVE: Memory for pain is crucial in the assessment of pain, with little research devoted to the study of this topic. The current study demonstrates that people higher on neuroticism had better recall of pain unpleasantness, and people with higher levels of depressive symptoms had poorer recall of pain in general.}, Doi = {10.1016/j.jpain.2013.03.006}, Key = {fds273646} } @article{fds273724, Author = {Cook, KF and Roddey, TS and Bamer, AM and Amtmann, D and Keefe, FJ}, Title = {Validity of an observation method for assessing pain behavior in individuals with multiple sclerosis.}, Journal = {J Pain Symptom Manage}, Volume = {46}, Number = {3}, Pages = {413-421}, Year = {2013}, Month = {September}, ISSN = {0885-3924}, url = {http://dx.doi.org/10.1016/j.jpainsymman.2012.08.006}, Abstract = {CONTEXT: Pain is a common and complex experience for individuals who live with multiple sclerosis (MS) and it interferes with physical, psychological, and social function. A valid and reliable tool for quantifying observed pain behaviors in MS is critical to understand how pain behaviors contribute to pain-related disability in this clinical population. OBJECTIVES: To evaluate the reliability and validity of a pain behavioral observation protocol in individuals who have MS. METHODS: Community-dwelling volunteers with MS (N=30), back pain (N=5), or arthritis (N=8) were recruited based on clinician referrals, advertisements, fliers, web postings, and participation in previous research. Participants completed the measures of pain severity, pain interference, and self-reported pain behaviors and were videotaped doing typical activities (e.g., walking and sitting). Two coders independently recorded frequencies of pain behaviors by category (e.g., guarding and bracing) and interrater reliability statistics were calculated. Naïve observers reviewed videotapes of individuals with MS and rated their pain. The Spearman's correlations were calculated between pain behavior frequencies and self-reported pain and pain ratings by naïve observers. RESULTS: Interrater reliability estimates indicated the reliability of pain codes in the MS sample. Kappa coefficients ranged from moderate (sighing=0.40) to substantial agreements (guarding=0.83). These values were comparable with those obtained in the combined back pain and arthritis sample. Concurrent validity was supported by correlations with self-reported pain (0.46-0.53) and with self-reports of pain behaviors (0.58). Construct validity was supported by a finding of 0.87 correlation between total pain behaviors observed by coders and mean pain ratings by naïve observers. CONCLUSION: Results support the use of the pain behavior observation protocol for assessing pain behaviors of individuals with MS. Valid assessments of pain behaviors of individuals with MS could lead to creative interventions in the management of chronic pain in this population.}, Doi = {10.1016/j.jpainsymman.2012.08.006}, Key = {fds273724} } @article{fds273645, Author = {Somers, TJ and Kurakula, PC and Criscione-Schreiber, L and Keefe, FJ and Clowse, MEB}, Title = {Reply: To PMID 22505314.}, Journal = {Arthritis Care Res (Hoboken)}, Volume = {65}, Number = {7}, Pages = {1205}, Year = {2013}, Month = {July}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23371927}, Doi = {10.1002/acr.21960}, Key = {fds273645} } @article{fds273648, Author = {Keefe, FJ and Porter, L and Somers, T and Shelby, R and Wren, AV}, Title = {Psychosocial interventions for managing pain in older adults: outcomes and clinical implications.}, Journal = {Br J Anaesth}, Volume = {111}, Number = {1}, Pages = {89-94}, Year = {2013}, Month = {July}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23794650}, Abstract = {Interest in the use of psychosocial interventions to help older adults manage pain is growing. In this article, we review this approach. The first section reviews the conceptual background for psychosocial interventions with a special emphasis on the biopsychosocial model of pain. The second section highlights three psychosocial interventions used with older adults: cognitive behavioural therapy, emotional disclosure, and mind-body interventions (specifically mindfulness-based stress reduction and yoga). The final section of the paper highlights important future directions for work in this area.}, Doi = {10.1093/bja/aet129}, Key = {fds273648} } @article{fds273647, Author = {Vitiello, MV and McCurry, SM and Shortreed, SM and Balderson, BH and Baker, LD and Keefe, FJ and Rybarczyk, BD and Von Korff, M}, Title = {Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the lifestyles randomized controlled trial.}, Journal = {J Am Geriatr Soc}, Volume = {61}, Number = {6}, Pages = {947-956}, Year = {2013}, Month = {June}, ISSN = {0002-8614}, url = {http://dx.doi.org/10.1111/jgs.12275}, Abstract = {OBJECTIVES: To assess whether older persons with osteoarthritis (OA) pain and insomnia receiving cognitive-behavioral therapy for pain and insomnia (CBT-PI), a cognitive-behavioral pain coping skills intervention (CBT-P), and an education-only control (EOC) differed in sleep and pain outcomes. DESIGN: Double-blind, cluster-randomized controlled trial with 9-month follow-up. SETTING: Group Health and University of Washington, 2009 to 2011. PARTICIPANTS: Three hundred sixty-seven older adults with OA pain and insomnia. INTERVENTIONS: Six weekly group sessions of CBT-PI, CBT-P, or EOC delivered in participants' primary care clinics. MEASUREMENTS: Primary outcomes were insomnia severity and pain severity. Secondary outcomes were actigraphically measured sleep efficiency and arthritis symptoms. RESULTS: CBT-PI reduced insomnia severity (score range 0-28) more than EOC (adjusted mean difference = -1.89, 95% confidence interval = -2.83 to -0.96; P < .001) and CBT-P (adjusted mean difference = -2.03, 95% CI = -3.01 to -1.04; P < .001) and improved sleep efficiency (score range 0-100) more than EOC (adjusted mean difference = 2.64, 95% CI = 0.44-4.84; P = .02). CBT-P did not improve insomnia severity more than EOC, but improved sleep efficiency (adjusted mean difference = 2.91, 95% CI = 0.85-4.97; P = .006). Pain severity and arthritis symptoms did not differ between the three arms. A planned analysis in participants with severe baseline pain revealed similar results. CONCLUSION: Over 9 months, CBT of insomnia was effective for older adults with OA pain and insomnia. The addition of CBT for insomnia to CBT for pain alone improved outcomes.}, Doi = {10.1111/jgs.12275}, Key = {fds273647} } @article{fds273580, Author = {Evon, DM and Golin, CE and Fried, MW and Keefe, FJ}, Title = {Chronic hepatitis C and antiviral treatment regimens: where can psychology contribute?}, Journal = {J Consult Clin Psychol}, Volume = {81}, Number = {2}, Pages = {361-374}, Year = {2013}, Month = {April}, ISSN = {0022-006X}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000316908500014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Abstract = {OBJECTIVE: Our goal was to evaluate the existing literature on psychological, social, and behavioral aspects of chronic hepatitis C viral (HCV) infection and antiviral treatment; provide the state of the behavioral science in areas that presently hinder HCV-related health outcomes; and make recommendations for areas in which clinical psychology can make significant contributions. METHOD: The extant literature on HCV and antiviral therapy was reviewed as related to biopsychosocial factors such as mental health, substance/alcohol use, quality of life, coping, stigma, racial disparities, side effects, treatment adherence, integrated care, and psychological interventions. RESULTS: For reasons that have not been well elucidated, individuals infected with HCV experience psychological and somatic problems and report poor health-related quality of life. Preexisting conditions, including poor mental health and alcohol/substance use, can interfere with access to and successful completion of HCV treatment. Perceived stigma is highly prevalent and associated with psychological distress. Racial disparities exist for HCV prevalence, treatment uptake, and treatment success. During HCV treatment, patients experience exacerbation of symptoms, treatment side effects, and poorer quality of life, making it difficult to complete treatment. Despite pharmacological advances in HCV treatment, improvements in clinical and public health outcomes have not been realized. The reasons for this lack of impact are multifactorial, but include suboptimal referral and access to care for many patients, treatment-related side effects, treatment nonadherence, and lack of empirically based approaches. CONCLUSIONS: Biomedical advances in HCV and antiviral treatment have created a fertile field in which psychologists are uniquely positioned to make important contributions to HCV management and treatment.}, Doi = {10.1037/a0029030}, Key = {fds273580} } @article{fds273725, Author = {Tsai, P-F and Chang, JY and Beck, C and Kuo, Y-F and Keefe, FJ}, Title = {A pilot cluster-randomized trial of a 20-week Tai Chi program in elders with cognitive impairment and osteoarthritic knee: effects on pain and other health outcomes.}, Journal = {J Pain Symptom Manage}, Volume = {45}, Number = {4}, Pages = {660-669}, Year = {2013}, Month = {April}, ISSN = {0885-3924}, url = {http://dx.doi.org/10.1016/j.jpainsymman.2012.04.009}, Abstract = {CONTEXT: Because Tai Chi (TC) is beneficial to elders without cognitive impairment (CI), it also may benefit elders with CI. But elders with CI have generally been excluded from TC studies because many measurement tools require verbal reports that some elders with CI are unable to provide. OBJECTIVES: To test the efficacy of a TC program in improving pain and other health outcomes in community-dwelling elders with knee osteoarthritis (OA) and CI. METHODS: This pilot cluster-randomized trial was conducted between January 2008 and June 2010 (ClinicalTrials.gov Identifier: NCT01528566). The TC group attended Sun style TC classes, three sessions a week for 20 weeks; the control group attended classes providing health and cultural information for the same length of time. Measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, physical function and stiffness subscales; the Get Up and Go test; the Sit-to-Stand test; and the Mini-Mental State Examination (MMSE), administered at baseline, every four weeks during the intervention and at the end of the study (post-test). RESULTS: Eight sites participated in either the TC group (four sites, 28 participants) or control group (four sites, 27 participants). The WOMAC pain (P = 0.006) and stiffness scores (P = 0.010) differed significantly between the two groups at post-test, whereas differences between the two groups in the WOMAC physical function score (P = 0.071) and the MMSE (P = 0.096) showed borderline significance at the post-test. WOMAC pain (P = 0.001), physical function (P = 0.021), and stiffness (P ≤ 0.001) scores improved significantly more over time in the TC group than in controls. No adverse events were found in either group. CONCLUSION: Practicing TC can be efficacious in reducing pain and stiffness in elders with knee OA and CI.}, Doi = {10.1016/j.jpainsymman.2012.04.009}, Key = {fds273725} } @article{fds273726, Author = {Martire, LM and Stephens, MAP and Mogle, J and Schulz, R and Brach, J and Keefe, FJ}, Title = {Daily spousal influence on physical activity in knee osteoarthritis.}, Journal = {Ann Behav Med}, Volume = {45}, Number = {2}, Pages = {213-223}, Year = {2013}, Month = {April}, ISSN = {0883-6612}, url = {http://dx.doi.org/10.1007/s12160-012-9442-x}, Abstract = {BACKGROUND: Physical activity is critical for the management of knee osteoarthritis, and the spouse may play a role in encouraging or discouraging physical activity. PURPOSE: The purpose of this study was to examine four types of spousal influence-spouses' daily activity, autonomy support, pressure, and persuasion-on the daily physical activity of adults living with knee osteoarthritis. METHODS: A total of 141 couples reported their daily experiences for 22 days using a handheld computer and wore an accelerometer to measure moderate activity and steps. RESULTS: Spouses' autonomy support for patient physical activity, as well as their own level of activity, was concurrently associated with patients' greater daily moderate activity and steps. In addition, on days when male patients perceived that spouses exerted more pressure to be active, they spent less time in moderate activity. CONCLUSIONS: Couple-oriented interventions for knee osteoarthritis should target physical activity in both partners and spousal strategies for helping patients stay active.}, Doi = {10.1007/s12160-012-9442-x}, Key = {fds273726} } @article{fds372572, Author = {Carty, JN and Latsch, DV and Lumley, MA and Keefe, FJ and Mosley-Williams, A}, Title = {DOES CONTENT OF WRITTEN EMOTIONAL DISCLOSURE PREDICT HEALTH IMPROVEMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS?}, Journal = {PSYCHOSOMATIC MEDICINE}, Volume = {75}, Number = {3}, Pages = {A109-A110}, Publisher = {LIPPINCOTT WILLIAMS & WILKINS}, Year = {2013}, Month = {April}, Key = {fds372572} } @article{fds273723, Author = {Hunt, MA and Keefe, FJ and Bryant, C and Metcalf, BR and Ahamed, Y and Nicholas, MK and Bennell, KL}, Title = {A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis: a pilot study.}, Journal = {Knee}, Volume = {20}, Number = {2}, Pages = {106-112}, Year = {2013}, Month = {March}, ISSN = {0968-0160}, url = {http://dx.doi.org/10.1016/j.knee.2012.07.008}, Abstract = {BACKGROUND: Osteoarthritis (OA) of the knee is associated with a number of physical and psychological impairments. Unfortunately, very few treatment strategies are capable of addressing both types of impairments concurrently. We performed a pilot, randomized controlled, proof of principle trial investigating the feasibility and effects of an intervention combining physical exercise and pain coping skills training (PCST). METHODS: Twenty patients with a clinical and radiographical diagnosis of tibiofemoral OA were randomized to receive either 10 weeks of physiotherapist supervised exercises (lower limb strengthening and walking) combined with non-directive counseling (NDC) or the same exercise program delivered concurrently with PCST. Primary outcomes included self-reported pain and pain coping, while secondary outcomes included self efficacy and self-reported physical function. RESULTS: Ten participants were randomized to each group and both groups exhibited significant improvements in isometric knee strength, self-reported knee pain and physical function, self efficacy for control of pain management and other arthritis symptoms. Only those in the exercise + PCST group reported statistically significant improvements in pain control coping and rational thinking. No between-group differences existed in any outcome (0.07 < p < 0.98). Based on our findings, 63 participants per group would be needed for future large-scale studies using similar outcome measures and design. CONCLUSIONS: Our study showed that an intervention that combines exercise and PCST within the same treatment session and delivered by specially-trained physiotherapists is feasible and can improve both physical and psychological outcomes in individuals with knee OA. LEVEL OF EVIDENCE: Level II Clinical Trials Registry number: ACTRN12609000623291.}, Doi = {10.1016/j.knee.2012.07.008}, Key = {fds273723} } @article{fds371067, Author = {Edmond, SN and Farquhar, JM and Shelby, RA and Kimmick, GG and Marcom, PK and Peppercorn, JM and Blackwell, KL and Keefe, FJ}, Title = {RELATIONSHIPS BETWEEN SELF-EFFICACY FOR COMMUNICATION WITH ONE'S PHYSICIAN AND MEASURES OF WELL-BEING, CONCERNS ABOUT TAKING MEDICATIONS, AND MEDICATION ADHERENCE IN BREAST CANCER PATIENTS RECEIVING ADJUVANT ENDOCRINE THERAPY}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {45}, Pages = {S178-S178}, Publisher = {SPRINGER}, Year = {2013}, Month = {March}, Key = {fds371067} } @article{fds372573, Author = {Wong, K and Somers, TJ and Babyak, M and Sikkema, KJ and Keefe, FJ}, Title = {PAIN AND EATING IN OVERWEIGHT AND OBESE INDIVIDUALS WITH OSTEOARTHRITIS: AN ECOLOGICAL MOMENTARY STUDY}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {45}, Pages = {S95-S95}, Publisher = {SPRINGER}, Year = {2013}, Month = {March}, Key = {fds372573} } @article{fds273652, Author = {Flynn, KE and Lin, L and Cyranowski, JM and Reeve, BB and Reese, JB and Jeffery, DD and Smith, AW and Porter, LS and Dombeck, CB and Bruner, DW and Keefe, FJ and Weinfurt, KP}, Title = {Development of the NIH PROMIS ® Sexual Function and Satisfaction measures in patients with cancer.}, Journal = {J Sex Med}, Volume = {10 Suppl 1}, Number = {0 1}, Pages = {43-52}, Year = {2013}, Month = {February}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23387911}, Abstract = {INTRODUCTION: We describe the development and validation of the Patient-Reported Outcomes Measurement Information System(®) Sexual Function and Satisfaction (PROMIS(®) SexFS; National Institutes of Health) measures, version 1.0, for cancer populations. AIM: To develop a customizable self-report measure of sexual function and satisfaction as part of the U.S. National Institutes of Health PROMIS Network. METHODS: Our multidisciplinary working group followed a comprehensive protocol for developing psychometrically robust patient-reported outcome measures including qualitative (scale development) and quantitative (psychometric evaluation) development. We performed an extensive literature review, conducted 16 focus groups with cancer patients and multiple discussions with clinicians, and evaluated candidate items in cognitive testing with patients. We administered items to 819 cancer patients. Items were calibrated using item-response theory and evaluated for reliability and validity. MAIN OUTCOME MEASURES: The PROMIS SexFS measures, version 1.0, include 81 items in 11 domains: Interest in Sexual Activity, Lubrication, Vaginal Discomfort, Erectile Function, Global Satisfaction with Sex Life, Orgasm, Anal Discomfort, Therapeutic Aids, Sexual Activities, Interfering Factors, and Screener Questions. RESULTS: In addition to content validity (patients indicate that items cover important aspects of their experiences) and face validity (patients indicate that items measure sexual function and satisfaction), the measure shows evidence for discriminant validity (domains discriminate between groups expected to be different) and convergent validity (strong correlations between scores on PROMIS and scores on conceptually similar older measures of sexual function), as well as favorable test-retest reliability among people not expected to change (interclass correlations from two administrations of the instrument, 1 month apart). CONCLUSIONS: The PROMIS SexFS offers researchers a reliable and valid set of tools to measure self-reported sexual function and satisfaction among diverse men and women. The measures are customizable; researchers can select the relevant domains and items comprising those domains for their study.}, Doi = {10.1111/j.1743-6109.2012.02995.x}, Key = {fds273652} } @article{fds273740, Author = {Keefe, FJ and Wren, AA}, Title = {Optimism and pain: a positive move forward.}, Journal = {Pain}, Volume = {154}, Number = {1}, Pages = {7-8}, Year = {2013}, Month = {January}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23159574}, Doi = {10.1016/j.pain.2012.10.005}, Key = {fds273740} } @article{fds273638, Author = {Edmond, SN and Shelby, RA and Kimmick, GG and Marcom, PK and Peppercorn, JM and Keefe, FJ}, Title = {Symptom communication in breast cancer: relationships of holding back and self-efficacy for communication to symptoms and adjustment.}, Journal = {J Psychosoc Oncol}, Volume = {31}, Number = {6}, Pages = {698-711}, Year = {2013}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24175903}, Abstract = {Adjuvant endocrine therapy improves overall survival for women with breast cancer. However, side effects may compromise patients' quality of life (QOL). This study examined how two communication variables (self-efficacy for symptom communication [SE] and holding back from discussing cancer-related concerns [HB]) relate to QOL, pain and menopausal symptoms. Participants with breast cancer (N = 61) completed questionnaires regarding symptoms, communication, and QOL. SE was positively related to QOL and negatively related to pain interference. HB from discussing cancer-related concerns was related negatively to QOL and positively to pain interference. HB mediated the relationship between SE and QOL as well as between SE and pain interference. Increased SE is beneficial among women on endocrine therapy for breast cancer. Future research should determine if interventions to improve SE are feasible and can improve QOL and symptom tolerability.}, Doi = {10.1080/07347332.2013.835023}, Key = {fds273638} } @article{fds273649, Author = {Schroeder, D and Korsakov, F and Jolton, J and Keefe, FJ and Haley, A and Keefe, DF}, Title = {Creating widely accessible spatial interfaces: mobile VR for managing persistent pain.}, Journal = {IEEE Comput Graph Appl}, Volume = {33}, Number = {3}, Pages = {82-89}, Year = {2013}, ISSN = {0272-1716}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000318469500012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Abstract = {Using widely accessible VR technologies, researchers have implemented a series of multimodal spatial interfaces and virtual environments. The results demonstrate the degree to which we can now use low-cost (for example, mobile-phone based) VR environments to create rich virtual experiences involving motion sensing, physiological inputs, stereoscopic imagery, sound, and haptic feedback. Adapting spatial interfaces to these new platforms can open up exciting application areas for VR. In this case, the application area was in-home VR therapy for patients suffering from persistent pain (for example, arthritis and cancer pain). For such therapy to be successful, a rich spatial interface and rich visual aesthetic are particularly important. So, an interdisciplinary team with expertise in technology, design, meditation, and the psychology of pain collaborated to iteratively develop and evaluate several prototype systems. The video at http://youtu.be/mMPE7itReds demonstrates how the sine wave fitting responds to walking motions, for a walking-in-place application.}, Doi = {10.1109/MCG.2013.38}, Key = {fds273649} } @article{fds273653, Author = {Bastian, LA and Fish, LJ and Peterson, BL and Biddle, AK and Garst, J and Lyna, P and Molner, S and Bepler, G and Kelley, M and Keefe, FJ and McBride, CM}, Title = {Assessment of the impact of adjunctive proactive telephone counseling to promote smoking cessation among lung cancer patients' social networks.}, Journal = {Am J Health Promot}, Volume = {27}, Number = {3}, Pages = {181-190}, Year = {2013}, ISSN = {0890-1171}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23286595}, Abstract = {PURPOSE: When a patient is diagnosed with lung cancer, members of his/her social network may be more likely to engage in smoking cessation efforts. Proactive telephone counseling combined with a tailored self-directed intervention may be more effective at promoting smoking cessation than a tailored self-directed intervention alone. DESIGN: Randomized controlled trial. SETTING: Four clinical sites. SUBJECTS: Current smokers who are family members and close friends of patients with lung cancer. INTERVENTION: Six counselor-initiated counseling calls using motivational interviewing techniques and focusing on teaching adaptive coping skills based on the transactional model of stress and coping along with tailored self-directed materials (including nicotine patches, if not contraindicated) (n = 245) vs. tailored self-directed materials (including nicotine patches, if not contraindicated) (n = 251). MEASURES: Participants were surveyed at baseline and at 2 weeks, 6 months, and 12 months postintervention. The outcome was 7-day point prevalent abstinence. ANALYSIS: The objective of this study was to test for arm differences in smoking cessation rates at 2 weeks and 6 months postintervention (primary) and at 12 months postintervention (secondary). RESULTS: We found no overall effect of the proactive intervention on cessation rates. Among younger participants (age <50), the cessation rate in the intervention group was higher than in the control group at 2 weeks postintervention (16% vs. 4%, p = .046). For older participants (age >50), there were no group differences. CONCLUSION: Proactive telephone counseling focusing on adaptive coping skills was difficult to implement among smokers in lung cancer patients' social network. Although this study did not demonstrate any added benefit to cessation rates, this null finding may be a result of an intervention that was weaker than intended, owing to difficulties in completing the counseling phone calls. We discuss lessons learned and areas for future research in this special population.}, Doi = {10.4278/ajhp.101122-QUAN-387}, Key = {fds273653} } @article{fds273728, Author = {Debar, LL and Kindler, L and Keefe, FJ and Green, CA and Smith, DH and Deyo, RA and Ames, K and Feldstein, A}, Title = {A primary care-based interdisciplinary team approach to the treatment of chronic pain utilizing a pragmatic clinical trials framework.}, Journal = {Transl Behav Med}, Volume = {2}, Number = {4}, Pages = {523-530}, Year = {2012}, Month = {December}, ISSN = {1869-6716}, url = {http://dx.doi.org/10.1007/s13142-012-0163-2}, Abstract = {Chronic pain affects at least 116 million adults in the USA and exacts a tremendous cost in suffering and lost productivity. While health systems offer specialized pain services, the primary care setting is where most patients seek and receive care for pain. Primary care-based treatment of chronic pain by interdisciplinary teams (including behavioral specialists, nurse case managers, physical therapists, and pharmacists) is one of the most effective approaches for improving outcomes and managing costs. To ensure robust integration of such services into sustainable health-care programs, evaluations must be conducted by researchers well versed in the methodologies of clinical trials, mixed methods and implementation research, bioinformatics, health services, and cost-effectiveness. Recent national health policy changes, in addition to the increasing recognition of the high prevalence and cost of chronic pain conditions, present a unique opportunity to shift the care paradigm for patients with chronic pain.}, Doi = {10.1007/s13142-012-0163-2}, Key = {fds273728} } @article{fds273738, Author = {Keefe, FJ and Huling, DA and Coggins, MJ and Keefe, DF and Rosenthal, ZM and Herr, NR and Hoffman, HG}, Title = {Virtual reality for persistent pain: a new direction for behavioral pain management.}, Journal = {Pain}, Volume = {153}, Number = {11}, Pages = {2163-2166}, Year = {2012}, Month = {November}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22770840}, Doi = {10.1016/j.pain.2012.05.030}, Key = {fds273738} } @article{fds273739, Author = {Porter, LS and Keefe, FJ and Davis, D and Rumble, M and Scipio, C and Garst, J}, Title = {Attachment styles in patients with lung cancer and their spouses: associations with patient and spouse adjustment.}, Journal = {Support Care Cancer}, Volume = {20}, Number = {10}, Pages = {2459-2466}, Year = {2012}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22246596}, Abstract = {PURPOSE: This study examined attachment styles in patients with lung cancer and their spouses and associations between attachment styles and patient and spouse adjustment. METHODS: One hundred twenty-seven patients with early stage lung cancer completed measures of attachment style, marital quality, self-efficacy, pain, depression, anxiety, and quality of life. Their spouses completed measures of attachment style, marital quality, self-efficacy, caregiver strain, and mood. RESULTS: Analyses indicated that, among patients, those high in either attachment anxiety or avoidance had significantly higher levels of anxiety and poorer social well-being. Attachment avoidance was also significantly associated with higher levels of depression and poorer marital quality and functional well-being. Spouse avoidant attachment was significantly associated with patient reports of increased pain and poorer functional well-being, and spouse anxious attachment was associated with poorer patient marital quality. Among spouses, those high in attachment avoidance reported significantly higher levels of caregiver strain, anger, depressed mood, and poorer marital quality; those high in attachment anxiety reported higher anxious mood. Dyads in which both partners were insecurely attached had significantly poorer adjustment compared to dyads in which both partners reported secure attachment. CONCLUSIONS: These preliminary findings raise the possibility that attachment styles of cancer patients and their spouses as individuals and as a dyad may be important factors affecting adjustment in multiple domains.}, Doi = {10.1007/s00520-011-1367-6}, Key = {fds273739} } @article{fds273654, Author = {Campbell, LC and Keefe, FJ and McKee, DC and Waters, SJ and Moul, JW}, Title = {Masculinity beliefs predict psychosocial functioning in African American prostate cancer survivors.}, Journal = {Am J Mens Health}, Volume = {6}, Number = {5}, Pages = {400-408}, Year = {2012}, Month = {September}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22691305}, Abstract = {Research examining psychosocial functioning in African American prostate cancer survivors has been limited, in spite of documented higher mortality from prostate cancer and worse long-term physical and emotional outcomes from prostate cancer treatment reported by this group of survivors. In addition, the role of masculinity in psychosocial adjustment among prostate cancer survivors is not well understood. In this study, 59 African American prostate cancer survivors completed a questionnaire assessing masculinity beliefs related to self-reliance, emotional control, and dominance, as well as measures of psychosocial functioning (i.e., symptom distress, negative mood, and functional and social well-being). Results of regression analyses indicated that masculinity beliefs predicted negative mood, functional well-being, and social well-being, controlling for age, income, and medical comorbidities. The findings reported here, although preliminary, suggest that masculinity beliefs could be important therapeutic targets for improving the efficacy of cognitive-behavioral interventions for men adjusting to prostate cancer survivorship.}, Doi = {10.1177/1557988312450185}, Key = {fds273654} } @article{fds273759, Author = {Somers, TJ and Kurakula, PC and Criscione-Schreiber, L and Keefe, FJ and Clowse, MEB}, Title = {Self-efficacy and pain catastrophizing in systemic lupus erythematosus: relationship to pain, stiffness, fatigue, and psychological distress.}, Journal = {Arthritis Care Res (Hoboken)}, Volume = {64}, Number = {9}, Pages = {1334-1340}, Year = {2012}, Month = {September}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22505314}, Abstract = {OBJECTIVE: To determine how self-efficacy for pain control and pain catastrophizing, both potentially modifiable pain coping cognitions, are related to pain, stiffness, fatigue, and psychological distress in patients with systemic lupus erythematosus (SLE). METHODS: We conducted a cross-sectional study of patients with SLE who completed measures of pain coping cognitions (i.e., self-efficacy for pain control, pain catastrophizing), symptom ratings (i.e., pain, stiffness, fatigue), and psychological distress. RESULTS: Correlational analyses revealed that self-efficacy for pain control and pain catastrophizing were associated with the patients' physical symptom reports and psychological distress. After controlling for age, race, and disease activity, patients with lower levels of self-efficacy for pain control reported much higher levels of pain, stiffness, and fatigue. Patients with higher levels of pain catastrophizing reported much lower positive mood. SLE activity as assessed by the rheumatologist was not associated with physical symptoms, psychological distress, self-efficacy for pain control, or pain catastrophizing. CONCLUSION: These results suggest that pain coping cognitions (i.e., either self-efficacy for pain control or pain catastrophizing) are significantly related to physical symptoms and psychological distress in patients with SLE. This finding is important because the results of studies from other samples of patients with persistent pain conditions have shown that these pain coping variables can be modified using psychological interventions, and that such treatment-related changes in pain cognitions are related to improved patient outcomes.}, Doi = {10.1002/acr.21686}, Key = {fds273759} } @article{fds273799, Author = {Riddle, DL and Keefe, FJ and Ang, D and J, K and Dumenci, L and Jensen, MP and Bair, MJ and Reed, SD and Kroenke, K}, Title = {A phase III randomized three-arm trial of physical therapist delivered pain coping skills training for patients with total knee arthroplasty: the KASTPain protocol.}, Journal = {BMC Musculoskelet Disord}, Volume = {13}, Pages = {149}, Year = {2012}, Month = {August}, ISSN = {1471-2474}, url = {http://dx.doi.org/10.1186/1471-2474-13-149}, Abstract = {BACKGROUND: Approximately 20% of patients report persistent and disabling pain following total knee arthroplasty (TKA) despite an apparently normally functioning prosthesis. One potential risk factor for unexplained persistent pain is high levels of pain catastrophizing. We designed a three-arm trial to determine if a pain coping skills training program, delivered prior to TKA, effectively reduces function-limiting pain following the procedure in patients with high levels of pain catastrophizing. METHODS/DESIGN: The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated. DISCUSSION: The trial will be conducted at four University-based sites in the US. A sample of 402 patients with high levels of pain catastrophizing will be randomly assigned to either a pain coping skills training arm, an arthritis education control arm or usual care. Pain coping skills will be delivered by physical therapists trained and supervised by clinical psychologist experts. Arthritis education will be delivered by nurses trained in the delivery of arthritis-related content. The primary outcome will be change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain scale score 12 months following surgery. A variety of secondary clinical and economic outcomes also will be evaluated.}, Doi = {10.1186/1471-2474-13-149}, Key = {fds273799} } @article{fds273655, Author = {Abbasi, M and Dehghani, M and Keefe, FJ and Jafari, H and Behtash, H and Shams, J}, Title = {Spouse-assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: a 1-year randomized controlled trial.}, Journal = {Eur J Pain}, Volume = {16}, Number = {7}, Pages = {1033-1043}, Year = {2012}, Month = {August}, ISSN = {1090-3801}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000305903800011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Abstract = {This study examined the comparative efficacy of three interventions: a spouse-assisted coping skills training protocol for patients undergoing a multidisciplinary pain management programme (SA-MPMP), conventional patient-oriented multidisciplinary pain management programme (P-MPMP) and standard medical care (SMC). Thirty-six chronic low back pain (CLBP) patients and their spouses were randomly assigned to one of the three conditions. The SA-MPMP condition consisted of seven, weekly, 2-h, group sessions of training in dyadic pain coping and couple skills, delivered by a clinical psychologist with support of a multidisciplinary team of specialists, to patients together with their spouses. P-MPMP consisted of the SA-MPMP training delivered to the patient only (i.e., no spouse participation and assistance). The SMC condition entailed continuation of routine treatment, entailing medical care only. Data analysis revealed that, at the 12-month follow-up time point, patients receiving SA-MPMP had significant improvements in kinesiophobia and rumination about pain compared to those receiving P-MPMP and SMC. In patients suffering from CLBP, an intervention that combines spouse-assisted coping skills training with a multidisciplinary pain management programme can improve fear of movement and rumination about low back pain.}, Doi = {10.1002/j.1532-2149.2011.00097.x}, Key = {fds273655} } @article{fds273743, Author = {Porter, LS and Keefe, FJ and Baucom, DH and Hurwitz, H and Moser, B and Patterson, E and Kim, HJ}, Title = {Partner-assisted emotional disclosure for patients with GI cancer: 8-week follow-up and processes associated with change.}, Journal = {Support Care Cancer}, Volume = {20}, Number = {8}, Pages = {1755-1762}, Year = {2012}, Month = {August}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21947440}, Abstract = {PURPOSE: We recently reported that a partner-assisted emotional disclosure intervention for gastrointestinal cancer led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns. The purposes of the present study were to examine outcomes at 8-week follow-up and process variables that may influence treatment effects. METHODS: One hundred thirty couples were randomly assigned to either partner-assisted emotional disclosure or an education/support control condition. Participants completed measures of relationship quality, intimacy, and psychological distress before randomization, post-treatment, and 8 weeks later. Patients in the disclosure intervention completed measures of negative affect immediately following each treatment session, and their level of expressiveness during the sessions was rated by trained observers. Data were analyzed using multilevel modeling. RESULTS: Among couples in which the patient initially reported higher levels of holding back, the disclosure intervention led to improvements in relationship quality and intimacy that were maintained at 8-weeks follow-up. High levels of patient expressiveness during the disclosure sessions were associated with improvements in relationship quality and intimacy, and high levels of patient negative affect immediately following the sessions were associated with reductions in psychological distress at the post-test assessment. CONCLUSIONS: For couples in which the patient tends to hold back from discussing concerns, partner-assisted emotional disclosure is a beneficial intervention leading to improvements in relationship functioning that maintain over time. Future research is needed to examine methods of enhancing intervention effects, including encouraging patient expressiveness and negative affect during the sessions.}, Doi = {10.1007/s00520-011-1272-z}, Key = {fds273743} } @article{fds273757, Author = {Cox, CE and Porter, LS and Hough, CL and White, DB and Kahn, JM and Carson, SS and Tulsky, JA and Keefe, FJ}, Title = {Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers.}, Journal = {Intensive Care Med}, Volume = {38}, Number = {8}, Pages = {1289-1297}, Year = {2012}, Month = {August}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22527082}, Abstract = {PURPOSE: Survivors of acute lung injury (ALI) and their informal caregivers have difficulty coping with the physical and emotional challenges of recovery from critical illness. We aimed to develop and pilot test a telephone-based coping skills training intervention for this population. METHODS: Fifty-eight participants were enrolled overall. A total of 21 patients and 23 caregivers participated in a cross-sectional study to assess coping and its association with psychological distress. This also informed the development of an ALI coping skills training intervention in an iterative process involving content and methodological experts. The intervention was then evaluated in seven patients and seven caregivers in an uncontrolled, prospective, pre-post study. Outcomes included acceptability, feasibility, and symptoms of psychological distress measured with the Hospital Anxiety and Depression Scale (HADS) and Post-Traumatic Symptom Scale (PTSS). RESULTS: Survivors and their caregivers used adaptive coping infrequently, a pattern that was strongly associated with psychological distress. These findings informed the development of a 12-session intervention for acquiring, applying, and maintaining coping skills. In the evaluation phase, participants completed 77 (92 %) of a possible 84 telephone sessions and all (100 %) reported the intervention's usefulness in their daily routine. Mean change scores reflecting improvements in the HADS (7.8 U) and PTSS (10.3 U) were associated with adaptive coping (r = 0.50-0.70) and high self-efficacy (r = 0.67-0.79). CONCLUSIONS: A novel telephone-based coping skills training intervention was acceptable, feasible, and may have been associated with a reduction in psychological distress among survivors of ALI and their informal caregivers. A randomized trial is needed to evaluate the intervention.}, Doi = {10.1007/s00134-012-2567-3}, Key = {fds273757} } @article{fds273727, Author = {Bennell, KL and Ahamed, Y and Bryant, C and Jull, G and Hunt, MA and Kenardy, J and Forbes, A and Harris, A and Nicholas, M and Metcalf, B and Egerton, T and Keefe, FJ}, Title = {A physiotherapist-delivered integrated exercise and pain coping skills training intervention for individuals with knee osteoarthritis: a randomised controlled trial protocol.}, Journal = {BMC Musculoskelet Disord}, Volume = {13}, Pages = {129}, Year = {2012}, Month = {July}, ISSN = {1471-2474}, url = {http://dx.doi.org/10.1186/1471-2474-13-129}, Abstract = {BACKGROUND: Knee osteoarthritis (OA) is a prevalent chronic musculoskeletal condition with no cure. Pain is the primary symptom and results from a complex interaction between structural changes, physical impairments and psychological factors. Much evidence supports the use of strengthening exercises to improve pain and physical function in this patient population. There is also a growing body of research examining the effects of psychologist-delivered pain coping skills training (PCST) particularly in other chronic pain conditions. Though typically provided separately, there are symptom, resource and personnel advantages of exercise and PCST being delivered together by a single healthcare professional. Physiotherapists are a logical choice to be trained to deliver a PCST intervention as they already have expertise in administering exercise for knee OA and are cognisant of the need for a biopsychosocial approach to management. No studies to date have examined the effects of an integrated exercise and PCST program delivered solely by physiotherapists in this population. The primary aim of this multisite randomised controlled trial is to investigate whether an integrated 12-week PCST and exercise treatment program delivered by physiotherapists is more efficacious than either program alone in treating pain and physical function in individuals with knee OA. METHODS/DESIGN: This will be an assessor-blinded, 3-arm randomised controlled trial of a 12-week intervention involving 10 physiotherapy visits together with home practice. Participants with symptomatic and radiographic knee OA will be recruited from the community in two cities in Australia and randomized into one of three groups: exercise alone, PCST alone, or integrated PCST and exercise. Randomisation will be stratified by city (Melbourne or Brisbane) and gender. Primary outcomes are overall average pain in the past week measured by a Visual Analogue Scale and physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index subscale. Secondary outcomes include global rating of change, muscle strength, functional performance, physical activity levels, health related quality of life and psychological factors. Measurements will be taken at baseline and immediately following the intervention (12 weeks) as well as at 32 weeks and 52 weeks to examine maintenance of any intervention effects. Specific assessment of adherence to the treatment program will also be made at weeks 22 and 42. Relative cost-effectiveness will be determined from health service usage and outcome data. DISCUSSION: The findings from this randomised controlled trial will provide evidence for the efficacy of an integrated PCST and exercise program delivered by physiotherapists in the management of painful and functionally limiting knee OA compared to either program alone. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry reference number: ACTRN12610000533099.}, Doi = {10.1186/1471-2474-13-129}, Key = {fds273727} } @article{fds273736, Author = {Von Korff and M and Vitiello, MV and McCurry, SM and Balderson, BH and Moore, AL and Baker, LD and Yarbro, P and Saunders, K and Keefe, FJ and Rybarczyk, BD}, Title = {Group interventions for co-morbid insomnia and osteoarthritis pain in primary care: the lifestyles cluster randomized trial design.}, Journal = {Contemp Clin Trials}, Volume = {33}, Number = {4}, Pages = {759-768}, Year = {2012}, Month = {July}, ISSN = {1551-7144}, url = {http://dx.doi.org/10.1016/j.cct.2012.03.010}, Abstract = {Six weekly sessions of group cognitive-behavioral therapy for insomnia and osteoarthritis pain (CBT-PI), and for osteoarthritis pain alone (CBT-P) were compared to an education only control (EOC). Basic education about pain and sleep was comparable, so EOC controlled for information and group participation. Active interventions differed from EOC in training pain coping skills (CBT-P and CBT-PI) and sleep enhancement techniques (CBT-PI). Persons with osteoarthritis age 60 or older were screened for osteoarthritis pain and insomnia severity via mailed survey. Primary outcomes were pain severity (pain intensity and interference ratings from the Graded Chronic Pain Scale) and insomnia severity (Insomnia Severity Index). Secondary outcomes were arthritis pain (AIMS-2 symptom scale) and sleep efficiency assessed by wrist actigraphy. Ancillary outcomes included: cognitive function, depression, and health care use. A clustered randomized design provided adequate power to identify moderate effects on primary outcomes (effect size>0.35). Modified intent to treat analyses, including all participants who attended the first session, assessed effects across CBT-PI, CBT-P, and EOC groups. Treatment effects were assessed post-intervention (2 months) and at 9 months, with durability of intervention effects evaluated at 18 months. The trial was executed in 6 primary clinics, randomizing 367 participants, with 93.2% of randomized patients attending at least 4 group sessions. Response rates for post-intervention and 9 month assessments were 96.7% and 92.9% respectively. This hybrid efficacy-effectiveness trial design evaluates whether interventions yield specific benefits for clinical and behavioral outcomes relative to an education only control when implemented in a primary care setting.}, Doi = {10.1016/j.cct.2012.03.010}, Key = {fds273736} } @article{fds273734, Author = {Porter, LS and Baucom, DH and Keefe, FJ and Patterson, ES}, Title = {Reactions to a partner-assisted emotional disclosure intervention: direct observation and self-report of patient and partner communication.}, Journal = {J Marital Fam Ther}, Volume = {38 Suppl 1}, Pages = {284-295}, Year = {2012}, Month = {June}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22765340}, Abstract = {Partner-assisted emotional disclosure is a couple-based intervention designed to help patients disclose cancer-related concerns to their spouses-partners. We previously found that, compared with an education/support control condition, partner-assisted emotional disclosure led to significant improvements in relationship quality and intimacy for couples in which the patient initially reported holding back from discussing cancer-related concerns (Porter et al., 2009, Cancer, 115, 4326-4338). The purpose of this study was to examine the process data from couples who participated in the disclosure sessions including (a) observational ratings of couples' communication during the sessions; (b) couples' ratings of their communication during the sessions; and (c) associations between participants' observed communication and their baseline psychological/relationship functioning. As rated by trained observers, couples' communication was in the moderate range of adaptive skills. Self-report data indicated that participants had positive perceptions of their communication. Observational and self-report ratings were weakly associated. Patients reporting lower levels of relationship quality, higher levels of holding back, and higher partner avoidance at baseline were rated by observers as more expressive during the sessions. Overall, these findings suggest that the intervention was acceptable to couples and was particularly helpful for patients who had difficulty talking with their partners on their own without skills training.}, Doi = {10.1111/j.1752-0606.2011.00278.x}, Key = {fds273734} } @article{fds273735, Author = {Shelby, RA and Somers, TJ and Keefe, FJ and DeVellis, BM and Patterson, C and Renner, JB and Jordan, JM}, Title = {Brief Fear of Movement Scale for osteoarthritis.}, Journal = {Arthritis Care Res (Hoboken)}, Volume = {64}, Number = {6}, Pages = {862-871}, Year = {2012}, Month = {June}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22290689}, Abstract = {OBJECTIVE: Fear of movement has important clinical implications for individuals with osteoarthritis (OA). This study aimed to establish a brief fear of movement scale for use in OA. Items from the Tampa Scale for Kinesiophobia (TSK) were examined. METHODS: The English version of the TSK was examined in a community-based sample (n = 1,136) of individuals with OA of the hip or knee. Exploratory and confirmatory factor analyses were used to determine the number and content of the dimensions of fear of movement. Factorial invariance was tested across subgroups of sex, race, education, and OA severity. Convergent validity with measures of pain, physical functioning, and psychological functioning was examined. RESULTS: Factor analyses identified a single-factor 6-item scale that measures activity avoidance due to pain-related fear of movement (confirmatory factor analysis indices of model fit: root mean square error of approximation = 0.04, standardized root mean square residual = 0.01, comparative fit index = 0.99, and Tucker-Lewis Index = 0.99). The 6-item scale demonstrated factorial invariance across sex, race, levels of education, and OA severity, suggesting that this scale performs consistently across diverse groups of individuals with OA. Convergent validity with measures of pain (β = 0.30-0.41), physical functioning (β = 0.44-0.48), and psychological functioning (β = 0.36-0.37) was also demonstrated. CONCLUSION: The Brief Fear of Movement Scale identified in this study provides a promising and valid approach for assessing fear of movement in individuals with OA. This brief scale demonstrated several important strengths, including a small number of items, sound psychometric properties, and consistent performance across diverse groups of individuals with OA.}, Doi = {10.1002/acr.21626}, Key = {fds273735} } @article{fds273779, Author = {Somers, TJ and Blumenthal, JA and Guilak, F and Kraus, VB and Schmitt, DO and Babyak, MA and Craighead, LW and Caldwell, DS and Rice, JR and McKee, DC and Shelby, RA and Campbell, LC and Pells, JJ and Sims, EL and Queen, R and Carson, JW and Connelly, M and Dixon, KE and LaCaille, LJ and Huebner, JL and Rejeski, JW and Keefe, FJ}, Title = {Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study.}, Journal = {Pain}, Volume = {153}, Number = {6}, Pages = {1199-1209}, Year = {2012}, Month = {June}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22503223}, Abstract = {Overweight and obese patients with osteoarthritis (OA) experience more OA pain and disability than patients who are not overweight. This study examined the long-term efficacy of a combined pain coping skills training (PCST) and lifestyle behavioral weight management (BWM) intervention in overweight and obese OA patients. Patients (n=232) were randomized to a 6-month program of: 1) PCST+BWM; 2) PCST-only; 3) BWM-only; or 4) standard care control. Assessments of pain, physical disability (Arthritis Impact Measurement Scales [AIMS] physical disability, stiffness, activity, and gait), psychological disability (AIMS psychological disability, pain catastrophizing, arthritis self-efficacy, weight self-efficacy), and body weight were collected at 4 time points (pretreatment, posttreatment, and 6 months and 12 months after the completion of treatment). Patients randomized to PCST+BWM demonstrated significantly better treatment outcomes (average of all 3 posttreatment values) in terms of pain, physical disability, stiffness, activity, weight self-efficacy, and weight when compared to the other 3 conditions (Ps<0.05). PCST+BWM also did significantly better than at least one of the other conditions (ie, PCST-only, BWM-only, or standard care) in terms of psychological disability, pain catastrophizing, and arthritis self-efficacy. Interventions teaching overweight and obese OA patients pain coping skills and weight management simultaneously may provide the more comprehensive long-term benefits.}, Doi = {10.1016/j.pain.2012.02.023}, Key = {fds273779} } @article{fds273731, Author = {Schneider, S and Junghaenel, DU and Keefe, FJ and Schwartz, JE and Stone, AA and Broderick, JE}, Title = {Individual differences in the day-to-day variability of pain, fatigue, and well-being in patients with rheumatic disease: associations with psychological variables.}, Journal = {Pain}, Volume = {153}, Number = {4}, Pages = {813-822}, Year = {2012}, Month = {April}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2012.01.001}, Abstract = {This report examines day-to-day variability in rheumatology patients' ratings of pain and related quality-of-life variables as well as predictors of that variability. Data from 2 studies were used. The hypothesis was that greater psychological distress (i.e., depression and anxiety) and poorer coping appraisals (i.e., higher pain catastrophizing and lower self-efficacy) are associated with more variability. Electronic daily diary ratings were collected from 106 patients from a community rheumatology practice across 28 days (study 1) and from 194 osteoarthritis patients across 7 days (study 2). In multilevel modeling analyses, substantial day-to-day variability was evident for all variables in both studies, and individual patients differed considerably and somewhat reliably in the magnitude of their variability. Higher levels of depression significantly predicted greater variability in pain, as well as in happiness and frustration (study 1). Lower self-efficacy was associated with more variability in patients' daily satisfaction with accomplishments and in the quality of their day (study 2). Greater pain catastrophizing and higher depression predicted more variability in interference with social relationships (study 2). Anxiety was not significantly associated with day-to-day variability. The results of these studies suggest that individual differences in the magnitude of symptom fluctuation may play a vital role in understanding patients' adjustment to pain. Future research will be needed to examine the clinical utility of measuring variability in patients' pain and well-being, and to understand whether reducing variability may be an important treatment target.}, Doi = {10.1016/j.pain.2012.01.001}, Key = {fds273731} } @article{fds273733, Author = {Baucom, DH and Kirby, JS and Pukay-Martin, ND and Porter, LS and Fredman, SJ and Gremore, TM and Keefe, FJ and Atkins, D}, Title = {Men's psychological functioning in the context of women's breast cancer.}, Journal = {J Marital Fam Ther}, Volume = {38}, Number = {2}, Pages = {317-329}, Year = {2012}, Month = {April}, ISSN = {0194-472X}, url = {http://dx.doi.org/10.1111/j.1752-0606.2009.00133.x}, Abstract = {Previous research indicates that men are affected when their female partners have breast cancer. However, little is known about what predicts men's psychological well-being in this context. The current investigation involved couples in which the woman had early stage breast cancer and explored the degree to which men's positive and negative well-being was related to women's well-being, women's physical symptoms, relationship functioning, and relationship duration. The findings indicate that all of these factors play a role and interact in predicting men's well-being. In particular, when women have a high level of physical symptoms, the typical associations between men's well-being with women's well-being and relationship adjustment no longer persist. Implications for working with couples addressing health problems are provided.}, Doi = {10.1111/j.1752-0606.2009.00133.x}, Key = {fds273733} } @article{fds273748, Author = {Wren, AA and Somers, TJ and Wright, MA and Goetz, MC and Leary, MR and Fras, AM and Huh, BK and Rogers, LL and Keefe, FJ}, Title = {Self-compassion in patients with persistent musculoskeletal pain: relationship of self-compassion to adjustment to persistent pain.}, Journal = {J Pain Symptom Manage}, Volume = {43}, Number = {4}, Pages = {759-770}, Year = {2012}, Month = {April}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22071165}, Abstract = {CONTEXT: Self-compassion entails qualities such as kindness and understanding toward oneself in difficult circumstances and may influence adjustment to persistent pain. Self-compassion may be a particularly influential factor in pain adjustment for obese individuals who suffer from persistent pain, as they often experience heightened levels of pain and lower levels of psychological functioning. OBJECTIVES: The purpose of the present study was to examine the relationship of self-compassion to pain, psychological functioning, pain coping, and disability among patients who have persistent musculoskeletal pain and who are obese. METHODS: Eighty-eight obese patients with persistent pain completed a paper-and-pencil self-report assessment measure before or after their appointment with their anesthesiologist. RESULTS: Hierarchical linear regression analyses demonstrated that even after controlling for important demographic variables, self-compassion was a significant predictor of negative affect (β=-0.48, P<0.001), positive affect (β=0.29, P=0.01), pain catastrophizing (β=-0.32, P=0.003), and pain disability (β=-0.24, P<0.05). CONCLUSION: The results of this study indicate that self-compassion may be important in explaining the variability in pain adjustment among patients who have persistent musculoskeletal pain and are obese.}, Doi = {10.1016/j.jpainsymman.2011.04.014}, Key = {fds273748} } @article{fds371068, Author = {Somers, TJ and Keefe, FJ and Abernethy, A}, Title = {ELECTRONIC PATIENT REPORTED OUTCOMES (EPRO) TO GUIDE THE IMPLEMENTATION OF BEHAVIORAL CANCER PAIN INTERVENTIONS}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {43}, Pages = {S222-S222}, Publisher = {SPRINGER}, Year = {2012}, Month = {April}, Key = {fds371068} } @article{fds372574, Author = {Czajkowski, SM and Davidson, KW and Fitz-Simmons, SC and Keefe, FJ and Nilsen, WJ and Stirratt, MJ and Wiebe, DJ}, Title = {NIH GRANT WRITING SEMINAR FOR EARLY CAREER RESEARCHERS}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {43}, Pages = {S1-S1}, Publisher = {SPRINGER}, Year = {2012}, Month = {April}, Key = {fds372574} } @article{fds372575, Author = {Campbell, L and Keefe, FJ and McKee, DC and Waters, SL}, Title = {COMPARING PSYCHOSOCIAL INTERVENTIONS FOR IMPROVING QUALITY OF LIFE OUTCOMES AMONG AFRICAN AMERICAN PROSTATE CANCER SURVIVORS}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {43}, Pages = {S281-S281}, Publisher = {SPRINGER}, Year = {2012}, Month = {April}, Key = {fds372575} } @article{fds372576, Author = {Ahamed, Y and Egerton, T and Hunt, MA and Keefe, FJ and Bryant, C and Jull, G and Connellan, P and Bennell, KL}, Title = {Psychological factors associated with daily step count in knee osteoarthritis}, Journal = {Osteoarthritis and Cartilage}, Volume = {20}, Pages = {S191-S192}, Publisher = {Elsevier BV}, Year = {2012}, Month = {April}, url = {http://dx.doi.org/10.1016/j.joca.2012.02.305}, Doi = {10.1016/j.joca.2012.02.305}, Key = {fds372576} } @article{fds372577, Author = {Huebner, JL and Landerman, LR and Somers, TJ and Kraus, VB and Guilak, F and Blumenthal, JA and Caldwell, DS and Rice, JR and Keefe, FJ}, Title = {Inflammatory biomarkers of OA, IL-6 and leptin are modifiable in overweight/obese OA patients with a protocol that combines training in pain coping skills and weight management}, Journal = {Osteoarthritis and Cartilage}, Volume = {20}, Pages = {S38-S38}, Publisher = {Elsevier BV}, Year = {2012}, Month = {April}, url = {http://dx.doi.org/10.1016/j.joca.2012.02.570}, Doi = {10.1016/j.joca.2012.02.570}, Key = {fds372577} } @article{fds273732, Author = {Shelby, RA and Scipio, CD and Somers, TJ and Soo, MS and Weinfurt, KP and Keefe, FJ}, Title = {Prospective study of factors predicting adherence to surveillance mammography in women treated for breast cancer.}, Journal = {J Clin Oncol}, Volume = {30}, Number = {8}, Pages = {813-819}, Year = {2012}, Month = {March}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22331949}, Abstract = {PURPOSE: This prospective study examined the factors that predicted sustained adherence to surveillance mammography in women treated for breast cancer. METHODS: Breast cancer survivors (N = 204) who were undergoing surveillance mammography completed questionnaires assessing mammography-related anticipatory anxiety, persistent breast pain, mammography pain, and catastrophic thoughts about mammography pain. Adherence to mammography in the following year was assessed. RESULTS: In the year after study entry, 84.8% of women (n = 173) returned for a subsequent mammogram. Unadjusted associations showed that younger age, shorter period of time since surgery, and having upper extremity lymphedema were associated with lower mammography adherence. Forty percent of women reported moderate to high levels of mammography pain (score of ≥ 5 on a 0 to 10 scale). Although mammography pain was not associated with adherence, higher levels of mammography-related anxiety and pain catastrophizing were associated with not returning for a mammogram (P < .05). The impact of anxiety on mammography use was mediated by pain catastrophizing (indirect effect, P < .05). CONCLUSION: Findings suggest that women who are younger, closer to the time of surgery, or have upper extremity lymphedema may be less likely to undergo repeated mammograms. It may be important for health professionals to remind selected patients directly that some women avoid repeat mammography and to re-emphasize the value of mammography for women with a history of breast cancer. Teaching women behavioral techniques (eg, redirecting attention) or providing medication for reducing anxiety could be considered for women with high levels of anxiety or catastrophic thoughts related to mammography.}, Doi = {10.1200/JCO.2010.34.4333}, Key = {fds273732} } @article{fds273729, Author = {Keefe, FJ}, Title = {Translational behavioral pain management: new directions and new opportunities.}, Journal = {Transl Behav Med}, Volume = {2}, Number = {1}, Pages = {19-21}, Year = {2012}, Month = {March}, ISSN = {1869-6716}, url = {http://dx.doi.org/10.1007/s13142-012-0117-8}, Doi = {10.1007/s13142-012-0117-8}, Key = {fds273729} } @article{fds273730, Author = {Rini, C and Williams, DA and Broderick, JE and Keefe, FJ}, Title = {Meeting them where they are: Using the Internet to deliver behavioral medicine interventions for pain.}, Journal = {Transl Behav Med}, Volume = {2}, Number = {1}, Pages = {82-92}, Year = {2012}, Month = {March}, ISSN = {1869-6716}, url = {http://dx.doi.org/10.1007/s13142-011-0107-2}, Abstract = {Pharmacological and interventional pain medicine treatments are emphasized in the routine treatment of chronic pain despite strong evidence for the efficacy and safety of behavioral approaches. Most medical professionals have not incorporated behavioral pain treatments into their practices. Internet-based interventions have the potential to increase clinical use of these treatments. We discuss the strengths and weaknesses of current Internet-based behavioral pain management interventions, focusing on three broad intervention categories: therapist-guided interventions, unguided (automated) interventions, and pain-relevant applications for mobile platforms. Examples of each category are discussed, revealing a high degree of variation in approaches, user interfaces, and components as well as variability in the degree to which these interventions have been subjected to empirical testing. Finally, we highlight key issues for research and clinical implementation, with the goal of advancing this field so that it can meet its potential to increase access to evidence-based behavioral medicine treatments for chronic pain.}, Doi = {10.1007/s13142-011-0107-2}, Key = {fds273730} } @article{fds372578, Author = {Chen, W-H and Revicki, DA and Amtmann, D and Jensen, MP and Keefe, FJ and Cella, D}, Title = {Development and Analysis of PROMIS Pain Intensity Scale}, Journal = {QUALITY OF LIFE RESEARCH}, Volume = {20}, Pages = {18-18}, Publisher = {SPRINGER}, Year = {2012}, Month = {January}, Key = {fds372578} } @article{fds372579, Author = {Vitiello, MV and McCurry, SM and Von Korff and M and Shortreed, SM and Balderson, BH and Baker, LD and Keefe, FJ and Rybarczyk, B}, Title = {COGNITIVE BEHAVIORAL THERAPY FOR SLEEP AND PAIN IN OLDER ADULTS WITH CO-MORBID INSOMNIA AND OSTEOARTHRITIS: RESULTS OF THE LIFESTYLES RANDOMIZED CONTROLLED TRIAL}, Journal = {SLEEP}, Volume = {35}, Pages = {A217-A218}, Publisher = {OXFORD UNIV PRESS INC}, Year = {2012}, Month = {January}, Key = {fds372579} } @article{fds273737, Author = {Reese, JB and Porter, LS and Somers, TJ and Keefe, FJ}, Title = {Pilot feasibility study of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer.}, Journal = {J Sex Marital Ther}, Volume = {38}, Number = {5}, Pages = {402-417}, Year = {2012}, ISSN = {0092-623X}, url = {http://dx.doi.org/10.1080/0092623X.2011.606886}, Abstract = {No studies have tested interventions addressing the sexual concerns of colorectal cancer patients and their partners. The authors reported findings from a pilot feasibility study of a novel telephone-based intimacy enhancement protocol that addresses the intimacy and sexual concerns of couples facing colorectal cancer. On the basis of a flexible coping model, the intervention was designed to help couples make cognitive and behavioral shifts in their intimate relationships. Participants were 18 individuals (9 dyads) who completed the intervention and measures of feasibility (frequency, ease of use, helpfulness of skills, ratings of rapport), program evaluations, and measures of sexual and relationship functioning. Most participants reported that the intervention was "quite a bit" or "extremely" helpful and that they had used the skills taught within the past week. The skills most commonly practiced and perceived as most helpful tended to be behavioral (e.g., trying a new sexual activity). The authors found the largest effect sizes (≥.60) for sexual distress, sexual function (female), and sexual communication. Findings from this pilot study suggest that the intimacy enhancement protocol is feasible and holds promise for improving sexual and intimacy outcomes in colorectal cancer patients and their partners. The authors discuss the research and clinical implications.}, Doi = {10.1080/0092623X.2011.606886}, Key = {fds273737} } @article{fds273631, Author = {Somers, TJ and Moseley, GL and Keefe, FJ and Kothadia, SM}, Title = {Neuroimaging of pain: A psychosocial perspective}, Pages = {275-292}, Publisher = {Springer New York}, Year = {2011}, Month = {December}, url = {http://dx.doi.org/10.1007/978-1-4419-6373-4_17}, Abstract = {The past 60 years has witnessed major changes in the way that pain is conceptualized and treated. In the 1950s, pain was generally conceptualized using a sensory model that maintained that pain is a simple sensory event that warned of tissue damage. Treatments for pain were biomedical and consisted mainly of attempts to identify underlying tissue damage and treat it medically or surgically. In the 1960s, clinicians and researchers expressed growing dissatisfaction with the sensory model of pain. In particular, it became increasingly clear that the sensory model failed to explain phenomena often seen in patients experiencing chronic pain: pain persisting despite multiple medical and surgical treatments aimed at correcting underlying tissue damage, reports of pain showing poor correlation with underlying evidence of tissue damage, pain being modified by psychosocial factors such as anxiety, social support, or expectations. Melzack and Wall's gate control theory was one of the first to maintain that pain was complex in that it not only had a sensory component but also affective,-cognitive, and behavioral components (Science 150(699):971-979, 1965). A key tenet of the gate control theory was that the brain could play a major role in modulating nociceptive signals at the spinal cord, through descending pathways from brain areas thought to be involved in affect, cognition, and behavior. The gate control theory also led to renewed interest in expanding pain treatments beyond traditional medical and surgical approaches to a wide array of-interventions that could alter pain by modifying sensation (e.g.,-transcutaneous nerve stimulation, massage), or affective (e.g., antianxiety and antidepressant medications), cognitive (e.g., cognitive therapy, distraction techniques), and behavioral processes (e.g., exercise, graded activation). © 2011 Springer Science+Business Media, LLC.}, Doi = {10.1007/978-1-4419-6373-4_17}, Key = {fds273631} } @article{fds273749, Author = {Wright, MA and Wren, AA and Somers, TJ and Goetz, MC and Fras, AM and Huh, BK and Rogers, LL and Keefe, FJ}, Title = {Pain acceptance, hope, and optimism: relationships to pain and adjustment in patients with chronic musculoskeletal pain.}, Journal = {J Pain}, Volume = {12}, Number = {11}, Pages = {1155-1162}, Year = {2011}, Month = {November}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21820969}, Abstract = {UNLABELLED: There is growing interest in the role that positive aspects of psychological adjustment, such as pain acceptance, hope, and optimism, may play in explaining adjustment in persons suffering from persistent pain. This study conducted in obese patients with persistent musculoskeletal pain (N = 89) examined the degree to which pain acceptance and hope explained pain intensity, pain unpleasantness, psychological distress, and pain-related disability, after controlling for the effects of optimism. In correlational analyses, pain acceptance and optimism were associated with psychological distress and pain disability with hope being related to only psychological distress. Pain acceptance, optimism, and hope were not significantly associated with pain. Hierarchical linear regression (HLR) analyses found that pain acceptance remained a significant predictor of psychological distress and pain disability after controlling for optimism, demographic, and medical variables. HLR analyses found that hope was not a significant predictor of psychological distress after controlling for optimism, pain acceptance, and demographic and medical variables. The results of this study are important because they indicate that pain acceptance, hope, and optimism are all related to pain adjustment. They also highlight the importance of controlling for optimism when examining the effects of pain acceptance and hope on pain adjustment. PERSPECTIVE: In a sample of obese patients with persistent musculoskeletal pain, pain acceptance was a significant predictor of psychological distress and pain disability even after controlling for optimism, demographic, and medical variables. These results add to the growing literature on the importance of pain acceptance in understanding adjustment to persistent pain.}, Doi = {10.1016/j.jpain.2011.06.002}, Key = {fds273749} } @article{fds371069, Author = {Clowse, MEB and Criscione-Schreiber, LG and Jolly, M and Keefe, FJ and Somers, TJ}, Title = {Memory Complaints in Lupus Patients: Relationship to Lupus Activity, Symptoms, Quality of Life, Psychological Distress, and Coping}, Journal = {ARTHRITIS AND RHEUMATISM}, Volume = {63}, Number = {10}, Pages = {S556-S556}, Publisher = {WILEY-BLACKWELL}, Year = {2011}, Month = {October}, Key = {fds371069} } @article{fds372580, Author = {Kurakula, P and Somers, TJ and Criscione-Schreiber, LG and Keefe, FJ and Clowse, MEB}, Title = {The Relationship Between Pain Coping Skills and Pain, Fatigue, Mood, and Lupus Activity}, Journal = {ARTHRITIS AND RHEUMATISM}, Volume = {63}, Number = {10}, Pages = {S555-S556}, Publisher = {WILEY-BLACKWELL}, Year = {2011}, Month = {October}, Key = {fds372580} } @article{fds273721, Author = {Lumley, MA and Cohen, JL and Borszcz, GS and Cano, A and Radcliffe, AM and Porter, LS and Schubiner, H and Keefe, FJ}, Title = {Pain and emotion: a biopsychosocial review of recent research.}, Journal = {J Clin Psychol}, Volume = {67}, Number = {9}, Pages = {942-968}, Year = {2011}, Month = {September}, ISSN = {0021-9762}, url = {http://dx.doi.org/10.1002/jclp.20816}, Abstract = {OBJECTIVE AND METHOD: Research on emotion and pain has burgeoned. We review the last decade's literature, focusing on links between emotional processes and persistent pain. RESULTS: Neurobiological research documents the neural processes that distinguish affective from sensory pain dimensions, link emotion and pain, and generate central nervous system pain sensitization. Psychological research demonstrates that greater pain is related to emotional stress and limited emotional awareness, expression, and processing. Social research shows the potential importance of emotional communication, empathy, attachment, and rejection. CONCLUSIONS: Emotions are integral to the conceptualization, assessment, and treatment of persistent pain. Research should clarify when to eliminate or attenuate negative emotions, and when to access, experience, and express them. Theory and practice should integrate emotion into cognitive-behavioral models of persistent pain.}, Doi = {10.1002/jclp.20816}, Key = {fds273721} } @article{fds371070, Author = {Cox, CE and Porter, LS and Hough, CL and Kahn, JM and Carson, SS and Curtis, JR and White, DB and Keefe, FJ}, Title = {TELEPHONE-BASED COPING SKILLS TRAINING FOR ACUTE LUNG INJURY SURVIVORS & THEIR INFORMAL CAREGIVERS}, Journal = {INTENSIVE CARE MEDICINE}, Volume = {37}, Pages = {S135-S135}, Publisher = {SPRINGER}, Year = {2011}, Month = {September}, Key = {fds371070} } @article{fds273720, Author = {Porter, LS and Keefe, FJ}, Title = {Psychosocial issues in cancer pain.}, Journal = {Curr Pain Headache Rep}, Volume = {15}, Number = {4}, Pages = {263-270}, Year = {2011}, Month = {August}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21400251}, Abstract = {Cancer pain is a complex and multidimensional experience that affects and is affected by psychological and social factors. This article reviews recent research that points to a number of key psychosocial factors associated with pain, including psychological distress, coping, and social support, as well as the impact of socioeconomic factors on barriers to pain management. We also review recent research suggesting that psychosocial interventions, including education, coping-skills training, and hypnosis, may be useful adjuncts to medical management of pain. Clinical implications and recommendations for future research are discussed.}, Doi = {10.1007/s11916-011-0190-6}, Key = {fds273720} } @article{fds273754, Author = {Bastian, LA and Fish, LJ and Peterson, BL and Biddle, AK and Garst, J and Lyna, P and Molner, S and Bepler, G and Kelley, M and Keefe, FJ and McBride, CM}, Title = {Proactive recruitment of cancer patients' social networks into a smoking cessation trial.}, Journal = {Contemp Clin Trials}, Volume = {32}, Number = {4}, Pages = {498-504}, Year = {2011}, Month = {July}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21382509}, Abstract = {BACKGROUND: This report describes the characteristics associated with successful enrollment of smokers in the social networks (i.e., family and close friends) of patients with lung cancer into a smoking cessation intervention. METHODS: Lung cancer patients from four clinical sites were asked to complete a survey enumerating their family members and close friends who smoke, and provide permission to contact these potential participants. Family members and close friends identified as smokers were interviewed and offered participation in a smoking cessation intervention. Repeated measures logistic regression model examined characteristics associated with enrollment. RESULTS: A total of 1062 eligible lung cancer patients were identified and 516 patients consented and completed the survey. These patients identified 1325 potentially eligible family and close friends. Of these, 496 consented and enrolled in the smoking cessation program. Network enrollment was highest among patients who were white and had late-stage disease. Social network members enrolled were most likely to be female, a birth family, immediate family, or close friend, and live in close geographic proximity to the patient. CONCLUSIONS: Proactive recruitment of smokers in the social networks of lung cancer patients is challenging. In this study, the majority of family members and friends declined to participate. Enlisting immediate female family members and friends, who live close to the patient as agents to proactively recruit other network members into smoking cessation trials could be used to extend reach of cessation interventions to patients' social networks. Moreover, further consideration should be given to the appropriate timing of approaching network smokers to consider cessation.}, Doi = {10.1016/j.cct.2011.03.006}, Key = {fds273754} } @article{fds273718, Author = {Tsai, P-F and Kuo, Y-F and Beck, C and Richards, K and Means, KM and Pate, BL and Keefe, FJ}, Title = {Non-verbal cues to osteoarthritic knee and/or hip pain in elders.}, Journal = {Res Nurs Health}, Volume = {34}, Number = {3}, Pages = {218-227}, Year = {2011}, Month = {June}, ISSN = {0160-6891}, url = {http://dx.doi.org/10.1002/nur.20432}, Abstract = {Behavioral cues are believed to be useful to identify pain among elders who may be experiencing pain but unable to express it. To examine this assumption, we recruited 192 elders who could verbally express pain to determine whether regression models combining behavioral cues (motor and gait patterns) predicted verbal pain reports. In the best model, age (p < .01) and subscales that measured guarding (p < .001) and joint flexion (p < .01) motor patterns were significant predictors of verbal pain reports. The receiver operating characteristic curve indicated that the best cutoff for predictive probability was 40-44%, with a fair to good C statistic of .78 (SD = .04). With a 40% cutoff, sensitivity and specificity were 71.6% and 71.0%, respectively. The investigators concluded that the final model could serve as a building block for the development of a tool using behavioral cues to identify elders' pain.}, Doi = {10.1002/nur.20432}, Key = {fds273718} } @article{fds273780, Author = {Riddle, DL and Keefe, FJ and Nay, WT and McKee, D and Attarian, DE and Jensen, MP}, Title = {Pain coping skills training for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty: a quasi-experimental study.}, Journal = {Arch Phys Med Rehabil}, Volume = {92}, Number = {6}, Pages = {859-865}, Year = {2011}, Month = {June}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21530943}, Abstract = {OBJECTIVES: To (1) describe a behavioral intervention designed for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty, and (2) use a quasi-experimental design to evaluate the potential efficacy of the intervention on pain severity, catastrophizing cognitions, and disability. DESIGN: Quasi-experimental nonequivalent control group design with a 2-month follow-up. SETTING: Two university-based orthopedic surgery departments. PARTICIPANTS: Adults (N=63) scheduled for knee replacement surgery who reported elevated levels of pain catastrophizing. Patients were recruited from 2 clinics and were assessed prior to surgery and 2 months after surgery. INTERVENTIONS: A group of 18 patients received a psychologist-directed pain coping skills training intervention comprising 8 sessions. The other group, a historical cohort of 45 patients, received usual care. MAIN OUTCOME MEASURES: Western Ontario and McMaster Universities Arthritis Index Pain and Disability scores, as well as scores on the Pain Catastrophizing Scale. RESULTS: Two months after surgery, the patients who received pain coping skills training reported significantly greater reductions in pain severity and catastrophizing, and greater improvements in function as compared to the usual care cohort. CONCLUSIONS: Pain catastrophizing is known to increase risk of poor outcome after knee arthroplasty. The findings provide preliminary evidence that the treatment may be highly efficacious for reducing pain, catastrophizing, and disability, in patients reporting elevated catastrophizing prior to knee arthroplasty. A randomized controlled trial is warranted to confirm these effects.}, Doi = {10.1016/j.apmr.2011.01.003}, Key = {fds273780} } @article{fds371071, Author = {Shelby, RA and Keefe, FJ and Red, SN and Blackwell, KL and Peppercorn, JM and Marcom, PK and Kimmick, GG}, Title = {Symptom experiences and nonadherent medication-taking behaviors of breast cancer patients taking adjuvant hormone therapy.}, Journal = {Journal of Clinical Oncology}, Volume = {29}, Number = {15_suppl}, Pages = {524-524}, Publisher = {American Society of Clinical Oncology (ASCO)}, Year = {2011}, Month = {May}, url = {http://dx.doi.org/10.1200/jco.2011.29.15_suppl.524}, Doi = {10.1200/jco.2011.29.15_suppl.524}, Key = {fds371071} } @article{fds371072, Author = {Shelby, RA and Keefe, FJ and Red, SN and Blackwell, KL and Peppercorn, JM and Marcom, PK and Kimmick, GG}, Title = {Symptom experiences and nonadherent medication-taking behaviors of breast cancer patients taking adjuvant hormone therapy.}, Journal = {J Clin Oncol}, Volume = {29}, Number = {15_suppl}, Pages = {524}, Year = {2011}, Month = {May}, Abstract = {524 Background: Many breast cancer patients do not adhere to prescribed adjuvant hormone therapy. This pilot study explored symptom experiences and medication adherence behaviors. METHODS: Eligible women were postmenopausal, had hormone receptor positive stage I-IIIA breast cancer, completed surgery, chemotherapy, and radiation, and were taking adjuvant hormonal therapy. Standardized instruments were used: Brief Fatigue Inventory, Brief Pain Inventory, Menopause Specific Quality of Life Questionnaire, Pain Catastrophizing Scale, Modified Morisky Medication Adherence Scale, and Beliefs about Medicines Questionnaire. T-tests were used to compare symptoms by type of medication. Pearson correlations examined associations between medication taking behaviors and symptoms. RESULTS: 108 women enrolled: mean age 64 (SD 9) years, 81% white. Mean time from surgery was 46 (SD 29) months and on hormonal therapy, overall and current, was 41 (SD 30) and 26 (SD 20) months, respectively. 19% were taking tamoxifen and 81% an AI (30% anastrozole; 18% exemestane; 33% letrozole). 27% changed therapy. Reasons for change were pain (tamoxifen n=8 vs AI n=20), vasomotor symptoms (1 vs 1), osteoporosis (1 vs 3), and rash (1 vs 1). Significantly (p<.05) more fatigue, pain intensity, and pain interference were reported with AI compared to tamoxifen. Significant (p<.05) predictors of nonadherent medication taking behaviors were: greater fatigue (r=.28), pain intensity (r=.28), pain interference (r=.35), pain catastrophizing (r=.30), menopausal symptoms (r=.41), and medication concerns (r=.29). Type of medication and perceived medication necessity were not associated with nonadherent medication taking behaviors. CONCLUSIONS: Side effects and perceived side effect severity are associated with nonadherent medication taking behavior. Interventions to address perceived side effects may improve adherence to therapy. [Table: see text].}, Key = {fds371072} } @article{fds273719, Author = {Broderick, JE and Junghaenel, DU and Schneider, S and Bruckenthal, P and Keefe, FJ}, Title = {Treatment expectation for pain coping skills training: relationship to osteoarthritis patients' baseline psychosocial characteristics.}, Journal = {Clin J Pain}, Volume = {27}, Number = {4}, Pages = {315-322}, Year = {2011}, Month = {May}, ISSN = {0749-8047}, url = {http://dx.doi.org/10.1097/AJP.0b013e3182048549}, Abstract = {OBJECTIVES: This study examined predictors of treatment expectation among osteoarthritis (OA) patients in a multisite clinical trial of pain coping skills training (CST). METHODS: Patients (N=171) completed a pretreatment assessment battery that asked questions about treatment expectations, pain coping variables, pain, physical function, psychological distress, quality of life, and depression as well as background demographic and medical variables. RESULTS: Regression analyses indicated that several variables accounted for 21% of the variance in treatment expectations (P<0.0001). Patients who were classified as adaptive copers, reported higher self-efficacy and social interaction, had higher quality of life, and who had lower levels of affective distress and depression had more positive expectations about engaging in pain CST. Variables that were not associated with treatment expectation were level of pain and physical dysfunction, duration of disease, and disability status as well as demographic variables. DISCUSSION: Although many OA patients will approach pain CST with positive expectations, others have lower expectations. This study suggests that a multidimensional assessment of OA patients with chronic pain can identify those who have higher expectations versus lower expectations. The results suggest that patients who are psychologically distressed are less optimistic about engaging in treatment and that these patients, in particular, may benefit from and need pretreatment motivational interviewing to enhance their uptake of pain coping skills.}, Doi = {10.1097/AJP.0b013e3182048549}, Key = {fds273719} } @article{fds273717, Author = {Keefe, FJ}, Title = {Behavioral medicine: a voyage to the future.}, Journal = {Ann Behav Med}, Volume = {41}, Number = {2}, Pages = {141-151}, Year = {2011}, Month = {April}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21264691}, Abstract = {This paper discusses trends and future directions in behavioral medicine. It is divided into three sections. The first briefly reviews key developments in the history of behavioral medicine. The second section highlights trends and future directions in pain research and practice as a way of illustrating future directions for behavioral medicine. Consistent with the biopsychosocial model of pain, this section focuses on trends and future directions in three key areas: biological, psychological, and social. The third section describes recent Society of Behavioral Medicine initiatives designed to address some of the key challenges facing our field as we prepare for the future.}, Doi = {10.1007/s12160-010-9239-8}, Key = {fds273717} } @article{fds273752, Author = {Flynn, KE and Jeffery, DD and Keefe, FJ and Porter, LS and Shelby, RA and Fawzy, MR and Gosselin, TK and Reeve, BB and Weinfurt, KP}, Title = {Sexual functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS®).}, Journal = {Psychooncology}, Volume = {20}, Number = {4}, Pages = {378-386}, Year = {2011}, Month = {April}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20878833}, Abstract = {OBJECTIVE: Cancer and treatments for cancer affect specific aspects of sexual functioning and intimacy; however, limited qualitative work has been done in diverse cancer populations. As part of an effort to improve measurement of self-reported sexual functioning, we explored the scope and importance of sexual functioning and intimacy to patients across cancer sites and along the continuum of care. METHODS: We conducted 16 diagnosis- and sex-specific focus groups with patients recruited from the Duke University tumor registry and oncology/hematology clinics (N=109). A trained note taker produced field notes summarizing the discussions. An independent auditor verified field notes against written transcripts. The content of the discussions was analyzed for major themes by two independent coders. RESULTS: Across all cancers, the most commonly discussed cancer- or treatment-related effects on sexual functioning and intimacy were fatigue, treatment-related hair loss, weight gain and organ loss or scarring. Additional barriers were unique to particular diagnoses, such as shortness of breath in lung cancer, gastrointestinal problems in colorectal cancers and incontinence in prostate cancer. Sexual functioning and intimacy were considered important to quality of life. While most effects of cancer were considered negative, many participants identified improvements to intimacy after cancer. CONCLUSION: Overall evaluations of satisfaction with sex life did not always correspond to specific aspects of functioning (e.g. erectile dysfunction), presenting a challenge to researchers aiming to measure sexual functioning as an outcome. Health-care providers should not assume that level of sexual impairment determines sexual satisfaction and should explore cancer patients' sexual concerns directly.}, Doi = {10.1002/pon.1738}, Key = {fds273752} } @article{fds273772, Author = {Keefe, FJ and Shelby, RA and Somers, TJ and Varia, I and Blazing, M and Waters, SJ and McKee, D and Silva, S and She, L and Blumenthal, JA and O'Connor, J and Knowles, V and Johnson, P and Bradley, L}, Title = {Effects of coping skills training and sertraline in patients with non-cardiac chest pain: a randomized controlled study.}, Journal = {Pain}, Volume = {152}, Number = {4}, Pages = {730-741}, Year = {2011}, Month = {April}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21324590}, Abstract = {Non-cardiac chest pain (NCCP) is a common and distressing condition. Prior studies suggest that psychotropic medication or pain coping skills training (CST) may benefit NCCP patients. To our knowledge, no clinical trials have examined the separate and combined effects of CST and psychotropic medication in the management of NCCP. This randomized clinical trial examined the separate and combined effects of CST and antidepressant medication (sertraline) in participants with non-cardiac chest pain. A sample of individuals diagnosed with NCCP was randomly assigned to one of four treatments: (1) CST plus sertraline (CST+sertraline), (2) CST plus placebo (CST+placebo), (3) sertraline alone, or (4) placebo alone. Assessments of pain intensity, pain unpleasantness, anxiety, pain catastrophizing, depression, and physical disability were collected prior to treatment, and at 10- and 34-weeks following randomization. Data analyses revealed that CST and sertraline either alone or in combination significantly reduced pain intensity and pain unpleasantness. The combination of CST plus sertraline may have the greatest promise in that, when compared to placebo alone, it not only significantly reduced pain but also pain catastrophizing and anxiety. Overall, these findings support the importance of further research on the effects of CST and sertraline for non-cardiac chest pain.}, Doi = {10.1016/j.pain.2010.08.040}, Key = {fds273772} } @article{fds371073, Author = {Wren, AA and Somers, TJ and Wright, MA and Goetz, MC and Leary, MR and Fras, AM and Huh, BK and Rogers, LL and Keefe, FJ}, Title = {SELF-COMPASSION IN PATIENTS WHO ARE OBESE AND HAVE PERSISTENT MUSCULOSKELETAL PAIN: RELATIONSHIP OF SELF-COMPASSION TO PAIN- AND WEIGHT-RELATED FACTORS}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {41}, Pages = {S217-S217}, Publisher = {SPRINGER}, Year = {2011}, Month = {April}, Key = {fds371073} } @article{fds371074, Author = {Shelby, RA and Keefe, FJ and Soo, MS and Skinner, CS and Stinnett, S and Luce, MF and Zuley, ML and Sumkin, JH and Bovbjerg, DH}, Title = {PSYCHOLOGICAL FACTORS ASSOCIATED WITH SELF-REPORTED BREAST PAIN PRIOR TO ROUTINE MAMMOGRAPHY IN BREAST CANCER SURVIVORS AND WOMEN WITHOUT A HISTORY OF CANCER}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {41}, Pages = {S160-S160}, Publisher = {SPRINGER}, Year = {2011}, Month = {April}, Key = {fds371074} } @article{fds273716, Author = {Wren, AA and Wright, MA and Carson, JW and Keefe, FJ}, Title = {Yoga for persistent pain: new findings and directions for an ancient practice.}, Journal = {Pain}, Volume = {152}, Number = {3}, Pages = {477-480}, Year = {2011}, Month = {March}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21247696}, Doi = {10.1016/j.pain.2010.11.017}, Key = {fds273716} } @article{fds273790, Author = {Abernethy, AP and Wheeler, JL and Courtney, PK and Keefe, FJ}, Title = {Supporting implementation of evidence-based behavioral interventions: the role of data liquidity in facilitating translational behavioral medicine.}, Journal = {Transl Behav Med}, Volume = {1}, Number = {1}, Pages = {45-52}, Year = {2011}, Month = {March}, ISSN = {1869-6716}, url = {http://dx.doi.org/10.1007/s13142-011-0024-4}, Abstract = {The advancement of translational behavioral medicine will require that we discover new methods of managing large volumes of data from disparate sources such as disease surveillance systems, public health systems, and health information systems containing patient-centered data informed by behavioral and social sciences. The term "liquidity," when applied to data, refers to its availability and free flow throughout human/computer interactions. In seeking to achieve liquidity, the focus is not on creating a single, comprehensive database or set of coordinated datasets, nor is it solely on developing the electronic health record as the "one-stop shopping" source of health-related data. Rather, attention is on ensuring the availability of secure data through the various methods of collecting and storing data currently existent or under development-so that these components of the health information infrastructure together support a liquid data system. The value of accessible, interoperable, high-volume, reliable, secure, and contextually appropriate data is becoming apparent in many areas of the healthcare system, and health information liquidity is currently viewed as an important component of a patient-centered healthcare system. The translation from research interventions to behavioral and psychosocial indicators challenges the designers of healthcare systems to include this new set of data in the correct context. With the intention of advancing translational behavioral medicine at the local level, "on the ground" in the clinical office and research institution, this commentary discusses data liquidity from the patient's and clinician's perspective, requirements for a liquid healthcare data system, and the ways in which data liquidity can support translational behavioral medicine.}, Doi = {10.1007/s13142-011-0024-4}, Key = {fds273790} } @article{fds273715, Author = {Prasertsri, N and Holden, J and Keefe, FJ and Wilkie, DJ}, Title = {Repressive coping style: relationships with depression, pain, and pain coping strategies in lung cancer outpatients.}, Journal = {Lung Cancer}, Volume = {71}, Number = {2}, Pages = {235-240}, Year = {2011}, Month = {February}, ISSN = {0169-5002}, url = {http://dx.doi.org/10.1016/j.lungcan.2010.05.009}, Abstract = {Researchers have shown that coping style is related to pain and adjustment in people with chronic illness. This study was the first to examine how coping style related to pain, pain coping strategies, and depression in lung cancer outpatients. We conducted a comparative, secondary data analysis of 107 lung cancer patients (73% male, mean age 61.4±10.43 years, 88% Caucasian). As in prior studies, we classified patients into four coping style groups based on Marlowe-Crowne Social Desirability Scale and trait anxiety scores. The coping style groups were low-anxious (n=25); high-anxious (n=31); defensive high-anxious (n=21); and repressive (n=30). Compared to other coping style groups, the repressive group reported statistically significant lower mean scores for pain quality, pain catastrophizing, and depression. Assessing coping style by measuring personal characteristics such as social desirability and trait anxiety may help clinicians to identify vulnerable individuals with lung cancer who may be candidates for early and timely intervention efforts to enhance adjustment to pain.}, Doi = {10.1016/j.lungcan.2010.05.009}, Key = {fds273715} } @article{fds273712, Author = {Somers, TJ and Wren, AA and Keefe, FJ}, Title = {Understanding chronic pain in older adults: abdominal fat is where it is at.}, Journal = {Pain}, Volume = {152}, Number = {1}, Pages = {8-9}, Year = {2011}, Month = {January}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20952130}, Doi = {10.1016/j.pain.2010.09.022}, Key = {fds273712} } @article{fds273713, Author = {Gremore, TM and Baucom, DH and Porter, LS and Kirby, JS and Atkins, DC and Keefe, FJ}, Title = {Stress buffering effects of daily spousal support on women's daily emotional and physical experiences in the context of breast cancer concerns.}, Journal = {Health Psychol}, Volume = {30}, Number = {1}, Pages = {20-30}, Year = {2011}, Month = {January}, ISSN = {0278-6133}, url = {http://dx.doi.org/10.1037/a0021798}, Abstract = {OBJECTIVE: This study examined whether the relationship between daily spousal support and daily psychological and physical outcomes varied as a function of level of breast cancer related concern (stress buffering model). DESIGN: Ninety-five women with early stage breast cancer completed daily reports of emotional and physical experiences and satisfaction with spousal support for 30 days. Women also rated problems dealing with three types of cancer specific concerns: emotional, physical, and social. MAIN OUTCOME MEASURES: Women's positive and negative affect and cancer related pain and fatigue. RESULTS: Multilevel analyses supported a stress buffering effect for social concerns and a reverse stress buffering effect for emotional and physical concerns. CONCLUSION: Daily spousal support appears to be an important contributor to the daily emotional and physical wellbeing of women with breast cancer. Contrary to the tenets of the stress buffering model, these data suggest that the buffering effect of spousal support is attenuated when breast cancer related emotional and physical concerns reach high levels.}, Doi = {10.1037/a0021798}, Key = {fds273713} } @article{fds273714, Author = {Porter, LS and Keefe, FJ and Garst, J and Baucom, DH and McBride, CM and McKee, DC and Sutton, L and Carson, K and Knowles, V and Rumble, M and Scipio, C}, Title = {Caregiver-assisted coping skills training for lung cancer: results of a randomized clinical trial.}, Journal = {J Pain Symptom Manage}, Volume = {41}, Number = {1}, Pages = {1-13}, Year = {2011}, Month = {January}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20832982}, Abstract = {CONTEXT: Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms, including pain, fatigue, shortness of breath, and psychological distress. Caregivers and patients are adversely affected. However, previous studies of coping skills training (CST) interventions have not been tested in patients with lung cancer nor have systematically included caregivers. OBJECTIVES: This study tested the efficacy of a caregiver-assisted CST protocol in a sample of patients with lung cancer. METHODS: Two hundred thirty-three lung cancer patients and their caregivers were randomly assigned to receive 14 telephone-based sessions of either caregiver-assisted CST or education/support involving the caregiver. Patients completed measures assessing pain, psychological distress, quality of life (QOL), and self-efficacy for symptom management; caregivers completed measures assessing psychological distress, caregiver strain, and self-efficacy for helping the patient manage symptoms. RESULTS: Patients in both treatment conditions showed improvements in pain, depression, QOL, and self-efficacy, and caregivers in both conditions showed improvements in anxiety and self-efficacy from baseline to four-month follow-up. Results of exploratory analyses suggested that the CST intervention was more beneficial to patients/caregivers with Stage II and III cancers, whereas the education/support intervention was more beneficial to patients/caregivers with Stage I cancer. CONCLUSION: Taken together with the broader literature in this area, results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients. Suggestions for future studies include the use of three-group designs (e.g., comparing two active interventions with a standard-care control) and examining mechanisms of change.}, Doi = {10.1016/j.jpainsymman.2010.04.014}, Key = {fds273714} } @article{fds273722, Author = {Naylor, MR and Krauthamer, GM and Naud, S and Keefe, FJ and Helzer, JE}, Title = {Predictive relationships between chronic pain and negative emotions: a 4-month daily process study using Therapeutic Interactive Voice Response (TIVR).}, Journal = {Compr Psychiatry}, Volume = {52}, Number = {6}, Pages = {731-736}, Year = {2011}, ISSN = {0010-440X}, url = {http://dx.doi.org/10.1016/j.comppsych.2010.11.008}, Abstract = {This article examines temporal relationships between negative emotions and pain in a cohort of 33 patients with chronic musculoskeletal pain enrolled in a telephone-based relapse prevention program (Therapeutic Interactive Voice Response [TIVR]), after 11 weeks of group cognitive behavioral therapy (CBT). Patients were asked to make daily reports to the TIVR system for 4 months after CBT. Patients' daily reports were analyzed with path analysis to examine temporal relationships between 3 emotion variables (anger, sadness, and stress) and 2 pain variables (pain and pain control). As expected, same-day correlations were significant between emotion variables and both pain and pain control. The lagged associations revealed unidirectional relationships between pain and next-day emotions: increased pain predicted higher reports of sadness the following day (P < .05). Conversely, increased pain control predicted decreased sadness and anger the following day (P < .05). Unlike some previous studies, this study did not reveal that an increase of negative emotions predicted increased next-day pain. We speculate that CBT treatment followed by the relapse prevention program teaches patients how to modulate negative emotions such that they no longer have a negative impact on next-day pain perception. The clinical implications of our findings are discussed.}, Doi = {10.1016/j.comppsych.2010.11.008}, Key = {fds273722} } @article{fds273620, Author = {Shelby, RA and Keefe, FJ}, Title = {Chronic pain and adherence}, Pages = {179-214}, Publisher = {Springer New York}, Year = {2010}, Month = {December}, url = {http://dx.doi.org/10.1007/978-1-4419-5866-2_8}, Abstract = {Chronic pain of non-malignant etiology is a significant problem. Chronic non-malignant pain is typically defined as pain that persists for 3 months or longer and that is non-life threatening [1, 2]. Among the most common chronic pain conditions are chronic back pain, migraine headaches, and tension headaches. Chronic pain is very common. In the United States, 17% of patients seen in primary care report chronic pain [3], and chronic pain accounts for almost 80% of all physician visits [4]. A review of 15 epidemiologic studies found that the prevalence of chronic pain ranges from 2 to 40% in the adult population, with a median point prevalence of 15% [5]. The personal and economic costs of chronic pain are substantial. A study of primary care patients found that 13% of headache patients and 18% of back pain patients were unable to maintain full-time work over a 3-year period due to pain [6]. Chronic pain is often accompanied by substantial decreases in physical functioning, disruption of social and family roles, and psychological distress [4]. © 2010 Springer Science+Business Media, LLC.}, Doi = {10.1007/978-1-4419-5866-2_8}, Key = {fds273620} } @article{fds273710, Author = {Naylor, MR and Naud, S and Keefe, FJ and Helzer, JE}, Title = {Therapeutic Interactive Voice Response (TIVR) to reduce analgesic medication use for chronic pain management.}, Journal = {J Pain}, Volume = {11}, Number = {12}, Pages = {1410-1419}, Year = {2010}, Month = {December}, ISSN = {1526-5900}, url = {http://dx.doi.org/10.1016/j.jpain.2010.03.019}, Abstract = {UNLABELLED: This paper examines whether a telephone-based, automated maintenance enhancement program can help to reduce opioid and nonsteroidal anti-inflamatory drugs (NSAID) analgesic use in patients with chronic pain. Following 11 weeks of group cognitive-behavioral therapy (CBT), 51 subjects with chronic musculoskeletal pain were randomized to 1 of 2 study groups. Twenty-six subjects participated in 4 months of a Therapeutic Interactive Voice Response (TIVR) program in addition to standard follow-up care, while a control group of 25 subjects received standard follow-up care only. TIVR is an automated, telephone-based tool developed for the maintenance and enhancement of CBT skills. Opioid analgesic use decreased in the experimental group in both follow-ups: 4 and 8 months postCBT. In addition, at 8-month follow-up, 21% of the TIVR subjects had discontinued the use of opioid analgesics, 23% had discontinued NSAIDS, and 10% had discontinued antidepressant medications. In contrast, the control group showed increases in opioid and NSAIDS use. Analysis of covariance (ANCOVA) revealed significant between-group differences in opioid analgesic use at 8-month follow up (P = .004). We have previously demonstrated the efficacy of TIVR to decrease pain and improve coping; this analysis demonstrates that the use of TIVR may also result in concurrent reductions in opioid analgesic and NSAID medications use. PERSPECTIVE: This article demonstrates that the Therapeutic Interactive Voice Response maintenance enhancement program can help to reduce opioid analgesic use in patients with chronic pain. This automated maintenance enhancement program could potentially assist patients not only to decrease pain and improve coping, but also to diminish the likelihood of opioid dependence.}, Doi = {10.1016/j.jpain.2010.03.019}, Key = {fds273710} } @article{fds273709, Author = {Riddle, DL and Johnson, RE and Jensen, MP and Keefe, FJ and Kroenke, K and Bair, MJ and Ang, DC}, Title = {The Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) instrument was useful for refining a randomized trial design: experiences from an investigative team.}, Journal = {J Clin Epidemiol}, Volume = {63}, Number = {11}, Pages = {1271-1275}, Year = {2010}, Month = {November}, ISSN = {0895-4356}, url = {http://dx.doi.org/10.1016/j.jclinepi.2010.03.006}, Abstract = {OBJECTIVE: A recently published instrument (PRECIS) was designed to assist investigative teams in understanding the various design decisions that need to be made regarding pragmatic vs. explanatory trials. Our team used this instrument during an investigators' meeting to organize our discussion regarding the design of a planned trial and to determine the extent of consensus among the study investigators. STUDY DESIGN AND SETTING: The study was descriptive in nature and occurred during an investigator meeting. After reading and reviewing the 10 PRECIS criteria, the team made quantitative judgments of the planned study regarding each PRECIS criteria to reflect initial, ideal, and final study design perceptions. RESULTS: Data indicated that the final study design was more explanatory in nature than the preliminary plan. Evidence of consensus was obtained. CONCLUSION: The investigative team found that applying PRECIS principles were useful for (1) detailing points of discussion related to trial design, (2) making revisions to the design to be consistent with the project goals, and (3) achieving consensus. We believe our experiences with PRECIS may prove valuable for trial researchers in much the same way that case reports can provide valuable insights for clinicians.}, Doi = {10.1016/j.jclinepi.2010.03.006}, Key = {fds273709} } @article{fds273711, Author = {Rumble, ME and Keefe, FJ and Edinger, JD and Affleck, G and Marcom, PK and Shaw, HS}, Title = {Contribution of cancer symptoms, dysfunctional sleep related thoughts, and sleep inhibitory behaviors to the insomnia process in breast cancer survivors: a daily process analysis.}, Journal = {Sleep}, Volume = {33}, Number = {11}, Pages = {1501-1509}, Year = {2010}, Month = {November}, ISSN = {0161-8105}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21102992}, Abstract = {STUDY OBJECTIVES: using a comprehensive cognitive-behavioral model of insomnia and a daily process approach, this study was conducted to examine the contribution of cancer symptoms and dysfunctional sleep related thoughts and behaviors to the process of insomnia in breast cancer survivors. DESIGN: within-group longitudinal research design. SETTING: an academic medical center. PARTICIPANTS: 41 women with breast cancer who had completed their primary cancer treatment and met Research Diagnostic Criteria for primary insomnia or insomnia comorbid with breast cancer. INTERVENTIONS: NA. MEASUREMENTS AND RESULTS: for 28 days, participants completed morning diaries assessing sleep, nighttime pain and hot flashes, and dysfunctional sleep related thoughts and behaviors during the day and night, and evening diaries assessing daytime pain, fatigue, hot flashes, and mood. All diaries were collected using an automated telephone-based system. Results revealed that poorer sleep was related to nighttime pain and hot flashes in breast cancer patients. Time-lagged effects were also found. The current study identified higher levels of dysfunctional sleep related thoughts and sleep inhibitory behaviors during the day and night as antecedents of insomnia, and higher levels of pain, fatigue, and hot flashes and lower levels of positive mood and dysfunctional sleep related thoughts as consequences of insomnia in this population. CONCLUSIONS: the current study found support for a comprehensive cognitive-behavioral model of insomnia, which has several theoretical, practice, and research implications.}, Doi = {10.1093/sleep/33.11.1501}, Key = {fds273711} } @article{fds273707, Author = {Reese, JB and Somers, TJ and Keefe, FJ and Mosley-Williams, A and Lumley, MA}, Title = {Pain and functioning of rheumatoid arthritis patients based on marital status: is a distressed marriage preferable to no marriage?}, Journal = {J Pain}, Volume = {11}, Number = {10}, Pages = {958-964}, Year = {2010}, Month = {October}, ISSN = {1526-5900}, url = {http://dx.doi.org/10.1016/j.jpain.2010.01.003}, Abstract = {UNLABELLED: Relationships may influence adjustment to chronic pain conditions such as rheumatoid arthritis (RA). We examined how both marital status and marital adjustment were related to pain, physical disability, and psychological disability in 255 adults with RA. Among married participants (n = 158), better marital adjustment (assessed using the Locke-Wallace Marital Adjustment Scale) was correlated with less pain and physical and psychological disability (all P values < .05). Married participants were divided into distressed (n = 44) and nondistressed (n = 114) subgroups and compared with unmarried participants (n = 97). Controlling for demographics and disease severity, unmarried participants had higher affective pain (P = .009) and higher psychological disability (P = .02) than only the nondistressed married participants, but unmarried participants did not differ from distressed married participants. These findings suggest that being married in itself is not associated with better health in RA but that being in a well-adjusted or nondistressed marriage is linked with less pain and better functioning. PERSPECTIVE: This study examined relationships of marital status and marital adjustment to pain and physical and psychological disability in RA. Findings underscore the importance of considering not only marital status but also degree of marital adjustment in RA and may inform clinical interventions in this population.}, Doi = {10.1016/j.jpain.2010.01.003}, Key = {fds273707} } @article{fds273708, Author = {Kilts, JD and Tupler, LA and Keefe, FJ and Payne, VM and Hamer, RM and Naylor, JC and Calnaido, RP and Morey, RA and Strauss, JL and Parke, G and Massing, MW and Youssef, NA and Shampine, LJ and tVeterans Affairs Mid-Atlantic Mental Illness and Research, Education and Clinical Center Workgroup, and Marx, CE}, Title = {Neurosteroids and self-reported pain in veterans who served in the U.S. Military after September 11, 2001.}, Journal = {Pain Med}, Volume = {11}, Number = {10}, Pages = {1469-1476}, Year = {2010}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20735755}, Abstract = {OBJECTIVE: Nearly half of Operation Enduring Freedom/Operation Iraqi Freedom veterans experience continued pain post-deployment. Several investigations report analgesic effects of allopregnanolone and other neurosteroids in animal models, but few data are currently available focusing on neurosteroids in clinical populations. Allopregnanolone positively modulates GABA(A) receptors and demonstrates pronounced analgesic and anxiolytic effects in rodents, yet studies examining the relationship between pain and allopregnanolone in humans are limited. We thus hypothesized that endogenous allopregnanolone and other neurosteroid levels may be negatively correlated with self-reported pain symptoms in humans. DESIGN: We determined serum neurosteroid levels by gas chromatography/mass spectrometry (allopregnanolone, pregnenolone) or radioimmunoassay (dehydroepiandrosterone [DHEA], progesterone, DHEA sulfate [DHEAS]) in 90 male veterans who served in the U.S. military after September 11, 2001. Self-reported pain symptoms were assessed in four areas (low back pain, chest pain, muscle soreness, headache). Stepwise linear regression analyses were conducted to investigate the relationship between pain assessments and neurosteroids, with the inclusion of smoking, alcohol use, age, and history of traumatic brain injury as covariates. SETTING: Durham VA Medical Center. RESULTS: Allopregnanolone levels were inversely associated with low back pain (P=0.044) and chest pain (P=0.013), and DHEA levels were inversely associated with muscle soreness (P=0.024). DHEAS levels were positively associated with chest pain (P=0.001). Additionally, there was a positive association between traumatic brain injury and muscle soreness (P=0.002). CONCLUSIONS: Neurosteroids may be relevant to the pathophysiology of self-reported pain symptoms in this veteran cohort, and could represent future pharmacological targets for pain disorders.}, Doi = {10.1111/j.1526-4637.2010.00927.x}, Key = {fds273708} } @article{fds273753, Author = {Flynn, KE and Shelby, RA and Mitchell, SA and Fawzy, MR and Hardy, NC and Husain, AM and Keefe, FJ and Krystal, AD and Porter, LS and Reeve, BB and Weinfurt, KP}, Title = {Sleep-wake functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS(®)).}, Journal = {Psychooncology}, Volume = {19}, Number = {10}, Pages = {1086-1093}, Year = {2010}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20013938}, Abstract = {OBJECTIVE: Cancer and its treatments disturb sleep-wake functioning; however, there is little information available on the characteristics and consequences of sleep problems associated with cancer. As part of an effort to improve measurement of sleep-wake functioning, we explored the scope of difficulties with sleep in a diverse group of patients diagnosed with cancer. METHODS: We conducted 10 focus groups with patients recruited from the Duke University tumor registry and oncology/hematology clinics. Separate groups were held with patients scheduled to begin or currently undergoing treatment for breast, prostate, lung, colorectal, hematological, and other cancer types and with patients who were in posttreatment follow-up. The content of the focus group discussions was transcribed and analyzed for major themes by independent coders. RESULTS: Participants not only reported causes of sleep disturbance common in other populations, such as pain and restless legs, but they also reported causes that may be unique to cancer populations, including abnormal dreams, anxiety about cancer diagnosis and recurrence, night sweats, and problems with sleep positioning. Many participants felt that sleep problems reduced their productivity, concentration, social interactions, and overall quality of life. Many also shared beliefs about the increased importance of sleep when fighting cancer. CONCLUSIONS: The findings underscore the need for interventions that minimize the negative impact of cancer and its treatments on sleep. This study will inform efforts now underway to develop a patient-reported measure of sleep-wake functioning that reflects the breadth of concepts considered important by patients with cancer.}, Doi = {10.1002/pon.1664}, Key = {fds273753} } @article{fds372581, Author = {Riddle, DL and Keefe, FJ and Nay, WT and McKee, D and Attarian, DE and Jensen, MP}, Title = {495 PAIN COPING SKILLS TRAINING FOR PATIENTS WITH ELEVATED PAIN CATASTROPHIZING WHO ARE SCHEDULED FOR KNEE ARTHROPLASTY: A QUASI-EXPERIMENTAL STUDY}, Journal = {Osteoarthritis and Cartilage}, Volume = {18}, Pages = {S222-S223}, Publisher = {Elsevier BV}, Year = {2010}, Month = {October}, url = {http://dx.doi.org/10.1016/s1063-4584(10)60522-5}, Doi = {10.1016/s1063-4584(10)60522-5}, Key = {fds372581} } @article{fds273789, Author = {Reese, JB and Shelby, RA and Keefe, FJ and Porter, LS and Abernethy, AP}, Title = {Sexual concerns in cancer patients: a comparison of GI and breast cancer patients.}, Journal = {Support Care Cancer}, Volume = {18}, Number = {9}, Pages = {1179-1189}, Year = {2010}, Month = {September}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19777269}, Abstract = {PURPOSE: Although sexual concerns have been examined in breast cancer (BC), these concerns remain understudied and undertreated for patients with gastrointestinal (GI) cancer. Objectives were to: (1) assess sexual concerns in GI cancer patients compared with breast cancer patients; (2) examine whether sexual concerns are stable over time in GI and breast cancer patients; and (3) evaluate whether sexual concerns in GI and breast cancer are significantly associated with quality of life, symptom severity, and disease interference, and whether these associations change over time. METHODS: Data were collected from GI and breast cancer patients during four outpatient clinic visits over 6 months. Measures included sexual concerns (reduced sexual enjoyment, interest, or performance), quality of life (FACT-G), symptom severity, disease interference (MD Anderson Symptom Inventory), and disease-related distress (NCCN Distress Scale). Linear mixed model analyses were conducted. RESULTS: Sexual concerns were common in both samples, with 57% of GI cancer patients and 53% of breast cancer patients reporting at least mild sexual concerns. Sexual concerns were stable over time and were significantly associated with lower levels of functioning in multiple domains (e.g., quality of life, symptom severity, disease interference, and disease-related distress), irrespective of length of time since diagnosis. Cancer type (GI/breast cancer) was not a moderator of this relationship. CONCLUSIONS: Self-reported sexual concerns were common, stable, and related significantly to quality of life, symptom severity, disease interference, and disease-related distress for both GI and breast cancer patients. Limitations and implications for future research are discussed.}, Doi = {10.1007/s00520-009-0738-8}, Key = {fds273789} } @article{fds273706, Author = {Berendes, D and Keefe, FJ and Somers, TJ and Kothadia, SM and Porter, LS and Cheavens, JS}, Title = {Hope in the context of lung cancer: relationships of hope to symptoms and psychological distress.}, Journal = {J Pain Symptom Manage}, Volume = {40}, Number = {2}, Pages = {174-182}, Year = {2010}, Month = {August}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20579840}, Abstract = {CONTEXT: Hope may be important in explaining the variability in how patients adjust to lung cancer. OBJECTIVES: The aim of this study was to examine how hope, as conceptualized by Snyder et al., is associated with multiple indices of adjustment to lung cancer. This theoretical model of hope suggests that people with high levels of hope are able to think about the pathways to goals (pathways) and feel confident that they can pursue those pathways to reach their goals (agency). METHODS: We hypothesized that higher levels of hope, as measured by Snyder et al.'s hope scale, would be related to lower levels of pain and other lung cancer symptoms (i.e., fatigue and cough) and lower psychological distress (i.e., depression). Participants in this study included patients with a diagnosis of lung cancer (n=51). All participants provided demographic and medical information and completed measures of hope, lung cancer symptoms, and psychological distress. RESULTS: Data analyses found that hope was inversely associated with major symptoms of cancer (i.e., pain, fatigue, and cough) and psychological distress (i.e., depression), even after accounting for important demographic and medical variables (i.e., age and cancer stage). CONCLUSION: The findings of this cross-sectional study highlight the potential importance of hope in understanding adjustment to lung cancer. Future longitudinal research could help reveal how hope and adjustment interact over the course of cancer survivorship.}, Doi = {10.1016/j.jpainsymman.2010.01.014}, Key = {fds273706} } @article{fds371076, Author = {Shelby, RA and Keefe, FJ and Bovbjerg, DH and Skinner, CS and Somers, TJ and Soo, MS and Red, S and Stinnett, S and Luce, MF and Sumkin, J}, Title = {PERCEIVED RISK OF BREAST CANCER, BELIEFS ABOUT MAMMOGRAPHY, AND PSYCHOLOGICAL DISTRESS IN BREAST CANCER SURVIVORS AND HEALTHY WOMEN AT THE TIME OF MAMMOGRAPHY}, Journal = {INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE}, Volume = {17}, Number = {SUPPL 1}, Pages = {278-278}, Publisher = {SPRINGER}, Year = {2010}, Month = {August}, Key = {fds371076} } @article{fds371077, Author = {Red, SN and Shelby, RA and Kimmick, GG and Keefe, FJ}, Title = {SYMPTOM COMMUNICATION IN BREAST CANCER: RELATIONSHIPS OF HOLDING BACK AND SELF EFFICACY FOR COMMUNICATION TO SYMPTOMS AND ADJUSTMENT}, Journal = {INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE}, Volume = {17}, Pages = {27-27}, Publisher = {SPRINGER}, Year = {2010}, Month = {August}, Key = {fds371077} } @article{fds376460, Author = {Shelby, RA and Keefe, FJ and Bovbjerg, DH and Skinner, CS and Somers, TJ and Soo, MS and Red, S and Stinnett, S and Luce, MF and Sumkin, J}, Title = {PERCEIVED RISK OF BREAST CANCER, BELIEFS ABOUT MAMMOGRAPHY, AND PSYCHOLOGICAL DISTRESS IN BREAST CANCER SURVIVORS AND HEALTHY WOMEN AT THE TIME OF MAMMOGRAPHY}, Journal = {INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE}, Volume = {17}, Number = {SUPPL 1}, Pages = {278-278}, Publisher = {SPRINGER}, Year = {2010}, Month = {August}, Key = {fds376460} } @article{fds371075, Author = {Red, SN and Shelby, RA and Kimmick, GG and Keefe, FJ}, Title = {SYMPTOM COMMUNICATION IN BREAST CANCER: RELATIONSHIPS OF HOLDING BACK AND SELF EFFICACY FOR COMMUNICATION TO SYMPTOMS AND ADJUSTMENT}, Journal = {INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE}, Volume = {17}, Number = {SUPPL 1}, Pages = {27-27}, Publisher = {SPRINGER}, Year = {2010}, Month = {August}, Key = {fds371075} } @article{fds372582, Author = {Keefe, FJ}, Title = {PAIN COPING IN OSTEOARTHRITIS: CURRENT STATE OF THE SCIENCE}, Journal = {INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE}, Volume = {17}, Pages = {123-124}, Publisher = {SPRINGER}, Year = {2010}, Month = {August}, Key = {fds372582} } @article{fds372583, Author = {Keefe, FJ}, Title = {PAIN COPING IN OSTEOARTHRITIS: CURRENT STATE OF THE SCIENCE}, Journal = {INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE}, Volume = {17}, Number = {SUPPL 1}, Pages = {123-124}, Publisher = {SPRINGER}, Year = {2010}, Month = {August}, Key = {fds372583} } @article{fds273705, Author = {Amtmann, D and Cook, KF and Jensen, MP and Chen, W-H and Choi, S and Revicki, D and Cella, D and Rothrock, N and Keefe, F and Callahan, L and Lai, J-S}, Title = {Development of a PROMIS item bank to measure pain interference.}, Journal = {Pain}, Volume = {150}, Number = {1}, Pages = {173-182}, Year = {2010}, Month = {July}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2010.04.025}, Abstract = {This paper describes the psychometric properties of the PROMIS-pain interference (PROMIS-PI) bank. An initial candidate item pool (n=644) was developed and evaluated based on the review of existing instruments, interviews with patients, and consultation with pain experts. From this pool, a candidate item bank of 56 items was selected and responses to the items were collected from large community and clinical samples. A total of 14,848 participants responded to all or a subset of candidate items. The responses were calibrated using an item response theory (IRT) model. A final 41-item bank was evaluated with respect to IRT assumptions, model fit, differential item function (DIF), precision, and construct and concurrent validity. Items of the revised bank had good fit to the IRT model (CFI and NNFI/TLI ranged from 0.974 to 0.997), and the data were strongly unidimensional (e.g., ratio of first and second eigenvalue=35). Nine items exhibited statistically significant DIF. However, adjusting for DIF had little practical impact on score estimates and the items were retained without modifying scoring. Scores provided substantial information across levels of pain; for scores in the T-score range 50-80, the reliability was equivalent to 0.96-0.99. Patterns of correlations with other health outcomes supported the construct validity of the item bank. The scores discriminated among persons with different numbers of chronic conditions, disabling conditions, levels of self-reported health, and pain intensity (p<0.0001). The results indicated that the PROMIS-PI items constitute a psychometrically sound bank. Computerized adaptive testing and short forms are available.}, Doi = {10.1016/j.pain.2010.04.025}, Key = {fds273705} } @article{fds273788, Author = {Reese, JB and Keefe, FJ and Somers, TJ and Abernethy, AP}, Title = {Coping with sexual concerns after cancer: the use of flexible coping.}, Journal = {Support Care Cancer}, Volume = {18}, Number = {7}, Pages = {785-800}, Year = {2010}, Month = {July}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20165890}, Abstract = {INTRODUCTION: Although cancer treatment commonly has a negative impact on sexual functioning, sexual concerns are still largely undertreated in routine cancer care. The medical model that guides current approaches to sexual care in cancer does not adequately address key patient needs. METHODS: In this paper, we describe a broader approach to understanding and treating sexual concerns in cancer that focuses on the construct of flexibility in behavioral and cognitive coping strategies. We previously presented this model in the context of general medical conditions. We now adapt this model to the context of cancer, focusing on issues related to the benefits of flexible coping, interventions that shift perspectives following cancer, and on coping as a couple. RESULTS: We argue that coping flexibly with sexual concerns is likely to lead to improvements in mood and sexual and relationship satisfaction. We present clinical applications of the flexible coping model, including suggestions for assessment and sexual concerns and methods of introducing flexible coping into both the content and process of clinical interactions with patients. DISCUSSION: Finally, we discuss areas for future research, including the development of a validated instrument, the use of electronic methods of assessment, and intervention trials directly addressing flexibility in coping.}, Doi = {10.1007/s00520-010-0819-8}, Key = {fds273788} } @article{fds273766, Author = {Somers, TJ and Shelby, RA and Keefe, FJ and Godiwala, N and Lumley, MA and Mosley-Williams, A and Rice, JR and Caldwell, D}, Title = {Disease severity and domain-specific arthritis self-efficacy: relationships to pain and functioning in patients with rheumatoid arthritis.}, Journal = {Arthritis Care Res (Hoboken)}, Volume = {62}, Number = {6}, Pages = {848-856}, Year = {2010}, Month = {June}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20535796}, Abstract = {OBJECTIVE: To examine the degree to which disease severity and domains of self-efficacy (pain, function, and other symptoms) explain pain and functioning in rheumatoid arthritis (RA) patients. METHODS: Patients (n = 263) completed the Arthritis Impact Measurement Scales 2 to assess pain and functioning (physical, affective, and social), the Arthritis Self-Efficacy Scale to assess 3 self-efficacy domains (pain, physical function, and other). Disease severity was assessed with C-reactive protein level, physician's rating, and abnormal joint count. Structural equation modeling was used to examine 3 hypotheses: does disease severity have a direct relationship with pain and each area of functioning, does disease severity have a direct relationship with each arthritis self-efficacy domain, and do the self-efficacy domains mediate the relationship between disease severity and RA pain and each area of functioning. RESULTS: Disease severity was related to pain, physical functioning, and each self-efficacy domain (beta = 0.28-0.56, P < 0.001). Each self-efficacy domain was related to its respective domain of functioning (e.g., self-efficacy for pain was related to pain; beta = 0.36-0.54, P < 0.001). Self-efficacy mediated the relationship between disease severity and pain and functioning (beta = 0.12-0.19, P < 0.001). Self-efficacy for pain control and to perform functional tasks accounted for 32-42% of disease severity's total effect on their respective outcomes (e.g., self-efficacy for pain control accounted for 32% of disease severity's total effect on pain). Variance accounted for by the total model was 52% for pain, 53% for physical functioning, and 44% for affective and social functioning. CONCLUSION: Disease severity and self-efficacy both impact RA functioning, and intervening in these areas may lead to better outcomes.}, Doi = {10.1002/acr.20127}, Key = {fds273766} } @article{fds273783, Author = {Allen, KD and Coffman, CJ and Golightly, YM and Stechuchak, KM and Voils, CI and Keefe, FJ}, Title = {Comparison of pain measures among patients with osteoarthritis.}, Journal = {J Pain}, Volume = {11}, Number = {6}, Pages = {522-527}, Year = {2010}, Month = {June}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20096640}, Abstract = {UNLABELLED: This study compared recalled average pain, assessed at the end of the day, with the average of real-time pain ratings recorded throughout the day among patients with osteoarthritis (OA). Participants (N = 157) with hand, hip, or knee OA completed electronic pain diaries on 1 weekend day and 1 weekday. Diaries included at least 7 pain ratings per day, immediately after waking and every 2 hours following, using a visual analog scale (VAS) scored as 1 to 100 (scores not seen by participants). At the end of each diary day, participants rated their average pain that day on the same VAS. Pearson correlations examined associations between recalled average pain and the average of real-time pain ratings that day. Mixed models, including interaction terms, examined whether associations between recalled and actual average pain ratings differed according to the following patient characteristics: joint site, age, race, gender, study enrollment site, and pain catastrophizing. Correlations between recalled and actual average pain ratings were r = .88 for weekdays and r = .86 for weekends (P < .0001). In mixed models, there were no significant interaction terms for any patient characteristics. In summary, patients with OA accurately recalled their average pain over a 1-day period, and this did not differ according to any patient characteristics examined. PERSPECTIVE: This study showed that patients with OA accurately recalled their average pain over a single-day period, and this did not differ according to patient characteristics. Results of this study indicate that end-of-day recall is a practical and valid method for assessing patients' average pain during a day.}, Doi = {10.1016/j.jpain.2009.09.007}, Key = {fds273783} } @article{fds273703, Author = {Keefe, FJ and Shelby, RA and Somers, TJ}, Title = {Catastrophizing and pain coping: moving forward.}, Journal = {Pain}, Volume = {149}, Number = {2}, Pages = {165-166}, Year = {2010}, Month = {May}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20211526}, Doi = {10.1016/j.pain.2010.02.030}, Key = {fds273703} } @article{fds273630, Author = {Keefe, FJ and Somers, TJ and Abernethy, A}, Title = {Psychologic Interventions for Cancer Pain}, Pages = {337-347}, Publisher = {JOHN WILEY & SONS LTD}, Year = {2010}, Month = {April}, url = {http://dx.doi.org/10.1002/9781444314380.ch26}, Doi = {10.1002/9781444314380.ch26}, Key = {fds273630} } @article{fds273704, Author = {Keefe, FJ and Somers, TJ}, Title = {Psychological approaches to understanding and treating arthritis pain.}, Journal = {Nat Rev Rheumatol}, Volume = {6}, Number = {4}, Pages = {210-216}, Year = {2010}, Month = {April}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20357790}, Abstract = {Arthritis pain has traditionally been evaluated from a biomedical perspective, but there is increasing evidence that psychological factors have an important role in patients' adjustment to arthritis pain. The evolution of pain theories has led to the development of models, such as the cognitive-behavioral model, which recognize the potential involvement of psychological factors in pain. Emotional, cognitive, behavioral and social context variables are useful in understanding pain in patients with arthritis, and have led to the development of psychological approaches for treating arthritis pain. These include pain coping skills training, interventions that include patients' partners, and emotional disclosure strategies.}, Doi = {10.1038/nrrheum.2010.22}, Key = {fds273704} } @article{fds371078, Author = {Reese, JB and Somers, TJ and Keefe, FJ and Mosley-Williams, A and Lumley, MA}, Title = {PAIN IN SOCIAL CONTEXT: PAIN AND FUNCTIONING OF RHEUMATOID ARTHRITIS PATIENTS BASED ON MARITAL STATUS AND MARITAL ADJUSTMENT}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {39}, Pages = {150-150}, Publisher = {SPRINGER}, Year = {2010}, Month = {April}, Key = {fds371078} } @article{fds372584, Author = {Cheatle, M and Keefe, FJ}, Title = {"PAIN MANAGEMENT IN THE PRIMARY CARE SETTING: AN OPPORTUNITY FOR BEHAVIORAL MEDICINE"}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {39}, Pages = {117-117}, Publisher = {SPRINGER}, Year = {2010}, Month = {April}, Key = {fds372584} } @article{fds372585, Author = {Keefe, FJ}, Title = {PAIN MANAGEMENT IN THE PRIMARY CARE SETTING: AN OPPORTUNITY FOR BEHAVIORAL MEDICINE-DISCUSSANT}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {39}, Pages = {118-118}, Publisher = {SPRINGER}, Year = {2010}, Month = {April}, Key = {fds372585} } @article{fds273782, Author = {Allen, KD and Oddone, EZ and Coffman, CJ and Keefe, FJ and Lindquist, JH and Bosworth, HB}, Title = {Racial differences in osteoarthritis pain and function: potential explanatory factors.}, Journal = {Osteoarthritis Cartilage}, Volume = {18}, Number = {2}, Pages = {160-167}, Year = {2010}, Month = {February}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19825498}, Abstract = {OBJECTIVE: This study examined factors underlying racial differences in pain and function among patients with hip and/or knee osteoarthritis (OA). METHODS: Participants were n=491 African Americans and Caucasians enrolled in a clinical trial of telephone-based OA self-management. Arthritis Impact Measurement Scales-2 (AIMS2) pain and function subscales were obtained at baseline. Potential explanatory variables included arthritis self-efficacy, AIMS2 affect subscale, problem- and emotion-focused pain coping, demographic characteristics, body mass index, self-reported health, joint(s) with OA, symptom duration, pain medication use, current exercise, and AIMS2 pain subscale (in models of function). Variables associated with both race and pain or function, and which reduced the association of race with pain or function by >or=10%, were included in final multivariable models. RESULTS: In simple linear regression models, African Americans had worse scores than Caucasians on AIMS2 pain (B=0.65, P=0.001) and function (B=0.59, P<0.001) subscales. In multivariable models race was no longer associated with pain (B=0.03, P=0.874) or function (B=0.07, P=0.509), indicating these associations were accounted for by other covariates. Variables associated with worse AIMS2 pain and function were: worse AIMS2 affect scores, greater emotion-focused coping, lower arthritis self-efficacy, and fair or poor self-reported health. AIMS2 pain scores were also significantly associated with AIMS2 function. CONCLUSION: Factors explaining racial differences in pain and function were largely psychological, including arthritis self-efficacy, affect, and use of emotion-focused coping. Self-management and psychological interventions can influence these factors, and greater dissemination among African Americans may be a key step toward reducing racial disparities in pain and function.}, Doi = {10.1016/j.joca.2009.09.010}, Key = {fds273782} } @article{fds273701, Author = {Junghaenel, DU and Keefe, FJ and Broderick, JE}, Title = {Multi-modal examination of psychological and interpersonal distinctions among MPI coping clusters: a preliminary study.}, Journal = {J Pain}, Volume = {11}, Number = {1}, Pages = {87-96}, Year = {2010}, Month = {January}, ISSN = {1526-5900}, url = {http://dx.doi.org/10.1016/j.jpain.2009.06.006}, Abstract = {UNLABELLED: The Multidimensional Pain Inventory (MPI) is a widely used instrument to characterize distinct psychosocial subgroups of patients with chronic pain: Adaptive (AC), Dysfunctional (DYS), and Interpersonally Distressed (ID). To date, several questions remain about the validity and distinctiveness of the patient clusters, and continued scientific attention has strongly been recommended. It is unclear if AC patients experience better adjustment or merely present themselves favorably. Moreover, differences in psychological distress and interpersonal relations between DYS and ID patients are equivocal. The present study is the first to utilize comprehensive informant ratings to extend prior validity research on the MPI. We employed a multimodal methodology consisting of patient self-report, parallel informant ratings, and behavioral measures. Ninety-nine patients with chronic pain, their partners, and providers participated. They completed measures of patients' psychological distress and social relations. We also systematically observed patients' pain behavior. Results provided strong support for the validity of the AC cluster in that patients' positive adaptation was reliably corroborated by informants. The differentiating characteristics between the 2 maladaptive clusters, however, remain elusive. We found evidence that DYS patients' distress appeared to be illness specific rather than generalized; however, both clusters were equally associated with social distress and partner/caregiver burden. PERSPECTIVE: An adaptive style of coping with chronic pain is reliably recognized by patients' partners and healthcare providers. Differences between a dysfunctional and an interpersonally distressed coping style, however, remain unclear. Patients with a dysfunctional style appear more distressed by their illness but both styles are characterized by social difficulties.}, Doi = {10.1016/j.jpain.2009.06.006}, Key = {fds273701} } @article{fds273702, Author = {Cassileth, BR and Keefe, FJ}, Title = {Integrative and behavioral approaches to the treatment of cancer-related neuropathic pain.}, Journal = {Oncologist}, Volume = {15 Suppl 2}, Pages = {19-23}, Year = {2010}, ISSN = {1549-490X}, url = {http://dx.doi.org/10.1634/theoncologist.2009-S504}, Abstract = {Integrative oncology is the synthesis of mainstream cancer care and evidence-based complementary therapies. Complementary strategies include massage therapies, acupuncture, fitness, and mind-body techniques, which take advantage of the reciprocal relationship between the mind and body. Neuropathic pain--and pain more generally--is part of a complex process involving the whole physical and psychosocial being, therefore requiring an integrative management approach. Several studies have demonstrated, for example, that social context plays an important role in the perception of pain and that a patient's coping strategies can influence the persistence of pain. In this article, we briefly describe research illustrating the promise of integrative approaches for the treatment of cancer-related neuropathic pain.}, Doi = {10.1634/theoncologist.2009-S504}, Key = {fds273702} } @article{fds273619, Author = {Somers, TJ and Keefe, FJ and Porter, L}, Title = {Understanding and enhancing patient and partner adjustment to disease-related pain: A biopsychosocial perspective}, Pages = {95-124}, Publisher = {Springer New York}, Year = {2009}, Month = {December}, url = {http://dx.doi.org/10.1007/978-0-387-78323-9_6}, Abstract = {Persistent, disease-related pain is a challenge not only for patients who experience it, but also for their loved ones. There is growing interest in involving partners and caregivers in pain management efforts. The purpose of this chapter is to discuss factors that influence patient and partner adjustment to diseaserelated pain within a biopsychosocial framework and provide an overview of biopsychosocial approaches involving partners in pain management. The chapter is divided into three sections. In the first section, we present a biopsychosocial model that can be used to understand how patients and their partners adjust to disease-related pain. In the second section, we discuss factors that influence patient and partner adjustment to both arthritis pain and cancer pain and how these factors are influenced by patient and partner pain management interventions. Finally, we highlight important future directions for clinical and research efforts in this area.}, Doi = {10.1007/978-0-387-78323-9_6}, Key = {fds273619} } @article{fds273700, Author = {Lai, Y-H and Guo, S-L and Keefe, FJ and Tsai, L-Y and Shun, S-C and Liao, Y-C and Li, I-F and Liu, C-P and Lee, Y-H}, Title = {Multidimensional Pain Inventory-Screening Chinese version (MPI-sC): psychometric testing in terminal cancer patients in Taiwan.}, Journal = {Support Care Cancer}, Volume = {17}, Number = {12}, Pages = {1445-1453}, Year = {2009}, Month = {December}, ISSN = {0941-4355}, url = {http://dx.doi.org/10.1007/s00520-009-0597-3}, Abstract = {INTRODUCTION: Cancer pain is identified as a multidimensional experience, but relatively few brief instruments are available for assessing the complex pain-related experiences of terminal cancer patients in Taiwan. The purposes of this study were to (1) translate and examine the feasibility and psychometric characteristics of the eight-item Multidimensional Pain Inventory-Screening Chinese (MPI-sC) when used with patients having terminal cancer and (2) apply the MPI-sC to examine multidimensional pain-related experiences of terminal cancer patients in Taiwan. MATERIALS AND METHODS: The MPI-sC was tested in 106 terminal cancer inpatients at a hospice setting in Taipei. RESULTS: The results showed that the MPI-sC has satisfactory face and content validity, feasibility, acceptable internal consistency reliability (overall Cronbach's alpha of 0.75), and overall support of theoretical assumptions. However, instead of the four-factor structure of the original instrument, we found a three-factor structure (with pain intensity and pain interference merged into one factor) that explained 76.73% of the variance. Close to half the patients (48.1%) had considerable levels of pain interference, and a majority (72.6%) reported not having control in life based on the cut-point of MPI-sC categorization. CONCLUSION: Our results support the brief MPI-sC as a feasible and valid tool for assessing and representing multidimensional pain experiences in terminal cancer patients. The MPI-sC could help clinicians and researchers assess the complex multidimensional pain experiences of terminal cancer patients, including Chinese-speaking cancer populations.}, Doi = {10.1007/s00520-009-0597-3}, Key = {fds273700} } @article{fds273746, Author = {Sims, EL and Keefe, FJ and Kraus, VB and Guilak, F and Queen, RM and Schmitt, D}, Title = {Racial differences in gait mechanics associated with knee osteoarthritis.}, Journal = {Aging Clin Exp Res}, Volume = {21}, Number = {6}, Pages = {463-469}, Year = {2009}, Month = {December}, ISSN = {1594-0667}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20154517}, Abstract = {BACKGROUND AND AIMS: This study examines racial differences in gait mechanics in persons with knee osteoarthritis and the influence of anthropometrics, educational level, radiographic disease severity (rOA), and self-report measures of pain and disability on racial differences in gait. METHODS: One hundred seventy five (64 black and 111 white) adults with radiographic knee OA were tested. 3-D kinematic and kinetic data were collected while subjects walked at two self-selected speeds (normal and fast). Anthropometric data, radiographic level of OA, and self-report measures of pain and disability were also collected. Gait patterns were compared across groups and within groups. RESULTS: Black and white subjects did not differ significantly in radiographic OA. However, blacks walked significantly more slowly when asked to walk fast. At the normal speed, blacks had a smaller knee range of motion and loading rate than whites. Blacks also took longer to reach their peak maximum ground reaction force than whites. Within black subjects variations in gait mechanics were primarily explained by BMI, rOA, selfreported psychological disability, and pain self-efficacy. In white subjects, variations in gait mechanics were primarily explained by weight, age, velocity, psychological disability, and self-efficacy. CONCLUSIONS: Blacks in this study had a pattern of gait mechanics generally associated with high levels of osteoarthritis, though they did not differ significantly in rOA from whites. The variability in gait patterns exhibited by blacks was most strongly related to variance in walking speed, anthropometrics, and perceived physical ability. Taken together, these results suggest that race is an important factor that must be considered in the treatment and study of osteoarthritis.}, Doi = {10.1007/BF03327442}, Key = {fds273746} } @article{fds273698, Author = {Revicki, DA and Chen, W-H and Harnam, N and Cook, KF and Amtmann, D and Callahan, LF and Jensen, MP and Keefe, FJ}, Title = {Development and psychometric analysis of the PROMIS pain behavior item bank.}, Journal = {Pain}, Volume = {146}, Number = {1-2}, Pages = {158-169}, Year = {2009}, Month = {November}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2009.07.029}, Abstract = {The measurement of pain behavior is a key component of the assessment of persons with chronic pain; however, few self-reported pain behavior instruments have been developed. We developed a pain behavior item bank as part of the Patient-Reported Outcome Measurement Information System (PROMIS). For the Wave I testing, because of the large number of PROMIS items, a complex sampling approach was used where participants were randomly assigned to either respond to two full-item banks or to multiple 7-item blocks of items. A web-based survey was designed and completed by 15,528 members of the general population and 967 individuals with different types of chronic pain. Item response theory (IRT) analysis models were used to evaluate item characteristics and to scale both items and individuals on the pain behavior domain. The pain behavior item bank demonstrated good fit to a unidimensional model (Comparative Fit Index = 0.94). Several iterations of IRT analyses resulted in a final 39-item pain behavior bank, and different IRT models were fit to the total sample and to those participants who experienced some pain. The results indicated that these items demonstrated good coverage of the pain behavior construct. Pain behavior scores were strongly related to pain intensity and moderately related to self-reported general health status. Mean pain behavior scores varied significantly by groups based on pain severity and general health status. The PROMIS pain behavior item bank can be used to develop static short-form and dynamic measures of pain behavior for clinical studies.}, Doi = {10.1016/j.pain.2009.07.029}, Key = {fds273698} } @article{fds273767, Author = {Nebel, MB and Sims, EL and Keefe, FJ and Kraus, VB and Guilak, F and Caldwell, DS and Pells, JJ and Queen, R and Schmitt, D}, Title = {The relationship of self-reported pain and functional impairment to gait mechanics in overweight and obese persons with knee osteoarthritis.}, Journal = {Arch Phys Med Rehabil}, Volume = {90}, Number = {11}, Pages = {1874-1879}, Year = {2009}, Month = {November}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19887211}, Abstract = {OBJECTIVE: To examine the degree to which 2 commonly used measures of pain and disability, the Arthritis Impact Measurement Scales (AIMS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), relate to objective gait measurements. DESIGN: A descriptive study of the influence of self-reported pain and perceived functional impairment on gait mechanics in osteoarthritic adults. SETTING: A university clinical research laboratory. PARTICIPANTS: Overweight/obese adults with radiographic knee osteoarthritis (OA) as well as pain and disability associated with the disease (N=179). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The AIMS and WOMAC were administered to determine self-report measures of pain and disability. Speed, stride length, support time, knee angle, and peak vertical force (PVF) were determined from 3-dimensional kinematic and kinetic data collected on subjects walking at self-selected normal and fast speeds. Anthropometric data and radiographic levels of OA were also collected. RESULTS: Pearson correlation analysis showed that the AIMS physical disability score was inversely correlated with speed, stride length, and knee range of motion at both speeds and PVF at the fast speed. The WOMAC function score was inversely correlated with speed and stride length at both speeds and with PVF at fast speed. The WOMAC pain score was inversely correlated with speed and PVF at the fast speed. Regression analysis revealed that the AIMS physical disability score and body mass index accounted for the greatest variation in speed at the normal speed. Overall, AIMS physical disability and WOMAC function explained a larger proportion of variance in gait mechanics than radiographic measures of OA disease severity. CONCLUSIONS: Taken together, the results suggest that the AIMS physical disability and WOMAC function scores are associated with some important measures of gait impairment.}, Doi = {10.1016/j.apmr.2009.07.010}, Key = {fds273767} } @article{fds273697, Author = {Carson, JW and Carson, KM and Porter, LS and Keefe, FJ and Seewaldt, VL}, Title = {Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial.}, Journal = {Support Care Cancer}, Volume = {17}, Number = {10}, Pages = {1301-1309}, Year = {2009}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19214594}, Abstract = {GOAL OF WORK: Breast cancer survivors have limited options for the treatment of hot flashes and related symptoms. Further, therapies widely used to prevent recurrence in survivors, such as tamoxifen, tend to induce or exacerbate menopausal symptoms. The aim of this preliminary, randomized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer (stages IA-IIB). MATERIALS AND METHODS: Thirty-seven disease-free women experiencing hot flashes were randomized to the 8-week Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) or to wait-list control. The primary outcome was daily reports of hot flashes collected at baseline, posttreatment, and 3 months after treatment via an interactive telephone system. Data were analyzed by intention to treat. MAIN RESULTS: At posttreatment, women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency, severity, and total scores and in levels of joint pain, fatigue, sleep disturbance, symptom-related bother, and vigor. At 3 months follow-up, patients maintained their treatment gains in hot flashes, joint pain, fatigue, symptom-related bother, and vigor and showed additional significant gains in negative mood, relaxation, and acceptance. CONCLUSIONS: This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors.}, Doi = {10.1007/s00520-009-0587-5}, Key = {fds273697} } @article{fds273751, Author = {Fortune-Greeley, AK and Flynn, KE and Jeffery, DD and Williams, MS and Keefe, FJ and Reeve, BB and Willis, GB and Weinfurt, KP and PROMIS Sexual Function Domain Committee}, Title = {Using cognitive interviews to evaluate items for measuring sexual functioning across cancer populations: improvements and remaining challenges.}, Journal = {Qual Life Res}, Volume = {18}, Number = {8}, Pages = {1085-1093}, Year = {2009}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19672697}, Abstract = {PURPOSE: One goal of the Patient-Reported Outcomes Measurement Information System (PROMIS) is to develop a measure of sexual functioning that broadens the definition of sexual activity and incorporates items that reflect constructs identified as important by patients with cancer. We describe how cognitive interviews improved the quality of the items and discuss remaining challenges to assessing sexual functioning in research with cancer populations. METHODS: We conducted 39 cognitive interviews of patients with cancer and survivors on the topic of sexual experience. Each of the 83 candidate items was seen by 5-24 participants. Participants included both men and women and varied by cancer type, treatment trajectory, race, and literacy level. Significantly revised items were retested in subsequent interviews. RESULTS: Cognitive interviews provided useful feedback about the relevance, sensitivity, appropriateness, and clarity of the items. Participants identified broad terms (e.g., "sex life") to assess sexual experience and exposed the challenges of measuring sexual functioning consistently, considering both adjusted and unadjusted sexual experiences. CONCLUSIONS: Cognitive interviews were critical for item refinement in the development of the PROMIS measure of sexual function. Efforts are underway to validate the measure in larger cancer populations.}, Doi = {10.1007/s11136-009-9523-x}, Key = {fds273751} } @article{fds273755, Author = {Campbell, LC and Andrews, N and Scipio, C and Flores, B and Feliu, MH and Keefe, FJ}, Title = {Pain coping in Latino populations.}, Journal = {J Pain}, Volume = {10}, Number = {10}, Pages = {1012-1019}, Year = {2009}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19595635}, Abstract = {UNLABELLED: Although there has been a rapid increase in Latino populations in the United States over the last 10 years, health research with Latino cultural groups is sorely lacking. In the area of pain-coping research, one consequence of the limited research is that very little is known about pain coping among Latinos. The purpose of this paper is to review the existing literature on pain coping in Latino populations, and to propose new directions for the future study of pain coping in Latino populations. This review is divided into 4 sections. In the first section, the challenges of defining Latino populations are discussed. In the second section, the current literature on pain coping in Latinos is reviewed. Third, we discuss the implications of existing findings for pain-coping assessment and pain treatment. Finally, we offer ideas for future research on pain coping in Latino populations. PERSPECTIVE: In this review article, we identify gaps in our current understanding of pain coping in Latino cultural groups, and associated implications for pain assessment and treatment. We also highlight potential directions for future pain-coping research with Latino populations.}, Doi = {10.1016/j.jpain.2009.03.004}, Key = {fds273755} } @article{fds273771, Author = {Shelby, RA and Somers, TJ and Keefe, FJ and Silva, SG and McKee, DC and She, L and Waters, SJ and Varia, I and Riordan, YB and Knowles, VM and Blazing, M and Blumenthal, JA and Johnson, P}, Title = {Pain catastrophizing in patients with noncardiac chest pain: relationships with pain, anxiety, and disability.}, Journal = {Psychosom Med}, Volume = {71}, Number = {8}, Pages = {861-868}, Year = {2009}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19737857}, Abstract = {OBJECTIVE: To examine the contributions of chest pain, anxiety, and pain catastrophizing to disability in 97 patients with noncardiac chest pain (NCCP) and to test whether chest pain and anxiety were related indirectly to greater disability via pain catastrophizing. METHODS: Participants completed daily diaries measuring chest pain for 7 days before completing measures of pain catastrophizing, trait anxiety, and disability. Linear path model analyses examined the contributions of chest pain, trait anxiety, and catastrophizing to physical disability, psychosocial disability, and disability in work, home, and recreational activities. RESULTS: Path models accounted for a significant amount of the variability in disability scales (R(2) = 0.35 to 0.52). Chest pain and anxiety accounted for 46% of the variance in pain catastrophizing. Both chest pain (beta = 0.18, Sobel test Z = 2.58, p < .01) and trait anxiety (beta = 0.14, Sobel test Z = 2.11, p < .05) demonstrated significant indirect relationships with physical disability via pain catastrophizing. Chest pain demonstrated a significant indirect relationship with psychosocial disability via pain catastrophizing (beta = 0.12, Sobel test Z = 1.96, p = .05). After controlling for the effects of chest pain and anxiety, pain catastrophizing was no longer related to disability in work, home, and recreational activities. CONCLUSIONS: Chest pain and anxiety were directly related to greater disability and indirectly related to physical and psychosocial disability via pain catastrophizing. Efforts to improve functioning in patients with NCCP should consider addressing pain catastrophizing.}, Doi = {10.1097/PSY.0b013e3181b49584}, Key = {fds273771} } @article{fds273781, Author = {Allen, KD and Coffman, CJ and Golightly, YM and Stechuchak, KM and Keefe, FJ}, Title = {Daily pain variations among patients with hand, hip, and knee osteoarthritis.}, Journal = {Osteoarthritis Cartilage}, Volume = {17}, Number = {10}, Pages = {1275-1282}, Year = {2009}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19410670}, Abstract = {OBJECTIVE: This study examined within-day osteoarthritis (OA)-related pain patterns and associated patient characteristics. METHODS: Participants with physician diagnoses and self-reported symptoms of hand (N=40), hip (N=32), and knee (N=85) OA recorded pain using a handheld computer on one weekday and one weekend day, with ratings beginning immediately after waking, then approximately every 2h following. Pain was rated on a sliding visual analog scale with hidden coding of 1-100. Multivariable linear mixed models examined associations of patient demographic characteristics, enrollment site (Durham VA Medical Center vs Duke University Medical Center), joint site, body mass index, and pain medication use with within-day pain range (maximum minus minimum pain rating) and area under the curve (AUC) of pain ratings, which incorporates the magnitude of all pain measurements. RESULTS: Pain patterns differed substantially across individuals. The sample means of the average, maximum, and minimum weekday pain scores were 35.3, 54.4, and 17.9, respectively. The mean pain range was 36.4, and the mean pain AUC was 564.3 (possible range: 16-1600). Pain scores were similar on weekends. In multivariable mixed models, both knee and hip OA were associated with a greater within-day pain range than hand OA. Only VA enrollment site was associated with a significantly greater pain AUC. CONCLUSION: There is substantial within-day range in OA-related pain. Both pain range and overall within-day magnitude vary according to patient characteristics. Patients' records of within-day pain patterns could be used in clinical encounters to tailor recommendations for the timing of medication use and behavioral strategies.}, Doi = {10.1016/j.joca.2009.03.021}, Key = {fds273781} } @article{fds372586, Author = {Martire, LM and Stephens, M and Brach, J and Keefe, FJ and Schulz, R}, Title = {SPOUSAL INFLUENCE ON DAILY FUNCTIONING IN KNEE OSTEOARTHRITIS}, Journal = {GERONTOLOGIST}, Volume = {49}, Pages = {509-509}, Publisher = {GERONTOLOGICAL SOC AMER}, Year = {2009}, Month = {October}, Key = {fds372586} } @article{fds273742, Author = {Porter, LS and Keefe, FJ and Baucom, DH and Hurwitz, H and Moser, B and Patterson, E and Kim, HJ}, Title = {Partner-assisted emotional disclosure for patients with gastrointestinal cancer: results from a randomized controlled trial.}, Journal = {Cancer}, Volume = {115}, Number = {18 Suppl}, Pages = {4326-4338}, Year = {2009}, Month = {September}, ISSN = {0008-543X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19731357}, Abstract = {BACKGROUND: For patients with cancer who are married or in an intimate relationship, their relationships with their partners play a critical role in their adaptation to illness. However, cancer patients and their partners often have difficulty in talking with each other about their cancer-related concerns. Difficulties in communication ultimately may compromise both the patient-partner relationship and the patient's psychological adjustment. The current study tested the efficacy of a novel partner-assisted emotional disclosure intervention in a sample of patients with gastrointestinal (GI) cancer. METHODS: One hundred thirty patients with GI cancer and their partners were assigned randomly to receive 4 sessions of either partner-assisted emotional disclosure or a couples cancer education/support intervention. Patients and partners completed measures of relationship quality, intimacy with their partner, and psychological distress before randomization and at the end of the intervention sessions. Data were analyzed using multilevel modeling. RESULTS: Compared with an education/support condition, the partner-assisted emotional disclosure condition led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns. CONCLUSIONS: Partner-assisted emotional disclosure is a novel intervention that builds on both the private emotional disclosure and the cognitive-behavioral marital literature. The results of this study suggested that this intervention may be beneficial for couples in which the patient tends to hold back from discussing concerns. The authors concluded that future research on methods of enhancing the effects of partner-assisted emotional disclosure is warranted.}, Doi = {10.1002/cncr.24578}, Key = {fds273742} } @article{fds273696, Author = {Somers, TJ and Keefe, FJ and Godiwala, N and Hoyler, GH}, Title = {Psychosocial factors and the pain experience of osteoarthritis patients: new findings and new directions.}, Journal = {Curr Opin Rheumatol}, Volume = {21}, Number = {5}, Pages = {501-506}, Year = {2009}, Month = {September}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19617836}, Abstract = {PURPOSE OF REVIEW: The present paper reviews recent psychosocial research in the area of osteoarthritis pain. First, the review highlights studies of psychosocial factors that can influence osteoarthritis pain. Next, research testing the efficacy of psychosocial treatments for osteoarthritis pain is summarized. RECENT FINDINGS: Recent studies suggest that asking osteoarthritis patients to recall pain experiences may not be as accurate as having them keep daily pain records. New studies also support the notion that fatigue and increased weight are linked to higher osteoarthritis pain. Osteoarthritis patients who report higher levels of depression are more prone to report increased osteoarthritis pain. New studies also indicate that social factors such as ethnic background, ability to communicate pain to others, and participation in social activities can influence osteoarthritis pain and disability. Cognitions about pain (i.e. pain catastrophizing, acceptance, self-efficacy for pain) also have been found to relate to pain in patients with osteoarthritis. Recent, randomized controlled studies suggest that psychosocial interventions (i.e. self-management programs, exercise) can decrease osteoarthritis pain and disability. SUMMARY: Several psychosocial variables have been suggested as influencing osteoarthritis pain and disability. There is evidence that psychosocial interventions may decrease osteoarthritis pain and disability.}, Doi = {10.1097/BOR.0b013e32832ed704}, Key = {fds273696} } @article{fds273787, Author = {Dixon, KE and Keefe, FJ and Scipio, CD and Perri, LCM and Abernethy, AP}, Title = {Response to Knittle}, Journal = {Health Psychology}, Volume = {28}, Number = {5}, Pages = {647-648}, Publisher = {American Psychological Association (APA)}, Year = {2009}, Month = {September}, ISSN = {0278-6133}, url = {http://dx.doi.org/10.1037/a0017217}, Doi = {10.1037/a0017217}, Key = {fds273787} } @article{fds273695, Author = {Saab, PG and Bang, H and Williams, RB and Powell, LH and Schneiderman, N and Thoresen, C and Burg, M and Keefe, F and ENRICHD Investigators}, Title = {The impact of cognitive behavioral group training on event-free survival in patients with myocardial infarction: the ENRICHD experience.}, Journal = {J Psychosom Res}, Volume = {67}, Number = {1}, Pages = {45-56}, Year = {2009}, Month = {July}, ISSN = {0022-3999}, url = {http://dx.doi.org/10.1016/j.jpsychores.2009.01.015}, Abstract = {OBJECTIVE: Although the Enhancing Recovery in Coronary Heart Disease (ENRICHD) treatment was designed to include individual therapy and cognitive behavioral group training for patients with depression and/or low perceived social support, only 31% of treated participants received group training. Secondary analyses classified intervention participants into two subgroups, (1) individual therapy only or (2) group training (i.e., coping skills training) plus individual therapy, to determine whether medical outcomes differed in participants who received the combination of group training and individual therapy compared to participants who received individual therapy only or usual care. METHODS: Secondary analyses of 1243 usual care, 781 individual therapy only, and 356 group plus individual therapy myocardial infarction (MI) patients were performed. Depression was diagnosed using modified Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria; low perceived social support was determined by the ENRICHD Social Support Instrument. Psychosocial treatment followed MI, and for participants with severe or unremitting depression, was supplemented with a selective serotonin reuptake inhibitor. Cox proportional hazards regression was used to estimate intervention effects on time to first occurrence of the composite end point of death plus nonfatal MI. To control for confounding of group participation with survival (because individual sessions preceded group), we used risk set sampling to match minimal survival time of those receiving or not receiving group training. RESULTS: Analyses correcting for differential survival among comparison groups showed that group plus individual therapy was associated with a 33% reduction (hazard ratio=0.67; 95% confidence interval, 0.49-0.92, P=.01) in medical outcome compared to usual care. No significant effect on event-free survival was associated with individual therapy alone. The group training benefit was reduced to 23% (hazard ratio=0.77; 95% confidence interval: 0.56-1.07, P=.11) in the multivariate-adjusted model. CONCLUSIONS: Findings suggest that adding group training to individual therapy may be associated with reduction in the composite end point. A randomized controlled trial is warranted to definitively resolve this issue.}, Doi = {10.1016/j.jpsychores.2009.01.015}, Key = {fds273695} } @article{fds273694, Author = {Sullivan, M and Tanzer, M and Stanish, W and Fallaha, M and Keefe, FJ and Simmonds, M and Dunbar, M}, Title = {Psychological determinants of problematic outcomes following Total Knee Arthroplasty.}, Journal = {Pain}, Volume = {143}, Number = {1-2}, Pages = {123-129}, Year = {2009}, Month = {May}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2009.02.011}, Abstract = {The primary objective of the present study was to examine the role of pain-related psychological factors in predicting pain and disability following Total Knee Arthroplasty (TKA). The study sample consisted of 75 (46 women, 29 men) individuals with osteoarthritis of the knee who were scheduled for TKA. Measures of pain severity, pain catastrophizing, depression, and pain-related fears of movement were completed prior to surgery. Participants completed measures of pain severity and self-reported disability 6 weeks following surgery. Consistent with previous research, cross-sectional analyses revealed significant correlations among measures of pre-surgical pain severity, pain catastrophizing, depression and pain-related fears of movement. Prospective analyses revealed that pre-surgical pain severity and pain catastrophizing were unique predictors of post-surgical pain severity (6-week follow-up). Pain-related fears of movement were predictors of post-surgical functional difficulties in univariate analyses, but not when controlling for pre-surgical co-morbidities (e.g. back pain). The results of this study add to a growing literature highlighting the prognostic value of psychological variables in the prediction of post-surgical health outcomes. The results support the view that the psychological determinants of post-surgical pain severity differ from the psychological determinants of post-surgical disability. The results suggest that interventions designed to specifically target pain-related psychological risk factors might improve post-surgical outcomes.}, Doi = {10.1016/j.pain.2009.02.011}, Key = {fds273694} } @article{fds273770, Author = {Somers, TJ and Keefe, FJ and Pells, JJ and Dixon, KE and Waters, SJ and Riordan, PA and Blumenthal, JA and McKee, DC and LaCaille, L and Tucker, JM and Schmitt, D and Caldwell, DS and Kraus, VB and Sims, EL and Shelby, RA and Rice, JR}, Title = {Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability.}, Journal = {J Pain Symptom Manage}, Volume = {37}, Number = {5}, Pages = {863-872}, Year = {2009}, Month = {May}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19041218}, Abstract = {This study examined the degree to which pain catastrophizing and pain-related fear explain pain, psychological disability, physical disability, and walking speed in patients with osteoarthritis (OA) of the knee. Participants in this study were 106 individuals diagnosed as having OA of at least one knee, who reported knee pain persisting for six months or longer. Results suggest that pain catastrophizing explained a significant proportion (all Ps < or = 0.05) of variance in measures of pain (partial r(2) [pr(2)] = 0.10), psychological disability (pr(2) = 0.20), physical disability (pr(2) = 0.11), and gait velocity at normal (pr(2) = 0.04), fast (pr(2) = 0.04), and intermediate speeds (pr(2) = 0.04). Pain-related fear explained a significant proportion of the variance in measures of psychological disability (pr(2) = 0.07) and walking at a fast speed (pr(2) = 0.05). Pain cognitions, particularly pain catastrophizing, appear to be important variables in understanding pain, disability, and walking at normal, fast, and intermediate speeds in knee OA patients. Clinicians interested in understanding variations in pain and disability in this population may benefit by expanding the focus of their inquiries beyond traditional medical and demographic variables to include an assessment of pain catastrophizing and pain-related fear.}, Doi = {10.1016/j.jpainsymman.2008.05.009}, Key = {fds273770} } @article{fds273778, Author = {Blumenthal, JA and Keefe, FJ and Babyak, MA and Fenwick, CV and Johnson, JM and Stott, K and Funk, RK and McAdams, MJ and Palmer, S and Martinu, T and Baucom, D and Diaz, PT and Emery, CF}, Title = {Caregiver-assisted coping skills training for patients with COPD: background, design, and methodological issues for the INSPIRE-II study.}, Journal = {Clin Trials}, Volume = {6}, Number = {2}, Pages = {172-184}, Year = {2009}, Month = {April}, ISSN = {1740-7745}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19342470}, Abstract = {BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a progressive illness characterized by airflow obstruction and dyspnea that afflicts over 12 million people and represents a leading cause of death in the United States. Not surprisingly, COPD is often associated with emotional distress and reduced psychosocial adjustment, which can negatively impact physical functioning and impair quality of life. However, the psychosocial consequences of COPD remain largely untreated. A previous randomized trial from our research team demonstrated that coping skills training (CST) can improve pulmonary-specific quality of life among pulmonary patients awaiting lung transplant (the INSPIRE study). To date, however, no studies have examined the effects of a caregiver-assisted CST intervention in patients with COPD with less severe disease. PURPOSE: INSPIRE II is a randomized clinical trial (RCT) funded by the NHLBI to evaluate the effects of telephone-based enhanced CST for patients with COPD and their caregivers compared to standardized medical care (SMC) including COPD education and symptom monitoring on medical outcomes, physical functioning, and quality of life. METHODS: Six hundred COPD patients and their respective caregivers recruited from Duke University and Ohio State University will be evaluated and randomized (in a 1:1 ratio) to enhanced CST (including sessions promoting physical activity, relaxation, cognitive restructuring, communication skills, and problem solving) or to SMC. The primary outcomes include all-cause mortality, COPD-related hospitalizations/ physician visits, and quality of life. These endpoints will be measured through self-report questionnaires, behavioral measures of functional capacity (i.e., accelerometer and six minute walk test) and pulmonary function tests (e.g., FEV(1)). RESULTS: This article reviews prior studies in the area and describes the design of INSPIRE-II. Several key methodological issues are discussed including the delivery of CST over the telephone, encouraging physical activity, and inclusion of caregivers as patient coaches to enhance the effectiveness of the intervention. LIMITATIONS: We recognize that SMC does not adequately control for attention, support, and non-specific factors, and that, in theory, non-specific effects of the intervention could account for some, or all, of the observed benefits. However, our fundamental question is whether the telephone intervention produces benefits over-and-above the usual care that patients typically receive. The SMC condition will provide education and additional weekly telephone contact, albeit less than the attention received by the CST group. We recognize that this attention control condition may not provide equivalent patient contact, but it will minimize group differences due to attention. We considered several alternative designs including adding a third usual care only arm as well as an education only control arm. However, these alternatives would require more patients, reduce the power to detect significant effects of our primary medical endpoints, and add a significant additional expense to the cost of the study that would make such an undertaking neither scientifically or financially viable. CONCLUSIONS: We believe that this novel approach to patient care in which caregivers are used to assist in the delivery of coping skills training to patients with COPD has the potential to change the way in which COPD patients are routinely managed in order to reduce distress, enhance quality of life, and potentially improve medical outcomes.}, Doi = {10.1177/1740774509102565}, Key = {fds273778} } @article{fds273750, Author = {Jeffery, DD and Tzeng, JP and Keefe, FJ and Porter, LS and Hahn, EA and Flynn, KE and Reeve, BB and Weinfurt, KP}, Title = {Initial report of the cancer Patient-Reported Outcomes Measurement Information System (PROMIS) sexual function committee: review of sexual function measures and domains used in oncology.}, Journal = {Cancer}, Volume = {115}, Number = {6}, Pages = {1142-1153}, Year = {2009}, Month = {March}, ISSN = {0008-543X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19195044}, Abstract = {For this report, the authors described the initial activities of the Cancer Patient-Reported Outcomes Measurement Information System (PROMIS)-Sexual Function domain group, which is part of the National Institutes of Health Roadmap Initiative to develop brief questionnaires or individually tailored assessments of quality-of-life domains. Presented are a literature review of sexual function measures used in cancer populations and descriptions of the domains found in those measures. By using a consensus-driven approach, an electronic bibliographic search was conducted for articles that were published from 1991 to 2007, and 486 articles were identified for in-depth review. In total, 257 articles reported the administration of a psychometrically evaluated sexual function measure to individuals who were diagnosed with cancer. Apart from the University of California-Los Angeles Prostate Cancer Index, the International Index of Erectile Function, and the Female Sexual Function Index, the 31 identified measures have not been tested widely in cancer populations. Most measures were multidimensional and included domains related to the sexual response cycle and to general sexual satisfaction. The current review supports the need for a flexible, psychometrically robust measure of sexual function for use in oncology settings and strongly justifies the development of the PROMIS-Sexual Function instrument. When the PROMIS-Sexual Function instrument is available publicly, cancer clinicians and researchers will have another measure with which to assess patient-reported sexual function outcomes in addition to the few legacy measures that were identified through this review.}, Doi = {10.1002/cncr.24134}, Key = {fds273750} } @article{fds273692, Author = {Daniel, M and Keefe, FJ and Lyna, P and Peterson, B and Garst, J and Kelley, M and Bepler, G and Bastian, LA}, Title = {Persistent smoking after a diagnosis of lung cancer is associated with higher reported pain levels.}, Journal = {J Pain}, Volume = {10}, Number = {3}, Pages = {323-328}, Year = {2009}, Month = {March}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19254679}, Abstract = {UNLABELLED: The purpose of this study was to evaluate the impact of smoking status after a diagnosis of lung cancer on reported pain levels. We conducted a telephone survey of patients with lung cancer identified from 4 participating sites between September 2004 and July 2006. Patients were asked to rate their usual pain level over the past week on a 0 to 10 rating scale on which 0 was "no pain" and 10 "pain as bad as you can imagine." We operationally defined persistent smokers as patients who reported continuing to smoke after their lung cancer diagnosis. A logistic regression analysis was used to test the hypothesis that persistent smokers report higher usual pain levels than nonsmokers. Overall, 893 patients completed the survey. The majority (76%) was found to have advanced cancer (stages IIIb and IV). The mean age was 63 years (SD = 10). Seventeen percent of the patients studied were categorized as persistent smokers. The mean pain score for the study sample was 3.1 (SD = 2.7) and 41% reported moderate (4 to 6) or severe pain (7 to 10). A greater proportion of persistent smokers reported moderate or severe pain than nonsmokers or former smokers (P < .001). Logistic regression analysis revealed that smoking status was associated with the usual pain even after adjusting for age, perceived health status, and other lung cancer symptoms such as dyspnea, fatigue, and trouble eating. In conclusion, patients who continue to smoke after a diagnosis of lung cancer report higher levels of usual pain than nonsmokers or former smokers. More research is needed to understand the mechanisms that relate nicotine intake to pain and disease progression in late-stage lung cancer. PERSPECTIVE: This article examines the relationship between pain and persistent smoking in patients with lung cancer. Although more research is needed to understand the mechanisms that relate nicotine intake to pain and disease progression, physicians can promote smoking cessation in patients with lung cancer to improve health and quality of life.}, Doi = {10.1016/j.jpain.2008.10.006}, Key = {fds273692} } @article{fds273693, Author = {Baucom, DH and Porter, LS and Kirby, JS and Gremore, TM and Wiesenthal, N and Aldridge, W and Fredman, SJ and Stanton, SE and Scott, JL and Halford, KW and Keefe, FJ}, Title = {A couple-based intervention for female breast cancer.}, Journal = {Psychooncology}, Volume = {18}, Number = {3}, Pages = {276-283}, Year = {2009}, Month = {March}, ISSN = {1057-9249}, url = {http://dx.doi.org/10.1002/pon.1395}, Abstract = {OBJECTIVE: Although women's breast cancer affects both women and their male partners, as well as their relationships, few interventions have been developed to work with couples confronting breast cancer. The current investigation presents the pilot results from a new couple-based intervention program for breast cancer that teaches couples how to minimize negative effects and maximize positive functioning during this difficult time. METHOD: In this pilot study, 14 couples in which the wife had early stage breast cancer were randomly assigned to one of the two treatment conditions: Couple-based relationship enhancement (RE) or treatment-as-usual (TAU). RESULTS: The results from this study suggest that compared with couples receiving treatment-as-usual, both women and men in the RE condition experienced improved functioning on individual psychological variables as well as relationship functioning at posttest and 1-year follow-up. In addition, women in RE show fewer medical symptoms at both time periods. CONCLUSIONS: In this pilot study, the couple-based intervention, RE, has shown promise in improving individual, medical, and relationship functioning for couples in which the woman is facing breast cancer, and therefore merits further investigation on a larger scale.}, Doi = {10.1002/pon.1395}, Key = {fds273693} } @article{fds273691, Author = {Hunter, DJ and McDougall, JJ and Keefe, FJ}, Title = {The symptoms of osteoarthritis and the genesis of pain.}, Journal = {Med Clin North Am}, Volume = {93}, Number = {1}, Pages = {83-xi}, Year = {2009}, Month = {January}, ISSN = {0025-7125}, url = {http://dx.doi.org/10.1016/j.mcna.2008.08.008}, Abstract = {This article delineates the characteristic symptoms and signs associated with OA and how they can be used to make the clinical diagnosis. The predominant symptom in most patients is pain. The remainder of the article focuses on what we know causes pain in OA and contributes to its severity. Much has been learned over recent years; however, for the budding researcher much of this puzzle remains unexplored or inadequately understood.}, Doi = {10.1016/j.mcna.2008.08.008}, Key = {fds273691} } @article{fds273699, Author = {Verra, ML and Angst, F and Brioschi, R and Lehmann, S and Keefe, FJ and Staal, JB and de Bie, RA and Aeschlimann, A}, Title = {Does classification of persons with fibromyalgia into Multidimensional Pain Inventory subgroups detect differences in outcome after a standard chronic pain management program?}, Journal = {Pain Res Manag}, Volume = {14}, Number = {6}, Pages = {445-453}, Year = {2009}, ISSN = {1203-6765}, url = {http://dx.doi.org/10.1155/2009/137901}, Abstract = {INTRODUCTION: The present study aimed to replicate and validate the empirically derived subgroup classification based on the Multidimensional Pain Inventory (MPI) in a sample of highly disabled fibromyalgia (FM) patients. Second, it examined how the identified subgroups differed in their response to an intensive, interdisciplinary inpatient pain management program. METHODS: Participants were 118 persons with FM who experienced persistent pain and were disabled. Subgroup classification was conducted by cluster analysis using MPI subscale scores at entry to the program. At program entry and discharge, participants completed the MPI, Medical Outcomes Study Short Form-36, Hospital Anxiety and Depression Scale and Coping Strategies Questionnaire. RESULTS: Cluster analysis identified three subgroups in the highly disabled sample that were similar to those described by other studies using less disabled samples of FM. The dysfunctional subgroup (DYS; 36% of the sample) showed the highest level of depression, the interpersonally distressed subgroup (ID; 24%) showed a modest level of depression and the adaptive copers subgroup (AC; 38%) showed the lowest depression scores in the MPI (negative mood), Medical Outcomes Study Short Form-36 (mental health), Hospital Anxiety and Depression Scale (depression) and Coping Strategies Questionnaire (catastrophizing). Significant differences in treatment outcome were observed among the three subgroups in terms of reduction of pain severity (as assessed using the MPI). The effect sizes were 1.42 for DYS, 1.32 for AC and 0.62 for ID (P=0.004 for pairwise comparison of ID-AC and P=0.018 for ID-DYS). DISCUSSION: These findings underscore the importance of assessing individuals' differences in how they adjust to FM.}, Doi = {10.1155/2009/137901}, Key = {fds273699} } @article{fds273745, Author = {Sims, EL and Carland, JM and Keefe, FJ and Kraus, VB and Guilak, F and Schmitt, D}, Title = {Sex differences in biomechanics associated with knee osteoarthritis.}, Journal = {J Women Aging}, Volume = {21}, Number = {3}, Pages = {159-170}, Year = {2009}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20183142}, Abstract = {Osteoarthritis of the knee is seen more frequently in females than males. However, few studies have examined the interplay of gender, gait mechanics, pain, and disability in persons with osteoarthritis. This study examines the influence of anthropometrics, radiographic disease severity, pain, and disability on gender differences in gait mechanics in patients with knee osteoarthritis. Gait mechanics for 26 men and 30 women were collected using 3-D kinematics and kinetics. Women had a significantly lower knee adduction moment than men and a significantly higher stride frequency. Within female subjects, variations in gait mechanics were primarily explained by weight, BMI, pain, and disability. In males, variations in gait mechanics were primarily explained by age and disability.}, Doi = {10.1080/08952840903054856}, Key = {fds273745} } @article{fds273690, Author = {Porter, LS and Keefe, FJ and Wellington, C and de Williams, A}, Title = {Pain communication in the context of osteoarthritis: patient and partner self-efficacy for pain communication and holding back from discussion of pain and arthritis-related concerns.}, Journal = {Clin J Pain}, Volume = {24}, Number = {8}, Pages = {662-668}, Year = {2008}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18806530}, Abstract = {OBJECTIVES: This preliminary study examined aspects of pain communication (self-efficacy for pain communication and holding back from discussing pain and arthritis-related concerns) among patients with osteoarthritis (OA) and their partners, and associations between patient and partner pain communication and measures of patient and partner adjustment. METHODS: A sample of 38 patients with OA and their partners completed measures of self-efficacy for pain communication and holding back from discussion of pain and arthritis-related concerns. Patients completed measures of pain, physical and psychologic disability, and pain catastrophizing, and partners completed measures of caregiver strain and positive and negative affect. RESULTS: Correlation analyses indicated that, among patients, higher levels of self-efficacy for pain communication were associated with significantly lower levels of pain, physical and psychologic disability, and pain catastrophizing, and with lower levels of partner negative affect. Among partners, high self-efficacy for pain communication was associated with higher levels of positive affect. Among patients, higher levels of holding back were significantly correlated with higher levels of psychologic disability and catastrophizing. Higher levels of partner holding back were associated with significantly higher levels of caregiver strain, and with higher levels of patient psychologic disability and catastrophizing. DISCUSSION: Taken together, results from this preliminary study suggest that self-efficacy for pain communication and holding back from discussions of pain and arthritis-related concerns may be important in understanding how patients with OA and their partners adjust to the demands of the patient's disease.}, Doi = {10.1097/AJP.0b013e31816ed964}, Key = {fds273690} } @article{fds273769, Author = {Shelby, RA and Somers, TJ and Keefe, FJ and Pells, JJ and Dixon, KE and Blumenthal, JA}, Title = {Domain specific self-efficacy mediates the impact of pain catastrophizing on pain and disability in overweight and obese osteoarthritis patients.}, Journal = {J Pain}, Volume = {9}, Number = {10}, Pages = {912-919}, Year = {2008}, Month = {October}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18602871}, Abstract = {UNLABELLED: This study examined whether self-efficacy mediated the relationship between pain catastrophizing and pain and disability. Participants were 192 individuals diagnosed with osteoarthritis (OA) of the knees who were overweight or obese. Multiple mediator analyses were conducted to simultaneously test self-efficacy for pain control, physical function, and emotional symptoms as mediators while controlling for demographic and medical status variables. Higher pain catastrophizing was associated with lower self-efficacy in all 3 domains (Ps < .05). Self-efficacy for pain control fully mediated the relationship between pain catastrophizing and pain (beta = .08, Sobel test Z = 1.97, P < .05). The relationship between pain catastrophizing and physical disability was fully mediated by self-efficacy for physical function (beta = .06, Sobel test Z = 1.95, P = .05). Self-efficacy for emotional symptoms partially mediated the relationship between pain catastrophizing and psychological disability (beta = .12, Sobel test Z = 2.92, P < .05). These results indicate that higher pain catastrophizing contributed to greater pain and disability via lower domain-specific self-efficacy. Efforts to reduce pain and improve functioning in OA patients should consider addressing pain catastrophizing and domain specific self-efficacy. Pain catastrophizing may be addressed through cognitive therapy techniques and self-efficacy may be enhanced through practice of relevant skills and personal accomplishments. PERSPECTIVE: This study found that higher pain catastrophizing contributed to greater pain and disability via domain specific self-efficacy. These results suggest that treatment efforts to reduce pain and improve functioning in OA patients who are overweight or obese should consider addressing both pain catastrophizing and self-efficacy.}, Doi = {10.1016/j.jpain.2008.05.008}, Key = {fds273769} } @article{fds273688, Author = {Shega, JW and Rudy, T and Keefe, FJ and Perri, LC and Mengin, OT and Weiner, DK}, Title = {Validity of pain behaviors in persons with mild to moderate cognitive impairment.}, Journal = {J Am Geriatr Soc}, Volume = {56}, Number = {9}, Pages = {1631-1637}, Year = {2008}, Month = {September}, ISSN = {0002-8614}, url = {http://dx.doi.org/10.1111/j.1532-5415.2008.01831.x}, Abstract = {OBJECTIVES: To evaluate the validity of traditional pain behaviors (guarding, bracing, rubbing, grimacing, and sighing) in persons with and without cognitive impairment and chronic low back pain (CLBP). DESIGN: Prospective observational study. SETTING: Outpatient clinics. PARTICIPANTS: Thirty-seven cognitively intact and 40 cognitively impaired participants with and without CLBP. MEASUREMENTS: Frequency of traditional pain behaviors. RESULTS: Forty-six of the participants were pain free, and 31 had CLBP. The internal consistency reliability coefficient of the five pain behaviors was 0.32, suggesting that a unidimensional scale did not exist. Multivariate analysis of variance analysis according to the independent variables pain status (pain free vs CLBP) and cognitive status (intact vs impaired) with the dependent variable frequency of pain behaviors found significant differences according to pain status (F[5,61]=3.06, P=.02) and cognitive status (F[5,61]=5.41, P<.001) but without evidence of an interaction (F[5,61]=1.14, P=.35). Participants with CLBP exhibited significantly higher levels of grimacing (P<.001) and guarding (P=.02) than pain-free participants. Intact subjects exhibited fewer guarding (P=.02) and rubbing behaviors (P<.001) but a higher number of bracing behaviors (P=.03) than cognitively impaired participants. CONCLUSION: These results support the utility of facial grimacing in assessing pain in patients with mild to moderate cognitive impairment and call into question the validity of guarding and rubbing in assessing pain in persons with mild to moderate cognitive impairment.}, Doi = {10.1111/j.1532-5415.2008.01831.x}, Key = {fds273688} } @article{fds273687, Author = {Hunter, DJ and McDougall, JJ and Keefe, FJ}, Title = {The symptoms of osteoarthritis and the genesis of pain.}, Journal = {Rheum Dis Clin North Am}, Volume = {34}, Number = {3}, Pages = {623-643}, Year = {2008}, Month = {August}, ISSN = {0889-857X}, url = {http://dx.doi.org/10.1016/j.rdc.2008.05.004}, Abstract = {Symptomatic osteoarthritis (OA) causes substantial physical and psychosocial disability. This article delineates the characteristic symptoms and signs associated with OA and how they can be used to make the clinical diagnosis. The predominant symptom in most patients is pain. The remainder of the article focuses on what is known about the causes of pain in OA and factors that contribute to its severity. Much has been learned during recent years, but much of this puzzle remains unexplored or inadequately understood.}, Doi = {10.1016/j.rdc.2008.05.004}, Key = {fds273687} } @article{fds273686, Author = {Porter, LS and Keefe, FJ and Garst, J and McBride, CM and Baucom, D}, Title = {Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: associations with symptoms and distress.}, Journal = {Pain}, Volume = {137}, Number = {2}, Pages = {306-315}, Year = {2008}, Month = {July}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17942229}, Abstract = {This study examined self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their caregivers, and associations between self-efficacy and patient and caregiver adjustment. One hundred and fifty-two patients with early stage lung cancer completed measures of self-efficacy, pain, fatigue, quality of life, depression, and anxiety. Their caregivers completed a measure assessing their self-efficacy for helping the patient manage symptoms and measures of psychological distress and caregiver strain. Analyses indicated that, overall, patients and caregivers were relatively low in self-efficacy for managing pain, symptoms, and function, and that there were significant associations between self-efficacy and adjustment. Patients low in self-efficacy reported significantly higher levels of pain, fatigue, lung cancer symptoms, depression, and anxiety, and significantly worse physical and functional well being, as did patients whose caregivers were low in self-efficacy. When patients and caregivers both had low self-efficacy, patients reported higher levels of anxiety and poorer quality of life than when both were high in self-efficacy. There were also significant associations between patient and caregiver self-efficacy and caregiver adjustment, with lower levels of self-efficacy associated with higher levels of caregiver strain and psychological distress. These preliminary findings raise the possibility that patient and caregiver self-efficacy for managing pain, symptoms, and function may be important factors affecting adjustment, and that interventions targeted at increasing self-efficacy may be useful in this population.}, Doi = {10.1016/j.pain.2007.09.010}, Key = {fds273686} } @article{fds273685, Author = {Waters, SJ and Riordan, PA and Keefe, FJ and Lefebvre, JC}, Title = {Pain behavior in rheumatoid arthritis patients: identification of pain behavior subgroups.}, Journal = {J Pain Symptom Manage}, Volume = {36}, Number = {1}, Pages = {69-78}, Year = {2008}, Month = {July}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18358682}, Abstract = {This study used Ward's minimum variance hierarchical cluster analysis to identify homogeneous subgroups of rheumatoid arthritis patients suffering from chronic pain who exhibited similar pain behavior patterns during a videotaped behavior sample. Ninety-two rheumatoid arthritis patients were divided into two samples. Six motor pain behaviors were examined: guarding, bracing, active rubbing, rigidity, grimacing, and sighing. The cluster analysis procedure identified four similar subgroups in Samples 1 and 2. The first subgroup exhibited low levels of all pain behaviors. The second subgroup exhibited a high level of guarding and low levels of other pain behaviors. The third subgroup exhibited high levels of guarding and rigidity and low levels of other pain behaviors. The fourth subgroup exhibited high levels of guarding and active rubbing and low levels of other pain behaviors. Sample 1 contained a fifth subgroup that exhibited a high level of active rubbing and low levels of other pain measures. The results of this study suggest that there are homogeneous subgroups within rheumatoid arthritis patient populations who differ in the motor pain behaviors they exhibit.}, Doi = {10.1016/j.jpainsymman.2007.08.015}, Key = {fds273685} } @article{fds273765, Author = {Keefe, FJ and Anderson, T and Lumley, M and Caldwell, D and Stainbrook, D and Mckee, D and Waters, SJ and Connelly, M and Affleck, G and Pope, MS and Weiss, M and Riordan, PA and Uhlin, BD}, Title = {A randomized, controlled trial of emotional disclosure in rheumatoid arthritis: can clinician assistance enhance the effects?}, Journal = {Pain}, Volume = {137}, Number = {1}, Pages = {164-172}, Year = {2008}, Month = {July}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17923329}, Abstract = {Emotional disclosure by writing or talking about stressful life experiences improves health status in non-clinical populations, but its success in clinical populations, particularly rheumatoid arthritis (RA), has been mixed. In this randomized, controlled trial, we attempted to increase the efficacy of emotional disclosure by having a trained clinician help patients emotionally disclose and process stressful experiences. We randomized 98 adults with RA to one of four conditions: (a) private verbal emotional disclosure; (b) clinician-assisted verbal emotional disclosure; (c) arthritis information control (all of which engaged in four, 30-min laboratory sessions); or (d) no-treatment, standard care only control group. Outcome measures (pain, disability, affect, stress) were assessed at baseline, 2 months following treatment (2-month follow-up), and at 5-month, and 15-month follow-ups. A manipulation check demonstrated that, as expected, both types of emotional disclosure led to immediate (post-session) increases in negative affect compared with arthritis information. Outcome analyses at all three follow-ups revealed no clear pattern of effects for either clinician-assisted or private emotional disclosure compared with the two control groups. There were some benefits in terms of a reduction in pain behavior with private disclosure vs. clinician-assisted disclosure at the 2-month follow-up, but no other significant between group differences. We conclude that verbal emotional disclosure about stressful experiences, whether conducted privately or assisted by a clinician, has little or no benefit for people with RA.}, Doi = {10.1016/j.pain.2007.08.031}, Key = {fds273765} } @article{fds273777, Author = {Taylor, JL and Smith, PJ and Babyak, MA and Barbour, KA and Hoffman, BM and Sebring, DL and Davis, RD and Palmer, SM and Keefe, FJ and Carney, RM and Csik, I and Freedland, KE and Blumenthal, JA}, Title = {Coping and quality of life in patients awaiting lung transplantation.}, Journal = {J Psychosom Res}, Volume = {65}, Number = {1}, Pages = {71-79}, Year = {2008}, Month = {July}, ISSN = {0022-3999}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18582615}, Abstract = {OBJECTIVE: Patients with end-stage lung disease (ESLD) experience significant decrements in quality of life (QOL). Although coping strategies are related to QOL in patients with ESLD, the extent to which specific native lung disease moderates this relationship is unknown. METHODS: We investigated the relationship between coping, native lung disease, and QOL among 187 patients awaiting lung transplantation, including 139 patients with chronic obstructive pulmonary disease (COPD) and 48 with cystic fibrosis (CF). Participants completed a psychosocial battery assessing psychological QOL, physical QOL, and coping strategies. RESULTS: For both COPD and CF patients, higher levels of Active Coping (P< .0001) and lower levels of Disengagement (P< .0001) were associated with better psychological QOL. For physical QOL, we observed a Native Disease x Coping interaction (P=.01) such that Active Coping was associated with better physical QOL in patients with COPD but not in patients with CF. CONCLUSIONS: The relationship between coping and QOL may vary as a function of native lung disease. Patients' native disease may need to be considered in order to develop effective interventions to help patients cope successfully with ESLD.}, Doi = {10.1016/j.jpsychores.2008.04.009}, Key = {fds273777} } @article{fds273683, Author = {Martire, LM and Schulz, R and Keefe, FJ and Rudy, TE and Starz, TW}, Title = {Couple-Oriented Education and Support Intervention for Osteoarthritis: Effects on Spouses' Support and Responses to Patient Pain.}, Journal = {Fam Syst Health}, Volume = {26}, Number = {2}, Pages = {185-195}, Year = {2008}, Month = {June}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19946460}, Abstract = {The purpose of this study was to determine whether a couple-oriented education and support intervention for osteoarthritis was more efficacious than a similar patient-oriented intervention in terms of enhancing spouses' support of patients and their positive and negative responses to patient pain. Repeated-measures analyses of covariance with the completers sample (N = 103 dyads) showed that at the postintervention assessment, patients in the couple-oriented intervention reported a greater decrease in their spouses' punishing responses (e.g., anger, irritation) than did patients in the patient-oriented intervention. In addition, a trend effect was observed in regard to the advantage of couple-oriented intervention for increasing spouses' attempts to distract patients from their pain. At the 6-month follow-up, patients in the couple-oriented intervention reported greater increased spouse support than those in the patient-oriented intervention. Findings illustrate the value of examining change in specific types of marital interactions targeted in a couples intervention, and the need to strengthen the impact of future couple-oriented interventions.}, Doi = {10.1037/1091-7527.26.2.185}, Key = {fds273683} } @article{fds273768, Author = {Pells, JJ and Shelby, RA and Keefe, FJ and Dixon, KE and Blumenthal, JA and LaCaille, L and Tucker, JM and Schmitt, D and Caldwell, DS and Kraus, VB}, Title = {Arthritis self-efficacy and self-efficacy for resisting eating: relationships to pain, disability, and eating behavior in overweight and obese individuals with osteoarthritic knee pain.}, Journal = {Pain}, Volume = {136}, Number = {3}, Pages = {340-347}, Year = {2008}, Month = {June}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17764844}, Abstract = {This study examined arthritis self-efficacy and self-efficacy for resisting eating as predictors of pain, disability, and eating behaviors in overweight or obese patients with osteoarthritis (OA) of the knee. Patients (N=174) with a body mass index between 25 and 42 completed measures of arthritis-related self-efficacy, weight-related self-efficacy, pain, physical disability, psychological disability, overeating, and demographic and medical information. Hierarchical linear regression analyses were conducted to examine whether arthritis self-efficacy (efficacy for pain control, physical function, and other symptoms) and self-efficacy for resisting eating accounted for significant variance in pain, disability, and eating behaviors after controlling for demographic and medical characteristics. Analyses also tested whether the contributions of self-efficacy were domain specific. Results showed that self-efficacy for pain accounted for 14% (p=.01) of the variance in pain, compared to only 3% accounted for by self-efficacy for physical function and other symptoms. Self-efficacy for physical function accounted for 10% (p=.001) of the variance in physical disability, while self-efficacy for pain and other symptoms accounted for 3%. Self-efficacy for other (emotional) symptoms and resisting eating accounted for 21% (p<.05) of the variance in psychological disability, while self-efficacy for pain control and physical function were not significant predictors. Self-efficacy for resisting eating accounted for 28% (p=.001) of the variance in eating behaviors. Findings indicate that self-efficacy is important in understanding pain and behavioral adjustment in overweight or obese OA patients. Moreover, the contributions of self-efficacy were domain specific. Interventions targeting both arthritis self-efficacy and self-efficacy for resisting eating may be helpful in this population.}, Doi = {10.1016/j.pain.2007.07.012}, Key = {fds273768} } @article{fds372011, Author = {Baucom, DH and Dyo, S and Porter, LS and Kirby, JS and Gremore, TM and Pukay-Martin, N and Keefe, FJ}, Title = {Body image and sexual functioning among women with early stage breast cancer: The impact of a couple-based intervention program}, Journal = {INTERNATIONAL JOURNAL OF PSYCHOLOGY}, Volume = {43}, Number = {3-4}, Pages = {40-40}, Publisher = {PSYCHOLOGY PRESS}, Year = {2008}, Month = {June}, Key = {fds372011} } @article{fds273684, Author = {Keefe, FJ and Somers, TJ and Martire, LM}, Title = {Psychologic interventions and lifestyle modifications for arthritis pain management.}, Journal = {Rheum Dis Clin North Am}, Volume = {34}, Number = {2}, Pages = {351-368}, Year = {2008}, Month = {May}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18638681}, Abstract = {This article provides an overview of self-management interventions used to manage pain in patients who have arthritis. The article is divided in two major sections. The first section reviews psychologic interventions used to manage arthritis pain, including pain-coping skills training and cognitive behavioral therapy for pain management, emotional disclosure interventions, and partner-assisted interventions. The second section addresses lifestyle behavioral weight loss interventions used to reduce arthritis pain. In each section, the authors briefly describe the rationale and nature of the interventions, present data on their efficacy, and highlight potential future research directions.}, Doi = {10.1016/j.rdc.2008.03.001}, Key = {fds273684} } @article{fds273786, Author = {Keefe, F and Abernethy, AP and Wheeler, J and Affleck, G}, Title = {Don't ask, don't tell? Revealing placebo responses to research participants and patients.}, Journal = {Pain}, Volume = {135}, Number = {3}, Pages = {213-214}, Year = {2008}, Month = {April}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18282661}, Doi = {10.1016/j.pain.2008.01.009}, Key = {fds273786} } @article{fds273682, Author = {Perri, LM and Keefe, FJ}, Title = {Applying centrality of event to persistent pain: a preliminary view.}, Journal = {J Pain}, Volume = {9}, Number = {3}, Pages = {265-271}, Year = {2008}, Month = {March}, ISSN = {1526-5900}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18096438}, Abstract = {UNLABELLED: Living with persistent pain is a complex experience. Based on clinical observations, persistent pain is often described as a stressful life event that has significantly altered how patients view themselves and the world around them. The Centrality of Event Scale (CES) assesses how much a stressful life event serves as a turning point in the individual's life, forms a reference point for personal identity, and affects the attribution of meaning to other life experiences. In this study, 47 patients with persistent pain were asked to complete the CES using "the experience of persistent pain" as the designated stressful life event. Data analyses revealed patients scoring high on the CES (ie, those who viewed persistent pain as a central life event) were significantly more likely to experience higher levels of pain intensity (r = .35, P = .02), life interference due to pain (r = .50, P = .002), and psychological distress (r = .46, P = .001). Additional analyses revealed that the CES was a significant predictor of life interference due to pain and psychological distress even after controlling for the effects of age, sex, education, and pain intensity. PERSPECTIVE: The experience of persistent pain can serve as a major turning point in patients' lives, affect patients' interpretations of other life events, and become a key component of patients' identities. The results of this study indicate that centrality of event, a relatively new construct, could improve our understanding of persistent pain.}, Doi = {10.1016/j.jpain.2007.10.019}, Key = {fds273682} } @article{fds372012, Author = {Porter, LS and Keefe, FJ and Baucom, DH and Hurwitz, H and Bendell, J}, Title = {Spouse disclosure of cancer-related concerns: Associations with spouse and patient adjustment}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {35}, Pages = {S171-S171}, Publisher = {SPRINGER}, Year = {2008}, Month = {March}, Key = {fds372012} } @article{fds273679, Author = {Naylor, MR and Keefe, FJ and Brigidi, B and Naud, S and Helzer, JE}, Title = {Therapeutic Interactive Voice Response for chronic pain reduction and relapse prevention.}, Journal = {Pain}, Volume = {134}, Number = {3}, Pages = {335-345}, Year = {2008}, Month = {February}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2007.11.001}, Abstract = {We developed Therapeutic Interactive Voice Response (TIVR) as an automated, telephone-based tool for maintenance enhancement following group cognitive-behavioral therapy (CBT) for chronic pain. TIVR has four components: a daily self-monitoring questionnaire, a didactic review of coping skills, pre-recorded behavioral rehearsals of coping skills, and monthly personalized feedback messages from the CBT therapist based on a review of the patient's daily reports. The first three components are pre-recorded and all four can be accessed remotely by patients via touch-tone telephone on demand. Following 11 weeks of group CBT, 51 subjects with chronic musculoskeletal pain were randomized to one of two study groups. Twenty-six subjects participated in 4 months of TIVR, while a control group of 25 subjects received standard care only. The TIVR group showed maximum improvement over baseline at the 8-month follow-up for seven of the eight outcome measures; improvement was found to be significant for all outcomes (p<or=001). Between-group analysis of covariance (ANCOVA) revealed significantly greater improvement for the experimental group at both 4- and 8-month follow-ups for most of the outcomes. Results demonstrate that TIVR can be used to decrease pain, improve coping and decrease likelihood of relapse into pain behavior. Preliminary analysis of medication usage suggests that the superior outcome of the TIVR group was unlikely to be a consequence of differential medication use.}, Doi = {10.1016/j.pain.2007.11.001}, Key = {fds273679} } @article{fds273680, Author = {Malenbaum, S and Keefe, FJ and Williams, ACDC and Ulrich, R and Somers, TJ}, Title = {Pain in its environmental context: implications for designing environments to enhance pain control.}, Journal = {Pain}, Volume = {134}, Number = {3}, Pages = {241-244}, Year = {2008}, Month = {February}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18178010}, Doi = {10.1016/j.pain.2007.12.002}, Key = {fds273680} } @article{fds273681, Author = {Shaw, A and Keefe, FJ}, Title = {Genetic and environmental determinants of postthoracotomy pain syndrome.}, Journal = {Curr Opin Anaesthesiol}, Volume = {21}, Number = {1}, Pages = {8-11}, Year = {2008}, Month = {February}, ISSN = {0952-7907}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18195602}, Abstract = {PURPOSE OF REVIEW: Pain after thoracic surgery may persist for up to a year or longer in as many as 50% of patients undergoing lung resection. There is currently no specific therapy, and our ability to predict who will develop a persistent pain syndrome is poor at best. Persistent pain after thoracotomy is not an acute somatic pain, rather it is a complex syndrome with many of the characteristics of neuropathic, dysesthetic pain. RECENT FINDINGS: The pain genetics field has been dominated by reports of single variants leading to severe phenotypes. These (Mendelian) diseases are not representative of the more common, complex phenotype that is characterized by the lay term 'pain threshold'. Recently, work describing the association of genetic variants with idiopathic pain disorders has appeared in the literature, and here the authors suggest that these concepts are applicable to postthoracotomy pain syndrome. SUMMARY: Postthoracotomy pain syndrome likely arises as a direct result of an environmental stress (surgery) occurring on a landscape of susceptibility that is determined by an individual's behavioral, clinical and genetic characteristics.}, Doi = {10.1097/ACO.0b013e3282f2daa2}, Key = {fds273681} } @article{fds372588, Author = {Rumble, M and Keefe, FJ and Edinger, J and Affleck, G}, Title = {Examining a comprehensive cognitive behavioral model of insomnia for breast cancer patients: A daily process analysis}, Journal = {SLEEP}, Volume = {31}, Pages = {A226-A226}, Publisher = {OXFORD UNIV PRESS INC}, Year = {2008}, Month = {January}, Key = {fds372588} } @article{fds273689, Author = {Somers, TJ and Keefe, FJ and Carson, JW and Pells, JJ and Lacaille, L}, Title = {Pain catastrophizing in borderline morbidly obese and morbidly obese individuals with osteoarthritic knee pain.}, Journal = {Pain Res Manag}, Volume = {13}, Number = {5}, Pages = {401-406}, Year = {2008}, ISSN = {1203-6765}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18958312}, Abstract = {OBJECTIVE: There is limited information about how morbidly obese osteoarthritis (OA) patients cope with the pain they experience. Pain catastrophizing is an important predictor of pain and adjustment in persons with persistent pain. This may be particularly relevant in the morbidly obese (body mass index [BMI] of 40 kg/m(2) or greater) OA population at risk for increased pain. The present study first examined whether borderline morbidly obese and morbidly obese OA patients report higher levels of pain catastrophizing than a sample of OA patients in the overweight and obese category (BMI between 25 kg/m(2) and 34 kg/m(2)). Next, it examined how pain catastrophizing is related to important indexes of pain and adjustment in borderline morbidly obese and morbidly obese OA patients. METHODS: Participants included 43 individuals with knee OA who were borderline morbidly obese or morbidly obese (BMI of 38 kg/m(2) or greater). Participants completed self-report measures of pain catastrophizing, pain, psychological distress, quality of life, binge eating and eating self-efficacy. RESULTS: The sample of borderline morbidly obese and morbidly obese OA patients reported significantly higher levels of pain catastrophizing (P=0.007) than a comparison sample of overweight and obese OA patients. Results suggested that patients who engaged in a high level of pain catastrophizing reported having much more intense and unpleasant pain, higher levels of binge eating, lower self-efficacy for controlling their eating and lower weight-related quality of life (P<0.05 for all). CONCLUSIONS: Pain catastrophizing is related to pain and adjustment in borderline morbidly obese and morbidly obese OA patients. Clinicians working with this population should consider assessing pain catastrophizing in the patients they treat.}, Doi = {10.1155/2008/652453}, Key = {fds273689} } @article{fds372013, Author = {Carson, JW and Carson, KM and Porter, LS and Keefe, FJ and Shaw, H}, Title = {YOGA FOR WOMEN WITH METASTATIC BREAST CANCER: RESULTS FROM A PILOT STUDY}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {33}, Pages = {S30-S30}, Publisher = {SPRINGER}, Year = {2007}, Month = {December}, Key = {fds372013} } @article{fds372014, Author = {Porter, LS and Keefe, FJ and Baucom, DH and Hurwitz, H and Bendell, J}, Title = {GENDER DIFFERENCES IN CORRELATES OF GI CANCER PATIENTS' DISCLOSURE TO THEIR SPOUSES}, Journal = {ANNALS OF BEHAVIORAL MEDICINE}, Volume = {33}, Pages = {S27-S27}, Publisher = {SPRINGER}, Year = {2007}, Month = {December}, Key = {fds372014} } @article{fds273776, Author = {Blumenthal, JA and Babyak, MA and Ironson, G and Thoresen, C and Powell, L and Czajkowski, S and Burg, M and Keefe, FJ and Steffen, P and Catellier, D}, Title = {Spirituality, religion, and clinical outcomes in patients recovering from an acute myocardial infarction (vol 69, pg 501, 2007)}, Journal = {PSYCHOSOMATIC MEDICINE}, Volume = {69}, Number = {8}, Pages = {826-826}, Publisher = {LIPPINCOTT WILLIAMS & WILKINS}, Year = {2007}, Month = {October}, ISSN = {0033-3174}, url = {http://dx.doi.org/10.1097/PSY.0b013e31815adb80}, Doi = {10.1097/PSY.0b013e31815adb80}, Key = {fds273776} } @article{fds273677, Author = {Connelly, M and Keefe, FJ and Affleck, G and Lumley, MA and Anderson, T and Waters, S}, Title = {Effects of day-to-day affect regulation on the pain experience of patients with rheumatoid arthritis.}, Journal = {Pain}, Volume = {131}, Number = {1-2}, Pages = {162-170}, Year = {2007}, Month = {September}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2007.01.002}, Abstract = {Individual differences in the regulation of affect are known to impact pain and other symptoms in rheumatoid arthritis. However, no studies have yet used a rigorous daily diary methodology to address the question of whether current pain is reduced when positive or negative affects are effectively regulated. We used a prospective, repeated daily sampling design to infer the regulation of affect from day-to-day changes in affect intensity and examined how these changes in affect were prospectively related to pain from rheumatoid arthritis. Ninety-four adult patients diagnosed with rheumatoid arthritis completed daily measures of pain and positive and negative affect over a period of 30 days. Information on demographic and disease status variables was collected during a medical evaluation. Results of hierarchical linear model analyses indicated that the regulation of both positive and negative affect from the prior day to the current day predicted significantly greater decreases in pain that day, resulting in up to a 28% reduction in pain intensity. These findings were partly influenced by disease status and demographic variables. This study suggests that the day-to-day regulation of negative and positive affect is a key variable for understanding the pain experience of individuals with rheumatoid arthritis and is a potentially important target for intervention.}, Doi = {10.1016/j.pain.2007.01.002}, Key = {fds273677} } @article{fds273678, Author = {Keefe, FJ and Porter, L}, Title = {Pain catastrophizing in the context of satisfaction with spousal responses: New perspectives and new opportunities.}, Journal = {Pain}, Volume = {131}, Number = {1-2}, Pages = {1-2}, Year = {2007}, Month = {September}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2007.05.016}, Doi = {10.1016/j.pain.2007.05.016}, Key = {fds273678} } @article{fds372015, Author = {Jeffery, DD and Reeve, BB and Tzeng, J and Weinfurt, KP and Flynn, KE and Keefe, FJ and Porter, LS and Hahn, EA and Cella, D}, Title = {The sexual function domain of the NIHPROMIS: Preliminary report}, Journal = {PSYCHO-ONCOLOGY}, Volume = {16}, Number = {9}, Pages = {S233-S233}, Publisher = {JOHN WILEY & SONS LTD}, Year = {2007}, Month = {September}, Key = {fds372015} } @article{fds273676, Author = {Martire, LM and Schulz, R and Keefe, FJ and Rudy, TE and Starz, TW}, Title = {Couple-oriented education and support intervention: Effects on individuals with osteoarthritis and their spouses}, Journal = {Rehabilitation Psychology}, Volume = {52}, Number = {2}, Pages = {121-132}, Publisher = {American Psychological Association (APA)}, Year = {2007}, Month = {May}, ISSN = {0090-5550}, url = {http://dx.doi.org/10.1037/0090-5550.52.2.121}, Abstract = {Objective: To determine whether a couple-oriented intervention for osteoarthritis (OA) was more efficacious than a patient-oriented intervention and whether each intervention was more efficacious than usual medical care. Research Design: 242 older adults with OA and their spouses were randomly assigned to patient-oriented education and support, couple-oriented education and support, or usual care. Results: Intent-to-treat analyses indicated no significant differences between the 3 study conditions in outcomes for individuals with OA or their spouses. Completers analyses showed that at the 6-month follow-up, contrary to prediction, individuals with OA who received the patient-oriented intervention reported greater reductions in pain and improvements in physical function than those who received the couple-oriented intervention. At the postintervention assessment, spouses who received the coupleoriented intervention reported greater reductions in stress and a trend toward less critical attitudes than spouses of individuals with OA who received the patient-oriented intervention. Moderator analyses indicated that female spouses and spouses with high marital satisfaction who received the couple-oriented intervention also experienced better outcomes in terms of depressive symptoms and caregiver mastery. Conclusions: A couples approach to education and support for OA may offer no advantage for individuals with OA but may prove helpful for spouses, thereby indirectly benefiting individuals with OA over time. © 2007 APA, all rights reserved.}, Doi = {10.1037/0090-5550.52.2.121}, Key = {fds273676} } @article{fds273747, Author = {Carson, JW and Keefe, FJ and Lowry, KP and Porter, LS and Goli, V and Fras, AM}, Title = {Conflict about expressing emotions and chronic low back pain: associations with pain and anger.}, Journal = {J Pain}, Volume = {8}, Number = {5}, Pages = {405-411}, Year = {2007}, Month = {May}, ISSN = {1526-5900}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17276143}, Abstract = {UNLABELLED: There has been growing interest among researchers and clinicians in the role of ambivalence over emotional expression (AEE) in adjustment to chronic illness. Because of the salience of anger in chronic low back pain, this condition provides a particularly good model in which to examine the role of AEE. This study examined the relation of AEE to pain and anger in a sample of 61 patients with chronic low back pain. Patients completed standardized measures of AEE, pain, and anger. Correlational analyses showed that patients who had higher AEE scores reported higher levels of evaluative and affective pain as well as higher levels of state and trait anger and the tendency to hold in angry thoughts and feelings. Mediational analyses revealed that most of the associations between AEE and pain, and AEE and anger, were independent of one another. These findings suggest that a potentially important relationship exists between AEE and key aspects of living with persistent pain. PERSPECTIVE: This preliminary study suggests that there is a relation between ambivalence over emotional expression and pain and anger in patients with chronic low back pain. Patients who report greater conflict with regard to expressing emotions may be experiencing higher pain and anger.}, Doi = {10.1016/j.jpain.2006.11.004}, Key = {fds273747} } @article{fds273785, Author = {Dixon, KE and Keefe, FJ and Scipio, CD and Perri, LM and Abernethy, AP}, Title = {Psychological interventions for arthritis pain management in adults: a meta-analysis.}, Journal = {Health Psychol}, Volume = {26}, Number = {3}, Pages = {241-250}, Year = {2007}, Month = {May}, ISSN = {0278-6133}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17500610}, Abstract = {CONTEXT: The psychosocial impact of arthritis can be profound. There is growing interest in psychosocial interventions for managing pain and disability in arthritis patients. OBJECTIVE: This meta-analysis reports on the efficacy of psychosocial interventions for arthritis pain and disability. DATA SOURCES: Articles evaluating psychosocial interventions for arthritis were identified through Cochrane Controlled Trials, EMBASE, Ovid MEDLINE, and Ovid PsycINFO data sources. STUDY SELECTION: Randomized controlled trials testing the efficacy of psychosocial interventions in arthritis pain management were reviewed. DATA EXTRACTION: Twenty-seven randomized controlled trials were analyzed. Pain intensity was the primary outcome. Secondary outcomes included psychological, physical, and biological functioning. DATA SYNTHESIS: An overall effect size of 0.177 (95% CI=0.256-0.094) indicated that patients receiving psychosocial interventions reported significantly lower pain than patients in control conditions (combined p=.01). Meta-analyses also supported the efficacy of psychosocial interventions for the secondary outcomes. CONCLUSIONS: These findings indicate that psychosocial interventions may have significant effects on pain and other outcomes in arthritis patients. Ample evidence for the additional benefit of such interventions over and above that of standard medical care was found.}, Doi = {10.1037/0278-6133.26.3.241}, Key = {fds273785} } @article{fds273675, Author = {Porter, LS and Davis, D and Keefe, FJ}, Title = {Attachment and pain: recent findings and future directions.}, Journal = {Pain}, Volume = {128}, Number = {3}, Pages = {195-198}, Year = {2007}, Month = {April}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17321050}, Doi = {10.1016/j.pain.2007.02.001}, Key = {fds273675} } @article{fds273673, Author = {Carson, JW and Carson, KM and Porter, LS and Keefe, FJ and Shaw, H and Miller, JM}, Title = {Yoga for women with metastatic breast cancer: results from a pilot study.}, Journal = {J Pain Symptom Manage}, Volume = {33}, Number = {3}, Pages = {331-341}, Year = {2007}, Month = {March}, ISSN = {0885-3924}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17349503}, Abstract = {Metastatic breast cancer (MBC) remains a terminal illness for which major treatment advances are slow to appear, and hence it is crucial that effective palliative interventions be developed to reduce the cancer-related symptoms of women with this condition during the remaining years of their lives. This pilot/feasibility study examined a novel, yoga-based palliative intervention, the Yoga of Awareness Program, in a sample of women with MBC. The eight-week protocol included gentle yoga postures, breathing exercises, meditation, didactic presentations, and group interchange. Outcome was assessed using daily measures of pain, fatigue, distress, invigoration, acceptance, and relaxation during two preintervention weeks and the final two weeks of the intervention. Thirteen women completed the intervention (mean age=59; mean time since diagnosis=7 years; two African American, 11 Caucasian). During the study, four participants had cancer recurrences, and the physical condition of several others deteriorated noticeably. Despite low statistical power, pre-to-post multilevel outcomes analyses showed significant increases in invigoration and acceptance. Lagged analyses of length of home yoga practice (controlling for individual mean practice time and outcome levels on the lagged days) showed that on the day after a day during which women practiced more, they experienced significantly lower levels of pain and fatigue, and higher levels of invigoration, acceptance, and relaxation. These findings support the need for further investigation of the effects of the Yoga of Awareness Program in women with MBC.}, Doi = {10.1016/j.jpainsymman.2006.08.009}, Key = {fds273673} } @article{fds273674, Author = {Stephenson, NLN and Swanson, M and Dalton, JA and Keefe, FJ and Engelke, M}, Title = {Partner-delivered reflexology: Effects on cancer pain and anxiety (Oncology Nursing Forum (2007) 34, (127))}, Journal = {Oncology Nursing Forum}, Volume = {34}, Number = {2}, Pages = {280}, Publisher = {Oncology Nursing Society (ONS)}, Year = {2007}, Month = {March}, ISSN = {0190-535X}, url = {http://dx.doi.org/10.1188/07.ONF.275-280}, Doi = {10.1188/07.ONF.275-280}, Key = {fds273674} } @article{fds273672, Author = {Morley, S and Keefe, FJ}, Title = {Getting a handle on process and change in CBT for chronic pain.}, Journal = {Pain}, Volume = {127}, Number = {3}, Pages = {197-198}, Year = {2007}, Month = {February}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2006.10.025}, Doi = {10.1016/j.pain.2006.10.025}, Key = {fds273672} } @article{fds273756, Author = {Campbell, LC and Keefe, FJ and Scipio, C and McKee, DC and Edwards, CL and Herman, SH and Johnson, LE and Colvin, OM and McBride, CM and Donatucci, C}, Title = {Facilitating research participation and improving quality of life for African American prostate cancer survivors and their intimate partners. A pilot study of telephone-based coping skills training.}, Journal = {Cancer}, Volume = {109}, Number = {2 Suppl}, Pages = {414-424}, Year = {2007}, Month = {January}, ISSN = {0008-543X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17173280}, Abstract = {African American men experience worse prostate cancer outcomes compared with those of Caucasian men, not only in incidence and mortality rates, but also in coping with the side effects of treatment. Unfortunately, African American men have been significantly under-represented in research evaluating the efficacy of psychosocial interventions for improving coping in prostate cancer survivors. This pilot study explored the feasibility and efficacy of coping skills training (CST), an intervention developed to enhance coping with treatment side effects in a sample of African American prostate cancer survivors and their intimate partners. The intervention was delivered in a telephone-based format designed to facilitate research participation. A total of 40 couples were randomized to either 6 sessions of CST or usual care. Survivors completed measures of disease-specific quality of life (QOL) related to urinary, sexual, bowel, and hormonal symptom domains, as well as measures of global QOL (i.e., physical functioning and mental health). Partners completed measures of caregiver strain, mood, and vigor. Analysis of data from 30 couples (12 couples in CST, 18 couples in usual care) indicated that CST produced moderate to large treatment effects for QOL related to bowel, urinary, sexual, and hormonal symptoms. Partners who underwent CST reported less caregiver strain, depression, and fatigue, and more vigor, with moderate effect sizes observed that approached conventional levels of statistical significance. These preliminary findings suggest that telephone-based CST is a feasible approach that can successfully enhance coping inAfrican American prostate cancer survivors and their intimate partners. Cancer 2007. (c) 2006 American Cancer Society.}, Doi = {10.1002/cncr.22355}, Key = {fds273756} } @article{fds273670, Author = {Stephenson, NLN and Swanson, M and Dalton, J and Keefe, FJ and Engelke, M}, Title = {Partner-delivered reflexology: effects on cancer pain and anxiety.}, Journal = {Oncol Nurs Forum}, Volume = {34}, Number = {1}, Pages = {127-132}, Year = {2007}, Month = {January}, ISSN = {0190-535X}, url = {http://dx.doi.org/10.1188/07.ONF.127-132}, Abstract = {PURPOSE/OBJECTIVES: To compare the effects of partner-delivered foot reflexology and usual care plus attention on patients' perceived pain and anxiety. DESIGN: The experimental pretest/post-test design included patient-partner dyads randomly assigned to an experimental or control group. SETTING: Four hospitals in the southeastern United States. SAMPLE: 42 experimental and 44 control subjects comprised 86 dyads of patients with metastatic cancer and their partners, representing 16 different types of cancer; 23% of patients had lung cancer, followed by breast, colorectal, and head and neck cancer and lymphoma. The subjects had a mean age of 58.3 years, 51% were female, 66% had a high school education or less, and 58% were Caucasian, 40% were African American, and 1% were Filipino. METHODS: The intervention included a 15- to 30-minute teaching session on foot reflexology to the partner by a certified reflexologist, an optional 15- to 30-minute foot reflexology session for the partner, and a 30-minute, partner-delivered foot reflexology intervention for the patient. The control group received a 30-minute reading session from their partners. MAIN RESEARCH VARIABLES: Pain and anxiety. FINDINGS: Following the initial partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety. CONCLUSIONS: A nurse reflexologist taught partners how to perform reflexology on patients with metastatic cancer pain in the hospital, resulting in an immediate decrease in pain intensity and anxiety; minimal changes were seen in the control group, who received usual care plus attention. IMPLICATIONS FOR NURSING: Hospitals could have qualified professionals offer reflexology as a complementary therapy and teach interested partners the modality.}, Doi = {10.1188/07.ONF.127-132}, Key = {fds273670} } @article{fds273671, Author = {Hadjistavropoulos, T and Herr, K and Turk, DC and Fine, PG and Dworkin, RH and Helme, R and Jackson, K and Parmelee, PA and Rudy, TE and Lynn Beattie, B and Chibnall, JT and Craig, KD and Ferrell, B and Ferrell, B and Fillingim, RB and Gagliese, L and Gallagher, R and Gibson, SJ and Harrison, EL and Katz, B and Keefe, FJ and Lieber, SJ and Lussier, D and Schmader, KE and Tait, RC and Weiner, DK and Williams, J}, Title = {An interdisciplinary expert consensus statement on assessment of pain in older persons.}, Journal = {Clin J Pain}, Volume = {23}, Number = {1 Suppl}, Pages = {S1-43}, Year = {2007}, Month = {January}, ISSN = {0749-8047}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17179836}, Abstract = {This paper represents an expert-based consensus statement on pain assessment among older adults. It is intended to provide recommendations that will be useful for both researchers and clinicians. Contributors were identified based on literature prominence and with the aim of achieving a broad representation of disciplines. Recommendations are provided regarding the physical examination and the assessment of pain using self-report and observational methods (suitable for seniors with dementia). In addition, recommendations are provided regarding the assessment of the physical and emotional functioning of older adults experiencing pain. The literature underlying the consensus recommendations is reviewed. Multiple revisions led to final reviews of 2 complete drafts before consensus was reached.}, Doi = {10.1097/AJP.0b013e31802be869}, Key = {fds273671} } @article{fds273669, Author = {Waters, SJ and McKee, DC and Keefe, FJ}, Title = {Cognitive behavioral approaches to the treatment of pain.}, Journal = {Psychopharmacol Bull}, Volume = {40}, Number = {4}, Pages = {74-88}, Year = {2007}, ISSN = {0048-5764}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18227779}, Abstract = {How can cognitive-behavioral therapy benefit patients with persistent pain? The purpose of this review is to provide an overview of cognitive-behavioral treatment approaches to persistent pain. The review is divided into four sections. In the first section, we describe the conceptual back ground for cognitive-behavioral approaches to pain. In the second section, we describe the basic elements of a typical cognitive-behavioral treatment protocol used in pain management. In the third section, we address questions that health care professionals frequently ask about cognitive - behavioral treatment. In the fourth section, we discuss new clinical applications of cognitive-behavioral treatment.}, Key = {fds273669} } @article{fds273775, Author = {Blumenthal, JA and Babyak, MA and Ironson, G and Thoresen, C and Powell, L and Czajkowski, S and Burg, M and Keefe, FJ and Steffen, P and Catellier, D and ENRICHD Investigators}, Title = {Spirituality, religion, and clinical outcomes in patients recovering from an acute myocardial infarction.}, Journal = {Psychosom Med}, Volume = {69}, Number = {6}, Pages = {501-508}, Year = {2007}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17636153}, Abstract = {OBJECTIVE: To assess the prospective relationship between spiritual experiences and health in a sample of patients surviving an acute myocardial infarction (AMI) with depression or low social support. METHODS: A subset of 503 patients participating in the enhancing recovery in coronary heart disease (ENRICHD) trial completed a Daily Spiritual Experiences (DSE) questionnaire within 28 days from the time of their AMI. The questionnaire assessed three spirituality variables-worship service/church attendance, prayer/meditation, and total DSE score. Patients also completed the Beck Depression Inventory to assess depressive symptoms and the ENRICHD Social Support Inventory to determine perceived social support. The sample was subsequently followed prospectively every 6 months for an average of 18 months to assess all-cause mortality and recurrent AMI. RESULTS: Of the 503 participants who completed the DSE questionnaire at the time of index AMI, 61 (12%) participants either died or sustained a recurrent MI during the follow-up period. After adjustment for gender, education level, ethnicity, and a composite medical prognosis risk score derived specifically for the ENRICHD trial, we observed no relationship between death or nonfatal AMI and total spirituality as measured by the DSE (p = .446), worship service attendance (p = .120), or frequency of prayer/meditation (p = .679). CONCLUSION: We found little evidence that self-reported spirituality, frequency of church attendance, or frequency of prayer is associated with cardiac morbidity or all-cause mortality post AMI in patients with depression and/or low perceived support.}, Doi = {10.1097/PSY.0b013e3180cab76c}, Key = {fds273775} } @article{fds273668, Author = {Wachholtz, AB and Keefe, FJ}, Title = {What physicians should know about spirituality and chronic pain.}, Journal = {South Med J}, Volume = {99}, Number = {10}, Pages = {1174-1175}, Year = {2006}, Month = {October}, ISSN = {0038-4348}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17100061}, Doi = {10.1097/01.smj.0000242813.97953.1c}, Key = {fds273668} } @article{fds273764, Author = {Carson, JW and Keefe, FJ and Affleck, G and Rumble, ME and Caldwell, DS and Beaupre, PM and Kashikar-Zuck, S and Sandstrom, M and Weisberg, JN}, Title = {A comparison of conventional pain coping skills training and pain coping skills training with a maintenance training component: a daily diary analysis of short- and long-term treatment effects.}, Journal = {J Pain}, Volume = {7}, Number = {9}, Pages = {615-625}, Year = {2006}, Month = {September}, ISSN = {1526-5900}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16942947}, Abstract = {UNLABELLED: Pain coping skills training (PCST) has been shown to produce immediate improvements in pain and disability in rheumatoid arthritis (RA). However, some patients have difficulty maintaining these gains. This study compared a conventional PCST protocol with a PCST protocol that included maintenance training (PCST/MT). Patients with RA (n = 167) were randomly assigned to either conventional PCST, PCST/MT, arthritis education control, or standard care control. Daily data were collected on joint pain, coping, coping efficacy, and mood. Multilevel analyses showed that at posttreatment, conventional PCST was superior to all other conditions in joint pain, coping efficacy, and negative mood, whereas PCST/MT was superior to all other conditions in emotion-focused coping and positive mood. At 18 months follow-up, both PCST conditions were superior to standard care in joint pain and coping efficacy. Interpretation of follow-up outcomes was limited by higher dropout rates in the 2 PCST groups. For RA, a maintenance training component does not appear to produce significant improvements over conventional PCST. PERSPECTIVE: This article reports a trial evaluating a conventional pain coping skills training protocol and a similar protocol that included a maintenance training component. Overall, results indicate similar results for both the conventional and the modified protocols.}, Doi = {10.1016/j.jpain.2006.02.008}, Key = {fds273764} } @article{fds273667, Author = {Martire, LM and Keefe, FJ and Schulz, R and Ready, R and Beach, SR and Rudy, TE and Starz, TW}, Title = {Older spouses' perceptions of partners' chronic arthritis pain: implications for spousal responses, support provision, and caregiving experiences.}, Journal = {Psychol Aging}, Volume = {21}, Number = {2}, Pages = {222-230}, Year = {2006}, Month = {June}, ISSN = {0882-7974}, url = {http://dx.doi.org/10.1037/0882-7974.21.2.222}, Abstract = {This study of older patients with osteoarthritis and their spouses examined concordance between patients' and spouses' reports of patients' pain severity and the association of concordance with support and caregiving outcomes. Patients and spouses independently viewed videotapes of the patient performing simulated household tasks and provided ratings of patients' pain. Spousal overestimation of patients' pain was the most common type of nonconcordance. Spouses who were accurate in their perceptions of their partner's level of pain during a log-carrying task responded less negatively and provided emotional support that was more satisfying to patients. In addition, spouses who were accurate in their perceptions of their partner's pain during the log-carrying task reported less stress from providing support and assistance. Future research that uses such observational methods may be highly useful for understanding the effects of chronic illness on older couples.}, Doi = {10.1037/0882-7974.21.2.222}, Key = {fds273667} } @article{fds273774, Author = {Blumenthal, JA and Babyak, MA and Keefe, FJ and Davis, RD and Lacaille, RA and Carney, RM and Freedland, KE and Trulock, E and Palmer, SM}, Title = {Telephone-based coping skills training for patients awaiting lung transplantation.}, Journal = {J Consult Clin Psychol}, Volume = {74}, Number = {3}, Pages = {535-544}, Year = {2006}, Month = {June}, ISSN = {0022-006X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16822110}, Abstract = {Impaired quality of life is associated with increased mortality in patients with advanced lung disease. Using a randomized controlled trial with allocation concealment and blinded outcome assessment at 2 tertiary care teaching hospitals, the authors randomly assigned 328 patients with end-stage lung disease awaiting lung transplantation to 12 weeks of telephone-based coping skills training (CST) or to usual medical care (UMC). Patients completed a battery of quality of life instruments and were followed for up to 3.4 years to assess all-cause mortality. Compared with UMC, CST produced lower scores on perceived stress, anxiety, depressive symptoms, and negative affect and improved scores on mental health functioning, optimism, vitality, and perceived social support. There were 29 deaths (9%) over a mean follow-up period of 1.1 year. Survival analyses revealed that there was no difference in survival between the 2 groups. The authors conclude that a telephone-based CST intervention can be effectively delivered to patients awaiting lung transplantation. Despite the severity of pulmonary disease in this patient population, significant improvements in quality of life, but not somatic measures or survival to transplant, were achieved.}, Doi = {10.1037/0022-006X.74.3.535}, Key = {fds273774} } @article{fds273762, Author = {Emery, CF and Keefe, FJ and France, CR and Affleck, G and Waters, S and Fondow, MDM and McKee, DC and France, JL and Hackshaw, KV and Caldwell, DS and Stainbrook, D}, Title = {Effects of a brief coping skills training intervention on nociceptive flexion reflex threshold in patients having osteoarthritic knee pain: a preliminary laboratory study of sex differences.}, Journal = {J Pain Symptom Manage}, Volume = {31}, Number = {3}, Pages = {262-269}, Year = {2006}, Month = {March}, ISSN = {0885-3924}, url = {http://dx.doi.org/10.1016/j.jpainsymman.2005.07.008}, Abstract = {Studies have documented the efficacy of coping skills training (CST) for managing pain, distress, and disability in persons with arthritis. However, no laboratory studies have examined the effects of CST on descending modulation of nociception. This study used the nociceptive flexion reflex (NFR) to document pain and nociceptive responding among 62 men and women with osteoarthritis of the knee (mean age=63.3+/-7.5 years). Before and after a 45-minute CST session, participants completed laboratory assessments of NFR threshold and questionnaires evaluating pain and state anxiety. Results indicated significantly increased NFR thresholds and decreased pain ratings following CST for men and women. A significant time by sex interaction was observed for state anxiety, with women reporting greater decreases in anxiety following CST than men. This is the first study to demonstrate effects of a CST protocol on a measure of descending inhibition of nociception among patients with osteoarthritic knee pain.}, Doi = {10.1016/j.jpainsymman.2005.07.008}, Key = {fds273762} } @article{fds372589, Author = {Rumble, M and Keefe, FJ and Edinger, JD and Porter, LS and Garst, JL and Marcom, PK}, Title = {Relationship of dysfunctional sleep-related thoughts and behaviors, pre-sleep arousal, cancer symptoms, and mood to sleep in breast and lung cancer patients with insomnia}, Journal = {SLEEP}, Volume = {29}, Pages = {A251-A251}, Publisher = {OXFORD UNIV PRESS INC}, Year = {2006}, Month = {January}, Key = {fds372589} } @article{fds273801, Author = {Porter, LS and Keefe, FJ and Hurwitz, H and Faber, M}, Title = {Disclosure between patients with gastrointestinal cancer and their spouses.}, Journal = {Psychooncology}, Volume = {14}, Number = {12}, Pages = {1030-1042}, Year = {2005}, Month = {December}, ISSN = {1057-9249}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15712247}, Abstract = {This study examined patterns of disclosure about cancer-related concerns between patients with GI cancer and their spouses, and associations between patient and spouse disclosure and patient adjustment, spouse adjustment, and aspects of relationship functioning. A sample of 47 patients and 45 of their spouses completed a measure of disclosure which included ratings of their level of disclosure and level of holding back from disclosure of cancer-related concerns. Patients completed a measure of quality of life, spouses completed a measure of caregiver strain, and all participants completed measures of psychological distress and relationship functioning (intimacy, empathy, and partner avoidance and criticism). Data analyses revealed that patients and spouses reported moderately high levels of disclosure and low levels of holding back, with patients reporting higher levels of disclosure than spouses. Among patients and spouses, low levels of disclosure and high levels of holding back were associated with poorer relationship functioning. There were also some indications that high levels of holding back, and to a lesser extent low levels of disclosure, were associated with increased psychological distress for both patients and spouses. However, there were no indications that patient or spouse disclosure was harmful for the other person. Considered overall, the results of this study suggest that levels of disclosure between cancer patients and their spouses may be important in understanding how they adjust as a couple to the demands of the patient's illness.}, Doi = {10.1002/pon.915}, Key = {fds273801} } @article{fds273741, Author = {Porter, LS and Keefe, FJ and Lipkus, I and Hurwitz, H}, Title = {Ambivalence over emotional expression in patients with gastrointestinal cancer and their caregivers: associations with patient pain and quality of life.}, Journal = {Pain}, Volume = {117}, Number = {3}, Pages = {340-348}, Year = {2005}, Month = {October}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16153771}, Abstract = {This study examined the role of patient and caregiver ambivalence over emotional expression (AEE) in pain and quality of life (QOL) in a sample of 78 patients with gastrointestinal (GI) cancer. Measures of ambivalence over emotional expression as well as ratings of patient pain and pain behavior were collected from patients and caregivers. Measures of pain catastrophizing, perceptions of social support, and QOL were obtained from patients. Data analyses revealed that patients high in AEE engaged in more catastrophizing and reported higher levels of pain behaviors and poorer QOL. In addition, patients whose caregivers were high in AEE engaged in more catastrophizing, had higher levels of pain and pain behavior, and reported lower emotional well-being. Patient catastrophizing mediated the effects of both patient and caregiver AEE on some patient outcomes. Taken together, these findings suggest that emotional regulation in both patients and their caregivers may be an important factor in understanding cancer patients' experience of and coping with symptoms such as pain.}, Doi = {10.1016/j.pain.2005.06.021}, Key = {fds273741} } @article{fds273800, Author = {Carson, JW and Keefe, FJ and Lynch, TR and Carson, KM and Goli, V and Fras, AM and Thorp, SR}, Title = {Loving-kindness meditation for chronic low back pain: results from a pilot trial.}, Journal = {J Holist Nurs}, Volume = {23}, Number = {3}, Pages = {287-304}, Year = {2005}, Month = {September}, ISSN = {0898-0101}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16049118}, Abstract = {PURPOSE: Loving-kindness meditation has been used for centuries in the Buddhist tradition to develop love and transform anger into compassion. This pilot study tested an 8-week loving-kindness program for chronic low back pain patients. METHOD: Patients (N = 43) were randomly assigned to the intervention or standard care. Standardized measures assessed patients' pain, anger, and psychological distress. FINDINGS: Post and follow-up analyses showed significant improvements in pain and psychological distress in the loving-kindness group, but no changes in the usual care group. Multilevel analyses of daily data showed that more loving-kindness practice on a given day was related to lower pain that day and lower anger the next day. CONCLUSIONS: Preliminary results suggest that the loving-kindness program can be beneficial in reducing pain, anger, and psychological distress in patients with persistent low back pain. IMPLICATIONS: Clinicians may find loving-kindness meditation helpful in the treatment of patients with persistent pain.}, Doi = {10.1177/0898010105277651}, Key = {fds273800} } @article{fds273666, Author = {Rumble, ME and Keefe, FJ and Edinger, JD and Porter, LS and Garst, JL}, Title = {A pilot study investigating the utility of the cognitive-behavioral model of insomnia in early-stage lung cancer patients.}, Journal = {J Pain Symptom Manage}, Volume = {30}, Number = {2}, Pages = {160-169}, Year = {2005}, Month = {August}, ISSN = {0885-3924}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16125031}, Abstract = {This pilot study investigated the utility of a cognitive-behavioral model in understanding insomnia in early-stage lung cancer patients. Nineteen patients meeting criteria for insomnia and a comparison group of 13 patients not meeting these criteria completed questionnaires assessing dysfunctional sleep-related thoughts, poor sleep hygiene, lung cancer symptoms, mood, quality of life, and insomnia symptoms. Participants also completed standard sleep logs and wore an Actiwatch while sleeping each day for 7 days. Findings indicated that the insomnia group reported significantly more dysfunctional sleep-related thoughts, higher levels of pain and anxiety, and lower quality of life than those in the comparison group. Men in the insomnia group reported significantly higher levels of fatigue than men in the comparison group, whereas women demonstrated no group differences. These pilot findings support the utility of the cognitive-behavioral model in understanding insomnia in early-stage lung cancer patients and the hypothesis that insomnia is related to poor clinical status.}, Doi = {10.1016/j.jpainsymman.2005.02.013}, Key = {fds273666} } @article{fds273744, Author = {Evans, DL and Charney, DS and Lewis, L and Golden, RN and Gorman, JM and Krishnan, KRR and Nemeroff, CB and Bremner, JD and Carney, RM and Coyne, JC and Delong, MR and Frasure-Smith, N and Glassman, AH and Gold, PW and Grant, I and Gwyther, L and Ironson, G and Johnson, RL and Kanner, AM and Katon, WJ and Kaufmann, PG and Keefe, FJ and Ketter, T and Laughren, TP and Leserman, J and Lyketsos, CG and McDonald, WM and McEwen, BS and Miller, AH and Musselman, D and O'Connor, C and Petitto, JM and Pollock, BG and Robinson, RG and Roose, SP and Rowland, J and Sheline, Y and Sheps, DS and Simon, G and Spiegel, D and Stunkard, A and Sunderland, T and Tibbits, P and Valvo, WJ}, Title = {Mood disorders in the medically ill: scientific review and recommendations.}, Journal = {Biol Psychiatry}, Volume = {58}, Number = {3}, Pages = {175-189}, Year = {2005}, Month = {August}, url = {http://dx.doi.org/10.1016/j.biopsych.2005.05.001}, Abstract = {OBJECTIVE: The purpose of this review is to assess the relationship between mood disorders and development, course, and associated morbidity and mortality of selected medical illnesses, review evidence for treatment, and determine needs in clinical practice and research. DATA SOURCES: Data were culled from the 2002 Depression and Bipolar Support Alliance Conference proceedings and a literature review addressing prevalence, risk factors, diagnosis, and treatment. This review also considered the experience of primary and specialty care providers, policy analysts, and patient advocates. The review and recommendations reflect the expert opinion of the authors. STUDY SELECTION/DATA EXTRACTION: Reviews of epidemiology and mechanistic studies were included, as were open-label and randomized, controlled trials on treatment of depression in patients with medical comorbidities. Data on study design, population, and results were extracted for review of evidence that includes tables of prevalence and pharmacological treatment. The effect of depression and bipolar disorder on selected medical comorbidities was assessed, and recommendations for practice, research, and policy were developed. CONCLUSIONS: A growing body of evidence suggests that biological mechanisms underlie a bidirectional link between mood disorders and many medical illnesses. In addition, there is evidence to suggest that mood disorders affect the course of medical illnesses. Further prospective studies are warranted.}, Doi = {10.1016/j.biopsych.2005.05.001}, Key = {fds273744} } @article{fds273802, Author = {Keefe, FJ and Ahles, TA and Sutton, L and Dalton, J and Baucom, D and Pope, MS and Knowles, V and McKinstry, E and Furstenberg, C and Syrjala, K and Waters, SJ and McKee, D and McBride, C and Rumble, M and Scipio, C}, Title = {Partner-guided cancer pain management at the end of life: a preliminary study.}, Journal = {J Pain Symptom Manage}, Volume = {29}, Number = {3}, Pages = {263-272}, Year = {2005}, Month = {March}, ISSN = {0885-3924}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15781177}, Abstract = {This preliminary study tested the efficacy of a partner-guided cancer pain management protocol for patients who are at the end of life. Seventy-eight advanced cancer patients meeting criteria for hospice eligibility and their partners were randomly assigned to a partner-guided pain management training intervention, or usual care control condition. The partner-guided pain management training protocol was a three-session intervention conducted in patients' homes that integrated educational information about cancer pain with systematic training of patients and partners in cognitive and behavioral pain coping skills. Data analyses revealed that the partner-guided pain management protocol produced significant increases in partners' ratings of their self-efficacy for helping the patient control pain and self-efficacy for controlling other symptoms. Partners receiving this training also showed a trend to report improvements in their levels of caregiver strain. Overall, the results of this preliminary study suggest that a partner-guided pain management protocol may have benefits in the context of cancer pain at the end of life. Given the significance of pain at the end of life, future research in this area appears warranted.}, Doi = {10.1016/j.jpainsymman.2004.06.014}, Key = {fds273802} } @article{fds273803, Author = {Carson, JW and Keefe, FJ and Goli, V and Fras, AM and Lynch, TR and Thorp, SR and Buechler, JL}, Title = {Forgiveness and chronic low back pain: a preliminary study examining the relationship of forgiveness to pain, anger, and psychological distress.}, Journal = {J Pain}, Volume = {6}, Number = {2}, Pages = {84-91}, Year = {2005}, Month = {February}, ISSN = {1526-5900}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15694874}, Abstract = {UNLABELLED: Clinical observations suggest that many patients with chronic pain have difficulty forgiving persons they perceive as having unjustly offended them in some way. By using a sample of 61 patients with chronic low back pain, this study sought to determine the reliability and variability of forgiveness assessments in patients and to examine the relationship of forgiveness to pain, anger, and psychological distress. Standardized measures were used to assess patients' current levels of forgiveness, forgiveness self-efficacy, pain, anger, and psychological distress. Results showed that forgiveness-related constructs can be reliably assessed in patients with persistent pain, and that patients vary considerably along dimensions of forgiveness. Furthermore, correlational analyses showed that patients who had higher scores on forgiveness-related variables reported lower levels of pain, anger, and psychological distress. Additional analyses indicated that state anger largely mediated the association between forgiveness and psychological distress, as well as some of the associations between forgiveness and pain. These findings indicate that forgiveness can be reliably assessed in patients with persistent pain, and that a relationship appears to exist between forgiveness and important aspects of living with persistent pain. PERSPECTIVE: This preliminary study suggests there is a relationship between forgiveness and pain, anger, and psychological distress in patients with chronic low back pain. Patients who report an inability to forgive others might be experiencing higher pain and psychological distress that are mediated by relatively higher levels of state anger.}, Doi = {10.1016/j.jpain.2004.10.012}, Key = {fds273803} } @article{fds273975, Author = {Applegate, KL and Keefe, FJ and Siegler, IC and Bradley, LA and McKee, DC and Cooper, KS and Riordan, P}, Title = {Does personality at college entry predict number of reported pain conditions at mid-life? A longitudinal study.}, Journal = {J Pain}, Volume = {6}, Number = {2}, Pages = {92-97}, Year = {2005}, Month = {February}, ISSN = {1526-5900}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15694875}, Abstract = {UNLABELLED: The purpose of this study was to evaluate whether personality traits, as assessed by the Minnesota Multiphasic Personality Inventory (MMPI), at time of college entry can predict the number of reported pain conditions at an approximate 30-year follow-up for 2332 subjects, 1834 men and 498 women, who were administered the MMPI on entry to the University of North Carolina (Chapel Hill) between 1964 and 1966. In 1997, a follow-up was conducted in which subjects were administered a self-report questionnaire regarding whether they had experienced 1 or more chronic pain conditions. Analyses of the relationship between the MMPI clinical scales at college entrance and the report of number of chronic pain conditions at follow-up were conducted. Among male participants, elevations of Scales 1 (Hypochondriasis), 3 (Hysteria), and 5 (Masculinity/Femininity) predicted increases in number of chronic pain conditions at follow-up. For female participants, elevations in Scales 1, 3, and 6 (Paranoia) predicted increases in number of chronic pain conditions at follow-up. The current study suggests that a statistically significant relationship exists between MMPI responses at college entry and reports of chronic pain conditions at mid-life. PERSPECTIVE: This study found a small, but significant relationship between elevations on MMPI scales measuring hypochondriasis and hysteria and the report of chronic pain conditions at follow-up. The study is important because it is the first to examine how personality assessed in younger adults relates to the number of chronic pain conditions reported 30 years later.}, Doi = {10.1016/j.jpain.2004.11.001}, Key = {fds273975} } @article{fds372590, Author = {Rumble, M and Edinger, JD and Keefe, FJ and Porter, LS and Marcom, PK}, Title = {A pilot study examining the utility of the cognitive-behavioral model of insomnia in early stage breast cancer patients}, Journal = {SLEEP}, Volume = {28}, Pages = {A228-A228}, Publisher = {OXFORD UNIV PRESS INC}, Year = {2005}, Month = {January}, Key = {fds372590} } @article{fds273664, Author = {Ledley, DR and Huppert, JD and Foa, EB and Davidson, JRT and Keefe, FJ and Potts, NLS}, Title = {Impact of depressive symptoms on the treatment of generalized social anxiety disorder.}, Journal = {Depress Anxiety}, Volume = {22}, Number = {4}, Pages = {161-167}, Year = {2005}, ISSN = {1091-4269}, url = {http://dx.doi.org/10.1002/da.20121}, Abstract = {Patients with depression are often excluded from studies on the treatment of social anxiety disorder (SAD), leaving gaps in our knowledge about the impact of depressive affect on treatment for SAD. Patients participated in a randomized, placebo-controlled study of treatment for SAD. As in previous studies, patients were excluded from the study if they met criteria for major depressive disorder in the past 6 months. This exclusion notwithstanding, patients who enrolled in the study exhibited a range of depressive symptoms, permitting an examination of the impact of depressive symptoms on treatment outcome for SAD. Assessment measures included the Clinical Global Impression Scale, Hamilton Rating Scale for Depression, Brief Social Phobia Scale, and Beck Depression Inventory. Higher levels of depressive symptoms were related to more severe social anxiety overall, and to less change in social anxiety symptoms over the course of the study. Patients who were deemed nonresponders to treatment had higher levels of depressive symptoms at pretreatment than those who responded. In addition, patients who dropped out of the study had higher levels of depressive symptoms at pretreatment than those who completed the study. These results suggest that modifications should be made to existing treatments to improve outcomes and decrease attrition in the substantial proportion of patients with SAD who also evidence depressive symptoms. Such modifications are likely to be more important when treating patients with SAD and comorbid major depressive disorder.}, Doi = {10.1002/da.20121}, Key = {fds273664} } @article{fds273665, Author = {Baucom, DH and Porter, LS and Kirby, JS and Gremore, TM and Keefe, FJ}, Title = {Psychosocial issues confronting young women with breast cancer.}, Journal = {Breast Dis}, Volume = {23}, Pages = {103-113}, Year = {2005}, ISSN = {0888-6008}, url = {http://dx.doi.org/10.3233/bd-2006-23114}, Abstract = {The current paper reviews the literature regarding psychosocial issues confronting young women with breast cancer. The findings indicate that younger women with breast cancer experience a lower quality of life after cancer compared to older women. In part, this lower quality of life results from the effects of medical treatment. The effects of surgery and removal of the breast result in more negative feelings regarding body image, particularly for young women. With systemic treatment, many younger women experience the sudden onset of menopause, with the attendant symptoms of hot flashes, decreased sexual desire, and vaginal dryness. These physical effects along with a variety of relationship issues contribute to a high level of sexual concerns for young women. From a psychosocial perspective, breast cancer affects both females and their male partners. Both partners experience psychological distress including depression and anxiety. Within the relationship, emotional support from the partner is important in women's adjustment. In terms of psychosocial interventions for breast cancer, findings suggest that the most frequently employed interventions, which treat the woman without her partner, are not optimal. Initial findings provide encouraging evidence that couple-based psychosocial interventions for women and their partners might be of particular assistance to both partners.}, Doi = {10.3233/bd-2006-23114}, Key = {fds273665} } @article{fds273784, Author = {Keefe, FJ and Abernethy, AP and C Campbell and L}, Title = {Psychological approaches to understanding and treating disease-related pain.}, Journal = {Annu Rev Psychol}, Volume = {56}, Pages = {601-630}, Year = {2005}, ISSN = {0066-4308}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15709948}, Abstract = {Psychologists are increasingly involved in the assessment and treatment of disease-related pain such as pain secondary to arthritis or cancer. This review is divided into four sections. In the first section, we provide a conceptual background on this area that discusses the limitations of the biomedical model of disease-related pain and traces the evolution of psychosocial theories of pain. In the second section, we discuss special issues and challenges involved in working with persons having disease-related pain, including the reluctance of some persons to report pain and to become involved in psychological treatments for pain. Section three provides an overview of psychosocial research conducted on arthritis pain and cancer pain that addresses both psychosocial factors related to pain and psychosocial interventions for pain management. In the final section, we describe important future directions, including strategies for disseminating psychosocial treatments and disparities in pain management.}, Doi = {10.1146/annurev.psych.56.091103.070302}, Key = {fds273784} } @article{fds273763, Author = {France, CR and Keefe, FJ and Emery, CF and Affleck, G and France, JL and Waters, S and Caldwell, DS and Stainbrook, D and Hackshaw, KV and Edwards, C}, Title = {Laboratory pain perception and clinical pain in post-menopausal women and age-matched men with osteoarthritis: relationship to pain coping and hormonal status.}, Journal = {Pain}, Volume = {112}, Number = {3}, Pages = {274-281}, Year = {2004}, Month = {December}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15561382}, Abstract = {The present study examined relationships between pain coping, hormone replacement therapy, and laboratory and clinical pain reports in post-menopausal women and age-matched men with osteoarthritis. Assessment of nociceptive flexion reflex threshold was followed by an assessment of electrocutaneous pain threshold and tolerance. Participants rated their arthritis pain using the Arthritis Impact Measurement Scales. To assess pain coping, participants completed measures of emotion-focused coping, problem-focused coping, and pain catastrophizing. Results indicated that women were more likely than men to report using emotion-focused pain strategies, and that emotion-focused coping was associated with more arthritic pain and lower electrocutaneous pain tolerance. Correlations between coping measures and pain reports revealed that catastrophizing was associated with greater arthritis pain and lower pain threshold and tolerance levels. However, catastrophizing was not related to nociceptive flexion reflex threshold, suggesting that the observed relationship between catastrophizing and subjective pain does not rely on elevated nociceptive input. A comparison of men (n=58), post-menopausal women receiving hormone replacement therapy (n=32), and post-menopausal women not receiving hormone replacement therapy (n=42) revealed no significant group differences in arthritis pain, electrocutaneous pain threshold or tolerance, or nociceptive flexion reflex threshold. Thus, older adults with osteoarthritis do not exhibit the pattern of sex differences in response to experimental pain procedures observed in prior studies, possibly due to the development of disease-related changes in pain coping strategies. Accordingly, individual differences in clinical and experimental pain may be better predicted by pain coping than by sex or hormonal differences.}, Doi = {10.1016/j.pain.2004.09.007}, Key = {fds273763} } @article{fds273806, Author = {Campbell, LC and Keefe, FJ and McKee, DC and Edwards, CL and Herman, SH and Johnson, LE and Colvin, OM and McBride, CM and Donattuci, CF}, Title = {Prostate cancer in African Americans: relationship of patient and partner self-efficacy to quality of life.}, Journal = {J Pain Symptom Manage}, Volume = {28}, Number = {5}, Pages = {433-444}, Year = {2004}, Month = {November}, ISSN = {0885-3924}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15504620}, Abstract = {This study examined the relationship between patient and partner ratings of self-efficacy for symptom control and quality of life (QOL) among 40 African American prostate cancer survivors and their intimate partners. Data analyses revealed that cancer survivors who had rated their self-efficacy for symptom control higher reported better QOL related to urinary, bowel, and hormonal symptoms and better general health QOL (i.e., better physical functioning and better mental health). Data analyses also revealed that partners who rated their self-efficacy for helping the patient manage symptoms as higher reported better QOL (i.e., less negative mood and less caregiver strain). Finally, exploratory analyses indicated that higher self-efficacy in patients was associated with less anxiety and caregiver strain in partners, and higher self-efficacy in partners was associated with better adjustment to bowel and hormonal symptoms and better mental health in patients. The clinical implications of these findings are discussed and future directions for research on self-efficacy in African American prostate cancer survivors are identified.}, Doi = {10.1016/j.jpainsymman.2004.02.020}, Key = {fds273806} } @article{fds273976, Author = {Smith, SJA and Keefe, FJ and Caldwell, DS and Romano, J and Baucom, D}, Title = {Gender differences in patient-spouse interactions: a sequential analysis of behavioral interactions in patients having osteoarthritic knee pain.}, Journal = {Pain}, Volume = {112}, Number = {1-2}, Pages = {183-187}, Year = {2004}, Month = {November}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/j.pain.2004.08.019}, Abstract = {Theory and research suggest that spousal responses to displays of pain behavior can vary markedly. To our knowledge, observational research on spousal responses to pain behavior has been carried out only in chronic low back pain patients, but not in other populations. In this study systematic observations were conducted of interactions occurring between 50 married osteoarthritis patients (25 male and 25 female) and their respective spouses. Observations were conducted as the patient and spouse performed three common household tasks: sweeping the floor, folding laundry, and carrying small, artificial logs from one side of the room to the other. Contrary to prior research on chronic low back pain this study found that in osteoarthritis patients spouse facilitative behavior preceded and followed patient pain behavior significantly more often than did spouse solicitous behavior. A gender difference in spousal responding to pain behavior also was observed in that wives were significantly more likely to show facilitative behavior preceding and following patient pain behavior than were husbands. The implications of these findings for future research and clinical interventions focused on patient-spouse interactions are discussed.}, Doi = {10.1016/j.pain.2004.08.019}, Key = {fds273976} } @article{fds273805, Author = {Anderson, T and Carson, KL and Darchuk, AJ and Keefe, FJ}, Title = {The influence of social skills on private and interpersonal emotional disclosure of negative events}, Journal = {Journal of Social and Clinical Psychology}, Volume = {23}, Number = {5}, Pages = {635-652}, Publisher = {Guilford Publications}, Year = {2004}, Month = {October}, url = {http://dx.doi.org/10.1521/jscp.23.5.635.50747}, Abstract = {This study examined the influence of social skills on emotional disclosure in private and interpersonal settings. Eighty-five women with either high or low social skills disclosed an emotionally painful event in private (i.e., to a tape recorder) orto another participant with either high or low social skills (interpersonal condition). Increases in negative affect were greatest when disclosure was in the private (vs. interpersonal) condition and also when the discloser had high social skill (vs. low social skill). Interestingly, increases in positive affect were greatest in the interpersonal condition where both discloser and facilitator had high social skills. However, these facilitators themselves experienced decreases in their positive affect. The authors propose that an interactive transfer of positive affect between individuals of high social skills can provide an interpersonal interaction conducive to self-disclosure.}, Doi = {10.1521/jscp.23.5.635.50747}, Key = {fds273805} } @article{fds304929, Author = {Davidson, JRT and Foa, EB and Huppert, JD and Keefe, FJ and Franklin, ME and Compton, JS and Zhao, N and Connor, KM and Lynch, TR and Gadde, KM}, Title = {Fluoxetine, comprehensive cognitive behavioral therapy, and placebo in generalized social phobia.}, Journal = {Arch Gen Psychiatry}, Volume = {61}, Number = {10}, Pages = {1005-1013}, Year = {2004}, Month = {October}, ISSN = {0003-990X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15466674}, Abstract = {BACKGROUND: Generalized social phobia is common, persistent, and disabling and is often treated with selective serotonin reuptake inhibitor drugs or cognitive behavioral therapy. OBJECTIVE: We compared fluoxetine (FLU), comprehensive cognitive behavioral group therapy (CCBT), placebo (PBO), and the combinations of CCBT/FLU and CCBT/PBO. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Two academic outpatient psychiatric centers. PATIENTS: Subjects meeting a primary diagnosis of generalized social phobia were recruited via advertisement. Seven hundred twenty-two were screened, and 295 were randomized and available for inclusion in an intention-to-treat efficacy analysis; 156 (52.9%) were male, 226 (76.3%) were white, and mean age was 37.1 years. INTERVENTIONS: Treatment lasted for 14 weeks. Fluoxetine and PBO were administered at doses from 10 mg/d to 60 mg/d (or equivalent). Group comprehensive cognitive behavioral therapy was administered weekly for 14 sessions. MAIN OUTCOME MEASURES: An independent blinded evaluator assessed response with the Brief Social Phobia Scale and Clinical Global Impressions scales as primary outcomes. A videotaped behavioral assessment served as a secondary outcome, using the Subjective Units of Distress Scale. Adverse effects were measured by self-rating. Each treatment was compared by means of chi2 tests and piecewise linear mixed-effects models. RESULTS: Clinical Global Impressions scales response rates in the intention-to-treat sample were 29 (50.9%) (FLU), 31 (51.7%) (CCBT), 32 (54.2%) (CCBT/FLU), 30 (50.8%) (CCBT/PBO), and 19 (31.7%) (PBO), with all treatments being significantly better than PBO. On the Brief Social Phobia Scale, all active treatments were superior to PBO. In the linear mixed-effects models analysis, FLU was more effective than CCBT/FLU, CCBT/PBO, and PBO at week 4; CCBT was also more effective than CCBT/FLU and CCBT/PBO. By the final visit, all active treatments were superior to PBO but did not differ from each other. Site effects were found for the Subjective Units of Distress Scale assessment, with FLU and CCBT/FLU superior to PBO at Duke University Medical Center, Durham, NC. Treatments were well tolerated. CONCLUSIONS: All active treatments were superior to PBO on primary outcomes. Combined treatment did not yield any further advantage. Notwithstanding the benefits of treatment, many patients remained symptomatic after 14 weeks.}, Doi = {10.1001/archpsyc.61.10.1005}, Key = {fds304929} } @article{fds273804, Author = {Lai, Y-H and Guo, S-L and Keefe, FJ and Tsai, S-L and Chien, C-C and Sung, Y-C and Chen, M-L}, Title = {Effects of brief pain education on hospitalized cancer patients with moderate to severe pain.}, Journal = {Support Care Cancer}, Volume = {12}, Number = {9}, Pages = {645-652}, Year = {2004}, Month = {September}, ISSN = {0941-4355}, url = {http://dx.doi.org/10.1007/s00520-004-0626-1}, Abstract = {The purpose of this randomized controlled study was to assess the effects of a structured pain education program on the pain experience of hospitalized cancer patients. Eligible cancer pain patients were randomly assigned to either an experimental group (receiving pain education 10-15 min per day for 5 days, n = 15) or a standard care control group (n = 15). The effects of the intervention on six pain-related variables were evaluated using three instruments. Pain intensity, pain interference with daily life, negative beliefs about opioids, beliefs about endurance of pain, pain catastrophizing (an individual's tendency to focus on and exaggerate the threat value of painful stimuli and negatively evaluate his or her own ability to deal with pain), and sense of control over pain were evaluated by the Brief Pain Inventory-Short Form Taiwanese version (BPI-T), Pain and Opioid Analgesic Beliefs Scale-Cancer (POABS-CA), and the Catastrophizing subscale and the sense of control over pain measure from the Coping Strategies Questionnaire (CSQ). The results indicated that, after completing treatment, patients who had received structured pain education had significantly less pain intensity on average, negative pain beliefs regarding opioids, pain endurance beliefs, and pain catastrophizing than patients in the control group. In addition, patients in the pain education group showed a significant increase in their sense of control over pain. These preliminary results strongly suggest that structured pain education can effectively improve the pain experience of hospitalized cancer patients and should be further implemented clinically.}, Doi = {10.1007/s00520-004-0626-1}, Key = {fds273804} } @article{fds273808, Author = {Keefe, FJ and Affleck, G and France, CR and Emery, CF and Waters, S and Caldwell, DS and Stainbrook, D and Hackshaw, KV and Fox, LC and Wilson, K}, Title = {Gender differences in pain, coping, and mood in individuals having osteoarthritic knee pain: a within-day analysis.}, Journal = {Pain}, Volume = {110}, Number = {3}, Pages = {571-577}, Year = {2004}, Month = {August}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15288397}, Abstract = {This study examined gender differences in prospective within-day assessments of pain, pain coping, and mood in men and women having OA, and analyzed gender differences in dynamic relations between pain, mood, and pain coping. A sample of 64 women and 36 men diagnosed as having pain due to osteoarthritis of the knee(s) rated their pain, pain coping, and mood two times each day (once in the afternoon and once in the evening) for 30 days using a booklet format. Two gender differences were found in between person-analyses: women used more problem focused coping than men, and women who catastrophized were less likely than men to report negative mood. Several within-day and across-day gender differences were noted. First, women were much more likely to show a significant increase in pain over the day. Second, men were more likely than women to experience an increase in coping efficacy over the day. Third, men were more likely than women to use emotion-focused coping when their mood was more negative. Finally, men were more likely than women to experience an increase in negative mood and a decrease in positive mood in the morning after an evening of increased pain. Taken together, these findings underscore the importance of obtaining multiple daily assessments when studying gender differences in the pain experience.}, Doi = {10.1016/j.pain.2004.03.028}, Key = {fds273808} } @article{fds273809, Author = {Thorn, BE and Keefe, FJ and Anderson, T}, Title = {The communal coping model and interpersonal context: problems or process?}, Journal = {Pain}, Volume = {110}, Number = {3}, Pages = {505-507}, Year = {2004}, Month = {August}, url = {http://dx.doi.org/10.1016/j.pain.2004.05.006}, Doi = {10.1016/j.pain.2004.05.006}, Key = {fds273809} } @article{fds273977, Author = {Keefe, FJ and Blumenthal, J and Baucom, D and Affleck, G and Waugh, R and Caldwell, DS and Beaupre, P and Kashikar-Zuck, S and Wright, K and Egert, J and Lefebvre, J}, Title = {Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study.}, Journal = {Pain}, Volume = {110}, Number = {3}, Pages = {539-549}, Year = {2004}, Month = {August}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15288394}, Abstract = {This study tested the separate and combined effects of spouse-assisted pain coping skills training (SA-CST) and exercise training (ET) in a sample of patients having persistent osteoarthritic knee pain. Seventy-two married osteoarthritis (OA) patients with persistent knee pain and their spouses were randomly assigned to: SA-CST alone, SA-CST plus ET, ET alone, or standard care (SC). Patients in SA-CST alone, together with their spouses, attended 12 weekly, 2-h group sessions for training in pain coping and couples skills. Patients in SA-CST + ET received spouse-assisted coping skills training and attended 12-weeks supervised ET. Patients in the ET alone condition received just an exercise program. Data analyses revealed: (1) physical fitness and strength: the SA-CST + ET and ET alone groups had significant improvements in physical fitness compared to SA-CST alone and patients in SA-CST + ET and ET alone had significant improvements in leg flexion and extension compared to SA-CST alone and SC, (2) pain coping: patients in SA-CST + ET and SA-CST alone groups had significant improvements in coping attempts compared to ET alone or SC and spouses in SA-CST + ET rated their partners as showing significant improvements in coping attempts compared to ET alone or SC, and (3) self-efficacy: patients in SA-CST + ET reported significant improvements in self-efficacy and their spouses rated them as showing significant improvements in self-efficacy compared to ET alone or SC. Patients receiving SA-CST + ET who showed increased self-efficacy were more likely to have improvements in psychological disability. An intervention that combines spouse-assisted coping skills training and exercise training can improve physical fitness, strength, pain coping, and self-efficacy in patients suffering from pain due to osteoarthritis.}, Doi = {10.1016/j.pain.2004.03.022}, Key = {fds273977} } @article{fds273807, Author = {Guilak, F and Fermor, B and Keefe, FJ and Kraus, VB and Olson, SA and Pisetsky, DS and Setton, LA and Weinberg, JB}, Title = {The role of biomechanics and inflammation in cartilage injury and repair.}, Journal = {Clin Orthop Relat Res}, Volume = {423}, Number = {423}, Pages = {17-26}, Year = {2004}, Month = {June}, ISSN = {0009-921X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15232421}, Abstract = {Osteoarthritis is a painful and debilitating disease characterized by progressive degenerative changes in the articular cartilage and other joint tissues. Biomechanical factors play a critical role in the initiation and progression of this disease, as evidenced by clinical and animal studies of alterations in the mechanical environment of the joint caused by trauma, joint instability, disuse, or obesity. The onset of these changes after joint injury generally has been termed posttraumatic arthritis and can be accelerated by factors such as a displaced articular fracture. Within this context, there is considerable evidence that interactions between biomechanical factors and proinflammatory mediators are involved in the progression of cartilage degeneration in posttraumatic arthritis. In vivo studies have shown increased concentrations of inflammatory cytokines and mediators in the joint in mechanically induced models of osteoarthritis. In vitro explant studies confirm that mechanical load is a potent regulator of matrix metabolism, cell viability, and the production of proinflammatory mediators such as nitric oxide and prostaglandin E2. Knowledge of the interaction of inflammatory and biomechanical factors in regulating cartilage metabolism would be beneficial to an understanding of the etiopathogenesis of posttraumatic osteoarthritis and in the improvement of therapies for joint injury.}, Doi = {10.1097/01.blo.0000131233.83640.91}, Key = {fds273807} } @article{fds273810, Author = {Keefe, FJ and Rumble, ME and Scipio, CD and Giordano, LA and Perri, LM}, Title = {Psychological aspects of persistent pain: current state of the science.}, Journal = {J Pain}, Volume = {5}, Number = {4}, Pages = {195-211}, Year = {2004}, Month = {May}, ISSN = {1526-5900}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15162342}, Abstract = {UNLABELLED: This article provides an overview of current research on psychological aspects of persistent pain. It is divided into 3 sections. In section 1, recent studies are reviewed that provide evidence that psychological factors are related to adjustment to persistent pain. This section addresses research on factors associated with increased pain and poorer adjustment to pain (ie, pain catastrophizing, pain-related anxiety and fear of pain, and helplessness) and factors associated with decreased pain and improved adjustment to pain (ie, self-efficacy, pain coping strategies, readiness to change, and acceptance). In section 2, we review recent research on behavioral and psychosocial interventions for patients with persistent pain. Topics addressed include early intervention, tailoring treatment, telephone/Internet-based treatment, caregiver-assisted treatment, and exposure-based protocols. In section 3, we conclude with a general discussion that highlights steps needed to advance this area of research including developing more comprehensive and integrative conceptual models, increasing attention to the social context of pain, examining the link of psychological factors to pain-related brain activation patterns, and investigating the mechanisms underlying the efficacy of psychological treatments for pain. PERSPECTIVE: This is one of several invited commentaries to appear in The Journal of Pain in recognition of The Decade of Pain Research. This article provides an overview of current research on psychological aspects of persistent pain, and highlights steps needed to advance this area of research.}, Doi = {10.1016/j.jpain.2004.02.576}, Key = {fds273810} } @article{fds273978, Author = {McCracken, LM and Carson, JW and Eccleston, C and Keefe, FJ}, Title = {Acceptance and change in the context of chronic pain.}, Journal = {Pain}, Volume = {109}, Number = {1-2}, Pages = {4-7}, Year = {2004}, Month = {May}, url = {http://dx.doi.org/10.1016/j.pain.2004.02.006}, Abstract = {Research and clinical developments over the past 20 years are beginning to shed new light on thoughts, sensations, emotions, their role in influencing behavior, and the particular ways in which private experiences contribute to human suffering (e.g. Hayes et al., 2001). This has led to different approaches to treating a broad array of behavior problems, approaches that incorporate a partnership of acceptance and change. We have defined acceptance of chronic pain as an active willingness to engage in meaningful activities in life regardless of pain-related sensations, thoughts, and other related feelings that might otherwise hinder that engagement. It is about not engaging in unnecessary struggles with private experiences, struggles that often intensify the aversiveness of those experiences and enhance their life disrupting influences. What is novel about this approach is that it is not simply a new psychological variable but a description of a different set of processes of pain and suffering. This approach is fully situated within the broader empirical tradition of the behavioral and cognitive therapies. The examination of its potential merits is already underway.}, Doi = {10.1016/j.pain.2004.02.006}, Key = {fds273978} } @article{fds273812, Author = {Keefe, FJ and Blumenthal, JA}, Title = {Health psychology: what will the future bring?}, Journal = {Health Psychol}, Volume = {23}, Number = {2}, Pages = {156-157}, Year = {2004}, Month = {March}, ISSN = {0278-6133}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15008660}, Abstract = {This commentary highlights several important themes and trends in this series of articles focusing on the future of health psychology. First, the challenges posed by changes in populations will only be met if health psychologists can develop a contextual competency. Second, with increasing evidence for the efficacy of health psychology interventions comes heightened interest in testing the effectiveness of these interventions. Third, issues of cost-effectiveness of health psychology will become increasingly important. Fourth, the growing integration of technological advances (e.g., telehealth, the Internet) into health psychology has major implications. Finally, the numerous changes outlined in this series of articles will demand that health psychologists extend and refine their theoretical models including the biopsychosocial model.}, Doi = {10.1037/0278-6133.23.2.156}, Key = {fds273812} } @article{fds273979, Author = {Dalton, JA and Keefe, FJ and Carlson, J and Youngblood, R}, Title = {Tailoring cognitive-behavioral treatment for cancer pain.}, Journal = {Pain Manag Nurs}, Volume = {5}, Number = {1}, Pages = {3-18}, Year = {2004}, Month = {March}, ISSN = {1524-9042}, url = {http://dx.doi.org/10.1016/s1524-9042(03)00027-4}, Abstract = {Though it has been shown that cancer patients report cognitive, behavioral, and physiologic responses to pain, little attention has been paid to the benefits of cognitive-behavioral therapy (CBT) protocols tailored to patient characteristics. To determine whether a profile-tailored CBT treatment program was more effective than either standard CBT or usual care in changing outcomes for patients with cancer-related pain, 131 patients receiving treatment at four sites were randomly assigned to standard CBT, profile-tailored CBT, or usual care. CBT patients attended five 50-minute treatment sessions. When compared to standard CBT patients, profile-tailored CBT patients experienced substantial improvement from baseline to immediately post-intervention in worst pain, least pain, less interference of pain with sleep, and less confusion. From baseline to one-month post-intervention, profile-tailored patients saw greater improvement in less interference of pain with activities, walking, relationships, and sleep; less composite pain interference; and less mobility and confusion symptom distress. Standard CBT and usual care patients experienced little change. Compared to profile-tailored CBT patients, standard CBT patients showed greater improvement at six-months post-intervention with less average pain, less pain now, better bowel patterns, lower summary symptom distress, better mental quality of life, and greater improvement in Karnofsky performance status; usual care patients showed little change. More research is needed to refine the matching of cognitive-behavioral treatments to psychophysiologic patient profiles, and to determine a treatment period that does not burden those patients too fatigued to participate in a five-week program. Delivery of CBT by home visits, phone, or Internet needs to be explored further.}, Doi = {10.1016/s1524-9042(03)00027-4}, Key = {fds273979} } @article{fds304928, Author = {Waters, SJ and Keefe, FJ and Strauman, TJ}, Title = {Self-discrepancy in chronic low back pain: relation to pain, depression, and psychological distress.}, Journal = {J Pain Symptom Manage}, Volume = {27}, Number = {3}, Pages = {251-259}, Year = {2004}, Month = {March}, ISSN = {0885-3924}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15010103}, Abstract = {Self-discrepancies occur when patients' evaluations of their actual self differ from their views of who they ideally would like to be (ideal self) or feel they ought to be (ought self), or from patients' perceptions of how significant others wish they could be (ideal-other self) or ought to be (ought-other self). These self-discrepancies may be related to psychological functioning and adjustment to pain. This study sought to: 1) determine the reliability of self-discrepancy assessments in patients; 2) determine whether each of the four types of self-discrepancies (actual self vs. ideal self, actual self vs. ought self, actual self vs. ideal-other self and actual self vs. ought-other self) measure a distinct type of self-discrepancy; and, 3) examine the relationship of self-discrepancies to pain intensity, depression, and psychological distress in 93 chronic low back pain patients. A semi-structured questionnaire assessed self-discrepancies. Standardized measures were used to assess pain intensity, depression, and psychological distress. Results showed that self-discrepancies can be reliably assessed in patients with persistent pain. Furthermore, data analyses showed that patients who had large ought-other self-discrepancies reported more severe pain and higher levels of psychological distress. Patients who had large ideal self-discrepancies reported higher levels of depression and psychological distress. Taken together, these findings suggest that self-discrepancy can be reliably assessed in patients with persistent pain and demonstrate that self-discrepancies are related in meaningful ways to measures of pain, depression, and psychological distress in chronic low back pain patients.}, Doi = {10.1016/j.jpainsymman.2003.07.001}, Key = {fds304928} } @article{fds273811, Author = {Dominick, KL and Bosworth, HB and Dudley, TK and Waters, SJ and Campbell, LC and Keefe, FJ}, Title = {Patterns of opioid analgesic prescription among patients with osteoarthritis.}, Journal = {J Pain Palliat Care Pharmacother}, Volume = {18}, Number = {1}, Pages = {31-46}, Year = {2004}, ISSN = {1536-0288}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15148007}, Abstract = {This study describes patterns of opioid analgesic prescription during a one-year period among a sample of patients with osteoarthritis (OA). The study sample included 3,061 patients with prior ICD-9 codes indicating a diagnosis of OA who were treated at a federal Veterans Affairs Medical Center. Specific opioid variables included: any opioid prescription, number of specific opioid drugs prescribed, total number of opioid prescriptions, total number of days supply of opioids, and daily opioid doses. We also examined relationships of demographic characteristics to opioid variables. Results revealed that 41% of patients received at least one opioid prescription. Opioids were prescribed significantly less frequently among African-Americans than Caucasians and the number of opioid prescriptions declined with increasing age. The mean annual supply of opioids was 104 days. Days' supply of opioids was also lower for African Americans and older patients. Daily opioid doses were, on average, below recommended daily doses for the treatment of OA. Findings of this study suggest that opioids are frequently prescribed to individuals with OA and that these drugs may be gaining acceptability for the treatment of chronic musculoskeletal pain. Additional research is needed to examine reasons for racial differences in opioid prescribing, as well as the prescription of these medications at fairly low doses.}, Doi = {10.1080/j354v18n01_03}, Key = {fds273811} } @article{fds273980, Author = {Waters, SJ and Keefe, FJ and Strauman, TJ}, Title = {Self-discrepancy in chronic low back pain: Relation to pain, depression, and psychological distress}, Journal = {Journal of Pain and Symptom Management}, Volume = {27}, Number = {3}, Pages = {253-261}, Year = {2004}, ISSN = {0885-3924}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15010103}, Abstract = {Self-discrepancies occur when patients' evaluations of their actual self differ from their views of who they ideally would like to be (ideal self) or feel they ought to be (ought self), or from patients' perceptions of how significant others wish they could be (ideal-other self) or ought to be (ought-other self). These self-discrepancies may be related to psychological functioning and adjustment to pain. This study sought to: 1) determine the reliability of self-discrepancy assessments in patients; 2) determine whether each of the four types of self-discrepancies (actual self vs. ideal self, actual self vs. ought self, actual self vs. ideal-other self and actual self vs. ought-other self) measure a distinct type of self-discrepancy; and, 3) examine the relationship of self-discrepancies to pain intensity, depression, and psychological distress in 93 chronic low back pain patients. A semi-structured questionnaire assessed self-discrepancies. Standardized measures were used to assess pain intensity, depression, and psychological distress. Results showed that self-discrepancies can be reliably assessed in patients with persistent pain. Furthermore, data analyses showed that patients who had large ought-other self-discrepancies reported more severe pain and higher levels of psychological distress. Patients who had large ideal self-discrepancies reported higher levels of depression and psychological distress. Taken together, these findings suggest that self-discrepancy can be reliably assessed in patients with persistent pain and demonstrate that self-discrepancies are related in meaningful ways to measures of pain, depression, and psychological distress in chronic low back pain patients.}, Doi = {10.1016/j.jpainsymman.2003.07.001}, Key = {fds273980} } @article{fds273981, Author = {Davidson, JT and Foa, EB and Huppert, JD and Keefe, FJ and Franklin, ME and Compton, JS and Zhao, N and Connor, KM and Lynch, TR and Gadde, KM}, Title = {Fluxetine, comprehensive cognitive behavioral therapy (CCBT) and placebo in generalized social phobia}, Journal = {Archives of General Psychiatry}, Volume = {61}, Number = {10}, Pages = {1005-1013}, Year = {2004}, ISSN = {0003-990X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15466674}, Abstract = {BACKGROUND: Generalized social phobia is common, persistent, and disabling and is often treated with selective serotonin reuptake inhibitor drugs or cognitive behavioral therapy. OBJECTIVE: We compared fluoxetine (FLU), comprehensive cognitive behavioral group therapy (CCBT), placebo (PBO), and the combinations of CCBT/FLU and CCBT/PBO. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Two academic outpatient psychiatric centers. PATIENTS: Subjects meeting a primary diagnosis of generalized social phobia were recruited via advertisement. Seven hundred twenty-two were screened, and 295 were randomized and available for inclusion in an intention-to-treat efficacy analysis; 156 (52.9%) were male, 226 (76.3%) were white, and mean age was 37.1 years. INTERVENTIONS: Treatment lasted for 14 weeks. Fluoxetine and PBO were administered at doses from 10 mg/d to 60 mg/d (or equivalent). Group comprehensive cognitive behavioral therapy was administered weekly for 14 sessions. MAIN OUTCOME MEASURES: An independent blinded evaluator assessed response with the Brief Social Phobia Scale and Clinical Global Impressions scales as primary outcomes. A videotaped behavioral assessment served as a secondary outcome, using the Subjective Units of Distress Scale. Adverse effects were measured by self-rating. Each treatment was compared by means of chi2 tests and piecewise linear mixed-effects models. RESULTS: Clinical Global Impressions scales response rates in the intention-to-treat sample were 29 (50.9%) (FLU), 31 (51.7%) (CCBT), 32 (54.2%) (CCBT/FLU), 30 (50.8%) (CCBT/PBO), and 19 (31.7%) (PBO), with all treatments being significantly better than PBO. On the Brief Social Phobia Scale, all active treatments were superior to PBO. In the linear mixed-effects models analysis, FLU was more effective than CCBT/FLU, CCBT/PBO, and PBO at week 4; CCBT was also more effective than CCBT/FLU and CCBT/PBO. By the final visit, all active treatments were superior to PBO but did not differ from each other. Site effects were found for the Subjective Units of Distress Scale assessment, with FLU and CCBT/FLU superior to PBO at Duke University Medical Center, Durham, NC. Treatments were well tolerated. CONCLUSIONS: All active treatments were superior to PBO on primary outcomes. Combined treatment did not yield any further advantage. Notwithstanding the benefits of treatment, many patients remained symptomatic after 14 weeks.}, Doi = {10.1001/archpsyc.61.10.1005}, Key = {fds273981} } @article{fds273814, Author = {Lai, Y-H and Chang, JT-C and Keefe, FJ and Chiou, C-F and Chen, S-C and Feng, S-C and Dou, S-J and Liao, M-N}, Title = {Symptom distress, catastrophic thinking, and hope in nasopharyngeal carcinoma patients.}, Journal = {Cancer Nurs}, Volume = {26}, Number = {6}, Pages = {485-493}, Year = {2003}, Month = {December}, url = {http://dx.doi.org/10.1097/00002820-200312000-00008}, Abstract = {The purposes of this study were to explore symptom distress, catastrophic thinking (catastrophizing) and hope, and factors predicting hope in Taiwanese nasopharyngeal carcinoma (NPC) patients within 3 years of receiving radiation therapy (RT). Instruments used were the modified Symptom Distress Scale, disease catastrophizing scale (modified from Coping Strategies Questionnaire), and Herth's Hope Index. Adult NPC patients (N = 115; 33 undergoing RT, 44 who completed RT within 1 year, and 38 who completed RT more than 1 year but less than 3 years) were recruited from an outpatient RT center in Northern Taiwan. Although participants' overall symptom distress was mild to moderate, they scored moderate level for several distressful symptoms: dry mouth, fatigue, hearing difficulty, loss of appetite, insomnia, and pain. Patients undergoing RT had greater symptom distress than subjects in the other 2 groups. Regression analysis revealed that catastrophizing was the only predictor of hope. Patients who engaged in catastrophizing reported much lower levels of hope. Particular care and attention are recommended to help NPC patients deal with the top distressful symptoms listed. Nursing interventions to reduce catastrophic thinking and enhance hope are discussed.}, Doi = {10.1097/00002820-200312000-00008}, Key = {fds273814} } @article{fds273815, Author = {Williams, DA and Gehrman, C and Ashmore, J and Keefe, FJ}, Title = {Psychological considerations in the surgical treatment of patients with chronic pain}, Journal = {Techniques in Neurosurgery}, Volume = {8}, Number = {3}, Pages = {168-175}, Publisher = {Ovid Technologies (Wolters Kluwer Health)}, Year = {2003}, Month = {September}, ISSN = {1077-2855}, url = {http://dx.doi.org/10.1097/00127927-200308030-00005}, Abstract = {Implantable pain management devices are becoming increasingly popular. The success of these devices, however, often depends on psychological factors being screened out prior to or addressed concomitantly with implanting the device. Currently there is little consensus in practice regarding the parameters of the screening process. A review of the literature is presented that reveals many psychological and behavioral risk factors for implanted pain management devices. However, little consistency exists in how these risk factors have been addressed, and a few attempts actually categorize the level of risk these factors pose to the neurosurgical procedures. Based on the literature review, this article provides recommendations for clinical decision making that transforms the psychological screening process into one that both facilitates patient selection, and enhances the development of a long-range treatment plan that can include preimplant preparation to help convert marginal implant candidates into those more likely to benefit from these procedures. Future practice in this arena will need to emphasize physicians' routine use of psychological screening prior to implantation, gaining comfort in recommending screening to patients, and integrating screening and preimplant preparation into practice. Future research in this area will need to include more randomized clinical trials of screening effectiveness, preimplant preparation effectiveness, and the development of uniform criteria for success. © 2003 Lippincott Williams & Wilkins, Inc.}, Doi = {10.1097/00127927-200308030-00005}, Key = {fds273815} } @article{fds273816, Author = {Campbell, LC and Clauw, DJ and Keefe, FJ}, Title = {Persistent pain and depression: a biopsychosocial perspective.}, Journal = {Biol Psychiatry}, Volume = {54}, Number = {3}, Pages = {399-409}, Year = {2003}, Month = {August}, ISSN = {0006-3223}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12893114}, Abstract = {This review highlights recent research findings on the relationship between persistent pain and depression and discusses the implications of these findings for future research in persons who suffer from both pain and depression. First, we briefly discuss advances in theories of pain that underscore the important role that depression can play in the chronic pain experience. Second, we discuss depression in persons suffering from chronic pain from a biopsychosocial perspective that takes into account both biological and psychosocial mechanisms linking pain and depression. Third, we address biomedical, psychosocial, and combined medical-psychosocial approaches to treatment in persons with persistent pain and depression. We conclude by highlighting future directions for research related to screening and diagnosis of depression in persons having persistent pain, treatment of comorbid pain and depression, and individual and subgroup differences in the experience of persistent pain and depression.}, Doi = {10.1016/s0006-3223(03)00545-6}, Key = {fds273816} } @article{fds273817, Author = {Jensen, MP and Keefe, FJ and Lefebvre, JC and Romano, JM and Turner, JA}, Title = {One- and two-item measures of pain beliefs and coping strategies.}, Journal = {Pain}, Volume = {104}, Number = {3}, Pages = {453-469}, Year = {2003}, Month = {August}, url = {http://dx.doi.org/10.1016/S0304-3959(03)00076-9}, Abstract = {Pain-related beliefs and pain coping strategies are central components of current cognitive-behavioral models of chronic pain, and have been found in numerous studies to be associated significantly with psychosocial and physical disability. However, the length of most measures of pain-related beliefs and coping restricts the ability of clinicians and researchers to perform a thorough assessment of these variables in many situations. The availability of very brief versions of existing scales would make possible the assessment of a range of important pain beliefs and coping strategies in settings where subject or patient assessment burden is an issue. In this study, one- and two-item versions of the subscales of several commonly used measures of pain beliefs and coping strategies were developed using both rational and empirical procedures. The findings support the validity of these brief subscales. The appropriate use and limitations of these measures are discussed.}, Doi = {10.1016/S0304-3959(03)00076-9}, Key = {fds273817} } @article{fds273819, Author = {Greenwood, KA and Thurston, R and Rumble, M and Waters, SJ and Keefe, FJ}, Title = {Anger and persistent pain: current status and future directions.}, Journal = {Pain}, Volume = {103}, Number = {1-2}, Pages = {1-5}, Year = {2003}, Month = {May}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12749952}, Doi = {10.1016/s0304-3959(03)00132-5}, Key = {fds273819} } @article{fds273982, Author = {Keefe, FJ and Lipkus, I and Lefebvre, JC and Hurwitz, H and Clipp, E and Smith, J and Porter, L}, Title = {The social context of gastrointestinal cancer pain: a preliminary study examining the relation of patient pain catastrophizing to patient perceptions of social support and caregiver stress and negative responses.}, Journal = {Pain}, Volume = {103}, Number = {1-2}, Pages = {151-156}, Year = {2003}, Month = {May}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12749969}, Abstract = {A number of studies have shown that catastrophizing is an important predictor of pain and disability in persons having persistent pain conditions. The newly developed communal model of catastrophizing maintains that catastrophizing is a part of broader, interpersonal style of coping in which coping efforts are directed at interpersonal goals, rather than solely at pain reduction. This study examined the potential interpersonal correlates of pain catastrophizing in a sample of 70 patients having gastrointestinal cancers and their caregivers. Measures of pain catastrophizing, perceptions of social support, pain level, and pain behavior were obtained from patients. Caregivers completed measures that included their judgments about the patient's pain level, caregiver stress, and their tendency to engage in negative responses (critical or avoidant behaviors). Overall, patients who engaged in catastrophizing reported receiving higher levels of instrumental support. Caregivers of patients who catastrophized, rated the patient as having more pain and engaging in more pain behavior. Caregivers of patients who catastrophized, also reported higher levels of caregiver stress and critical behaviors. Taken together, these preliminary findings suggest that pain catastrophizing has interpersonal correlates and support the need for additional research examining the social context of pain catastrophizing.}, Doi = {10.1016/s0304-3959(02)00447-5}, Key = {fds273982} } @article{fds273983, Author = {Keefe, FJ and Ahles, TA and Porter, LS and Sutton, LM and McBride, CM and Pope, MS and McKinstry, ET and Furstenberg, CP and Dalton, J and Baucom, DH}, Title = {The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life.}, Journal = {Pain}, Volume = {103}, Number = {1-2}, Pages = {157-162}, Year = {2003}, Month = {May}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12749970}, Abstract = {This preliminary study examined the self-efficacy of family caregivers with regard to helping cancer patients manage pain at end of life. A sample of 63 family caregivers of hospice-eligible cancer patients with pain provided ratings of their self-efficacy in assisting the patient in pain management and rated their own mood and level of caregiver strain. Patients completed measures of pain and quality of life. Data analyses revealed that caregivers who rated their self-efficacy as high reported much lower levels of caregiver strain as well as decreased negative mood and increased positive mood. Caregiver self-efficacy in managing the patient's pain was related to the patient's physical well-being. In dyads where the caregiver reported high self-efficacy, the patient reported having more energy, feeling less ill, and spending less time in bed. Considered overall, the results of this study suggest that caregiver self-efficacy in pain management is important in understanding how caregivers adjust to the demands of caring for cancer patients who have pain at the end of life.}, Doi = {10.1016/s0304-3959(02)00448-7}, Key = {fds273983} } @article{fds273818, Author = {Labus, JS and Keefe, FJ and Jensen, MP}, Title = {Self-reports of pain intensity and direct observations of pain behavior: when are they correlated?}, Journal = {Pain}, Volume = {102}, Number = {1-2}, Pages = {109-124}, Year = {2003}, Month = {March}, url = {http://dx.doi.org/10.1016/s0304-3959(02)00354-8}, Abstract = {Meta-analytic techniques were utilized to investigate the relationship between self-reports of pain intensity and direct observations of pain behavior. Estimation of the overall effect size from 29 studies and 85 effect sizes yielded a moderately positive association, z=0.26. High variability across studies permitted a random-effects moderator analysis that determined chronicity of pain, the timing of the pain assessment, the use of global measures of pain behavior, and pain site significantly moderate the relationship between self-reports of pain intensity and direct observations of pain behavior. These findings indicate that self-reports of pain intensity and direct observations of pain behavior are more likely to be significantly related to each other when the individual being studied has acute pain (z=0.35), when the self-report of pain intensity data are collected soon after the observation of pain behavior (z=0.40), when global composite measures are used to quantify pain behavior (z=0.37), and when the person being observed suffers from chronic low back pain (z=0.30). Other factors not found to be significant moderators include: extent of observer training, relevance of the pain-inducing task, and pain behavior observation measure used. The implications of the findings for the assessment of pain are discussed.}, Doi = {10.1016/s0304-3959(02)00354-8}, Key = {fds273818} } @article{fds304935, Author = {Martire, LM and Schulz, R and Keefe, FJ and Starz, TW and Osial, TA and Dew, MA and Reynolds, CF}, Title = {Feasibility of a dyadic intervention for management of osteoarthritis: a pilot study with older patients and their spousal caregivers.}, Journal = {Aging Ment Health}, Volume = {7}, Number = {1}, Pages = {53-60}, Year = {2003}, Month = {January}, url = {http://dx.doi.org/10.1080/1360786021000007045}, Abstract = {This study evaluated a novel intervention for older osteoarthritis (OA) patients and their spousal caregivers that consisted of standard patient education supplemented by information related to effectively managing arthritis as a couple. Twenty-four female OA patients and their husbands were randomly assigned to either an educational intervention that was targeted at both patient and spouse or to a patient education intervention that was targeted at only the patient. Findings revealed that both interventions were evaluated favorably but the couple intervention was better attended than the patient intervention. In addition, patients in the couple intervention experienced greater increased efficacy in managing arthritis pain and other symptoms. The findings of this pilot study point to the utility of a dyadic intervention approach to management of OA in late life.}, Doi = {10.1080/1360786021000007045}, Key = {fds304935} } @article{fds273813, Author = {McBride, CM and Pollak, KI and Garst, J and Keefe, F and Lyna, P and Fish, L and Hood, L}, Title = {Distress and motivation for smoking cessation among lung cancer patients' relatives who smoke.}, Journal = {J Cancer Educ}, Volume = {18}, Number = {3}, Pages = {150-156}, Year = {2003}, ISSN = {0885-8195}, url = {http://www.ncbi.nlm.nih.gov/pubmed/14512262}, Abstract = {BACKGROUND: Heightened distress at the time of a loved one's lung cancer diagnosis may motivate relatives to quit smoking or could undermine cessation. METHODS: Relatives of new lung cancer patients at Duke were surveyed by telephone to assess diagnosis-related depression, distress, and motivation for smoking cessation. RESULTS: Relatives who reported above average avoidant and intrusive thinking patterns, depressive symptoms or worry were more likely to report that the patient's diagnosis increased their intentions to quit than the less distressed. CONCLUSIONS: Interventions are needed that encourage smoking cessation as a strategy for adaptively coping with a loved ones' lung cancer diagnosis.}, Doi = {10.1207/S15430154JCE1803_08}, Key = {fds273813} } @article{fds273820, Author = {Martire, LM and Schulz, R and Keefe, FJ and Starz, TW and Osial, TA and Dew, MA and Reynolds, CF}, Title = {Feasibility of a dyadic intervention for management of osteoarthritis: A pilot study with older patients and their spousal caregivers}, Journal = {Aging and Mental Health}, Volume = {7}, Number = {1}, Pages = {55-62}, Year = {2003}, url = {http://dx.doi.org/10.1080/1360786021000007045}, Abstract = {This study evaluated a novel intervention for older osteoarthritis (OA) patients and their spousal caregivers that consisted of standard patient education supplemented by information related to effectively managing arthritis as a couple. Twenty-four female OA patients and their husbands were randomly assigned to either an educational intervention that was targeted at both patient and spouse or to a patient education intervention that was targeted at only the patient. Findings revealed that both interventions were evaluated favorably but the couple intervention was better attended than the patient intervention. In addition, patients in the couple intervention experienced greater increased efficacy in managing arthritis pain and other symptoms. The findings of this pilot study point to the utility of a dyadic intervention approach to management of OA in late life.}, Doi = {10.1080/1360786021000007045}, Key = {fds273820} } @article{fds273984, Author = {Naylor, MR and Helzer, JE and Naud, S and Keefe, FJ}, Title = {Automated telephone as an adjunct for the treatment of chronic pain: a pilot study.}, Journal = {J Pain}, Volume = {3}, Number = {6}, Pages = {429-438}, Year = {2002}, Month = {December}, url = {http://dx.doi.org/10.1054/jpai.2002.129563}, Abstract = {The objective of this study was to test whether Interactive Voice Response (IVR) can be used to enhance the therapeutic outcome of patients receiving group cognitive behavioral therapy (CBT) for chronic pain. Ten subjects with chronic pain syndromes participated in 10 weeks of group CBT followed by 4 months of Therapeutic Interactive Voice Response (TIVR). Our specially designed TIVR is based on a computerized telephone system in which callers are asked questions and respond by using the telephone keypad. It was created to reinforce pain coping skills and to provide messages for relaxation, sleep induction, and emotional support that can be accessed by patients on demand. Within-subject analysis showed that maximum positive change for nearly all outcome measures was observed at the post-TIVR point. For some measures, improvement compared to baseline was significant after TIVR despite the fact it had not been significant after CBT. Measures showing this pattern included SF-36 Mental Health Composite Score (P < .0004), McGill Pain Questionnaire pain (P < .01), Coping Strategies Questionnaire Catastrophizing (P < .0006), Treatment Outcomes in Pain Survey Total Pain Experience (P < .03), and Perceived Family/Social Disability (P < .02). Our preliminary results suggest that TIVR can be used to improve coping skills adherence and to prevent relapse into pain behavior.}, Doi = {10.1054/jpai.2002.129563}, Key = {fds273984} } @article{fds273985, Author = {Edwards, C and Keefe, F}, Title = {New directions in research on pain and ethnicity: a comment on Riley, Wade, Myers, Sheffield, Pappas, and Price (2002).}, Journal = {Pain}, Volume = {100}, Number = {3}, Pages = {211-212}, Year = {2002}, Month = {December}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12467991}, Doi = {10.1016/S0304-3959(02)00307-X}, Key = {fds273985} } @article{fds273821, Author = {Lai, Y-H and Keefe, FJ and Sun, W-Z and Tsai, L-Y and Cheng, P-L and Chiou, J-F and Wei, L-L}, Title = {Relationship between pain-specific beliefs and adherence to analgesic regimens in Taiwanese cancer patients: a preliminary study.}, Journal = {J Pain Symptom Manage}, Volume = {24}, Number = {4}, Pages = {415-423}, Year = {2002}, Month = {October}, url = {http://dx.doi.org/10.1016/s0885-3924(02)00509-2}, Abstract = {This pilot cross-sectional study aimed to 1) explore pain beliefs and adherence to prescribed analgesics in Taiwanese cancer patients, and 2) examine how selected pain beliefs, pain sensory characteristics, and demographic factors predict analgesic adherence. Pain beliefs were measured by the Chinese version of Pain and Opioid Analgesic Beliefs Scale-Cancer (POABS-CA) and the Survey of Pain Attitudes (SOPA). Analgesic adherence was measured by patient self-report of all prescribed pain medicine taken during the previous 7 days. Only 66.5% of hospitalized cancer patients with pain (n = 194) adhered to their analgesic regimen. Overall, patients had relatively high mean scores in beliefs about disability, medications, negative effects, and pain endurance, and low scores in control and emotion beliefs. Medication and control beliefs significantly predicted analgesic adherence. Patients with higher medication beliefs and lower control beliefs were more likely to be adherent. Findings support the importance of selected pain beliefs in patients' adherence to analgesics, suggesting that pain beliefs be assessed and integrated into pain management and patient education to enhance adherence.}, Doi = {10.1016/s0885-3924(02)00509-2}, Key = {fds273821} } @article{fds273986, Author = {Sutton, LM and Porter, LS and Keefe, FJ}, Title = {Cancer pain at the end of life: a biopsychosocial perspective.}, Journal = {Pain}, Volume = {99}, Number = {1-2}, Pages = {5-10}, Year = {2002}, Month = {September}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12237179}, Doi = {10.1016/s0304-3959(02)00236-1}, Key = {fds273986} } @article{fds273887, Author = {Porter, LS and Keefe, FJ and McBride, CM and Pollak, K and Fish, L and Garst, J}, Title = {Perceptions of patients' self-efficacy for managing pain and lung cancer symptoms: correspondence between patients and family caregivers.}, Journal = {Pain}, Volume = {98}, Number = {1-2}, Pages = {169-178}, Year = {2002}, Month = {July}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12098629}, Abstract = {This study examined the degree of correspondence between lung cancer patients and their family caregivers in their perceptions of the patients' self-efficacy for managing pain and other symptoms of lung cancer, and the association of this correspondence to demographic, disease, and psychosocial variables. Thirty patients who were newly diagnosed with lung cancer and their primary family caregivers completed telephone interviews assessing the patient's symptoms, the patient's self-efficacy for managing symptoms, the quality of the relationship between the patient and caregiver, patient and caregiver psychological distress, and caregiver strain. Although patients and their caregivers showed a moderate degree of agreement in their perceptions of the patient's self-efficacy for managing pain and other symptoms, there was considerable variability in the degree of congruence. Factors that contributed to lower levels of congruence included low patient-rated self-efficacy, female gender of the patient, high patient psychological distress, and high caregiver strain. Caregivers were about evenly split in their tendency to overestimate versus underestimate the patient's self-efficacy. A poorer quality of relationship between the caregiver and the patient (as rated by the patient), high levels of patient-rated symptoms, and high levels of caregiver strain were associated with caregivers overestimating patient self-efficacy.}, Doi = {10.1016/s0304-3959(02)00042-8}, Key = {fds273887} } @article{fds304926, Author = {Smith, TW and Kendall, PC and Keefe, FJ}, Title = {Behavioral medicine and clinical health psychology: introduction to the special issue, a view from the decade of behavior.}, Journal = {J Consult Clin Psychol}, Volume = {70}, Number = {3}, Pages = {459-462}, Year = {2002}, Month = {June}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037//0022-006x.70.3.459}, Abstract = {This collection of articles follows prior special issues on behavioral medicine published in the Journal of Consulting and Clinical Psychology in 1982 and 1992. From the vantage point of the Decade of Behavior, the field has grown in scope, depth of basic science foundations, and evidence of applied utility. Yet many challenges remain-especially in addressing a wide range of health problems across diverse populations and in a health care context characterized by rapid changes in technology and by a growing concern with costs and evidence-based practice.}, Doi = {10.1037//0022-006x.70.3.459}, Key = {fds304926} } @article{fds273660, Author = {AGS Panel on Persistent Pain in Older Persons}, Title = {The management of persistent pain in older persons.}, Journal = {J Am Geriatr Soc}, Volume = {50}, Number = {6 Suppl}, Pages = {S205-S224}, Year = {2002}, Month = {June}, url = {http://dx.doi.org/10.1046/j.1532-5415.50.6s.1.x}, Doi = {10.1046/j.1532-5415.50.6s.1.x}, Key = {fds273660} } @article{fds273823, Author = {Keefe, FJ and Smith, S}, Title = {The assessment of pain behavior: implications for applied psychophysiology and future research directions.}, Journal = {Appl Psychophysiol Biofeedback}, Volume = {27}, Number = {2}, Pages = {117-127}, Year = {2002}, Month = {June}, ISSN = {1090-0586}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12206046}, Abstract = {Persons who have pain engage in behaviors such as resting in bed, taking medication, moving in a guarded fashion, or grimacing that communicate the fact that pain is being experienced. Pain-related behaviors increasingly are viewed as an important target in pain assessment. Traditionally, pain behavior has been assessed through interview or self-recording methods (e.g. diary records). Pain behaviors, however, are overt and can be recorded through direct observation. Over the past 20 years, observation methods have been developed to assess pain behavior in patients having persistent pain conditions. Although these methods are not widely used in applied psychophysiological settings, they potentially could be quite useful. The purpose of this paper is to review the literature on such observation methods. The paper is divided into five parts. The first part provides a description of the basic elements of pain behavior observation protocols. The second part presents information on the psychometric properties of the most commonly used protocols. The third part highlights applications of pain behavior observation protocols. The fourth part briefly describes the strengths and limitations of pain behavior observation. The paper concludes with a discussion of the implications of pain behavior observation for applied psychophysiology and future directions for research and practice in this area.}, Doi = {10.1023/a:1016240126437}, Key = {fds273823} } @article{fds273987, Author = {Keefe, FJ and Buffington, ALH and Studts, JL and Rumble, ME}, Title = {Behavioral medicine: 2002 and beyond.}, Journal = {J Consult Clin Psychol}, Volume = {70}, Number = {3}, Pages = {852-856}, Year = {2002}, Month = {June}, ISSN = {0022-006X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12090388}, Abstract = {This article highlights future directions for research and practice in behavioral medicine. Topics addressed include social and environmental issues, the role of technology, translational research, improving and developing interventions, and professional training and retraining.}, Doi = {10.1037//0022-006x.70.3.852}, Key = {fds273987} } @article{fds273988, Author = {Keefe, FJ and Smith, SJ and Buffington, ALH and Gibson, J and Studts, JL and Caldwell, DS}, Title = {Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis.}, Journal = {J Consult Clin Psychol}, Volume = {70}, Number = {3}, Pages = {640-655}, Year = {2002}, Month = {June}, ISSN = {0022-006X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12090374}, Abstract = {This article provides an overview of the emerging literature on biopsychosocial assessment and treatment for two of the most common forms of arthritis: osteoarthritis and rheumatoid arthritis. The article is divided into 3 parts. In the 1st part, the basic elements of the biopsychosocial approach to assessing and treating persons having arthritis is described. In the 2nd part, the authors evaluate studies of biopsychosocial approaches to the assessment of arthritis pain and disability. Six research areas are reviewed: learned helplessness, depression, stress, pain coping, self-efficacy, and the social context of arthritis. The 3rd part of the article reviews studies that testing the efficacy of biopsychosocial treatment approaches for persons having osteoarthritis and rheumatoid arthritis.}, Doi = {10.1037//0022-006x.70.3.640}, Key = {fds273988} } @article{fds304927, Author = {Keefe, FJ and McKee, D and Lynch, T}, Title = {Point of view.}, Journal = {Spine (Phila Pa 1976)}, Volume = {27}, Number = {11}, Pages = {1237}, Year = {2002}, Month = {June}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12045524}, Doi = {10.1097/00007632-200206010-00018}, Key = {fds304927} } @article{fds273825, Author = {Waters, SJ and McKee, DC and Keefe, FJ}, Title = {Cognitive behavioral approaches to the treatment of pain}, Journal = {Economics of Neuroscience}, Volume = {4}, Number = {2}, Pages = {57-63}, Year = {2002}, Month = {February}, Abstract = {How can cognitive-behavioral therapy benefit patients with persistent pain? The purpose of this review is to provide an overview of cognitive-behavioral treatment approaches to persistent pain. The review is divided into four sections. In the first section, we describe the conceptual background for cognitive-behavioral approaches to pain. In the second section, we describe the basic elements of a typical cognitive-behavioral treatment protocol used in pain management. In the third section, we address questions that healthcare professionals frequently ask about cognitive-behavioral treatment. In the fourth section, we discuss new clinical applications of cognitive-behavioral treatment.}, Key = {fds273825} } @article{fds273822, Author = {Keefe, FJ and McKee, D and Lynch, T}, Title = {The Role of Depression Screening in Lumbar Disc Herniations and Spinal Stenosis: A Comment on Levy, Hanscom, & Boden}, Journal = {Spine}, Volume = {27}, Number = {11}, Pages = {1237}, Year = {2002}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12045524}, Key = {fds273822} } @article{fds273824, Author = {Lefebvre, JC and Keefe, FJ}, Title = {Memory for pain: the relationship of pain catastrophizing to the recall of daily rheumatoid arthritis pain.}, Journal = {Clin J Pain}, Volume = {18}, Number = {1}, Pages = {56-63}, Year = {2002}, ISSN = {0749-8047}, url = {http://dx.doi.org/10.1097/00002508-200201000-00009}, Abstract = {OBJECTIVE: The assumption that individuals are capable of accurately recalling past painful experiences has been a fundamental tenet of a number of cognitive-behavioral theories of pain, including the gate control theory. However, there has been very little research on the topic in the past, and the results have often been contradictory. A general conclusion that can be drawn is that memory for pain is variable, and there is need to identify what factors contribute to this variability in memory for pain. The current study examined the relation of catastrophizing to the recall of persistent pain associated with rheumatoid arthritis. METHODS: Participants in this study were 45 individuals with persistent pain due to rheumatoid arthritis. Each participant was asked to complete a daily pain diary for a period of 30 days. Participants were subsequently asked to recall the pain they experienced over the entire period of time rather than provide a single, average rating. RESULTS: The results of a series of hierarchical regression analyses indicated that level of catastrophizing was related to the recall of both pain intensity and pain variability. This relation was statistically significant even after controlling for actual pain and variability and other background variables. CONCLUSIONS: Participants who scored higher on catastrophizing demonstrated better accuracy in the recall of general pain intensity and pattern over a 30-day diary period. The results of the study are discussed in terms of future studies as well as their potential clinical importance.}, Doi = {10.1097/00002508-200201000-00009}, Key = {fds273824} } @article{fds273826, Author = {Smith, TW and Kendall, PC and Keefe, FJ}, Title = {Behavioral medicine and clinical health psychology: A view from the decade of behavior}, Journal = {Journal of Consulting and Clinical Psychology}, Volume = {70}, Number = {3}, Pages = {459-462}, Year = {2002}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037//0022-006X.70.3.459}, Abstract = {This collection of articles follows prior special issues on behavioral medicine published in the Journal of Consulting and Clinical Psychology in 1982 and 1992. From the vantage point of the Decade of Behavior, the field has grown in scope, depth of basic science foundations, and evidence of applied utility. Yet many challenges remain-especially in addressing a wide range of health problems across diverse populations and in a health care context characterized by rapid changes in technology and by a growing concern with costs and evidence-based practice.}, Doi = {10.1037//0022-006X.70.3.459}, Key = {fds273826} } @article{fds273886, Author = {Keefe, FJ and Lumley, MA and Buffington, ALH and Carson, JW and Studts, JL and Edwards, CL and Macklem, DJ and Aspnes, AK and Fox, L and Steffey, D}, Title = {Changing face of pain: evolution of pain research in psychosomatic medicine.}, Journal = {Psychosom Med}, Volume = {64}, Number = {6}, Pages = {921-938}, Year = {2002}, ISSN = {0033-3174}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12461198}, Abstract = {OBJECTIVE: This article provides an overview of how psychosomatic research on pain has evolved over the past 60 years as exemplified by studies published in Psychosomatic Medicine. METHODS: Each issue of Psychosomatic Medicine from 1939 to 1999 was reviewed to identify papers that dealt with pain, painful medical conditions, or pain management. A total of 150 papers were identified and grouped into seven categories: 1) case studies; 2) studies of personality traits and other individual differences; 3) psychophysiological studies of pain; 4) studies using pain induction techniques; 5) studies examining the relation of relation of race, ethnicity, and culture to pain; 6) studies of pain unique to women; and 7) studies examining treatments for pain. RESULTS: A substantial number of studies on pain and painful conditions were published in the Journal in the 1940s and 1950s, and that number has almost doubled in the most recent full decade of the Journal. Within the pain area, however, the topics of interest to psychosomatic researchers have been, and continue to be, quite diverse. Although publications on certain methods or topics (eg, psychodynamic case studies, physiological correlates of pain) have decreased over time, publications on other topics (eg, personality traits and individual differences) have remained relatively constant, and publications on still other topics (eg, studies using pain induction techniques; studies of race, ethnicity, and culture; women's pain; and treatment studies) have flourished recently. CONCLUSIONS: Considered overall, the results of our review suggest that the face of pain research published in PM has changed considerably in the past 60 years. Given the ongoing commitment of psychosomatic researchers to this area, we expect this evolution to continue in the years to come.}, Doi = {10.1097/01.psy.0000038934.67401.ba}, Key = {fds273886} } @article{fds273659, Author = {Keefe, FJ and Lumley, M and Anderson, T and Lynch, T and Studts, JL and Carson, KL}, Title = {Erratum: Pain and emotion: New research directions (Journal of Clinical Psychology (2001) 57 (587-607)}, Journal = {Journal of Clinical Psychology}, Volume = {57}, Number = {12}, Pages = {1597}, Publisher = {WILEY}, Year = {2001}, Month = {December}, ISSN = {0021-9762}, url = {http://dx.doi.org/10.1002/jclp.1122}, Doi = {10.1002/jclp.1122}, Key = {fds273659} } @article{fds273889, Author = {Edwards, CL and Fillingim, RB and Keefe, F}, Title = {Race, ethnicity and pain.}, Journal = {Pain}, Volume = {94}, Number = {2}, Pages = {133-137}, Year = {2001}, Month = {November}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11690726}, Abstract = {The current paper provides a brief overview of research on the effects of race and ethnicity on pain. More specifically, the article reviews the utility of the concepts of race and ethnicity for pain research, suggests operational definitions of race and ethnicity, reviews the literature on the effects of race and ethnicity on laboratory and clinical pain, and provides suggestions for future research.}, Doi = {10.1016/S0304-3959(01)00408-0}, Key = {fds273889} } @article{fds273890, Author = {Thurston, RC and Keefe, FJ and Bradley, L and Rama Krishnan and RK and Caldwell, DS}, Title = {Chest pain in the absence of coronary artery disease: a biopsychosocial perspective.}, Journal = {Pain}, Volume = {93}, Number = {2}, Pages = {95-100}, Year = {2001}, Month = {August}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11427319}, Doi = {10.1016/S0304-3959(01)00327-X}, Key = {fds273890} } @article{fds273828, Author = {Keefe, FJ and Affleck, G and Lefebvre, J and Underwood, L and Caldwell, DS and Drew, J and Egert, J and Gibson, J and Pargament, K}, Title = {Living with rheumatoid arthritis: the role of daily spirituality and daily religious and spiritual coping.}, Journal = {J Pain}, Volume = {2}, Number = {2}, Pages = {101-110}, Year = {2001}, Month = {April}, ISSN = {1526-5900}, url = {http://www.ncbi.nlm.nih.gov/pubmed/14622831}, Abstract = {The objective of this preliminary study was to evaluate more fully the role of daily spiritual experiences and daily religious/spiritual coping in the experience of individuals with pain due to rheumatoid arthritis (RA). Thirty-five individuals with RA were asked to keep a structured daily diary for 30 consecutive days. The diary included standardized measures designed to assess spiritual experiences, religious and spiritual pain coping, salience of religion in coping, religious/spiritual coping efficacy, pain, mood, and perceived social support. The participants in this study reported having spiritual experiences, such as feeling touched by the beauty of creation or feeling a desire to be closer or in union with God, on a relatively frequent basis. These participants also reported using positive religious and spiritual coping strategies much more frequently than negative religious and spiritual coping strategies. Although most of the variance in these measures was due to differences between persons, each measure also displayed a significant variability in scores from day to day. Indeed, there was just as much (or more) variability in these measures over time as there was variability in pain. Individuals who reported frequent daily spiritual experiences had higher levels of positive mood, lower levels of daily negative mood, and higher levels of each of the social support domains. Individuals who reported that religion was very salient in their coping with pain reported much higher levels of instrumental, emotional, arthritis-related, and general social support. Coping efficacy was significantly related to pain, mood, and social support in that on days that participants rated their ability to control pain and decrease pain using spiritual/religious coping methods as high, they were much less likely to have joint pain and negative mood and much more likely to have positive mood and higher levels of general social support. Taken together, these results suggest that daily spiritual experiences and daily religious/spiritual coping variables are important in understanding the experience of persons who have RA. They also suggest that newly developed daily diary methods may provide a useful methodology for studying religious and spiritual dimensions of living with arthritis.}, Doi = {10.1054/jpai.2001.19296}, Key = {fds273828} } @article{fds273888, Author = {Keefe, FJ and Lumley, M and Anderson, T and Lynch, T and Studts, JL and Carson, KL}, Title = {Pain and emotion: new research directions.}, Journal = {J Clin Psychol}, Volume = {57}, Number = {4}, Pages = {587-607}, Year = {2001}, Month = {April}, ISSN = {0021-9762}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11255208}, Abstract = {Recently, there has been growing interest in the relation between pain and emotion. Numerous recent studies have been conducted in this area. This article provides an introduction to this interesting area by highlighting selected research topics including studies on: stress and pain, negative emotional states and pain, catastrophizing and pain, the fear of pain, emotional regulation processes and pain, the effects of enhancing emotional regulation on pain, and the relation of emotional distress to treatment seeking in persons having pain. The article concludes with a discussion of important directions for future research in this area.}, Doi = {10.1002/jclp.1030}, Key = {fds273888} } @article{fds273891, Author = {Sullivan, MJ and Thorn, B and Haythornthwaite, JA and Keefe, F and Martin, M and Bradley, LA and Lefebvre, JC}, Title = {Theoretical perspectives on the relation between catastrophizing and pain.}, Journal = {Clin J Pain}, Volume = {17}, Number = {1}, Pages = {52-64}, Year = {2001}, Month = {March}, ISSN = {0749-8047}, url = {http://dx.doi.org/10.1097/00002508-200103000-00008}, Abstract = {The tendency to "catastrophize" during painful stimulation contributes to more intense pain experience and increased emotional distress. Catastrophizing has been broadly conceived as an exaggerated negative "mental set" brought to bear during painful experiences. Although findings have been consistent in showing a relation between catastrophizing and pain, research in this area has proceeded in the relative absence of a guiding theoretical framework. This article reviews the literature on the relation between catastrophizing and pain and examines the relative strengths and limitations of different theoretical models that could be advanced to account for the pattern of available findings. The article evaluates the explanatory power of a schema activation model, an appraisal model, an attention model, and a communal coping model of pain perception. It is suggested that catastrophizing might best be viewed from the perspective of hierarchical levels of analysis, where social factors and social goals may play a role in the development and maintenance of catastrophizing, whereas appraisal-related processes may point to the mechanisms that link catastrophizing to pain experience. Directions for future research are suggested.}, Doi = {10.1097/00002508-200103000-00008}, Key = {fds273891} } @article{fds273831, Author = {Keefe, FJ and Lefebvre, JC and Kerns, RD and Rosenberg, R and Beaupre, P and Prochaska, J and Prochaska, JO and Caldwell, DS}, Title = {Understanding the adoption of arthritis self-management: stages of change profiles among arthritis patients.}, Journal = {Pain}, Volume = {87}, Number = {3}, Pages = {303-313}, Year = {2000}, Month = {September}, url = {http://dx.doi.org/10.1016/S0304-3959(00)00294-3}, Abstract = {Clinical observations and recent studies suggest that arthritis patients vary considerably in their involvement in self-management efforts. In the literature on health promotion, there is growing recognition that patients may be at different stages of change with respect to the adoption of self-management strategies. The major goal of the present study was to examine whether cluster analysis could be used to identify homogeneous subgroups of patients having persistent arthritis pain based on their responses to a stages of change questionnaire. Participants in this study (103 patients having rheumatoid arthritis and 74 patients having osteoarthritis) completed a stages-of-change measure specific to adoption of a self-management approach to their arthritis. A cluster analysis identified five distinct subgroups of arthritis patients: (1) precontemplation - 44% of the sample; (2) contemplation - 11% of the sample; (3) preparation - 22% of the sample; (4) unprepared action - 6% of the sample; and (5) prepared maintenance - 17% of the sample. These subgroups are generally consistent with what might be expected based on the transtheoretical model of stages of change by Prochaska and DiClemente (Prochaska JO, DiClemente CC. Towards a comprehensive, transtheoretical model of change: states of change and addictive behaviors. In: Miller WR, Heather N, editors. Applied clinical psychology, 2nd ed. Treating addictive behaviors, New York: Plenum Press, 1998. pp. 3-24.), and may have important clinical implications. For example, it is possible that the arthritis subgroups identified may predict arthritis patients' participation in and responsiveness to pain-coping skills training, exercise interventions, or other formal self-management training programs. Also, one may be able enhance the outcomes of self-management interventions for arthritis by tailoring treatment to the patient's particular stage.}, Doi = {10.1016/S0304-3959(00)00294-3}, Key = {fds273831} } @article{fds273832, Author = {Keefe, FJ and Lefebvre, JC and Egert, JR and Affleck, G and Sullivan, MJ and Caldwell, DS}, Title = {The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing.}, Journal = {Pain}, Volume = {87}, Number = {3}, Pages = {325-334}, Year = {2000}, Month = {September}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10963912}, Abstract = {One hundred and sixty-eight patients with osteoarthritis (OA) of the knees participated in this study. Of the participants, 72 were men and 96 were women. All participants completed the Arthritis Impact Measurement Scales (AIMS), underwent a 10 min standardized observation session to assess their pain behavior, and completed the Catastrophizing Scale of the Coping Strategies Questionnaire (CSQ) and the Depression Scale of the Symptom Checklist 90 Revised (SCL-90R). The study found that there were significant differences in pain, pain behavior, and physical disability in men and women having OA. Women had significantly higher levels of pain and physical disability, and exhibited more pain behavior during an observation session than men. Further analyses revealed that catastrophizing mediated the relationship between gender and pain-related outcomes. Once catastrophizing was entered into the analyses, the previously significant effects of gender were no longer found. Interestingly, catastrophizing still mediated the gender-pain relationship even after controlling for depression. These findings underscore the importance of both gender and catastrophizing in understanding the OA pain experience and may have important implications for pain assessment and treatment.}, Doi = {10.1016/S0304-3959(00)00296-7}, Key = {fds273832} } @article{fds304103, Author = {Schanberg, LE and Sandstrom, MJ and Starr, K and Gil, KM and Lefebvre, JC and Keefe, FJ and Affleck, G and Tennen, H}, Title = {The relationship of daily mood and stressful events to symptoms in juvenile rheumatic disease.}, Journal = {Arthritis Care Res}, Volume = {13}, Number = {1}, Pages = {33-41}, Year = {2000}, Month = {February}, ISSN = {0893-7524}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11094924}, Abstract = {OBJECTIVES: The purpose of this study was 3-fold: 1) to assess the feasibility of a daily diary for use with children with juvenile rheumatic disease (JRD), 2) to describe daily variation in mood, stressful events, and symptoms in children with JRD, and 3) to examine the extent to which daily mood and daily stressful events predict daily symptoms in children with JRD. METHODS: Twelve children with JRD completed a daily booklet for 7 days. The daily booklet included measures of daily mood, daily stressful events, daily symptoms, and daily function. The children also completed a visual analog scale for pain and the Children's Depression Inventory. RESULTS: Subjects showed good compliance with scheduled completion and return of the daily diaries. Results indicated that children with JRD showed variability in daily mood, frequency of daily stressful events, and daily symptoms across days. Multilevel fixed effects models showed that more negative daily mood and more daily stressful events significantly predicted increased reports of fatigue, stiffness, and cutting back on daily activities. Negative daily mood also correlated with increases in daily reported pain. CONCLUSIONS: These results indicate that daily diary research is both feasible and potentially informative in children with JRD. Our data emphasize the need for further investigation into the role of daily mood and daily stressful events on disease course in JRD.}, Doi = {10.1002/1529-0131(200002)13:1<33::aid-art6>3.0.co;2-s}, Key = {fds304103} } @article{fds372016, Author = {Keefe, FJ and Affleck, G and Lefebvre, J and Underwood, L and Caldwell, DS and Drew, J and Gibson, J and Pargament, K}, Title = {Coping with arthritis pain: The role of daily spiritual experiences and religious and spiritual coping}, Journal = {PSYCHOSOMATIC MEDICINE}, Volume = {62}, Number = {1}, Pages = {149-149}, Publisher = {LIPPINCOTT WILLIAMS & WILKINS}, Year = {2000}, Month = {January}, Key = {fds372016} } @article{fds372591, Author = {Keefe, FJ}, Title = {Self-report of pain: Issues and opportunities}, Journal = {SCIENCE OF SELF-REPORT}, Pages = {317-337}, Publisher = {LAWRENCE ERLBAUM ASSOC PUBL}, Editor = {Stone, AA and Turkkan, JS and Bachrach, CA and Jobe, JB and Kurtzman, HS and Cain, VS}, Year = {2000}, Month = {January}, ISBN = {0-8058-2990-3}, Key = {fds372591} } @article{fds372592, Author = {Keefe, FJ}, Title = {Can cognitive-behavioral therapies succeed where medical treatments fail?}, Journal = {PROCEEDINGS OF THE 9TH WORLD CONGRESS ON PAIN}, Volume = {16}, Pages = {1069-1084}, Publisher = {INT ASSOC STUDY PAIN (IASP) PRESS}, Editor = {Devor, M and Rowbotham, MC and WiesenfeldHallin, Z}, Year = {2000}, Month = {January}, ISBN = {0-931092-31-0}, Key = {fds372592} } @article{fds273827, Author = {Keefe, FJ}, Title = {Pain behavior observation: current status and future directions.}, Journal = {Curr Rev Pain}, Volume = {4}, Number = {1}, Pages = {12-17}, Year = {2000}, ISSN = {1069-5850}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10998710}, Abstract = {Individuals who have pain engage in certain pain-related behaviors that tend to communicate their pain to others. There is growing recognition that the careful observation of such pain behaviors is an important component of a comprehensive pain assessment. This article provides an overview of the current status of behavioral observation methods used to assess pain behavior. The first half of this article describes and evaluates the most commonly used pain behavior observation methods. These include self-observation methods such as activity diaries, and direct observation methods such as the use of standard behavior sampling methods and naturalistic observation methods. The second half of the article discusses several important future clinical and research applications of pain behavior observation methods. The need to develop practical, clinical methods for incorporating pain behavior observation methods into practice settings is emphasized. Important future research topics include studying the social context of pain behavior (eg, by examining how spouses respond to displays of pain behavior), examining the predictive validity of pain behavior (ie, how observed pain behaviors predict future disability and impairment), and identifying pain behavior subgroups within heterogeneous chronic pain populations. Further development and refinement of pain behavior observation methods is likely to increase our understanding of the varied ways that patients adapt to persistent pain.}, Doi = {10.1007/s11916-000-0004-8}, Key = {fds273827} } @article{fds273829, Author = {Kornguth, PJ and Keefe, FJ and Wright, KR and Delong, DM}, Title = {Mammography pain in women treated conservatively for breast cancer.}, Journal = {J Pain}, Volume = {1}, Number = {4}, Pages = {268-274}, Year = {2000}, ISSN = {1526-5900}, url = {http://dx.doi.org/10.1054/jpai.2000.7884}, Abstract = {In this study, pain during mammography in women treated conservatively for breast cancer was examined. It studied pain intensity and its relation to a variety of demographic, medical, and pain coping variables as well as to objective measures of breast compression. Ninety-nine women, treated with lumpectomy (with or without radiation) and undergoing follow-up screening mammography, were asked about strategies they use to cope with everyday pain and then were asked to report pain experienced during the mammogram. Treated and untreated breasts were rated separately and compared with a sample of 125 control women with no history of breast cancer. Women reported significantly greater pain in the treated breast (41% greater than the untreated breast and 32% greater than the control group). There was no consistent relationship between mammography pain and pain coping. Average intensity of pain at last mammogram was the best predictor of pain in both breasts. Women treated conservatively for breast cancer experience significantly greater pain during mammography of their treated breast. Radiologists and technologists can identify women at risk for a painful mammogram by asking about the pain at last mammogram. By applying pain-reducing interventions, they might be able to make the mammography experience more tolerable for these women.}, Doi = {10.1054/jpai.2000.7884}, Key = {fds273829} } @article{fds273830, Author = {Drossman, DA and Leserman, J and Li, Z and Keefe, F and Hu, YJ and Toomey, TC}, Title = {Effects of coping on health outcome among women with gastrointestinal disorders.}, Journal = {Psychosom Med}, Volume = {62}, Number = {3}, Pages = {309-317}, Year = {2000}, url = {http://dx.doi.org/10.1097/00006842-200005000-00004}, Abstract = {BACKGROUND: Studies have shown that the nature and quality of coping may positively or negatively affect health outcome; however, this relationship has not been well studied among patients with gastrointestinal (GI) disorders. OBJECTIVES: The primary objective was to study the effect of different coping strategies on the health outcome of women with GI disorders and how these coping strategies may modify the effects of education, GI disease type, neuroticism, and abuse severity on health outcome. METHODS: We followed 174 patients in a referral GI clinic for 12 months to assess their health status as a derived variable of daily pain, bed disability days, psychological distress, daily dysfunction, number of visits to physicians, and number of surgeries and procedures. We obtained at baseline their GI diagnosis (functional vs. organic), neuroticism score (NEO Personality Inventory), sexual and/or physical abuse history, and scores on two coping questionnaires. Regressions analyses were used to determine the relative effect of the coping measures on health outcome and their modifying effects on education, GI disease type, neuroticism, and abuse severity. RESULTS: A higher score on the Catastrophizing scale and a lower score on the Self-Perceived Ability to Decrease Symptoms scale (Coping Strategies Questionnaire) predicted poor health outcome. Less education, a functional GI diagnosis, a higher neuroticism score, and greater abuse severity also contributed to poor health status. However, the effect of GI disease type and neuroticism on health outcome was significantly reduced by the coping measures. CONCLUSIONS: Maladaptive coping (eg, catastrophizing) and decreased self-perceived ability to decrease symptoms may adversely affect health outcome and may modify the effect of GI disease type and neuroticism on health outcome.}, Doi = {10.1097/00006842-200005000-00004}, Key = {fds273830} } @article{fds273833, Author = {Schanberg, LE and Jacobs, MR and Starr, K and Gil, KM and Lefebvre, JC and Keefe, FJ and Affleck, G}, Title = {The relationship of daily mood and stressful events to symptoms in junvile rheumatic disease: A preliminary study using daily measures}, Journal = {Arthritis Care & Research}, Volume = {13}, Number = {1}, Pages = {33-41}, Year = {2000}, ISSN = {0893-7524}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11094924}, Abstract = {OBJECTIVES: The purpose of this study was 3-fold: 1) to assess the feasibility of a daily diary for use with children with juvenile rheumatic disease (JRD), 2) to describe daily variation in mood, stressful events, and symptoms in children with JRD, and 3) to examine the extent to which daily mood and daily stressful events predict daily symptoms in children with JRD. METHODS: Twelve children with JRD completed a daily booklet for 7 days. The daily booklet included measures of daily mood, daily stressful events, daily symptoms, and daily function. The children also completed a visual analog scale for pain and the Children's Depression Inventory. RESULTS: Subjects showed good compliance with scheduled completion and return of the daily diaries. Results indicated that children with JRD showed variability in daily mood, frequency of daily stressful events, and daily symptoms across days. Multilevel fixed effects models showed that more negative daily mood and more daily stressful events significantly predicted increased reports of fatigue, stiffness, and cutting back on daily activities. Negative daily mood also correlated with increases in daily reported pain. CONCLUSIONS: These results indicate that daily diary research is both feasible and potentially informative in children with JRD. Our data emphasize the need for further investigation into the role of daily mood and daily stressful events on disease course in JRD.}, Key = {fds273833} } @article{fds273761, Author = {Affleck, G and Tennen, H and Keefe, FJ and Lefebvre, JC and Kashikar-Zuck, S and Wright, K and Starr, K and Caldwell, DS}, Title = {Everyday life with osteoarthritis or rheumatoid arthritis: independent effects of disease and gender on daily pain, mood, and coping.}, Journal = {Pain}, Volume = {83}, Number = {3}, Pages = {601-609}, Year = {1999}, Month = {December}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/S0304-3959(99)00167-0}, Abstract = {The effects of disease (form of arthritis) and gender on pain, mood, and pain coping strategies were examined in a prospective 30-day diary study of 71 patients with osteoarthritis (OA) and 76 with rheumatoid arthritis (RA). Diary instruments included joint pain ratings, POMS-B checklists for positive and negative mood, and the Daily Coping Inventory. Women's average daily pain was 72% greater than men's pain, and RA patients' average daily pain was 42% greater than OA patients' pain. Hierarchical Linear Models were estimated for (a) within-person associations between pain and next-day mood; coping and next-day pain; and coping and next-day mood; and (b) the independent effects of disease and gender on individual intercepts for pain, mood, and coping and on individual slopes for pain-coping-mood relations. Women, regardless of their disease, and RA patients, regardless of their gender, reported more daily pain. Women used more emotion-focused strategies each day than did men, regardless of their disease and even after controlling for their greater pain. Men were more likely than women to report an increase in negative mood the day after a more painful day. RA patients' pain worsened, but OA patients' pain improved, following a day with more emotion-focused coping. Implications for research and clinical practice are summarized.}, Doi = {10.1016/S0304-3959(99)00167-0}, Key = {fds273761} } @article{fds273837, Author = {Weiner, D and Peterson, B and Ladd, K and McConnell, E and Keefe, F}, Title = {Pain in nursing home residents: an exploration of prevalence, staff perspectives, and practical aspects of measurement.}, Journal = {Clin J Pain}, Volume = {15}, Number = {2}, Pages = {92-101}, Year = {1999}, Month = {June}, ISSN = {0749-8047}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10382922}, Abstract = {OBJECTIVE: To help rectify the underdiagnosis of chronic pain in frail nursing home residents by developing a new feasible pain self-report instrument, the structured pain interview; to use this new tool to estimate pain prevalence and staff's knowledge of residents' pain in two nursing homes; and to compare the performance differences of the structured pain interview and the commonly used 0-10 scale. DESIGN: Cross-sectional survey. SETTING: One 120-bed VA-affiliated and one 125-bed university-affiliated, community-based nursing home in Durham, North Carolina. PATIENTS: One hundred fifty-eight chronic care nursing home residents without aphasia, acute illness, persistent vegetative status, or severe hearing impairment and 3 1 nursing home nurses. OUTCOME MEASURES: Pain prevalence according to resident self-report and nurse report; stability of response to the structured pain interview and 0-10 scale over 1 month; agreement between residents and nurses on the structured pain interview and 0-10 scale. RESULTS: Fifty-eight percent of the VA and 45% of the community nursing home residents reported pain. Forty-two percent at the VA and 20% at the community home were unable to respond to the 0-10 scale, compared with 7.5% and 14% using the structured pain interview. Stability of response to the structured pain interview at 1 month was 0.56 at the VA (nurse-resident agreement 0.38) and 0.72 in the community (nurse-resident agreement 0.07), which was very comparable to the 0-10 scale. CONCLUSIONS: We have developed a highly feasible tool for examining pain prevalence in nursing homes. This tool uncovered considerable miscommunication regarding pain between residents and staff. Improvement in pain communication between nursing home residents and staff is needed, so that more effective pain treatment programs can be developed for this vulnerable population.}, Doi = {10.1097/00002508-199906000-00005}, Key = {fds273837} } @article{fds273839, Author = {Weiner, D and Peterson, B and Keefe, F}, Title = {Chronic pain-associated behaviors in the nursing home: resident versus caregiver perceptions.}, Journal = {Pain}, Volume = {80}, Number = {3}, Pages = {577-588}, Year = {1999}, Month = {April}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/S0304-3959(98)00249-8}, Abstract = {Pain assessment in nursing home residents poses challenges since many of these individuals are too cognitively impaired to respond to traditional self-report instruments. Assessment of pain behavior in this population offers a logical alternative. The purpose of this study was to compare perceptions of behaviors identified as being pain-related in 42 nursing home residents with chronic pain, as reported by residents themselves, their nursing home caregivers and their family caregivers. Our specific research agenda was to identify the most salient behaviors that signal pain in nursing home residents; to determine the test-retest agreement of residents' self-perceived pain behaviors; to learn of the confidence that caregivers feel regarding assessment of residents' pain behavior; and to examine the agreement between caregivers and residents about pain behaviors in particular residents. We also wanted to compare residents' and caregivers' ratings of the residents' pain intensity. Finally, we explored the beliefs of nursing home staff about the influence of dementia on pain and pain assessment. Twenty-two of 26 pain-related behaviors identified by residents showed fair to perfect test-retest agreement (kappas 0.40-1). For the vast majority of pain-related behavior items, kappas for resident-caregiver agreement were <0.30. Agreement with regard to pain intensity was similarly poor (r = -0.19-0.34). Confidence in pain rating was high for both nurse (on average, 7.2 on a scale of 0-10) and family (on average, 6.7) caregivers. Seventy-one percent of nurses felt that pain assessment is more difficult in demented individuals, but that cognitive function does not influence pain prevalence. While nursing home residents with chronic pain and their caregivers have different perceptions regarding which behaviors are pain-related, additional studies are required to determine the underpinnings of these differing perceptions and to determine the extent to which formal pain behavior observation protocols will be useful for evaluating nursing home residents with chronic pain.}, Doi = {10.1016/S0304-3959(98)00249-8}, Key = {fds273839} } @article{fds273841, Author = {Keefe, FJ and Caldwell, DS and Baucom, D and Salley, A and Robinson, E and Timmons, K and Beaupre, P and Weisberg, J and Helms, M}, Title = {Spouse-assisted coping skills training in the management of knee pain in osteoarthritis: long-term followup results.}, Journal = {Arthritis Care Res}, Volume = {12}, Number = {2}, Pages = {101-111}, Year = {1999}, Month = {April}, ISSN = {2151-4658}, url = {http://dx.doi.org/10.1002/1529-0131(199904)12:2<101::aid-art5>3.0.co;2-9}, Abstract = {OBJECTIVE: To evaluate the long-term effects of a spouse-assisted coping skills intervention in patients with osteoarthritis (OA) of the knees, and to evaluate how pre- to posttreatment changes in marital adjustment and self-efficacy relate to long-term improvements in pain, psychological disability, physical disability, pain coping, and pain behavior. METHODS: A followup study was conducted with 88 OA patients who had been randomly assigned to 1 of 3 treatment conditions: 1) spouse-assisted coping skills training (spouse-assisted CST), 2) a conventional CST intervention with no spouse involvement, and 3) an arthritis education-spousal support (AE-SS) control condition. To evaluate long-term outcome, comprehensive measures of self-efficacy, marital adjustment, pain, psychological disability, physical disability, pain coping, and pain behavior were collected from these individuals at 6 and 12 months posttreatment. RESULTS: Data analysis revealed that, at 6-month followup, patients in the spouse-assisted CST condition scored higher on measures of coping and self-efficacy than those in the AE-SS control group. At 6-month followup, patients who received CST without spouse involvement showed a significantly higher frequency of coping attempts and reported higher levels of marital adjustment than those in the AE-SS control group. At 12-month followup, patients in the spouse-assisted CST condition had significantly higher overall self-efficacy than those in the AE-SS control condition. In addition, patients in both the spouse-assisted CST and CST only conditions tended to show improvements in physical disability at the 12-month followup. Individual differences in outcome were noted at the 12-month followup. Patients in the spouse-assisted CST condition who reported initial (pre- to posttreatment) increases in marital adjustment had lower levels of psychological disability, physical disability, and pain behavior at 12-month followup. However, for patients in the conventional CST and AE-SS control conditions, increases in marital adjustment occurring over the initial phase of treatment were related to increases in pain and decreases in scores on the Pain Control in Rational Thinking factor of the Coping Strategies Questionnaire. Finally, patients in the spouse-assisted CST condition who showed pre- to posttreatment increases in self-efficacy were more likely to show decreases in pain, psychological disability, and physical disability at 12-month followup. CONCLUSIONS: These findings suggest that spouse-assisted CST can enhance self-efficacy and improve the coping abilities of OA patients in the long term. Individual differences in the long-term outcome of spouse-assisted CST were noted, with some patients (those showing increases in marital satisfaction and self-efficacy) showing much better outcomes than others.}, Doi = {10.1002/1529-0131(199904)12:2<101::aid-art5>3.0.co;2-9}, Key = {fds273841} } @article{fds273842, Author = {Lefebvre, JC and Keefe, FJ and Affleck, G and Raezer, LB and Starr, K and Caldwell, DS and Tennen, H}, Title = {The relationship of arthritis self-efficacy to daily pain, daily mood, and daily pain coping in rheumatoid arthritis patients.}, Journal = {Pain}, Volume = {80}, Number = {1-2}, Pages = {425-435}, Year = {1999}, Month = {March}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/s0304-3959(98)00242-5}, Abstract = {There is an increasing awareness in the medical community that psychosocial variables such as beliefs in self-efficacy are important determinants of treatment outcome. However, before measures of self-efficacy are widely incorporated into clinical practice, there needs to be a better understanding of how they relate to daily pain, mood and coping. In the present study 128 rheumatoid arthritis patients completed diaries for 30 days in which they provided daily ratings of joint pain, negative and positive mood, the use of pain coping strategies, and coping efficacy. The patients then participated in an evaluation session during which measures of self-efficacy (the Arthritis Self Efficacy Scale (ASES)), demographic variables, and medical status were collected. A series of hierarchical regression analyses was conducted to determine the degree to which self-efficacy measures collected at the time of the evaluation session were related to daily diary measures collected during the 30 preceding days. The results revealed that self-efficacy was significantly related to daily ratings of pain, mood, coping and coping efficacy. Interestingly, the findings regarding self-efficacy were obtained even after taking into account the effects of important demographic and medical status variables. Taken together, these results suggest that self-efficacy ratings collected from arthritis patients at the time of an evaluation session may well be related to recent experiences of daily pain and mood, as well as the daily use and perceived effectiveness of pain coping strategies.}, Doi = {10.1016/s0304-3959(98)00242-5}, Key = {fds273842} } @article{fds273838, Author = {Keefe, FJ and Bonk, V}, Title = {Psychosocial assessment of pain in patients having rheumatic diseases.}, Journal = {Rheum Dis Clin North Am}, Volume = {25}, Number = {1}, Pages = {81-103}, Year = {1999}, Month = {February}, ISSN = {0889-857X}, url = {http://dx.doi.org/10.1016/s0889-857x(05)70056-9}, Abstract = {A variety of reliable and valid psychosocial assessment instruments have been developed. Many of these instruments are brief and easily incorporated into clinical practice settings. Measures of coping, self-efficacy, helplessness, and cognitive distortion are especially useful in understanding the pain experience in rheumatic disease populations. Information gleaned from psychosocial assessments is increasingly being used to guide pain treatment efforts. Recent research, suggests that treatment outcomes can be improved if one tailors psychosocial pain management protocols to address the particular problems identified by comprehensive psychosocial assessments. Considered overall, psychosocial assessment methods have much to offer the clinician working with patients having persistent pain. The current status of this field is promising, and as psychosocial assessment methods become even more fully integrated into clinical practice, they are likely to yield even greater insights into the pain experience of patients with rheumatic diseases.}, Doi = {10.1016/s0889-857x(05)70056-9}, Key = {fds273838} } @article{fds273834, Author = {Keefe, FJ and Lefebvre, JC and Smith, SJ and Geisser, ME and Robinson, ME and Riley, JL}, Title = {Catastrophizing research: Avoiding conceptual errors and maintaining a balanced perspective}, Journal = {Pain Forum}, Volume = {8}, Number = {4}, Pages = {176-180}, Year = {1999}, Month = {January}, Abstract = {This Commentary addresses some common conceptual errors and methodological issues raised by the Focus article by Geisser, Robinson, and Riley. One conceptual error, the problem of confounding coping with outcome, is evident in their assertion that catastrophizing is not a form of coping, but rather a maladaptive pain belief. Catastrophizing clearly fits current definitions of coping, even though it may be associated with negative outcomes. A second conceptual error is the tendency to oversimplify the coping process that is evident in the tendency to divide coping strategies into dichotomous categories (eg, active vs passive, adaptive vs maladaptive). Methodological issues raised by this article include: (1) the need to recognize the strengths of existing pain co ping instruments (eg, the Coping Strategies Questionnaire), and (2) the utility of new and alternative coping measures. This Commentary concludes with a discussion of important directions for future research on pain coping.}, Key = {fds273834} } @article{fds273836, Author = {Keefe, FJ and France, CR}, Title = {Pain: Biopsychosocial mechanisms and management}, Journal = {Current Directions in Psychological Science}, Volume = {8}, Number = {5}, Pages = {137-141}, Publisher = {SAGE Publications}, Year = {1999}, Month = {January}, url = {http://dx.doi.org/10.1111/1467-8721.00032}, Abstract = {Traditionally, pain has been viewed as a asensory event warning of tissue damage or illness. This explanation fails to account for many of the experiences of people suffering from clinically painful conditions. Over the past two decades, a new biopsychosocial perspective on pain has emerged. This perspective emphasizes that pain is a dynamic process that not only is influenced by biological, psychological, and social mechanisms of pain, but also produces biological, psychological, and social changes that can affect future responses to pain. This review presents findings from recent studies of the biological, psychological, and social mechanisms of pain and discusses the implications of these findings for pain research, assessment, prevention, and treatment, as well as for health care policy.}, Doi = {10.1111/1467-8721.00032}, Key = {fds273836} } @article{fds273835, Author = {Affleck, G and Tennen, H and Keefe, FJ and Lefebvre, JC and Kashikar Zuck, S and Wright, K and Starr, K and Caldwell, DS}, Title = {Effects of Disease and Gender on Daily Pain, Mood, and Coping}, Journal = {Pain}, Volume = {83}, Pages = {601-610}, Year = {1999}, Key = {fds273835} } @article{fds273840, Author = {Dominick, KL and Gullette, EC and Babyak, MA and Mallow, KL and Sherwood, A and Waugh, R and Chilikuri, M and Keefe, FJ and Blumenthal, JA}, Title = {Predicting peak oxygen uptake among older patients with chronic illness.}, Journal = {J Cardiopulm Rehabil}, Volume = {19}, Number = {2}, Pages = {81-89}, Year = {1999}, ISSN = {0883-9212}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10200913}, Abstract = {PURPOSE: To compare three equations developed to predict VO2 among patients diagnosed with one of two chronic diseases: essential hypertension (HTN), and fibromyalgia (FM). The equations included the American College of Sports Medicine (ACSM) equation, the FAST equation developed from the Fitness and Arthritis in Seniors Trial (FAST), and an equation developed by Foster et al. METHODS: One hundred twenty-two HTN subjects and 68 FM subjects completed a maximum exercise test according to the Duke/Wake Forest protocol. Measured peak VO2 was then compared with the VO2 predicted by the ACSM, FAST and FOSTER equations, using several statistical methods. RESULTS: The ACSM equation overpredicted peak VO2 in the HTN group by 10.0 +/- 4.0 mL/kg-1/min-1, and in the FM group by 8.6 +/- 4.9 mL/kg-1/min-1 (P < 0.0001). The FAST equation, however, underestimated peak VO2 by 1.5 +/- 4.2 mL/kg-1/min-1 (P < 0.01) and 1.0 +/- 3.3 mL/kg-1/min-1 (P < 0.0001) in the HTN and FM groups, respectively. The FOSTER equation overestimated peak VO2 by 2.3 +/- 3.6 mL/kg-1/min-1 in the HTN group and by 2.1 +/- 3.5 mL/kg-1/min-1 in the FM group (P < 0.0001). A large degree of variability was found for each of the equations. CONCLUSION: Results of this investigation indicate that all three equations produced peak VO2 values that were statistically different from measured values. Although the ACSM equation overestimated VO2 by more than 2 metabolic equivalents (METs) in each patient group, both the FAST and FOSTER equations produced differences that were less than 1 MET. Further research is needed to examine the FAST and FOSTER equations among other patient populations and with other exercise protocols.}, Doi = {10.1097/00008483-199903000-00001}, Key = {fds273840} } @article{fds273846, Author = {Sandstrom, MJ and Keefe, FJ}, Title = {Self-management of fibromyalgia: the role of formal coping skills training and physical exercise training programs.}, Journal = {Arthritis Care Res}, Volume = {11}, Number = {6}, Pages = {432-447}, Year = {1998}, Month = {December}, ISSN = {0893-7524}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10030175}, Abstract = {There has been growing interest in the use of formal self-management training programs for people with fibromyalgia (FM). In these programs, health care professionals serve as trainers and provide education about FM and guided instruction in specific self-management strategies. A review of the literature on formal self-management training programs for FM suggests that they can be divided into groups: 1) those emphasizing training in coping skills (e.g., relaxation, activity pacing, and problem-solving techniques), and 2) those emphasizing training in physical exercise (e.g., cardiovascular fitness, strength, and endurance training). In this article, we review studies that have tested the efficacy of both types of programs. In addition, we identify key individual and contextual variables that are related to outcome and highlight future directions in the research and development of self-management programs.}, Doi = {10.1002/art.1790110603}, Key = {fds273846} } @article{fds273657, Author = {Keefe, FJ}, Title = {Cognitive processes and the pain experience}, Journal = {Journal of Musculoskeletal Pain}, Volume = {6}, Number = {3}, Pages = {41-45}, Publisher = {The Haworth Press}, Editor = {S.R. Pillemer}, Year = {1998}, Month = {November}, ISSN = {1058-2452}, url = {http://dx.doi.org/10.1300/J094v06n03_08}, Doi = {10.1300/J094v06n03_08}, Key = {fds273657} } @article{fds273843, Author = {Weiner, DK and Peterson, BL and Logue, P and Keefe, FJ}, Title = {Predictors of pain self-report in nursing home residents.}, Journal = {Aging (Milano)}, Volume = {10}, Number = {5}, Pages = {411-420}, Year = {1998}, Month = {October}, ISSN = {0394-9532}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9932145}, Abstract = {The purpose of this study was to examine the influence of cognitive function and other biopsychosocial factors on test-retest agreement, four-week variability, and intensity of self-reported pain using the verbal 0 to 10 scale and a pain thermometer in 115 nursing home residents over four weeks. Pain was assessed twice on three days during week 1, and once each during weeks 2, 3 and 4. A forward stepwise regression procedure was used to examine the influence of biopsychosocial parameters (age, race, gender, educational status, marital status, comorbidity, cognitive function, depression, social support, physical function and self-rated health) on pain intensity, test-retest agreement and variability. There was a quadratic association between cognitive function and test-retest agreement with the 0-10 scale; residents with Folstein scores of 22-26 were more likely to show disagreement (50% of 34) than residents with scores < 22 or > 26 (7% of 71). Higher Folstein scores were also associated with greater pain intensity for both pain scales (p < 0.001). Baseline pain intensity was significantly related to pain variability (0-10 scale only). The clinician should be cognizant of these relationships when interpreting verbalizations of pain in long-term care facilities.}, Doi = {10.1007/BF03339888}, Key = {fds273843} } @article{fds273845, Author = {Schanberg, LE and Keefe, FJ and Lefebvre, JC and Kredich, DW and Gil, KM}, Title = {Social context of pain in children with Juvenile Primary Fibromyalgia Syndrome: parental pain history and family environment.}, Journal = {Clin J Pain}, Volume = {14}, Number = {2}, Pages = {107-115}, Year = {1998}, Month = {June}, ISSN = {0749-8047}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9647451}, Abstract = {OBJECTIVE: The purpose of this study was to describe parental pain history and the family environment as it relates to the functional status of children with Juvenile Primary Fibromyalgia Syndrome (JPFS). DESIGN AND OUTCOME MEASURES: Twenty-nine parents of children with JPFS completed a pain history questionnaire, Von Korff Chronic Pain Grading system, and the Family Environment Scale (FES). Twenty-one adolescents with JPFS completed the FES, the Visual Analogue Scale for Pain, the modified Fibromyalgia Impact Questionnaire for Children, the Arthritis Impact Measurement Scales, and the Symptom Checklist-90-Revised. Correlational analyses were performed. RESULTS: Parents of children with JPFS reported multiple chronic pain conditions, including but not limited to fibromyalgia. Parental pain history and the family environment correlated with the health status of adolescents with JPFS. Children with JPFS perceived the family environment as significantly more cohesive than did their parents. Greater incongruence between parent and child responses on the FES positively correlated with greater impairment. CONCLUSIONS: These results suggest that family environment and parental pain history ày be related to how children cope with JPFS. Behavioral interventions targeting the family may improve the long-term functional status of children with JPFS.}, Doi = {10.1097/00002508-199806000-00004}, Key = {fds273845} } @article{fds273849, Author = {Weiner, D and Peterson, B and Keefe, F}, Title = {Evaluating persistent pain in long term care residents: what role for pain maps?}, Journal = {Pain}, Volume = {76}, Number = {1-2}, Pages = {249-257}, Year = {1998}, Month = {May}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/s0304-3959(98)00059-1}, Abstract = {The purpose of this study was to examine the utility of the pain map as a pain assessment tool in frail nursing home residents. The study was conducted in two phases. In Phase 1, nursing home staff's knowledge of the locations of resident pain complaints was examined. We found significant deficiencies in this knowledge. In Phase 2, we examined the following test characteristics of pain extensity (number of painful body areas annotated on pain map): (1) test-retest reliability, (2) convergent validity as compared with pain intensity measured by a pain thermometer (modified vertical verbal descriptor scale) and an 11 point numerical graphic rating scale (NGRS), and (3) predictive validity with depression, functional impairment and self-rated health. Pain map scoring was performed by counting the number of involved body areas (i.e., numbered segments) using an established scoring template. Test-retest reliability by body area was excellent. Pain extensity was modestly associated with pain thermometer-scored pain intensity but not with NGRS-scored pain intensity. Pain extensity also demonstrated modest predictive validity with self-rated health, but not with depression or functional impairment. The advantage of knowing where residents hurt is that this allows staff to target their assessment and thus determine the functional implications of residents' pain. It appears that pain maps add a useful dimension to pain assessment in residents of long term care facilities.}, Doi = {10.1016/s0304-3959(98)00059-1}, Key = {fds273849} } @article{fds273848, Author = {Compas, BE and Haaga, DA and Keefe, FJ and Leitenberg, H and Williams, DA}, Title = {Sampling of empirically supported psychological treatments from health psychology: smoking, chronic pain, cancer, and bulimia nervosa.}, Journal = {J Consult Clin Psychol}, Volume = {66}, Number = {1}, Pages = {89-112}, Year = {1998}, Month = {February}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037//0022-006x.66.1.89}, Abstract = {Interventions in health psychology and behavioral medicine represent an integral area of research for the development of psychological therapies to enhance health behaviors, manage symptoms and sequelae of disease, treat psychological symptoms and disorders, prolong survival in the face of a life-threatening illness, and improve quality of life. A sampling of interventions in health psychology and behavioral medicine is offered that meet the criteria for empirically supported treatments for smoking cessation, chronic pain, cancer, and bulimia nervosa. Evidence for empirically supported treatments is identified, along with promising interventions that do not yet meet the criteria as outlined by D. L. Chambless and S. D. Hollon (1998). Evidence for the effectiveness and clinical significance of these interventions is reviewed, and issues in this area of research are outlined.}, Doi = {10.1037//0022-006x.66.1.89}, Key = {fds273848} } @article{fds273844, Author = {Keefe, FJ}, Title = {Current status and future directions of pain behavior observation}, Journal = {Current Review of Pain}, Volume = {2}, Pages = {61-65}, Year = {1998}, Key = {fds273844} } @article{fds273847, Author = {Barsky, and A, and Baszener, and I, and Bradley, and L, and Casey, and K, and Chapman, and R, C and Gracely, and R, and Haythornthwaite, and J, and Jackson, and Jensen, and M, and Keefe, and J, F and Liebeskind, and J, and Logan, and H, and McGrath, and P, and McGuire, and B, D and Melzack, and R, and Morris, and D, and Post, and G, S and Price, and D, and Rouse, and F, and Spro}, Title = {Perspectives on pain-related suffering: presentations and discussions}, Journal = {Advances in Mind-Body Medicine}, Volume = {14}, Pages = {167-203}, Year = {1998}, Key = {fds273847} } @article{fds273856, Author = {Schanberg, LE and Lefebvre, JC and Keefe, FJ and Kredich, DW and Gil, KM}, Title = {Pain coping and the pain experience in children with juvenile chronic arthritis.}, Journal = {Pain}, Volume = {73}, Number = {2}, Pages = {181-189}, Year = {1997}, Month = {November}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9415504}, Abstract = {This study examined the pain experience and pain coping of children with juvenile chronic arthritis (JCA). The purpose of the study was to describe present pain and the pain coping strategies utilized by children with juvenile chronic arthritis and examine pain coping strategies and pain efficacy as a predictor of pain intensity and distribution. Fifty-six children with JCA rated their present pain using two measures of pain intensity, the Oucher and the pain thermometer, and reported on the number of pain locations using a body map. In addition, each child completed the Child Version of the Coping Strategies Questionnaire (CSQ-C) and health status was determined by a physician's disease activity rating. On average, children reported current pain in the low to middle range on the different pain scales, although there was considerable variability in pain ratings. Up to 30% of all children had pain ratings higher than or equal to the middle range on both the Oucher and the pain thermometer. On average, children reported pain in more than two body areas. Correlational analyses were conducted to examine how the composite factors on the CSQ-C (Pain Control and Rational Thinking, and Coping Attempts) related to variations in reported pain intensity and location. Children who scored higher on the Pain Control and Rational Thinking factor of the CSQ-C had much lower ratings of pain intensity and reported pain in fewer body areas. Hierarchical regression analyses indicated that disease activity and scores on the Pain Control and Rational Thinking factor of the CSQ-C each accounted for a unique, statistically significant proportion of variance in the measures of pain intensity and pain location. Behavioral and cognitive therapy interventions designed to increase pain coping efficacy may be useful adjuncts in treating pain in children with chronic arthritis.}, Doi = {10.1016/S0304-3959(97)00110-3}, Key = {fds273856} } @article{fds273857, Author = {Keefe, FJ and Kashikar-Zuck, S and Robinson, E and Salley, A and Beaupre, P and Caldwell, D and Baucom, D and Haythornthwaite, J}, Title = {Pain coping strategies that predict patients' and spouses' ratings of patients' self-efficacy.}, Journal = {Pain}, Volume = {73}, Number = {2}, Pages = {191-199}, Year = {1997}, Month = {November}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9415505}, Abstract = {This study examined the relationship of pain coping strategies to osteoarthritis patients' ratings of self-efficacy and to spouses' ratings of the patients' self-efficacy. Subjects, 130 individuals having osteoarthritis of the knees and persistent knee pain, completed a pain coping strategies measure (the Coping Strategies Questionnaire), a measure of self-efficacy (the Arthritis Self-Efficacy Scale), and a measure of pain (the McGill Pain Questionnaire). Two sets of regression analyses were conducted, one examining the degree to which pain coping strategies predicted patients' self-efficacy ratings, and the other examining the degree to which coping strategies predicted spouses' ratings of the patients' self-efficacy. Several pain coping strategies were found to predict a significant proportion of variance in patients' ratings of self-efficacy: (i) ignoring pain sensations was related to higher self-efficacy for pain; (ii) coping self statements were related to higher self-efficacy for controlling other arthritis symptoms (e.g., fatigue or mood symptoms: and (iii) catastrophizing was related to lower self-efficacy for pain, and self-efficacy for other arthritis symptoms. Pain coping strategies were also found to predict a significant proportion of variance in spouses' ratings of the patients' self-efficacy. Specifically: (i) diverting attention was related to lower spousal ratings of self-efficacy for pain; (ii) praying or hoping was related to lower spousal ratings of self-efficacy for function; and (iii) catastrophizing was related to lower spousal ratings of self-efficacy for control of fatigue or mood symptoms. The findings regarding coping strategies were particularly interesting in that they were obtained even after controlling for pain intensity and demographic variables. The pain coping strategies identified are potentially important targets for cognitive-behavioral assessment and treatment efforts. Interventions designed to increase the use of adaptive pain coping strategies and decrease the use of maladaptive pain coping strategies could enhance self-efficacy, reduce pain, and improve the physical and psychological functioning of individuals having osteoarthritis.}, Doi = {10.1016/S0304-3959(97)00109-7}, Key = {fds273857} } @article{fds304102, Author = {Kashikar-Zuck, S and Keefe, FJ and Kornguth, P and Beaupre, P and Holzberg, A and Delong, D}, Title = {Pain coping and the pain experience during mammography: a preliminary study.}, Journal = {Pain}, Volume = {73}, Number = {2}, Pages = {165-172}, Year = {1997}, Month = {November}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9415502}, Abstract = {This study examined how pain coping efficacy and pain coping strategies were related to reports of pain during mammography. Subjects were 125 women over the age of 50 undergoing screening mammograms. Prior to their mammogram, all subjects completed the Coping Strategies Questionnaire (CSQ) to assess how they cope with day-to-day pain experiences. Ratings of pain during the mammogram were collected using a 6-point pain/discomfort scale, a 100-mm Visual Analog Scale, the adjective checklist of the McGill Pain Questionnaire, and the Brief Pain Inventory. Up to 93% of the women reported the mammogram examination was painful. On average, women rated the mammography pain in the low to moderate range. Considerable variability in pain ratings was found, however, with some women reporting severe pain and others reporting little or no pain. Correlational analyses were conducted to examine how coping efficacy (CSQ ratings of ability to decrease pain and ability to control pain) and coping strategies (CSQ pain coping strategy subscales) related to variations in pain report. There was a pattern for ratings of ability to decrease pain to be related to lower ratings of current mammography pain. Women who rated their ability to decrease pain as high reported lower average levels of mammography pain, lower ratings on the mammography pain/discomfort scale, and were much more likely to report having had lower levels of pain during their last mammogram. These findings suggest that women who rate their coping efficacy in decreasing day-to-day pain as low may be at higher risk for having a painful mammogram. Individual pain coping strategies were not generally correlated with pain ratings. Behavioral interventions (e.g., patient controlled breast compression) and cognitive therapy interventions (e.g., training in the use of calming self-statements or distraction techniques) designed to increase coping efficacy potentially could be useful in reducing pain in women who are at risk for pain during mammography.}, Doi = {10.1016/S0304-3959(97)00114-0}, Key = {fds304102} } @article{fds372017, Author = {Schanberg, LE and Keefe, FJ and Lefebvre, JC and Kredich, DW and Gil, KM}, Title = {Pain coping and the pain experience in children with juvenile chronic arthritis.}, Journal = {ARTHRITIS AND RHEUMATISM}, Volume = {40}, Number = {9}, Pages = {1172-1172}, Publisher = {LIPPINCOTT-RAVEN PUBL}, Year = {1997}, Month = {September}, Key = {fds372017} } @article{fds372018, Author = {Schanberg, LE and Keefe, FJ and Lefebvre, JC and Kredich, DW and Gil, KM}, Title = {Social context of pain in children with fibromyalgia: Parental pain history and family environment.}, Journal = {ARTHRITIS AND RHEUMATISM}, Volume = {40}, Number = {9}, Pages = {1518-1518}, Publisher = {LIPPINCOTT-RAVEN PUBL}, Year = {1997}, Month = {September}, Key = {fds372018} } @article{fds372593, Author = {Jacobs, M and Lefebvre, J and Keefe, FJ}, Title = {Negative pain-related thoughts in FM: Relationship to pain and fatigue.}, Journal = {ARTHRITIS AND RHEUMATISM}, Volume = {40}, Number = {9}, Pages = {14-14}, Publisher = {LIPPINCOTT-RAVEN PUBL}, Year = {1997}, Month = {September}, Key = {fds372593} } @article{fds372594, Author = {Weiner, DK and Peterson, B and Keefe, FJ}, Title = {Predictors of self-reported pain intensity and stability in the nursing home.}, Journal = {JOURNAL OF THE AMERICAN GERIATRICS SOCIETY}, Volume = {45}, Number = {9}, Pages = {P218-P218}, Publisher = {WILLIAMS & WILKINS}, Year = {1997}, Month = {September}, Key = {fds372594} } @article{fds273851, Author = {Keefe, FJ and Jacobs, M and Underwood-Gordon, L}, Title = {Biobehavioral pain research: a multi-institute assessment of cross-cutting issues and research needs.}, Journal = {Clin J Pain}, Volume = {13}, Number = {2}, Pages = {91-103}, Year = {1997}, Month = {June}, ISSN = {0749-8047}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9186016}, Abstract = {In 1994 ten NIH institutes sponsored an interagency workshop focusing on biobehavioral pain research. The workshop had three major goals: (1) to review the current status of biobehavioral pain research (2) to identify critical research needs, and (3) to enhance interdisciplinary and interagency cooperation in pain research. The purpose of this article is to summarize the presentations at this meeting and to highlight some of the key research recommendations. Research topics addressed include (a) understanding critical interfaces between biology and behavior; (b) pain, suffering, and emotion; (c) pain and behavior; (d) behavior-related interventions; (e) commonalities and differences in pain expression, experience, and treatment; and (f) pain in special populations. The article concludes with a summary of NIH pain research activities that have taken place since the workshop.}, Doi = {10.1097/00002508-199706000-00003}, Key = {fds273851} } @article{fds273852, Author = {Keefe, FJ and Lefebvre, JC and Maixner, W and Salley, AN and Caldwell, DS}, Title = {Self-efficacy for arthritis pain: relationship to perception of thermal laboratory pain stimuli.}, Journal = {Arthritis Care Res}, Volume = {10}, Number = {3}, Pages = {177-184}, Year = {1997}, Month = {June}, ISSN = {0893-7524}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9335629}, Abstract = {OBJECTIVE: To examine how self-efficacy for arthritis pain relates to the perception of controlled laboratory pain stimuli. METHODS: Forty patients with osteoarthritis completed self-report measures of self-efficacy for arthritis pain. They then participated in a single experimental session in which measures of thermal pain threshold and tolerance were collected, as well as measures of the perceived intensity and unpleasantness of a range of thermal pain stimuli. RESULTS: Correlational analyses revealed that patients reporting high self-efficacy for arthritis pain rated the thermal pain stimuli as less unpleasant than those reporting low self-efficacy. When subjects scoring very high and very low in self-efficacy were compared, it was found that subjects scoring high on self-efficacy for arthritis pain had significantly higher pain thresholds and pain tolerance than those scoring low on self-efficacy. CONCLUSIONS: These results indicate that self-efficacy for arthritis pain is related to judgments of thermal pain stimuli. Implications for the understanding of arthritis pain and for future laboratory research are discussed.}, Doi = {10.1002/art.1790100305}, Key = {fds273852} } @article{fds273850, Author = {Robinson, ME and Riley, JL and Myers, CD and Sadler, IJ and Kvaal, SA and Geisser, ME and Keefe, FJ}, Title = {The Coping Strategies Questionnaire: a large sample, item level factor analysis.}, Journal = {Clin J Pain}, Volume = {13}, Number = {1}, Pages = {43-49}, Year = {1997}, Month = {March}, ISSN = {0749-8047}, url = {http://dx.doi.org/10.1097/00002508-199703000-00007}, Abstract = {OBJECTIVE: The Coping Strategies Questionnaire (CSQ), a measure of coping in chronic pain patients, was subjected to item-level exploratory factor analysis. SUBJECTS: A sample of 965 chronic pain patients were used in the analysis. RESULTS: Principal components analysis using a varimax rotation procedure identified nine factors that accounted for 54.5% of the variance. Of these nine factors, the first five represent subscales of the original CSQ subscales. The catastrophizing subscale replicated with significant loadings for all six original items, and ignoring sensations replicated with five of six items. Factors representing reinterpreting pain sensations, coping self-statements, and diverting attention subscales also appeared. The items from the praying and hoping subscale split into separate praying and hoping factors (factors 6 and 8). When reliability coefficients were calculated, factors 7 through 9 had unacceptably low internal consistency and thus were not considered stable factors. Correlations between factors 1 through 6 and other measures of psychological and physical functioning were calculated in the construct validation portion of this study. Previously found relationships were replicated in that the correlations between CSQ factor scores and measures of pain, depression, and disability were in the same direction in this data set as those previously reported.}, Doi = {10.1097/00002508-199703000-00007}, Key = {fds273850} } @article{fds273862, Author = {Weisberg, JN and Keefe, FJ}, Title = {Methodological considerations for diagnosis of personality disorders in chronic pain patients}, Journal = {PAIN FORUM}, Volume = {6}, Number = {1}, Pages = {20-21}, Publisher = {CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS}, Year = {1997}, Month = {March}, ISSN = {1058-9139}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:A1997WQ44300005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds273862} } @article{fds273859, Author = {Beaupre, P and Keefe, FJ and Lester, N and Affleck, G and Freedrickson, B and Caldwell, DS}, Title = {A computer-assisted observational method for assessing spouses' ratings of osteoarthritis patients' pain}, Journal = {Psychology, Health and Medicine}, Volume = {2}, Number = {2}, Pages = {99-108}, Publisher = {Informa UK Limited}, Year = {1997}, Month = {January}, url = {http://dx.doi.org/10.1080/13548509708400568}, Abstract = {This article presents preliminary data on a new method for analysing spouses' ratings of their marital partner's pain. Subjects were 19 individuals with persistent osteoarthritic knee pain and their spouses. Spouses viewed a videotape of the patient engaging in a series of daily activities (sitting, walking, standing, and reclining) and simultaneously made continuous ratings of the patient's pain using a computer-controlled mouse. Ratings made by the spouse were directly compared to ratings of pain provided by the patient to establish agreement about both the mean level of pain as well as the temporal synchrony between patients' and spouses' ratings. There was a significant positive correlation between spouses' mean ratings of pain and the patient's mean ratings of their own pain. However, when individual patient-spouse dyads were examined separately using time series analyse's individual differences in synchrony were clearly apparent. In some couples there was very high synchrony between patient's and spouse's ratings, while in other couples there was very low synchrony between these ratings. The level of synchrony was found to be higher in couples where the spouse was female and in which the patient had pain for a shorter duration or lower levels of physical disability. Although these findings are preliminary, they suggest that further research using this approach is warranted.}, Doi = {10.1080/13548509708400568}, Key = {fds273859} } @article{fds273861, Author = {Keefe, FJ and Jacobs, M and Edwards, C}, Title = {Persistent pain: Cognitive-behavioral approaches to assessment and treatment}, Journal = {Seminars in Anesthesia}, Volume = {16}, Number = {2}, Pages = {117-126}, Publisher = {Elsevier BV}, Year = {1997}, Month = {January}, ISSN = {0277-0326}, url = {http://dx.doi.org/10.1016/S0277-0326(97)80023-2}, Doi = {10.1016/S0277-0326(97)80023-2}, Key = {fds273861} } @article{fds273863, Author = {Polatin, PB and Gatchel, RJ and Fishbain, DA and Weisberg, JN and Keefe, FJ}, Title = {Personality disorders in the chronic pain population: Basic concepts, empirical findings, and clinical implications}, Journal = {Pain Forum}, Volume = {6}, Number = {1}, Pages = {1-21}, Year = {1997}, Month = {January}, Abstract = {Personality traits and characteristics have repeatedly been studied in the chronic pain literature. Accurate personality disorder diagnosis is now being conducted in the psychiatric literature through the use of semistructured interview techniques. There have been four studies to date that have used similar technology to diagnose personality disorders in chronicpain patients. Accurate personality disorder diagnosis can be beneficial if used appropriately to guide treatment decisions and to help treating clinicians work within a common paradigm. Unfortunately, there has yet to be a rigorous investigation of personality disorder diagnosis using semistructured instruments widely used in psychiatric research. The authors suggest that a diathesis-stress model may best help to explain the relatively high prevalence of personality disorder seen in the chronic pain population.}, Key = {fds273863} } @article{fds273865, Author = {Keefe, FJ and Caldwell, DS}, Title = {Cognitive behavioral control of arthritis pain.}, Journal = {Med Clin North Am}, Volume = {81}, Number = {1}, Pages = {277-290}, Year = {1997}, Month = {January}, ISSN = {0025-7125}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9012765}, Abstract = {Cognitive-behavioral approaches appear to offer a viable alternative for the management of arthritis pain. Controlled studies have documented the efficacy of CBT protocols for managing pain in individuals having OA and RA. Preliminary studies examining the efficacy of CBT for FM patients have also yielded encouraging results. A number of clinical and research issues need attention if CBT is to be incorporated into rheumatology practice settings. These issues include identifying the most important components of CBT, developing strategies for matching CBT interventions to patients' readiness for behavior change, testing the efficacy of different therapy formats (e.g., individual versus group), broadening the scope of CBT to address issues other than pain, and insurance reimbursement.}, Doi = {10.1016/s0025-7125(05)70515-0}, Key = {fds273865} } @article{fds304930, Author = {Keefe, FJ and Affleck, G and Lefebvre, JC and Starr, K and Caldwell, DS and Tennen, H}, Title = {Pain coping strategies and coping efficacy in rheumatoid arthritis: a daily process analysis.}, Journal = {Pain}, Volume = {69}, Number = {1-2}, Pages = {35-42}, Year = {1997}, Month = {January}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9060010}, Abstract = {Data from daily diaries were used to analyze pain coping processes in rheumatoid arthritis patients. For 30 consecutive days, 53 individuals described the pain coping strategies they used that day and rated the efficacy of their coping, joint pain, and positive and negative mood. Relations among variables were examined across-persons and within-persons over time. At the across-persons level of analysis, (i) daily coping efficacy was unrelated to pain coping or pain intensity, and (ii) the more frequent daily use of a wide variety of pain coping strategies was correlated with greater pain. Within-person analyses provided unique information about the relations among coping, pain, and mood not apparent in the across-persons results. Specifically, these analyses showed that increases in daily coping efficacy were not only related to decreases in pain, but also to decreases in negative mood and increases in positive mood. Time-lagged effects of coping and coping efficacy were also found. Individuals who reported high levels of coping efficacy on one day had lower levels of pain on the subsequent day. The daily use of pain reduction efforts and relaxation strategies also contributed to an improvement in next-day pain and an enhancement of positive mood. The implications of these findings for the assessment of pain and coping in rheumatoid arthritis patients are discussed.}, Doi = {10.1016/s0304-3959(96)03246-0}, Key = {fds304930} } @article{fds40986, Author = {Smarr, K.L. and Parker, J.C. and Wright, G.E. and Stucky-Ropp, R.C. and Buckelew, S.P. and Hoffman, R.W. and O'Sullivan, F.X. and Hewett, J.E.}, Title = {The importance of enhancing self-efficacy in rheumatoid arthritis}, Journal = {Arthritis Care and Research}, Volume = {10}, Pages = {18-26}, Year = {1997}, Key = {fds40986} } @article{fds273853, Author = {Koenig, HG and Weiner, DK and Peterson, BL and Meador, KG and Keefe, FJ}, Title = {Religious coping in the nursing home: a biopsychosocial model.}, Journal = {Int J Psychiatry Med}, Volume = {27}, Number = {4}, Pages = {365-376}, Year = {1997}, ISSN = {0091-2174}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9565732}, Abstract = {OBJECTIVE: To examine psychosocial and physical health correlates of religious coping in medically ill chronically institutionalized older adults. Religious coping is defined as the extent to which persons use religious beliefs and practices to help them to cope. METHOD: This is a cross-sectional cohort study conducted in a 120 bed VA-affiliated and a 125 bed university affiliated community-based nursing home in Durham, North Carolina. Participants were 115 chronic care nursing home residents; mean age of the sample was seventy-nine years, 44 percent were women, and 17 percent were African Americans. Subjects were enrolled for a one-month period during which comprehensive psychosocial and health assessments were performed, including evaluation of cognitive function (Mini-Mental State Exam), physical function (Barthel index), severity of medical comorbidity (Cumulative Illness Rating Scale), self-reported physical pain (vertical verbal descriptor scale), depressive symptoms (Geriatric Depression Scale), social support (social network), and religious coping (Religious Coping Index). RESULTS: Over 43 percent of the sample scored in the depressed range of the Geriatric Depression Scale. Almost 60 percent reported they used religion at least to a large extent when coping with their problems; 34 percent said that it was the most important factor that enabled them to cope. Patients who used religion to cope had greater social support (p = .01), more severe medical illness (p = .04), and better cognitive functioning (p = .02). CONCLUSIONS: Religious beliefs and practices are frequently used by chronically institutionalized older adults to help them to cope. Religious coping is associated with more severe medical illness, higher social support, and better cognitive functioning.}, Doi = {10.2190/M2D6-5YDG-M1DD-A958}, Key = {fds273853} } @article{fds273854, Author = {Schwartz, CE and Chesney, MA and Irvine, MJ and Keefe, FJ}, Title = {The control group dilemma in clinical research: applications for psychosocial and behavioral medicine trials.}, Journal = {Psychosom Med}, Volume = {59}, Number = {4}, Pages = {362-371}, Year = {1997}, ISSN = {0033-3174}, url = {http://dx.doi.org/10.1097/00006842-199707000-00005}, Abstract = {OBJECTIVE: Clinical research on psychosocial and behavioral medicine interventions has burgeoned in the past two decades, so much so that sole reliance on standard no-treatment control conditions may no longer be appropriate or feasible. We discuss the ethical, theoretical, scientific, and statistical considerations that shape current clinical outcomes research for psychosocial and behavioral medicine interventions. METHOD AND RESULTS: Secondary analysis of a psychosocial randomized trial (N = 127) illustrates some of these points. CONCLUSIONS: A new design for randomized clinical trials is described that does not require a no-treatment control group, and that reveals dose-response relationships between interventions and treatment outcomes.}, Doi = {10.1097/00006842-199707000-00005}, Key = {fds273854} } @article{fds273855, Author = {Kashikar Zuck and S and Keefe, FJ and Kornguth, P and Beaupre, P and Holzberg, A and Delong, D}, Title = {Pain coping and the pain experience during mammography}, Journal = {Pain}, Volume = {73}, Number = {2}, Pages = {165-172}, Year = {1997}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9415502}, Abstract = {This study examined how pain coping efficacy and pain coping strategies were related to reports of pain during mammography. Subjects were 125 women over the age of 50 undergoing screening mammograms. Prior to their mammogram, all subjects completed the Coping Strategies Questionnaire (CSQ) to assess how they cope with day-to-day pain experiences. Ratings of pain during the mammogram were collected using a 6-point pain/discomfort scale, a 100-mm Visual Analog Scale, the adjective checklist of the McGill Pain Questionnaire, and the Brief Pain Inventory. Up to 93% of the women reported the mammogram examination was painful. On average, women rated the mammography pain in the low to moderate range. Considerable variability in pain ratings was found, however, with some women reporting severe pain and others reporting little or no pain. Correlational analyses were conducted to examine how coping efficacy (CSQ ratings of ability to decrease pain and ability to control pain) and coping strategies (CSQ pain coping strategy subscales) related to variations in pain report. There was a pattern for ratings of ability to decrease pain to be related to lower ratings of current mammography pain. Women who rated their ability to decrease pain as high reported lower average levels of mammography pain, lower ratings on the mammography pain/discomfort scale, and were much more likely to report having had lower levels of pain during their last mammogram. These findings suggest that women who rate their coping efficacy in decreasing day-to-day pain as low may be at higher risk for having a painful mammogram. Individual pain coping strategies were not generally correlated with pain ratings. Behavioral interventions (e.g., patient controlled breast compression) and cognitive therapy interventions (e.g., training in the use of calming self-statements or distraction techniques) designed to increase coping efficacy potentially could be useful in reducing pain in women who are at risk for pain during mammography.}, Key = {fds273855} } @article{fds273858, Author = {Keefe, FJ}, Title = {Intervention specific response rates in behavioral treatments for chronic pain}, Journal = {Mind-Body Medicine}, Volume = {2}, Pages = {190-196}, Year = {1997}, Key = {fds273858} } @article{fds273860, Author = {Keefe, FJ and Lefebvre, JC}, Title = {Pain: From mechanisms to management}, Journal = {Health Psychology}, Volume = {16}, Number = {4}, Pages = {307-309}, Publisher = {American Psychological Association (APA)}, Year = {1997}, url = {http://dx.doi.org/10.1037/h0092701}, Doi = {10.1037/h0092701}, Key = {fds273860} } @article{fds273864, Author = {Keefe, FJ and Affleck, G and Lefebvre, JC and Starr, K and Caldwell, DS and Tennen, H}, Title = {Pain coping strategies and coping efficacy in rheumatoid arthritis: A daily process analysis}, Journal = {Pain}, Volume = {69}, Number = {1-2}, Pages = {43-48}, Year = {1997}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9060010}, Abstract = {Data from daily diaries were used to analyze pain coping processes in rheumatoid arthritis patients. For 30 consecutive days, 53 individuals described the pain coping strategies they used that day and rated the efficacy of their coping, joint pain, and positive and negative mood. Relations among variables were examined across-persons and within-persons over time. At the across-persons level of analysis, (i) daily coping efficacy was unrelated to pain coping or pain intensity, and (ii) the more frequent daily use of a wide variety of pain coping strategies was correlated with greater pain. Within-person analyses provided unique information about the relations among coping, pain, and mood not apparent in the across-persons results. Specifically, these analyses showed that increases in daily coping efficacy were not only related to decreases in pain, but also to decreases in negative mood and increases in positive mood. Time-lagged effects of coping and coping efficacy were also found. Individuals who reported high levels of coping efficacy on one day had lower levels of pain on the subsequent day. The daily use of pain reduction efforts and relaxation strategies also contributed to an improvement in next-day pain and an enhancement of positive mood. The implications of these findings for the assessment of pain and coping in rheumatoid arthritis patients are discussed.}, Key = {fds273864} } @article{fds304934, Author = {Lester, N and Lefebvre, JC and Keefe, FJ}, Title = {Pain in young adults--III: Relationships of three pain-coping measures to pain and activity interference.}, Journal = {Clin J Pain}, Volume = {12}, Number = {4}, Pages = {291-300}, Year = {1996}, Month = {December}, ISSN = {0749-8047}, url = {http://dx.doi.org/10.1097/00002508-199612000-00008}, Abstract = {The study had two purposes: (a) to examine the relationships among coping strategies measured by the Coping Strategies Questionnaire (CSQ) (1), the Vanderbilt Pain Management Inventory (VPMI) (2), and the Ways of Coping Inventory (WOC) (3) and identify the higher-order composite factors representing these relationships; and (b) to determine the degree to which individual coping scale scores and composite coping factor scores could explain variability in the pain intensity and pain-related activity interference reported by young adults. Measures of pain coping were collected from 206 young adults using the CSQ, VPMI, and WOC, along with measures of pain intensity, pain location, and the extent to which pain interfered with daily activities. Results indicated considerable variability in the reported frequency of use of pain-coping strategies and in pain intensity, location, and activity interference. Principal components factor analysis identified three higher-order coping factors (Emotional and Other-Directed Coping, Active Cognitive Coping, and Self-Efficacy for Pain Control) that explained 87% of the variance in individual coping scale scores. The degree to which individual scale scores and composite factor scores explained variability in pain intensity and activity interference variables was determined through a series of multiple regression analyses. The results revealed that individual scale scores, particularly the CSQ scales of catastrophizing and praying or hoping, were best able to explain the variance in measures of pain and activity interference. Taken together, these findings provide further support for the importance of coping variables in explaining the experience of pain and adjustment in young adults.}, Doi = {10.1097/00002508-199612000-00008}, Key = {fds304934} } @article{fds273867, Author = {Weiner, D and Pieper, C and McConnell, E and Martinez, S and Keefe, F}, Title = {Pain measurement in elders with chronic low back pain: traditional and alternative approaches.}, Journal = {Pain}, Volume = {67}, Number = {2-3}, Pages = {461-467}, Year = {1996}, Month = {October}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8951942}, Abstract = {Pain evaluation typically relies upon the use of self-report instruments. The validity of these tools is questionable in many older adults, however, particularly those with cognitive impairment. Rating of pain behavior (e.g. grimacing, sighing) by an objective observer represents an alternative pain assessment strategy which has been validated in subjects of heterogeneous ages. The purpose of this study was to examine, in a group of community-dwelling elderly with low back pain and lumbosacral osteoarthritis, the concurrent validity of observational pain behavior rating techniques as compared with self-report instruments and the degree to which pain and pain behavior relate to disability. Thirty-nine cognitively intact subjects, age > 65 years, without depression, other sources of pain, or other known spinal pathology underwent the following measures: (1) pain self-report using the verbal 0-10 scale, vertical verbal descriptor scale, Arthritis Impact Measurement Scales and McGill Pain Questionnaire; (2) pain behavior was sampled during two protocols, one, identical to that used by Keefe and Block (Behav. Ther., 13 (1982) 363-375), that required subjects to sit, stand, walk, and recline for 1-2 minute periods (which we have labelled the traditional protocol), and a second, more demanding protocol that was designed to simulate activities of daily living that place a premium on axial movement (the 'ADL' protocol); (3) disability was assessed using the Roland questionnaire, a 6 month global disability question and the Jette Functional Status Index; and (4) radiographic evaluation of the lumbosacral spine; osteoarthritis was quantitated using a previously validated scoring system. Interrelationships among pain, pain behavior and disability measures were tested using canonical correlations. Self-reported pain was associated with pain behavior frequency; the association was stronger when the ADL protocol was used, as compared with the traditional protocol. The association between pain and disability was modestly strong with both self-report instruments and pain behavior observation when the ADL protocol was used, but not when the traditional protocol was used. Our findings suggest that pain behavior observation is a valid assessment tool in the elderly. In addition, it seems that observation of elders during performance of activities of daily living may be a more sensitive and valid way of assessing pain behavior than observing pain behavior during sitting, walking, standing, or reclining.}, Doi = {10.1016/0304-3959(96)03150-8}, Key = {fds273867} } @article{fds273868, Author = {Keefe, FJ and Kashikar-Zuck, S and Opiteck, J and Hage, E and Dalrymple, L and Blumenthal, JA}, Title = {Pain in arthritis and musculoskeletal disorders: the role of coping skills training and exercise interventions.}, Journal = {J Orthop Sports Phys Ther}, Volume = {24}, Number = {4}, Pages = {279-290}, Year = {1996}, Month = {October}, ISSN = {0190-6011}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8892142}, Abstract = {There is growing recognition of the limitations of conventional, biomedical approaches to the management of pain in individuals having arthritis and musculoskeletal disorders. This article provides an overview of newly developed biopsychosocial approaches to the management of pain in this population. The presentation is divided into three sections. In the first section, a biopsychosocial model of pain is presented. This model highlights the role that biological factors (eg., disease severity, comorbid conditions), cognitive-behavioral factors (eg., thoughts, emotions, and behaviors), and environmental factors (eg., spouse or family responses to pain behavior) can play in influencing the pain experience. In the second section, we provide an overview of two newly developed treatment protocols based on the biopsychosocial model of pain: a pain coping skills training protocol and an exercise training protocol. Practical aspects of implementing these protocols are illustrated by highlighting how they are applied in the management of patients having persistent osteoarthritic pain. In the final section of the article, we pinpoint several important future directions for research in this area. Future studies need to explore the utility of combining pain coping skills and exercise training protocols. In addition, there is a need to identify variables that predict patients' response to biopsychosocial treatments.}, Doi = {10.2519/jospt.1996.24.4.279}, Key = {fds273868} } @article{fds273869, Author = {Kornguth, PJ and Keefe, FJ and Conaway, MR}, Title = {Pain during mammography: characteristics and relationship to demographic and medical variables.}, Journal = {Pain}, Volume = {66}, Number = {2-3}, Pages = {187-194}, Year = {1996}, Month = {August}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8880840}, Abstract = {Reports of pain during mammography show that there is great variability in both the incidence of reported pain (0.2-62%) and the intensity of that pain. Much of that variability may be due to the measures used to rate mammography pain. This is the first study that has examined the incidence, quality and intensity of mammography pain using a variety of pain measures. A sample of 119 women undergoing screening mammography was studied using four pain scales, three well-validated measures frequently used in the pain research literature as well as a pain/discomfort measure frequently reported in the radiology literature. A large proportion (up to 91%) of women report having some degree of pain during mammography. The intensity of that pain was typically in the low to moderate range, but a small proportion of women (< 15%) reported intense pain. The incidence of reported pain was related to the pain measure used. Pain measures that provided a woman with many options for reporting pain were associated with a higher incidence of pain than a scale that provided only one or two options. Thus, some of the variability in reported incidence of pain during mammography can be explained by the pain scale used in the study. Demographic and medical variables could explain 18-20% of the variance in mammography pain. Two of the variables that were shown to consistently predict a painful mammographic experience were (1) average pain at the last mammogram and (2) breast density. This study demonstrated that the pain measure selected for use in a particular study may depend on the population being studied. A college education was found to be an important predictor of pain scores on the McGill Pain Questionnaire. Thus, this pain measure may be of limited usefulness in studying a population of women with little formal education.}, Doi = {10.1016/0304-3959(96)03057-6}, Key = {fds273869} } @article{fds273870, Author = {Keefe, FJ and Caldwell, DS and Baucom, D and Salley, A and Robinson, E and Timmons, K and Beaupre, P and Weisberg, J and Helms, M}, Title = {Spouse-assisted coping skills training in the management of osteoarthritic knee pain.}, Journal = {Arthritis Care Res}, Volume = {9}, Number = {4}, Pages = {279-291}, Publisher = {WILEY}, Year = {1996}, Month = {August}, ISSN = {0893-7524}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8997917}, Abstract = {OBJECTIVE: To evaluate the effects of a spouse-assisted pain-coping skills training intervention on pain, psychological disability, physical disability, pain-coping, and pain behavior in patients with osteoarthritis (OA) of the knees. METHODS: Eighty-eight OA patients with persistent knee pain were randomly assigned to 1 of 3 conditions: 1) spouse-assisted pain-coping skills training, (spouse-assisted CST), 2) a conventional CST intervention with no spouse involvement (CST), or 3) an arthritis education-spousal support (AE-SS) control condition. All treatment was carried out in 10 weekly, 2-hour group sessions. RESULTS: Data analysis revealed that at the completion of treatment, patients in the spouse-assisted CST condition had significantly lower levels of pain, psychological disability, and pain behavior, and higher scores on measures of coping attempts, marital adjustment, and self-efficacy than patients in the AE-SS control condition. Compared to patients in the AE-SS control condition, patients who received CST without spouse involvement had significantly higher post-treatment levels of self-efficacy and marital adjustment and showed a tendency toward lower levels of pain and psychological disability and higher scores on measures of coping attempts and ratings of the perceived effectiveness of pain-coping strategies. CONCLUSION: These findings suggest that spouse-assisted CST has potential as a method for reducing pain and disability in OA patients.}, Doi = {10.1002/1529-0131(199608)9:4<279::aid-anr1790090413>3.0.co;2}, Key = {fds273870} } @article{fds273872, Author = {Keefe, FJ and Lefebvre, JC and Starr, KR}, Title = {From the gate Control Theory to the neuromatrix - Revolution or evolution?}, Journal = {PAIN FORUM}, Volume = {5}, Number = {2}, Pages = {143-146}, Publisher = {CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS}, Year = {1996}, Month = {June}, ISSN = {1058-9139}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:A1996UV44900011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds273872} } @article{fds273875, Author = {Schanberg, LE and Keefe, FJ and Lefebvre, JC and Kredich, DW and Gil, KM}, Title = {Pain coping strategies in children with juvenile primary fibromyalgia syndrome: correlation with pain, physical function, and psychological distress.}, Journal = {Arthritis Care Res}, Volume = {9}, Number = {2}, Pages = {89-96}, Publisher = {WILEY}, Year = {1996}, Month = {April}, ISSN = {0893-7524}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8970266}, Abstract = {OBJECTIVES: The purpose of this study was twofold: 1) to describe the coping strategies used by children with juvenile primary fibromyalgia syndrome (JPFS), and 2) to examine how pain coping relates to measures of pain, disability/function, psychological distress, and pain behavior. METHODS: Sixteen children with JPFS completed the Child Version of the Coping Strategies Questionnaire (CSQ-C), the visual analog scale for pain, the McGill Pain Questionnaire, the Fibromyalgia Impact Questionnaire modified for children, the Arthritis Impact Measurement Scales 2, and the Symptom Checklist-90-Revised. Subjects also also underwent pain behavior observation. Pearson's product moment correlations were conducted to examine the relationship of coping to measures of pain and disability. RESULTS: The Pain Control and Rational Thinking composite factor score on the CSQ-C correlated with measures of pain severity, functional disability, and psychological distress. Results supported the internal reliability of the CSQ-C in assessing pain coping. CONCLUSIONS: These results suggest that the CSQ-C may provide a reliable measure for assessing variations in pain coping in JPFS patients. Behavioral interventions aimed at increasing the perception of pain control may be beneficial in treating JPFS.}, Doi = {10.1002/1529-0131(199604)9:2<89::aid-anr1790090204>3.0.co;2-}, Key = {fds273875} } @article{fds372595, Author = {Keefe, FJ and Holzberg, AD and Beaupre, PM}, Title = {Contributions of pain behavior assessment and pain assessment to the development of pain clinics}, Journal = {PAIN TREATMENT CENTERS AT A CROSSROADS}, Volume = {7}, Pages = {79-100}, Publisher = {INT ASSOC STUDY PAIN (IASP) PRESS}, Editor = {Cohen, MJM and Campbell, JN}, Year = {1996}, Month = {January}, ISBN = {0-931092-14-0}, Key = {fds372595} } @article{fds372596, Author = {Keefe, FJ and Egert, JR}, Title = {A cognitive-behavioral perspective on pain in cumulative trauma disorders}, Journal = {BEYOND BIOMECHANICS}, Pages = {159-175}, Publisher = {TAYLOR & FRANCIS LTD}, Editor = {Moon, SD and Sauter, SL}, Year = {1996}, Month = {January}, ISBN = {0-7484-0321-3}, Key = {fds372596} } @article{fds273866, Author = {Lester, N and Lefebvre, JC and Keefe, FJ}, Title = {Pain in young adults-III: Comparison of three coping assessment methods}, Journal = {Clinical Journal of Pain}, Volume = {12}, Number = {4}, Pages = {291-300}, Year = {1996}, ISSN = {0749-8047}, url = {http://dx.doi.org/10.1097/00002508-199612000-00008}, Abstract = {The study had two purposes: (a) to examine the relationships among coping strategies measured by the Coping Strategies Questionnaire (CSQ) (1), the Vanderbilt Pain Management Inventory (VPMI) (2), and the Ways of Coping inventory (WOC) (3) and identify the higher-order composite factors representing these relationships; and (b) to determine the degree to which individual coping scale scores and composite coping factor scores could explain variability in the pain intensity and pain-related activity interference reported by young adults. Measures of pain coping were collected from 206 young adults using the CSQ, VPMI, and WOC, along with measures of pain intensity, pain location, and the extent to which pain interfered with daily activities. Results indicated considerable variability in the reported frequency of use of pain-coping strategies and in pain intensity, location, and activity interference. Principal components factor analysis identified three higher-order coping factors (Emotional and Other-Directed Coping, Active Cognitive Coping, and Self-Efficacy for Pain Control) that explained 87% of the variance in individual coping scale scores. The degree to which individual scale scores and composite factor scores explained variability in pain intensity and activity interference variables was determined through a series of multiple regression analyses. The results revealed that individual scale scores, particularly the CSQ scales of catastrophizing and praying or hoping, were best able to explain the variance in measures of pain and activity interference. Taken together, these findings provide further support for the importance of coping variables in explaining the experience of pain and adjustment in young adults.}, Doi = {10.1097/00002508-199612000-00008}, Key = {fds273866} } @article{fds273871, Author = {Keefe, FJ and Goli, V}, Title = {A practical guide to biobehavioral assessment and treatment of chronic pain}, Journal = {Journal of Practical Psychiatry and Behavioral Health}, Volume = {3}, Number = {3}, Pages = {151-161}, Year = {1996}, ISSN = {1076-5417}, Abstract = {The authors describe the biobehavioral management of chronic pain. They first discuss how to conduct a thorough pain assessment that includes an evaluation of medical-psychiatric and cognitive-behavioral factors. They describe the most useful self-report measures as well as cognitive-behavioral techniques for assessing pain, such as diary records, behavioral observation, and the evaluation of pain coping strategies and negative pain-related cognitions. The second half of the article focuses on the biobehavioral treatment of chronic pain and includes a detailed review of both pharmacological and cognitive-behavioral treatment strategies.}, Key = {fds273871} } @article{fds273873, Author = {Keefe, FJ}, Title = {Cognitive behavioral therapy for managing pain}, Journal = {The Clinical Psychologist}, Volume = {49}, Pages = {4-5}, Year = {1996}, Key = {fds273873} } @article{fds273874, Author = {Fillingim, RB and Keefe, FJ and Light, KC and Booker, DK and Maixner, W}, Title = {The influence of gender and psychological factors on pain perception}, Journal = {Journal of Gender, Culture, and Health}, Volume = {1}, Pages = {21-36}, Year = {1996}, Key = {fds273874} } @article{fds372597, Author = {WEINER, DK and LADD, KE and PIEPER, CF and KEEFE, FJ}, Title = {PAIN IN THE NURSING-HOME - RESIDENT VERSUS STAFF PERCEPTIONS}, Journal = {JOURNAL OF THE AMERICAN GERIATRICS SOCIETY}, Volume = {43}, Number = {9}, Pages = {SA2-SA2}, Publisher = {WILLIAMS & WILKINS}, Year = {1995}, Month = {September}, Key = {fds372597} } @article{fds372019, Author = {KEEFE, FJ and LEFEBVRE, JC and BEAUPRE, PM}, Title = {THE MINNESOTA MULTIPHASIC PERSONALITY-INVENTORY IN CHRONIC PAIN - SECURITY BLANKET OR SOUND INVESTMENT}, Journal = {PAIN FORUM}, Volume = {4}, Number = {2}, Pages = {101-103}, Publisher = {CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS}, Year = {1995}, Month = {June}, Key = {fds372019} } @article{fds273880, Author = {Williams, DA and Urban, B and Keefe, FJ and Shutty, MS and France, R}, Title = {Cluster analyses of pain patients' responses to the SCL-90R.}, Journal = {Pain}, Volume = {61}, Number = {1}, Pages = {81-91}, Year = {1995}, Month = {April}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(94)00165-B}, Abstract = {This study sought to identify distinct subgroups of chronic pain patients based on responses to the Symptom Checklist 90-revised (SCL-90R), a measure of psychological distress. Two scoring methods were used: the standard scoring that accompanies the manual, and a scoring method based upon factor scores obtained in an earlier study using low back pain patients. Two separate cluster analyses assigned patients into 2 groups: one based on standard scores and one based on factor scores. Results of this study support the hypothesis that distinct and replicable subgroups of chronic pain patients can be identified using the SCL-90R. Depending upon group membership, patients significantly differed on measures of qualitative pain and quantitative pain report, depressive symptoms, medication usage, and pain-related behaviors. This study supports the use of SCL-90R factor scoring with pain patients as greater differentiation between clusters was found for pain report and pain-related behavior when this method was used. Guidelines for clinical application of SCL-90R cluster groups is provided.}, Doi = {10.1016/0304-3959(94)00165-B}, Key = {fds273880} } @article{fds273879, Author = {Lefebvre, JC and Lester, N and Keefe, FJ}, Title = {Pain in young adults. II: The use and perceived effectiveness of pain-coping strategies.}, Journal = {Clin J Pain}, Volume = {11}, Number = {1}, Pages = {36-44}, Year = {1995}, Month = {March}, ISSN = {0749-8047}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7787337}, Abstract = {OBJECTIVE: The first goal of the study was to determine the internal reliability of the Coping Strategies Questionnaire (CSQ) in young adults. The second goal was to examine the relation of the CSQ to reported pain levels. The third goal was to investigate the relationship between the CSQ and concomitant pain problems. The fourth goal was to compare young adults and different chronic pain samples in terms of the frequency of coping strategy use and perceived effectiveness of coping strategies. DESIGN: The study included 252 undergraduate students who were given the CSQ, a demographic and pain level questionnaire, and a concomitant pain problem survey. RESULTS: The results indicated that the CSQ was internally reliable when used to assess pain coping strategy use among young adults. Catastrophizing was found to be associated with both pain level and concomitant pain problems, with subjects reporting higher levels of catastrophizing having higher levels of pain and a higher frequency of both migraine headaches and low back pain. Finally, differences were found when comparing the perceived effectiveness in controlling and decreasing pain, and in the use of specific coping strategies in the young adult and chronic pain samples. The young adult sample reported a greater perceived efficacy in controlling and decreasing pain, compared to a sample of low back pain patients and a sample of myofacial pain patients. CONCLUSIONS: The results indicate that the CSQ is a reliable measure for the study of pain-coping strategies used in this population, and one that relates to differences reported in the experience of pain.}, Key = {fds273879} } @article{fds273796, Author = {Main, CJ and Spanswick, CC and Bradley, LA and Keefe, FJ and Lefebvre, JC and Beaupre, PM and Turk, DC and Fernandez, E and Sanders, SH}, Title = {Personality assessment and the Minnesota Multiphasic Personality Inventory: 50 Years on: Do we still need our security blanket?}, Journal = {Pain Forum}, Volume = {4}, Number = {2}, Pages = {90-96}, Year = {1995}, Month = {January}, Abstract = {Personality assessment has a long history in the investigation of pain problems, and perhaps it is time to reflect on its relevance in the context of understanding pain. Although number of different personality inventories have been developed recently, the Minnesota Multiphasic Personality Inventory (MMPI) is still the most widely used personality inventory and, in terms of detailed debate, particular emphasis will be placed on the MMPI and its successor, the MMPI-2. Although much of the subsequent discussion will be of a more general nature, the authors contend that its continued use is understandable, but no longer justifiable, and will argue that, even in its latest incarnation, the MMPI is overdependent on outdated concepts of psychopathology, and that the recent critiques of the MMPI, while illuminating, have failed to address a more fundamental set of problems with personality assessment, which inherently constrain and limit its utility.}, Key = {fds273796} } @article{fds273878, Author = {Lane, JD and Lefebvre, JC and Rose, JE and Keefe, FJ}, Title = {Effects of Cigarette Smoking on Perception of Thermal Pain}, Journal = {Experimental and Clinical Psychopharmacology}, Volume = {3}, Number = {2}, Pages = {140-147}, Publisher = {American Psychological Association (APA)}, Year = {1995}, Month = {January}, ISSN = {1064-1297}, url = {http://dx.doi.org/10.1037/1064-1297.3.2.140}, Abstract = {The effects of cigarette smoking on pain perception were evaluated in 18 healthy smokers. Thermal pain stimuli were used to assess pain detection threshold and tolerance and to collect subjective ratings of the intensity and unpleasantness of painful stimuli. After overnight abstinence, pain perception was evaluated before and after 3 experimental treatments. Participants smoked normal cigarettes, smoked denicotinized cigarettes, or remained abstinent. Smoking normal cigarettes produced relative increases in pain tolerance compared with abstinence. Smoking denicotinized cigarettes produced intermediate effects on tolerance not different from the other 2 treatments. Effects were not detected for pain threshold or subjective pain ratings. Results suggest that cigarette smoking can have antinociceptive effects, which may depend both on nicotine and on other factors associated with smoking. © 1995 American Psychological Association.}, Doi = {10.1037/1064-1297.3.2.140}, Key = {fds273878} } @article{fds372598, Author = {KEEFE, FJ}, Title = {CONTROL AND COMPARISON GROUPS IN BEHAVIORAL TREATMENT STUDIES OF ARTHRITIS PATIENTS}, Journal = {PSYCHOSOMATIC MEDICINE}, Volume = {57}, Number = {1}, Pages = {59-60}, Publisher = {WILLIAMS & WILKINS}, Year = {1995}, Month = {January}, Key = {fds372598} } @article{fds273876, Author = {Edens, JL and Wilson, JJ and Gil, KM and Keefe, FJ}, Title = {Critical issues in pain management training for psychologists}, Journal = {American Pain Society Journal}, Pages = {14-17}, Year = {1995}, Key = {fds273876} } @article{fds273877, Author = {Keefe, FJ and Lefebvre, JC and Beaupre, PM}, Title = {The MMPI in chronic pain: Security blanket or sound investment}, Journal = {Pain Forum}, Volume = {4}, Pages = {101-103}, Year = {1995}, Key = {fds273877} } @article{fds273881, Author = {Lester, N and Lefebvre, JC and Keefe, FJ}, Title = {Pain in young adults: I. Relationship to gender and family pain history.}, Journal = {Clin J Pain}, Volume = {10}, Number = {4}, Pages = {282-289}, Year = {1994}, Month = {December}, ISSN = {0749-8047}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7858357}, Abstract = {OBJECTIVES/DESIGN: Two studies were carried out to examine how gender and family pain history related to pain and activity interference in young adults. The first study (n = 252 college students) examined how gender and family pain history related to pain intensity and the second study (n = 206 college students) examined how these variables related to pain intensity, location, and activity interference. Whenever possible, data from the two studies were combined for purposes of data analyses. RESULTS: Results indicated that more than half of the young adults studied reported experiencing some type of pain at the time of the investigation. The intensity of the pain was in the low range and the most frequent sites of pain were in the head and legs or feet. Gender differences were noted, with women reporting a greater number of sites of pain. Family pain history was found to be related to pain and activity interference. Subjects who had a strong family history of pain problems reported a greater number of pain sites, and higher levels of pain-related activity interference. CONCLUSIONS: Generalizability of results is limited due to the group of young adults studied, yet several conclusions relative to this group may be suggested. First, this group of young adults do appear to experience pain. Second, there may be gender differences in the types of pain they report and the ways they react to pain. Third, family history of pain may be related to the pain experiences of this group of young adults.}, Doi = {10.1097/00002508-199412000-00007}, Key = {fds273881} } @article{fds273882, Author = {Buckelew, SP and Parker, JC and Keefe, FJ and Deuser, WE and Crews, TM and Conway, R and Kay, DR and Hewett, JE}, Title = {Self-efficacy and pain behavior among subjects with fibromyalgia.}, Journal = {Pain}, Volume = {59}, Number = {3}, Pages = {377-384}, Year = {1994}, Month = {December}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(94)90024-8}, Abstract = {Given the lack of objective physical measures for assessing fibromyalgia syndrome (FS), the role of pain assessment is particularly important. The role of psychological factors is controversial among FS patients. This study was designed to better understand the relationship between pain behaviors and psychological variables. Specifically, this study (1) refined a pain behavior observation (PBO) methodology for use with FS patients, (2) determined whether stretching is a valid pain behavior, and (3) assessed whether psychological variables including self-efficacy and/or depression can predict pain behaviors after controlling for disease severity and age. The 73 FS subjects meeting the American College of Rheumatology classification system completed questionnaires measuring self-efficacy, depression, and pain. Trained physicians conducted tender-point examinations. Subjects were video-taped using a standardized procedure. Two trained raters independently coded all pain behaviors. Kappa coefficients and correlations among pain behaviors and self-reported pain indicated that the PBO method was both reliable and valid. However, the newly defined pain behavior 'stretching' was found to be negatively associated with self-reported pain. Hierarchical multiple regression (MR) analyses revealed that depression did not predict pain behavior over and above myalgic scores and age; however, in 3 separate MR analyses, self-efficacy for function, pain, and other symptoms each predicted pain behavior over and above myalgic scores and age. This study indicated that the original pain behavior scoring methodology is appropriate for use with the FS population and should not be modified to include the pain behavior 'stretching'. Self-efficacy was related to pain behavior while depression was not among this FS sample.}, Doi = {10.1016/0304-3959(94)90024-8}, Key = {fds273882} } @article{fds273883, Author = {Geisser, ME and Robinson, ME and Keefe, FJ and Weiner, ML}, Title = {Catastrophizing, depression and the sensory, affective and evaluative aspects of chronic pain.}, Journal = {Pain}, Volume = {59}, Number = {1}, Pages = {79-83}, Year = {1994}, Month = {October}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(94)90050-7}, Abstract = {Research has shown that catastrophizing is related to increased depression and chronic pain. However, some researchers have questioned the utility of catastrophizing as a separate construct, suggesting that it may just be a symptom of depression. The present investigation used path analysis to determine if catastrophizing was related to McGill Pain Questionnaire scores when controlling for depression as assessed by the Beck Depression Inventory in a group of 85 chronic pain patients. According to Fields' model of the relationship between pain and depression, we predicted that catastrophizing would mediate the the relationship between depression and the evaluative and affective aspects of pain, but not the sensory aspect. The resulting path coefficients appear to support these predictions. The results suggest that catastrophizing is a separate construct which may impact on pain perception and treatment. The data also provide some support for Field's neurobiological model of the relationship between depression and pain.}, Doi = {10.1016/0304-3959(94)90050-7}, Key = {fds273883} } @article{fds273885, Author = {Keefe, FJ and Hauck, ER and Egert, J and Rimer, B and Kornguth, P}, Title = {Mammography pain and discomfort: a cognitive-behavioral perspective.}, Journal = {Pain}, Volume = {56}, Number = {3}, Pages = {247-260}, Year = {1994}, Month = {March}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8022619}, Abstract = {Although some women report having little pain or discomfort during mammography, other women find mammography to be a painful and uncomfortable experience. Cognitive and behavioral factors may influence the perception of pain and discomfort during mammography. This review critically evaluates the research on mammography pain from a cognitive-behavioral perspective. The review is in three sections. The first reviews studies measuring pain and discomfort in women who have recently had mammograms and studies investigating the relative importance of pain and discomfort in influencing women's decisions to have a mammogram. The second section presents a cognitive-behavioral model of mammography pain that is based on theories of behavior and self-regulation developed by Kanfer and Hagerman (1987). The review concludes with a discussion of the implications of the cognitive-behavioral perspective for clinical management and research on mammography pain and discomfort.}, Doi = {10.1016/0304-3959(94)90163-5}, Key = {fds273885} } @article{fds304933, Author = {Giorgino, KB and Blaloc, SJ and Devellis, RF and Devellis, BM and Keefe, FJ and Jordan, JM}, Title = {Appraisal of and coping with arthritis‐related problems in household activities, leisure activities, and pain management}, Journal = {Arthritis & Rheumatism}, Volume = {7}, Number = {1}, Pages = {20-28}, Publisher = {WILEY}, Year = {1994}, Month = {January}, ISSN = {2151-4658}, url = {http://dx.doi.org/10.1002/art.1790070106}, Abstract = {Purpose. We examined whether or not there are systematic differences in how people appraise different types of illness‐related problems and in how they cope with these problems. Methods. Two hundred thirty‐five adults with recently diagnosed rheumatoid arthritis completed a mailed questionnaire followed by a telephone interview. A series of stress appraisal and coping variables were assessed in relation to three areas: household activities, leisure activities, and pain management. Results. Pain Differed significantly from household and leisure activities with regard to several appraisal and coping variables. Participants reported the least control over problems with pain, while attaching the most importance to pain control. Leisure activities also stood out as unique on several variables. Participants perceived greater ability and were more satisfied with their ability in relation to leisure activities. Conclusion. These findings show that, at least early in the disease, appraisal and coping strategies differ across the areas of household activities, leisure activities, and pain management. Copyright © 1994 American College of Rheumatology}, Doi = {10.1002/art.1790070106}, Key = {fds304933} } @article{fds372599, Author = {KEEFE, FJ and LEFEBVRE, J}, Title = {PAIN BEHAVIOR CONCEPTS - CONTROVERSIES, CURRENT STATUS, AND FUTURE DIRECTIONS}, Journal = {PROCEEDINGS OF THE 7TH WORLD CONGRESS ON PAIN}, Volume = {2}, Pages = {127-147}, Publisher = {INT ASSOC STUDY PAIN (IASP) PRESS}, Editor = {Gebhart, GF and Hammond, DL and Jensen, TS}, Year = {1994}, Month = {January}, ISBN = {0-931092-07-8}, Key = {fds372599} } @article{fds273884, Author = {Giorgino, KB and Blalock, SJ and DeVellis, RF and DeVellis, BM and Keefe, FJ and Jordan, JM}, Title = {Appraisal and coping with rheumatoid arthritis related problems across three areas: Household activities, leisure activities, and pain management}, Journal = {Arthritis Care and Research}, Volume = {7}, Number = {1}, Pages = {20-28}, Year = {1994}, ISSN = {2151-4658}, Abstract = {Purpose. We examined whether or not there are systematic differences in how people appraise different types of illness-related problems and in how they cope with these problems. Methods. Two hundred thirty-five adults with recently diagnosed rheumatoid arthritis completed a mailed questionnaire followed by a telephone interview. A series of stress appraisal and coping variables were assessed in relation to three areas: household activities, leisure activities, and pain management. Results. Pain differed significantly from household and leisure activities with regard to several appraisal and coping variables. Participants reported the least control over problems with pain, while attaching the most importance to pain control. Leisure activities also stood out as unique on several variables. Participants perceived greater ability and were more satisfied with their ability in relation to leisure activities. Conclusion. These findings show that, at least early in the disease, appraisal and coping strategies differ across the areas of household activities, leisure activities, and pain management.}, Key = {fds273884} } @article{fds304932, Author = {Keefe, FJ and Van Horn and Y}, Title = {Cognitive-behavioral treatment of rheumatoid arthritis pain: maintaining treatment gains.}, Journal = {Arthritis Care Res}, Volume = {6}, Number = {4}, Pages = {213-222}, Publisher = {WILEY}, Year = {1993}, Month = {December}, ISSN = {2151-4658}, url = {http://dx.doi.org/10.1002/art.1790060408}, Abstract = {OBJECTIVE: This paper critically reviews research studies examining the long-term effects of cognitive-behavioral therapy interventions for managing pain in rheumatoid arthritis patients. METHODS AND RESULTS: The first section of the paper evaluates long-term results obtained in studies of cognitive-behavioral therapy, arthritis education interventions, and combined cognitive-behavioral therapy-arthritis education interventions. These studies show that although some rheumatoid arthritis patients are able to maintain initial improvements in pain and disability, other rheumatoid arthritis patients do not. In the second section of this review, a cognitive-behavioral model of maintenance of pain coping skills is presented. This model may be useful in increasing our understanding of the relapse process and in planning interventions to enhance and prolong cognitive-behavioral therapy treatment gains. The final section of this paper addresses important future directions for research. The need for empirical studies of relapse and maintenance processes is underscored. CONCLUSIONS: Controlled studies are needed to test the utility of new cognitive-behavioral interventions designed to enhance the long-term maintenance of treatment gains in RA patients. We suggest that a focus on issues of relapse and maintenance may be just as important for medical and surgical interventions for rheumatoid arthritis pain, as it is for cognitive-behavioral therapy interventions.}, Doi = {10.1002/art.1790060408}, Key = {fds304932} } @article{fds273893, Author = {Parker, JC and Bradley, LA and DeVellis, RM and Gerber, LH and Holman, HR and Keefe, FJ and Lawrence, TS and Liang, MH and Lorig, KR and Nicassio, PM}, Title = {Biopsychosocial contributions to the management of arthritis disability. Blueprints from an NIDRR-sponsored conference.}, Journal = {Arthritis Rheum}, Volume = {36}, Number = {7}, Pages = {885-889}, Year = {1993}, Month = {July}, url = {http://dx.doi.org/10.1002/art.1780360703}, Abstract = {The contributions of MACs and RRTCs to the generation of arthritis-related biopsychosocial research over the last 15 years have been enormous. However, the assimilation of biopsychosocial concepts into mainstream clinical practice, professional education, and public awareness will require a sustained national effort.}, Doi = {10.1002/art.1780360703}, Key = {fds273893} } @article{fds273894, Author = {Tota-Faucette, ME and Gil, KM and Williams, DA and Keefe, FJ and Goli, V}, Title = {Predictors of response to pain management treatment. The role of family environment and changes in cognitive processes.}, Journal = {Clin J Pain}, Volume = {9}, Number = {2}, Pages = {115-123}, Year = {1993}, Month = {June}, ISSN = {0749-8047}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8358134}, Abstract = {OBJECTIVE: The purpose of the present study was to examine factors that influence individual differences in treatment response after multidisciplinary pain management. DESIGN: Pre-post assessment design. PATIENTS: 119 chronic pain inpatients. MAIN MEASURES: Outcome measures included pain report from the McGill Pain Questionnaire, emotional distress from the Symptom Checklist-90 Revised, and activity discomfort from the Activity Discomfort Scale. Process measures included the Family Environment Scale, the Coping Strategies Questionnaire, and the Inventory of Negative Thoughts in Response to Pain. RESULTS: Results indicated that pretreatment family environment, cognitive coping strategies, and negative thinking accounted for small yet significant proportions of the variance in outcome. The proportion of variance accounted for by the changes in cognitive coping and negative thinking was somewhat higher. An increase in pain control and rational thinking was related to decreases in depression and anxiety, pain report, and activity discomfort. Decreases in negative social cognitions were related to decreased depression at posttreatment. CONCLUSIONS: Changes in coping strategies and negative thinking may be important mechanisms related to improvement, or lack of improvement, in a range of outcome measures. Patients from families who are controlling and disorganized, and patients high on negative thinking at pretreatment may represent high-risk groups in need of further individually tailored interventions.}, Doi = {10.1097/00002508-199306000-00006}, Key = {fds273894} } @article{fds273892, Author = {Keefe, FJ and Van Horn and Y}, Title = {Cognitive-behavioral treatment of rheumatoid arthritis pain: Understanding and enhancing maintenance of treatment gains}, Journal = {Arthritis Care and Research}, Volume = {6}, Number = {4}, Pages = {213-222}, Year = {1993}, ISSN = {2151-4658}, Abstract = {Objective. This paper critically reviews research studies examining the long-term effects of cognitive-behavioral therapy interventions for managing pain in rheumatoid arthritis patients. Methods and Results. The first section of the paper evaluates long-term results obtained in studies of cognitive-behavioral therapy, arthritis education interventions, and combined cognitive-behavioral therapy-arthritis education interventions. These studies show that although some rheumatoid arthritis patients are able to maintain initial improvements in pain and disability, other rheumatoid arthritis patients do not. In the second section of this review, a cognitive-behavioral model of maintenance of pain coping skills is presented. This model may be useful in increasing our understanding of the relapse process and in planning interventions to enhance and prolong cognitive-behavioral therapy treatment gains. The final section of this paper addresses important future directions for research. The need for empirical studies of relapse and maintenance processes is underscored. Conclusions. Controlled studies are needed to test the utility of new cognitive-behavioral interventions designed to enhance the long-term maintenance of treatment gains in RA patients. We suggest that a focus on issues of relapse and maintenance may be just as important for medical and surgical interventions for rheumatoid arthritis pain, as it is for cognitive-behavioral therapy interventions.}, Key = {fds273892} } @article{fds273897, Author = {Wilkie, DJ and Keefe, FJ and Dodd, MJ and Copp, LA}, Title = {Behavior of patients with lung cancer: description and associations with oncologic and pain variables.}, Journal = {Pain}, Volume = {51}, Number = {2}, Pages = {231-240}, Year = {1992}, Month = {November}, url = {http://dx.doi.org/10.1016/0304-3959(92)90264-C}, Abstract = {Although reflexes are recognized as protective responses to noxious stimuli, less is known about voluntary behavioral responses to cancer pain, which could provide clinicians with important diagnostic and therapeutic information. Forty-five patients with lung cancer were studied in their homes on 2 occasions to identify pain behaviors and to examine relationships between behaviors and selected variables. Patients completed the McGill Pain Questionnaire (MPQ) and Visual Analogue scale (VAS). Using a videotape observation method, patients sat, stood, walked, and reclined for 10 min. Videotapes were scored using 5 position-related and 31 pain-related behavior definitions. Within 3 days scored behaviors were described to patients who reported whether each scored behavior was performed: to express pain; because pain prevented usual behavior; to control pain; or as a habit. Patients reported that pain was controlled by 42 different behaviors; the number of different pain-reduction behaviors was correlated with pain intensity (r = 0.44) and pain quality (r = 0.64). Simultaneous multiple regression indicated that length of time pain was experienced, number of pain sites, pain quality, and pain intensity accounted for 41% of the variance in the number of pain control behaviors. None of the taped behaviors was reported as performed to express pain, and few of the patients reported that pain prevented behavior during the video session. Results clarify the pain-behavior construct, provide insight about the multidimensional nature of lung cancer pain, and suggest directions for behavioral interventions to augment pharmacological therapy for lung cancer pain.}, Doi = {10.1016/0304-3959(92)90264-C}, Key = {fds273897} } @article{fds273898, Author = {Blalock, SJ and DeVellis, BM and DeVellis, RF and Giorgino, KB and Sauter, SV and Jordan, JM and Keefe, FJ and Mutran, EJ}, Title = {Psychological well-being among people with recently diagnosed rheumatoid arthritis. Do self-perceptions of abilities make a difference?}, Journal = {Arthritis Rheum}, Volume = {35}, Number = {11}, Pages = {1267-1272}, Year = {1992}, Month = {November}, ISSN = {0004-3591}, url = {http://dx.doi.org/10.1002/art.1780351105}, Abstract = {OBJECTIVE: Satisfaction with abilities and perceived importance of abilities are 2 factors involved in the process of self-evaluation. We examined the role that these factors play in adjustment to rheumatoid arthritis (RA). METHODS: Data were collected, via telephone interview and mailed questionnaire, from 234 individuals with recently diagnosed RA. Disease severity information was obtained from participants' physicians. RESULTS: Consistent with study hypotheses, satisfaction was associated with psychological well-being only among those who viewed as very important the abilities being evaluated. CONCLUSION: These findings increase understanding of the conditions under which low levels of satisfaction are likely to be associated with psychological distress.}, Doi = {10.1002/art.1780351105}, Key = {fds273898} } @article{fds273907, Author = {Keefe, FJ and Salley, AN and Lefebvre, JC}, Title = {Coping with pain: conceptual concerns and future directions.}, Journal = {Pain}, Volume = {51}, Number = {2}, Pages = {131-134}, Year = {1992}, Month = {November}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(92)90253-8}, Doi = {10.1016/0304-3959(92)90253-8}, Key = {fds273907} } @article{fds273900, Author = {Beckham, JC and Caldwell, DS and Peterson, BL and Pippen, AM and Currie, MS and Keefe, FJ and Weinberg, JB}, Title = {Disease severity in rheumatoid arthritis: relationships of plasma tumor necrosis factor-alpha, soluble interleukin 2-receptor, soluble CD4/CD8 ratio, neopterin, and fibrin D-dimer to traditional severity and functional measures.}, Journal = {J Clin Immunol}, Volume = {12}, Number = {5}, Pages = {353-361}, Year = {1992}, Month = {September}, ISSN = {0271-9142}, url = {http://www.ncbi.nlm.nih.gov/pubmed/1430106}, Abstract = {Rheumatoid arthritis is a complex inflammatory disease of unknown cause. Although various laboratory and clinical measurements are useful in managing these patients, there is a need for better tests to quantitatively assess disease activity. The purpose of this study was to investigate the association of certain immune and inflammation (I-I) parameters with four traditional disease severity measures and a functional measure in rheumatoid arthritis patients. A single set of patient blood samples was analyzed, and four traditional disease severity measures and patient functional statuses were determined from 64 consecutive outpatients with rheumatoid arthritis. Plasma tumor necrosis factor-alpha (TNF), soluble interleukin-2 receptor (sIL-2R), sCD4 and sCD8 (and the sCD4/sCD8 ratio), neopterin, and fibrin D-dimer were analyzed in relationship to Westergren erythrocyte sedimentation rate (ESR), physician assessment of disease activity, joint pain count, grip strength, and Arthritis Impact Measurement Scale (AIMS) scores. Rheumatoid arthritis patients had higher mean levels of all I-I measures (except sCD4) compared to healthy subjects. Initial significant correlations between TNF, sIL-2R, and D-dimer and several disease severity and functional measures were detected. When we controlled for the covariates age, gender, race, and medications, regression analyses indicated that, as a group, the I-I measures were significantly related to grip strength, physician disease severity rating, ESR, and total joint pain. When the predictive values of the I-I measures were tested controlling for the covariates and ESR, D-dimer was independently and significantly associated with variability in grip strength, physician disease severity, and AIMS physical disability, while TNF was associated with a significant amount of variability in total joint pain.(ABSTRACT TRUNCATED AT 250 WORDS)}, Doi = {10.1007/BF00920793}, Key = {fds273900} } @article{fds273901, Author = {Von Korff and M and Ormel, J and Keefe, FJ and Dworkin, SF}, Title = {Grading the severity of chronic pain.}, Journal = {Pain}, Volume = {50}, Number = {2}, Pages = {133-149}, Year = {1992}, Month = {August}, url = {http://dx.doi.org/10.1016/0304-3959(92)90154-4}, Abstract = {This research develops and evaluates a simple method of grading the severity of chronic pain for use in general population surveys and studies of primary care pain patients. Measures of pain intensity, disability, persistence and recency of onset were tested for their ability to grade chronic pain severity in a longitudinal study of primary care back pain (n = 1213), headache (n = 779) and temporomandibular disorder pain (n = 397) patients. A Guttman scale analysis showed that pain intensity and disability measures formed a reliable hierarchical scale. Pain intensity measures appeared to scale the lower range of global severity while disability measures appeared to scale the upper range of global severity. Recency of onset and days in pain in the prior 6 months did not scale with pain intensity or disability. Using simple scoring rules, pain severity was graded into 4 hierarchical classes: Grade I, low disability--low intensity; Grade II, low disability--high intensity; Grade III, high disability--moderately limiting; and Grade IV, high disability--severely limiting. For each pain site, Chronic Pain Grade measured at baseline showed a highly statistically significant and monotonically increasing relationship with unemployment rate, pain-related functional limitations, depression, fair to poor self-rated health, frequent use of opioid analgesics, and frequent pain-related doctor visits both at baseline and at 1-year follow-up. Days in Pain was related to these variables, but not as strongly as Chronic Pain Grade. Recent onset cases (first onset within the prior 3 months) did not show differences in psychological and behavioral dysfunction when compared to persons with less recent onset. Using longitudinal data from a population-based study (n = 803), Chronic Pain Grade at baseline predicted the presence of pain in the prior 2 weeks. Chronic Pain Grade and pain-related functional limitations at 3-year follow-up. Grading chronic pain as a function of pain intensity and pain-related disability may be useful when a brief ordinal measure of global pain severity is required. Pain persistence, measured by days in pain in a fixed time period, provides useful additional information.}, Doi = {10.1016/0304-3959(92)90154-4}, Key = {fds273901} } @article{fds273902, Author = {Keefe, FJ and Dunsmore, J and Burnett, R}, Title = {Behavioral and cognitive-behavioral approaches to chronic pain: recent advances and future directions.}, Journal = {J Consult Clin Psychol}, Volume = {60}, Number = {4}, Pages = {528-536}, Year = {1992}, Month = {August}, ISSN = {0022-006X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/1506501}, Abstract = {Behavioral and cognitive-behavioral approaches to chronic pain are receiving increasing attention from researchers and clinicians. This article reviews and highlights recent research advances and future research directions. Assessment research reviewed includes studies examining the social context of pain, the relationship of chronic pain to depression, cognitive variables affecting pain, and comprehensive assessment measures. Treatment outcome studies reviewed are those evaluating the effects of behavioral and cognitive-behavioral treatments for chronic pain. These studies focus on comparisons of behavioral treatment with control conditions, comparisons of two behavioral treatments, and prevention of chronic pain. Future directions for assessment and treatment research are outlined.}, Doi = {10.1037//0022-006x.60.4.528}, Key = {fds273902} } @article{fds273906, Author = {Buckelew, SP and Conway, RC and Shutty, MS and Lawrence, JA and Grafing, MR and Anderson, SK and Hewett, JE and Keefe, FJ}, Title = {Spontaneous coping strategies to manage acute pain and anxiety during electrodiagnostic studies.}, Journal = {Arch Phys Med Rehabil}, Volume = {73}, Number = {6}, Pages = {594-598}, Year = {1992}, Month = {June}, ISSN = {0003-9993}, Abstract = {Electrodiagnostic studies produce both anxiety and pain, which can prevent adequate examination and limit the usefulness of test results. This study examined the spontaneous coping strategies used to manage the pain and anxiety experienced during electrodiagnostic testing. Fifty patients (26 women and 24 men) evaluated in our electrodiagnostic laboratory were administered visual analogue scale (VAS) pain and anxiety measures and the Spielberger State-Trait Anxiety Inventory (STAI) before the procedure. Immediately after the procedure, subjects reported pain, anxiety, and coping strategies used during electrodiagnostic testing using the VAS, the STAI, and a situation-specific version of the Coping Strategies Questionnaire (CSQ-S). The CSQ-S appears to be a valid and reliable measure of spontaneous coping strategies. Multiple-regression analyses revealed that frequent use of catastrophizing, diverting attention, and coping self-statement strategies was significantly and positively correlated with pain, whereas reinterpreting pain was significantly and negatively associated with pain. Judgments of control over pain were also significantly and negatively associated with anxiety experienced during electrodiagnostic studies. Physicians' ratings of pain and anxiety were highly correlated with patients' self-reports. This study suggests that ineffective coping strategies may enhance the pain and anxiety experienced during electromyography. Alternatively, teaching subjects active self-control skills and increasing patients' self-efficacy beliefs may help manage this situation-specific acute anxiety and, possibly, the associated pain.}, Key = {fds273906} } @article{fds273896, Author = {Holroyd, KA and Holm, JE and Keefe, FJ and Turner, JA and Bradley, LA and Murphy, WD and Johnson, P and Anderson, K and Hinkle, AL and O'Malley, BW}, Title = {A multi-center evaluation of the McGill Pain Questionnaire: results from more than 1700 chronic pain patients.}, Journal = {Pain}, Volume = {48}, Number = {3}, Pages = {301-311}, Year = {1992}, Month = {March}, url = {http://dx.doi.org/10.1016/0304-3959(92)90077-O}, Abstract = {We argue that the conflicting results reported in previous studies examining the factor structure of the McGill Pain Questionnaire Pain Rating Index (PRI) can be explained by differences in the patient samples and statistical analyses used across studies. In an effort to clarify the factor structure of the PRI, 3 different factor models were compared using confirmatory factor analysis in 2 samples of low-back pain patients (N = 1372) and in a third sample of patients suffering from other chronic pain problems (N = 423). A 4-factor model, similar to those obtained in previous studies where multiple criteria were used to determine the number of factors extracted, best explained covariation among PRI subclasses. However, relatively high interfactor correlations (approximately two-thirds of the variance explained by the best fitting factor structure was common variance) cast doubt on the discriminant validity of PRI subscales; examination of relationships between the PRI and MMPI subscales also failed to provide evidence of the discriminant validity or clinical utility of PRI subscales. Reducing the information from the 10 PRI sensory subclasses to a single subscale score may seriously limit the usefulness of the PRI. Alternate methods of using PRI data are suggested.}, Doi = {10.1016/0304-3959(92)90077-O}, Key = {fds273896} } @article{fds273903, Author = {Keefe, FJ and Dunsmore, J}, Title = {The multifaceted nature of pain behavior}, Journal = {APS Journal}, Volume = {1}, Number = {2}, Pages = {112-114}, Publisher = {Elsevier BV}, Year = {1992}, Month = {January}, ISSN = {1058-9139}, url = {http://dx.doi.org/10.1016/1058-9139(92)90039-F}, Doi = {10.1016/1058-9139(92)90039-F}, Key = {fds273903} } @article{fds273904, Author = {Keefe, FJ and Dunsmoret, J}, Title = {Pain behavior concepts and controversies}, Journal = {APS Journal}, Volume = {1}, Number = {2}, Pages = {92-100}, Publisher = {Elsevier BV}, Year = {1992}, Month = {January}, ISSN = {1058-9139}, url = {http://dx.doi.org/10.1016/1058-9139(92)90035-B}, Abstract = {This article summarizes recent research on pain behavior observation and highlights a number of controversial issues involved in applying this approach to the assessment of chronic pain patients. The article is divided into two major sections. In the first section, a number of observation methods used to record pain behavior in standardized situations and naturalistic settings are described. The reliability and validity of these observation methods, and their advantages and disadvantages, are discussed. The second section addresses five criticisms of the pain behavior construct. These criticisms include: the pain behavior construct is too simplistic, the focus on pain behavior denies the existence of pain, the questions of whether pain behavior is an expression of pain or a coping response, the measures of pain behavior may not be useful in clinical settings, and the notion that pain behavior has been oversold. The criticisms are evaluated from a behavioral perspective and the discussion highlights the potential utility of the pain behavior construct. The paper concludes with suggestions for future research. © 1992.}, Doi = {10.1016/1058-9139(92)90035-B}, Key = {fds273904} } @article{fds273895, Author = {Linton, SJ and Keefe, FJ and Jansson, O and Aslaksen, K}, Title = {The Outcome Evaluation Questionnaire: Preliminary findings from a sampe of actue pain patients}, Journal = {Scandinavian Journal of Behavior Therapy}, Volume = {21}, Number = {4}, Pages = {163-170}, Publisher = {Informa UK Limited}, Year = {1992}, url = {http://dx.doi.org/10.1080/16506079209455911}, Abstract = {This paper examines the test-retest reliability, internal validity, and compliance to complete the Outcome Evaluation Questionnaire (OEQ) with a sample of patients seeking care for acute musculoskeletal problems. The OEQ is a brief questionnaire designed to provide a basic measure of behavioral and cognitive responses. Participants were asked to complete the form during a visit to an occupational health care facility. Results showed that all patients completed the questionnaire and compliance to answer properly each individual item ranged from 84% to 100%. Items that required patients to provide frequency estimates had the lowest compliance rates. Test-retest reliability was high for most items and ranged between.42 and.96. An intercorrelation matrix showed several moderate relationships which may indicate internal consistency as well as show that the items do not tend to measure the same entity. Taken together with previous findings, the OEQ appears to be a reliable and valid instrument which may be helpful in conducting cognitive-behavioral assessments of patients having pain. © 1992 Taylor & Francis Group, LLC.}, Doi = {10.1080/16506079209455911}, Key = {fds273895} } @article{fds273899, Author = {Keefe, FJ and Robinson, E}, Title = {Psychological and behavioral aspects of pain}, Journal = {Current Opinion in Anaestheosiology}, Volume = {5}, Pages = {698-704}, Year = {1992}, Key = {fds273899} } @article{fds273905, Author = {Keefe, FJ and Linton, SJ and Lefebvre, JC}, Title = {The Outcome Evaluation Questionnaire: Description and initial findings}, Journal = {Scandinavian Journal of Behavior Therapy}, Volume = {21}, Number = {1}, Pages = {19-33}, Publisher = {Informa UK Limited}, Year = {1992}, url = {http://dx.doi.org/10.1080/16506079209455886}, Abstract = {This paper describes the Outcome Evaluation Questionnaire (OEQ) and presents preliminary OEQ data gathered from a sample of 147 chronic pain patients. The OEQ is designed to provide a basic measure of behavioral and cognitive responses to pain. It includes items measuring pain, pain medication intake, sleep problems, mood, negative cognitions, and functional impairment. The OEQ is relatively brief (14 items) and easy to score. Results of this study provide support for the validity of OEQ items measuring pain intensity, sleep quality/sleep onset difficulties, depression, irritability and negative cognitions (negative thoughts of worthlessness and pain interference). OEQ items that required patients to provide fequency estimates (e.g number of pain-free days, days out of work) were problematic in that they were generally skewed in this chronic pain population. With further refinements the OEQ could provide a practical method for conducting cognitive-behavioral assessments of patients having pain. © 1992 Taylor & Francis Group, LLC.}, Doi = {10.1080/16506079209455886}, Key = {fds273905} } @article{fds273908, Author = {Wilkie, DJ and Keefe, FJ}, Title = {Coping strategies of patients with lung cancer-related pain.}, Journal = {Clin J Pain}, Volume = {7}, Number = {4}, Pages = {292-299}, Year = {1991}, Month = {December}, url = {http://dx.doi.org/10.1097/00002508-199112000-00007}, Abstract = {Previous findings in patients with nonmalignant pain indicate a relationship between pain coping strategies and psychological factors. Although coping strategies have been explored in patients with cancer pain, relationships with such factors have not been reported. We wished to examine relationships between selected pain and psychological variables and the use of pain coping strategies. Forty-five patients with pain related to lung cancer indicated how they expressed their pain to others and completed the McGill-Melzack Pain Questionnaire (MPQ), State-Trait Anxiety Inventory, Visual Analogue Scale of pain intensity, and the Coping Strategies Questionnaire (CSQ). Forty-two percent of the patients reported that they tried not to let others know they had pain, and 40% indicated they told others when they had pain. Preferences for not telling others was associated with more frequent pain coping attempts for all CSQ subscales but those of catastrophizing and reinterpreting pain sensation. State anxiety demonstrated positive correlation with catastrophizing coping strategies (r = 0.48) and negative correlation with ability to control (r = -0.50) and decrease (r = -0.50) pain. The number of pain sites was correlated with coping self-statements (r = 0.34). Pain intensity and state anxiety demonstrated similar relationships. Pain quality as measured with the MPQ demonstrated moderately strong correlation with diverting attention, praying and hoping, catastrophizing, and increased activity. Interventions aimed at reinforcing or expanding a patient's pain coping repertoire should be developed with consideration given to the patient's anxiety level, pain intensity, pain quality, and pain expression preference.}, Doi = {10.1097/00002508-199112000-00007}, Key = {fds273908} } @article{fds304104, Author = {Keefe, FJ and Caldwell, DS and Martinez, S and Nunley, J and Beckham, J and Williams, DA}, Title = {Analyzing pain in rheumatoid arthritis patients. Pain coping strategies in patients who have had knee replacement surgery.}, Journal = {Pain}, Volume = {46}, Number = {2}, Pages = {153-160}, Year = {1991}, Month = {August}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/1749638}, Abstract = {This study used the Coping Strategies Questionnaire (CSQ) to investigate pain coping strategies in 52 rheumatoid arthritis patients who reported having knee pain 1 year or more following knee replacement surgery. Data analysis revealed that, as a group, these patients were active copers in that they reported frequent use of a variety of pain coping strategies. Pain coping strategies were found to be related to measures of pain and adjustment. Patients who rated their ability to control and decrease pain high and who rarely engaged in catastrophizing (i.e., who scored high on the Pain Control and Rational Thinking factor of the CSQ) had much lower levels of pain and psychological disability than patients who did not. Coping strategies were not found to relate to age, gender, obesity status or disability/compensation status. Taken together, these results suggest that an analysis of pain coping strategies may be helpful in understanding pain in arthritis patients who have pain following joint replacement surgery.}, Doi = {10.1016/0304-3959(91)90070-E}, Key = {fds304104} } @article{fds273910, Author = {Williams, DA and Keefe, FJ}, Title = {Pain beliefs and the use of cognitive-behavioral coping strategies.}, Journal = {Pain}, Volume = {46}, Number = {2}, Pages = {185-190}, Year = {1991}, Month = {August}, url = {http://dx.doi.org/10.1016/0304-3959(91)90074-8}, Abstract = {Patients' beliefs about chronic pain, such as how long it will last and whether it is a mysterious experience, have been shown to be related to compliance with treatment programs. The present study examined whether these pain beliefs related to a specific component of pain management, namely the frequency of use and the perceived effectiveness of cognitive and behavioral coping strategies. One hundred twenty chronic pain patients were administered the Pain Beliefs and Perceptions inventory (PBAPI) and the Coping Strategies questionnaire (CSQ). A cluster analysis of 2 pain beliefs (that pain is enduring and that pain is mysterious) was conducted revealing 3 distinct subgroups of patients based upon these 2 beliefs. Multivariate analysis of variance was used to detect whether the use of cognitive-behavioral pain coping strategies differed in patients in the 3 pain beliefs subgroups. The results indicated that patients belonging to the group characterized by the belief that pain was enduring and mysterious were less likely to use cognitive coping strategies (e.g., reinterpretation of pain sensation), more likely to catastrophize, and less likely to rate their coping strategies as effective in controlling and decreasing pain than patients believing their pain to be understandable and of short duration. The implications of these results for understanding the patient's choice of and compliance with treatment and coping efforts is discussed.}, Doi = {10.1016/0304-3959(91)90074-8}, Key = {fds273910} } @article{fds273913, Author = {Beckham, JC and Keefe, FJ and Caldwell, DS and Brown, CJ}, Title = {Biofeedback as a means to alter electromyographic activity in a total knee replacement patient.}, Journal = {Biofeedback Self Regul}, Volume = {16}, Number = {1}, Pages = {23-35}, Year = {1991}, Month = {March}, ISSN = {0363-3586}, url = {http://www.ncbi.nlm.nih.gov/pubmed/2012824}, Abstract = {This paper presents a single case controlled study of a 75-year-old male having bilateral total knee replacement. Baseline EMG recordings demonstrated differential levels of vastus medialis and vastus lateralis muscle activity in both knees during exercise, with increased vastus lateralis activity compared to vastus medialis activity. The purpose of the study was to use electromyographic (EMG) biofeedback training to train the patient to equalize vastus medialis and vastus lateralis EMG activity during exercise. After 11 and 13 training sessions for the left and right knees, respectively, differences between vastus medialis and vastus lateralis activity had markedly decreased. Following the termination of biofeedback training, EMG activity during exercise showed a return toward baseline levels. Several concomitant changes in psychological and physical function were noted. These results suggested that EMG biofeedback can be used to train vastus medialis and vastus lateralis activity in total knee replacement patients, and that biofeedback training may produce positive benefits in other functional areas.}, Doi = {10.1007/BF01000443}, Key = {fds273913} } @article{fds273793, Author = {Keefe, FJ}, Title = {Editorial}, Journal = {Annals of Behavioral Medicine}, Volume = {13}, Number = {3}, Pages = {ii}, Year = {1991}, Month = {January}, Key = {fds273793} } @article{fds273911, Author = {Beckham, JC and Keefe, FJ and Caldwell, DS and Roodman, AA}, Title = {Pain coping strategies in rheumatoid arthritis: Relationships to pain, disability, depression and daily hassles}, Journal = {Behavior Therapy}, Volume = {22}, Number = {1}, Pages = {113-124}, Publisher = {Elsevier BV}, Year = {1991}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(05)80249-7}, Abstract = {The present study investigated the relation of pain coping strategies to physical disability, pain, psychological disability, depression and daily hassles in rheumatoid arthritis (RA) patients. Subjects were 65 RA patients recruited from an outpatient rheumatology clinic. Each subject completed the Coping Strategies Questionnaire (CSQ), The Arthritis Impact Measurement Scale (AIMS), the Beck Depression Inventory (BDI) and the Hassles Scale. Correlational analyses indicated that the Pain Control and Rational Thinking (PCRT) factor of the CSQ was strongly related to measures of adjustment. Regression analyses revealed that after controlling for demographic variables (age, gender) and medical variables (functional classification, disability support status), the PCRT factor of the CSQ explained a significant proportion of variance in physical disability, pain, psychological disability, depression, and hassles severity. Patients scoring high on the PCRT factor had lower levels of physical disability, pain, psychological disability, depression and hassles severity. Taken together, these findings suggest that pain coping strategies in RA patients are significantly related to pain and disability. © 1991 Association for Advancement of Behavior Therapy. All rights reserved.}, Doi = {10.1016/S0005-7894(05)80249-7}, Key = {fds273911} } @article{fds273909, Author = {Keefe, FJ and Fillingim, RB and Williams, DA}, Title = {Behavioral assessment of pain: Non-verbal measures in animals and humans}, Journal = {Institute of Laboratory Animal Resources News}, Volume = {33}, Pages = {3-13}, Year = {1991}, Key = {fds273909} } @article{fds273912, Author = {Keefe, FJ and Caldwell, DS and Martinez, S and Nunley, J and Beckham, J and Williams, DA}, Title = {Analyzing pain in rheumatoid arthritis patients: Pain coping strategies in patients who have had knee replacement surgery}, Journal = {Pain}, Volume = {46}, Number = {2}, Pages = {154-160}, Year = {1991}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/1749638}, Abstract = {This study used the Coping Strategies Questionnaire (CSQ) to investigate pain coping strategies in 52 rheumatoid arthritis patients who reported having knee pain 1 year or more following knee replacement surgery. Data analysis revealed that, as a group, these patients were active copers in that they reported frequent use of a variety of pain coping strategies. Pain coping strategies were found to be related to measures of pain and adjustment. Patients who rated their ability to control and decrease pain high and who rarely engaged in catastrophizing (i.e., who scored high on the Pain Control and Rational Thinking factor of the CSQ) had much lower levels of pain and psychological disability than patients who did not. Coping strategies were not found to relate to age, gender, obesity status or disability/compensation status. Taken together, these results suggest that an analysis of pain coping strategies may be helpful in understanding pain in arthritis patients who have pain following joint replacement surgery.}, Key = {fds273912} } @article{fds273914, Author = {Lawson, K and Reesor, KA and Keefe, FJ and Turner, JA}, Title = {Dimensions of pain-related cognitive coping: cross-validation of the factor structure of the Coping Strategy Questionnaire.}, Journal = {Pain}, Volume = {43}, Number = {2}, Pages = {195-204}, Year = {1990}, Month = {November}, url = {http://dx.doi.org/10.1016/0304-3959(90)91073-R}, Abstract = {Previous research has demonstrated a relationship between cognitive pain coping activity and adjustment in pain patients. The empirically derived dimensions of coping activity, as measured by scales from the Coping Strategy Questionnaire (CSQ), however, have varied across investigations. The purpose of this investigation was to determine both the content and number of dimensions of the CSQ and to explore the potential moderating influence that sociodemographic and patient history variables may have on the latent structure of the CSQ. A total of 620 patients from 5 different chronic pain patient samples were used to assess the generalizability of the dimensions across samples. Confirmatory factor analytic procedures identified a 3-factor solution in most of the samples that was robust across various demographic characteristics. Two factors appeared particularly robust: one reflected conscious use of cognitive coping strategies (with high loadings on ignoring pain and coping self-statements) and another reflected self-efficacy beliefs concerning pain (with high loadings on ability to control and decrease pain). A third factor, which was somewhat less stable, appeared to reflect avoidance of pain by attention to non-pain-related mental activity (with high loadings on diverting attention and praying and hoping). Scales reflecting catastrophizing cognitions and behavioral coping strategies did not consistently load on the above dimensions. Issues concerning the conceptualization and measurement of pain-related cognitive coping dimensions are discussed.}, Doi = {10.1016/0304-3959(90)91073-R}, Key = {fds273914} } @article{fds273920, Author = {Keefe, FJ and Williams, DA}, Title = {A comparison of coping strategies in chronic pain patients in different age groups.}, Journal = {J Gerontol}, Volume = {45}, Number = {4}, Pages = {P161-P165}, Year = {1990}, Month = {July}, ISSN = {0022-1422}, url = {http://www.ncbi.nlm.nih.gov/pubmed/2365972}, Abstract = {This study examined the effects of age on the frequency of use and perceived effectiveness of coping strategies in patients having chronic pain. Subjects were chronic pain patients in four age groups (young, middle, older, and geriatric). All subjects completed the Coping Strategies Questionnaire, which measures the use and perceived effectiveness of a variety of cognitive and behavioral coping strategies in controlling and decreasing pain. Subjects also completed measures of pain, depression, and psychological distress. Data analysis revealed that there were no significant age differences in either the use or perceived effectiveness of pain coping strategies. Correlational analyses based on data combined from the different age groups suggested that, while certain pain coping strategies appear to be adaptive (e.g., coping self-statements), other coping strategies appear to be maladaptive (e.g., catastrophizing, diverting attention, increasing behavioral activities). Patients who rated their ability to decrease pain as relatively high, reported lower levels of depression and pain. These findings are consistent with a contextual perspective on coping which postulates that few, if any, age differences in coping are to be expected when individuals are coping with a similar life event.}, Doi = {10.1093/geronj/45.4.p161}, Key = {fds273920} } @article{fds273918, Author = {Keefe, FJ and Crisson, J and Urban, BJ and Williams, DA}, Title = {Analyzing chronic low back pain: the relative contribution of pain coping strategies.}, Journal = {Pain}, Volume = {40}, Number = {3}, Pages = {293-301}, Year = {1990}, Month = {March}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/2139204}, Abstract = {Sixty-two chronic low back pain patients were administered the Coping Strategies Questionnaire (CSQ) to assess the frequency of use and perceived effectiveness of a variety of cognitive and behavioral pain coping strategies. Analysis of individual variables revealed that CSQ factors, gender, physical examination findings, and chronicity of pain had significant effects on one or more of a series of pain, psychological distress or behavioral measures. To assess the relative contribution of each of these variables hierarchical stepwise regression analyses were carried out. These analyses revealed that the Helplessness factor of the CSQ explained 50% of the variance in psychological distress (Global Severity Index of the SCL-90R), and 46% of the variance in depression (Beck Depression Inventory). Patients scoring high on this CSQ factor had significantly higher levels of psychological distress. None of the demographic or medical status variables explained a significant proportion of variance in the psychological distress measures. The Diverting Attention and Praying factor of the CSQ explained a moderate (9%), but significant amount of variance in pain report. Patients scoring high on this factor had higher scores on the McGill Pain Questionnaire. Coping strategies were not strongly related to pain behavior measures such as guarding or uptime. A consideration of pain coping strategies may allow one to design pain coping skills training interventions so as to fit the needs of the individual low back pain patient.}, Doi = {10.1016/0304-3959(90)91126-4}, Key = {fds273918} } @article{fds273919, Author = {Keefe, FJ and Beckham, JC}, Title = {Behavioral assessment of chronic orofacial pain.}, Journal = {Anesthesia progress}, Volume = {37}, Number = {2-3}, Pages = {76-81}, Year = {1990}, Month = {March}, ISSN = {0003-3006}, url = {http://www.ncbi.nlm.nih.gov/pubmed/2085202}, Abstract = {Orofacial pain is usually evaluated and treated from a biomedical perspective. There is no question that the large majority of individuals having acute orofacial pain benefit from timely and appropriate medical intervention. When orofacial pain persists, however, the likelihood that this pain can influence and be influenced by behavioral factors increases. While some individuals are able to adapt and cope with chronic orofacial pain, others develop significant behavioral problems. These problems may include an overly sedentary lifestyle, dependence on habit-forming narcotic medications, or severe depression or anxiety. The hallmark of the behavioral perspective on chronic pain is the insistence that a careful assessment and treatment of such behavioral problems is just as important as appropriate biomedical intervention.(1)}, Key = {fds273919} } @article{fds273922, Author = {Keefe, FJ and Bradley, LA and Crisson, JE}, Title = {Behavioral assessment of low back pain: identification of pain behavior subgroups.}, Journal = {Pain}, Volume = {40}, Number = {2}, Pages = {153-160}, Year = {1990}, Month = {February}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/2137905}, Abstract = {A hierarchical cluster analysis procedure was used to identify homogeneous subgroups of low back pain patients who show similar pain behavior patterns during a videotaped behavior sample. Subjects, 106 chronic low back pain patients, were divided into 2 samples. The cluster analysis procedure identified 4 very similar subgroups in sample 1 and sample 2. The first subgroup showed a low or moderate level of guarding and a low level of other pain behaviors. The second subgroup showed a high level of guarding and a moderate level of rubbing of the painful area. The third subgroup showed high levels of guarding and moderate levels of bracing and rubbing. The fourth subgroup exhibited a very high level of rubbing and moderate levels of bracing. The subgroups identified may require somewhat different approaches to pain assessment and treatment. The results of this study suggest that the variability in pain behavior evident in low back pain populations may be due to the fact that within these populations there are homogeneous subgroups of patients who differ in the motor pain behaviors they display.}, Doi = {10.1016/0304-3959(90)90066-M}, Key = {fds273922} } @article{fds273915, Author = {Keefe, FJ and Caldwell, DS and Williams, DA and Gil, KM and Mitchell, D and Robertson, C and Martinez, S and Nunley, J and Beckham, JC and Helms, M}, Title = {Pain coping skills training in the management of osteoarthritic knee pain-II: Follow-up results}, Journal = {Behavior Therapy}, Volume = {21}, Number = {4}, Pages = {435-447}, Publisher = {Elsevier BV}, Year = {1990}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(05)80357-0}, Abstract = {This study examines six months follow-up data obtained from osteoarthritic knee pain patients participating in a study comparing pain coping skills training, arthritis education, and a standard care control condition. At the time of follow-up, patients receiving pain coping skills training had: 1) significantly lower levels of psychological and physical disability than patients receiving arthritis education, and 2) marginally lower levels of psychological disability (p<.052) and physical disability (p<.13) than patients in the standard care control condition. Although patients receiving pain coping skills training showed deterioration in their initial gains in psychological disability from post-treatment to follow-up, it was the only treatment group that showed a strong trend (p=.051) towards improvements in physical disability over time. Variability in outcome was noted; some patients showed better maintenance of treatment effects than others. Correlational analyses revealed that patients' scores on the Pain Control and Rational Thinking (PCRT) factor of the Coping Strategies Questionnaire were related to outcome at six months follow-up. Patients receiving pain coping skills training who scored high on the PCRT factor at the end of treatment had lower levels of pain, physical disability, and pain behavior at six months follow-up. The implications of these findings for future research on cognitive-behavioral interventions for arthritis pain and disability are discussed. © 1990 Association for Advancement of Behavior Therapy.}, Doi = {10.1016/S0005-7894(05)80357-0}, Key = {fds273915} } @article{fds273916, Author = {Gil, KM and Williams, DA and Keefe, FJ and Beckham, JC}, Title = {The relationship of negative thoughts to pain and psychological distress}, Journal = {Behavior Therapy}, Volume = {21}, Number = {3}, Pages = {349-362}, Publisher = {Elsevier BV}, Year = {1990}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(05)80336-3}, Abstract = {This study examines the degree to which negative thoughts during flare-ups of pain are related to pain and psychological distress in three pain populations, sickle cell disease, rheumatoid arthritis, and chronic pain. One-hundred eighty-five subjects completed the Inventory of Negative Thoughts in Response to Pain (INTRP), a pain rating scale, the Symptom Checklist 90-R, and the Coping Strategies Questionnaire. Factor analysis of the INTRP revealed three factors: Negative Self-Statements, Negative Social Cognitions, and Self-Blame. High scorers on Negative Self-Statements and Negative Social Cognitions reported more severe pain and psychological distress. Patients with chronic daily pain had more frequent negative thoughts during flare-ups than patients having intermittent pain secondary to sickle cell disease or rheumatoid arthritis. Data suggest that the INTRP has adequate internal consistency and construct validity, and appears to be a useful tool for assessing negative throughts in response to pain. © 1990 Association for Advancement of Behavior Therapy. All rights reserved.}, Doi = {10.1016/S0005-7894(05)80336-3}, Key = {fds273916} } @article{fds273917, Author = {Ahles, TA and Coombs, DW and Jensen, L and Stukel, T and Maurer, LH and Keefe, FJ}, Title = {Development of a behavioral observation technique for the assessment of pain behaviors in cancer patients}, Journal = {Behavior Therapy}, Volume = {21}, Number = {4}, Pages = {449-460}, Publisher = {Elsevier BV}, Year = {1990}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(05)80358-2}, Abstract = {The present study assessed the reliability and validity of a behavioral observation technique designed to assess pain behaviors in cancer patients. Data supported the reliability of the procedure in that the level of interobserver agreement was quite acceptable. The validity of the technique was supported in that the pain behavior scores correlated significantly, as predicted, with the Sickness Impact Profile-Physical Scale and the Global Adjustment to Illness Scale, but not with the Sickness Impact Profile-Psychosocial Scale. Pain behavior scores and ratings of pain intensity, as measured on a visual analogue scale, were not significantly correlated. Additional support for the construct validity of the measure was provided in that nurses' and students' judgments of pain intensity correlated highly with pain behavior scores. Therefore, the behavioral observation method holds promise as a reliable, valid measure of pain behavior in a cancer pain population. © 1990 Association for Advancement of Behavior Therapy.}, Doi = {10.1016/S0005-7894(05)80358-2}, Key = {fds273917} } @article{fds273921, Author = {Keefe, FJ and Caldwell, DS and Williams, DA and Gil, KM and Mitchell, D and Robertson, C and Martinez, S and Nunley, J and Beckham, JC and Crisson, JE and Helms, M}, Title = {Pain coping skills training in the management of osteoarthritic knee pain: A comparative study}, Journal = {Behavior Therapy}, Volume = {21}, Number = {1}, Pages = {49-62}, Publisher = {Elsevier BV}, Year = {1990}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(05)80188-1}, Abstract = {The purpose of this study was to determine whether a cognitive-behavioral intervention designed to improve pain coping skills could reduce pain, physical disability, psychological disability, and pain behavior in osteoarthritic knee pain patients. Patients in this study were older adults (mean age=64 years) having persistent pain (mean duration=12 years), who were diagnosed as having osteoarthritis of the knee on the basis of medical evaluation and x-rays. Patients were randomly assigned to one of three conditions: pain coping skills training, arthritis education, or a standard care control condition. Patients in the pain coping skills training condition (n=32) attended 10 weekly group sessions training them to recognize and reduce irrational cognitions and to use attention diversion and changes in activity patterns to control and decrease pain. Arthritis education subjects (n=36) attended 10 weekly group sessions providing them with detailed information on osteoarthritis. Standard care control subjects (n=31) continued with their routine care. Measures of coping strategies, pain, psychological disability, physical disability, medication use, and pain behavior were collected from all subjects before and after treatment. Results indicated that patients receiving pain coping skills training had significantly lower levels of pain and psychological disability post-treatment than patients receiving arthritis education or standard care. Correlational analyses revealed that patients in the pain coping skills training group who reported increases in the perceived effectiveness of their coping strategies were more likely to have lower levels of physical disability post-treatment. Taken together, these findings indicate that pain coping skills training can reduce pain and psychological disability in osteoarthritis patients. Future studies should examine whether behavioral rehearsal or spouse training can strengthen the effects of pain coping skills training in order to reduce physical disability and pain behavior as well as pain and psychological disability. © 1990 Association for Advancement of Behavior Therapy. All rights reserved.}, Doi = {10.1016/S0005-7894(05)80188-1}, Key = {fds273921} } @article{fds273923, Author = {Gil, KM and Abrams, MR and Phillips, G and Keefe, FJ}, Title = {Sickle cell disease pain: relation of coping strategies to adjustment.}, Journal = {J Consult Clin Psychol}, Volume = {57}, Number = {6}, Pages = {725-731}, Year = {1989}, Month = {December}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037//0022-006x.57.6.725}, Abstract = {This study examines pain coping strategies in a relatively neglected pain population, sickle cell disease (SCD) patients. Seventy-nine patients diagnosed with SCD were given a structured interview to assess pain, activity level, and health care use during painful episodes. Patients also completed the SCL-90-R as an index of psychological distress and the Coping Strategies Questionnaire. Regression analyses controlled for age, sex, and disease severity measures. Results indicated that the coping strategies factors were important predictors of pain and adjustment. Individuals high on Negative Thinking and Passive Adherence had more severe pain, were less active and more distressed, and used more health care services. Individuals high on Coping Attempts were more active during painful episodes.}, Doi = {10.1037//0022-006x.57.6.725}, Key = {fds273923} } @article{fds273925, Author = {Keefe, FJ and Brown, GK and Wallston, KA and Caldwell, DS}, Title = {Coping with rheumatoid arthritis pain: catastrophizing as a maladaptive strategy.}, Journal = {Pain}, Volume = {37}, Number = {1}, Pages = {51-56}, Year = {1989}, Month = {April}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/2726278}, Abstract = {The present study examined catastrophizing in rheumatoid arthritis (RA) patients. Subjects were 223 RA patients who were participants in a longitudinal study. Each patient completed the Catastrophizing scale of the Coping Strategies Questionnaire (CSQ) on 2 occasions separated by 6 months (time 1, time 2). The Catastrophizing scale is designed to measure negative self-statements, castastrophizing thoughts and ideation (sample items = 'I worry all the time about whether it will end,' 'It is awful and I feel that it overwhelms me'). Data analysis revealed that the Catastrophizing scale was internally reliable (alpha = 0.91) and had high test-retest reliability (r = 0.81) over a 6 month period. Correlational analyses revealed that catastrophizing recorded at time 1 was related to pain intensity ratings, functional impairment on the Arthritis Impact Measurement scale (AIMS), and depression at time 2. Predictive findings regarding catastrophizing while modest were obtained after controlling for initial scores on the dependent variables, demographic variables (age, sex, socioeconomic status), duration of pain, and disability support status. Taken together, these findings suggest that catastrophizing is a maladaptive coping strategy in RA patients. Further research is needed to determine whether cognitive-behavioral interventions designed to decrease catastrophizing can reduce pain and improve the physical and psychological functioning of RA patients.}, Doi = {10.1016/0304-3959(89)90152-8}, Key = {fds273925} } @article{fds273924, Author = {Keefe, FJ and Williams, DA}, Title = {New directions in pain assessment and treatment}, Journal = {Clinical Psychology Review}, Volume = {9}, Number = {5}, Pages = {549-568}, Publisher = {Elsevier BV}, Year = {1989}, Month = {January}, ISSN = {0272-7358}, url = {http://dx.doi.org/10.1016/0272-7358(89)90011-1}, Abstract = {Psychological and behavioral methods have played an active role in shaping current approaches to the assessment and treatment of pain. This article assumes familiarity with the more traditional forms of psychological intervention for pain and reviews the developments of the past 3-5 years. The pain assessment section focuses on epidemiological approaches to chronic pain, objective measures of pain behavior, analysis of social and emotional factors, and analysis of cognitive factors affecting pain. The treatment section of the article focuses on early intervention for chronic pain, pain management in children, and cognitive-behavioral treatments for arthritis pain. Each section concludes with comments and potential directions for the future. © 1989.}, Doi = {10.1016/0272-7358(89)90011-1}, Key = {fds273924} } @article{fds273928, Author = {Crisson, JE and Keefe, FJ}, Title = {The relationship of locus of control to pain coping strategies and psychological distress in chronic pain patients.}, Journal = {Pain}, Volume = {35}, Number = {2}, Pages = {147-154}, Year = {1988}, Month = {November}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/3237429}, Abstract = {Although behavioral scientists have long been interested in how an individual's locus of control relates to coping and adjustment, basic information remains to be gathered on the relevance of locus of control to adaptation to persistent pain. This study examined the relationship of locus of control orientation to pain coping strategies and psychological distress in chronic pain patients. Subjects were 62 chronic pain patients. All patients were administered: (1) the Multidimensional Health Locus of Control Scales to assess locus of control, (2) the Coping Strategies Questionnaire to evaluate pain coping strategies, and (3) the Symptom Checklist-90 Revised to assess psychological distress. Correlational analyses revealed that patients who viewed outcomes as controlled by chance factors such as fate or luck tended to rely on maladaptive pain coping strategies and rated their abilities to control and decrease pain as poor. They also exhibited greater psychological distress. Regression analyses indicated that patients having a chance orientation toward locus of control were more likely to report depression, anxiety, and obsessive-compulsive symptoms and to have higher overall levels of psychological distress. Chance locus of control also predicted greater reliance on diverting attention and praying/hoping in dealing with their pain. In addition, patients high on chance locus of control reported feeling helpless to deal effectively with their pain problem. Clinicians evaluating chronic pain patients need to be aware that patients who view outcomes as controlled by external factors such as chance may have deficits in pain coping strategies and may report greater psychological distress than patients who do not have this locus of control orientation.}, Doi = {10.1016/0304-3959(88)90222-9}, Key = {fds273928} } @article{fds273927, Author = {Keefe, FJ and Gil, KM and Williams, DA}, Title = {Pain management programs. Clinical and research perspectives.}, Journal = {N C Med J}, Volume = {49}, Number = {10}, Pages = {526-529}, Year = {1988}, Month = {October}, Key = {fds273927} } @article{fds273929, Author = {Anderson, KO and Keefe, FJ and Bradley, LA and McDaniel, LK and Young, LD and Turner, RA and Agudelo, CA and Semble, EL and Pisko, EJ}, Title = {Prediction of pain behavior and functional status of rheumatoid arthritis patients using medical status and psychological variables.}, Journal = {Pain}, Volume = {33}, Number = {1}, Pages = {25-32}, Year = {1988}, Month = {April}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(88)90199-6}, Abstract = {This study examined the extent to which the psychological variables of depression, anxiety, and helplessness predicted the pain behavior and functional status of 64 rheumatoid arthritis (RA) patients beyond what could be predicted on the basis of demographic and medical status variables. Pain behavior was evaluated using a standardized observation method, and functional status was assessed using a modified Health Assessment Questionnaire (MHAQ) and rheumatologists' ratings. Regression analyses revealed that a modified rheumatoid activity index and/or disease duration were significant predictors of levels of guarding, rigidity, and total pain behavior. The psychological variables examined did not predict independently RA pain behavior. The rheumatoid activity index explained a significant proportion of the variance in functional status ratings and MHAQ daily function scores. Age, disease duration and depression also were independent predictors of functional status ratings. Thus, depression had a significant relationship with physician ratings of functional status but not with patient self-reports of disability. Psychological factors not examined in this study that might influence RA pain behavior and self-reports of functional status are discussed.}, Doi = {10.1016/0304-3959(88)90199-6}, Key = {fds273929} } @article{fds273933, Author = {Morrell, EM and Keefe, FJ}, Title = {The actometer: an evaluation of instrument applicability for chronic pain patients.}, Journal = {Pain}, Volume = {32}, Number = {3}, Pages = {265-270}, Year = {1988}, Month = {March}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(88)90036-X}, Abstract = {Three experiments were conducted to determine the reliability and validity of an activity measurement device, the actometer, as an index of ambulation for chronic pain patients. In experiment I, correlations between yoked actometers during ambulation showed the instrument to be internally reliable. In experiment II, actometer readings covaried very strongly with distance, showing the device to be valid during single trial assessment. However, experiment III found the device to show poor reliability over time (i.e., substantial measurement variability for the identical distance on 3 separate days). The results suggest that, for the chronic pain population, the actometer may not be a useful instrument for reliably assessing changes in walking activity over time.}, Doi = {10.1016/0304-3959(88)90036-X}, Key = {fds273933} } @article{fds273930, Author = {Romano, JM and Syrjala, KL and Levy, RL and Turner, JA and Evans, P and Keefe, FJ}, Title = {Overt pain behaviors: Relationship to patient functioning and treatment outcome}, Journal = {Behavior Therapy}, Volume = {19}, Number = {2}, Pages = {191-201}, Publisher = {Elsevier BV}, Year = {1988}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(88)80042-X}, Abstract = {Two related studies examined the relationship of overt pain behaviors to measures of patient functioning and treatment outcome. In Study 1, overt pain behaviors of 45 chronic low back pain patients beginning inpatient pain treatment were assessed, and self-report measures of pain, pain behaviors, and physical and psychosocial disability were also obtained. Frequency of observed pain behaviors was significantly associated with patient ratings of pain, pain behaviors, and physical disability, but not psychosocial functioning. In Study 2, changes in observed pain behaviors and self-report measures of pain, pain behaviors, and depression following inpatient treatment were examined. Observed pain behaviors and self-reported pain, pain behaviors, and depression decreased significantly pre- to posttreatment. Decreases in observed pain behaviors were significantly associated with decreases in depression, but not with changes in self-reported pain or pain behaviors. Results support the use of both observational and self-report measures in the comprehensive evaluation of chronic pain problems. © 1988 Association for Advancement of Behavior Therapy. All rights reserved.}, Doi = {10.1016/S0005-7894(88)80042-X}, Key = {fds273930} } @article{fds273932, Author = {Gil, KM and Keefe, FJ and Sampson, HA and McCaskill, CC and Rodin, J and Crisson, JE}, Title = {Direct observation of scratching behavior in children with atopic dermatitis}, Journal = {Behavior Therapy}, Volume = {19}, Number = {2}, Pages = {213-227}, Publisher = {Elsevier BV}, Year = {1988}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(88)80044-3}, Abstract = {This study examines scratching behavior in children with atopic dermatitis (AD). Thirty children with severe AD and one parent of each child were observed for a 10-minute observation period during a five-minute structured and five-minute unstructured task. Observers coded child and parent behaviors. Data analyses revealed that children engaged in more scratching behavior during the unstructured than structured task. Furthermore, regression analyses indicated that parent responses to scratching behavior in children were important predictors of scratching behavior even after controlling for demographic and medical status variables, such as serum IgE level and percentage of body area affected by AD. These results have important implications for health care professionals working with children who have AD. Suggestions for future behavioral treatment studies are discussed. © 1988 Association for Advancement of Behavior Therapy. All rights reserved.}, Doi = {10.1016/S0005-7894(88)80044-3}, Key = {fds273932} } @article{fds273926, Author = {Keefe, FJ and Dolan, EA}, Title = {Correlation of pain behavior and muscle activity in patients with myofascial pain-dysfunction syndrome.}, Journal = {J Craniomandib Disord}, Volume = {2}, Number = {4}, Pages = {181-184}, Year = {1988}, Key = {fds273926} } @article{fds273931, Author = {Dolan, EA and Keefe, FJ}, Title = {Muscle activity in myofascial pain-dysfunction syndrome patients: a structured clinical evaluation.}, Journal = {J Craniomandib Disord}, Volume = {2}, Number = {2}, Pages = {101-105}, Year = {1988}, Key = {fds273931} } @article{fds273934, Author = {Anderson, KO and Bradley, LA and McDaniel, LK and Young, LD and Turner, RA and Agudelo, CA and Gaby, NS and Keefe, FJ and Pisko, EJ and Snyder, RM}, Title = {The assessment of pain in rheumatoid arthritis: disease differentiation and temporal stability of a behavioral observation method.}, Journal = {J Rheumatol}, Volume = {14}, Number = {4}, Pages = {700-704}, Year = {1987}, Month = {August}, ISSN = {0315-162X}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:A1987K037600011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Abstract = {An observation method for the assessment of pain behaviors in patients with rheumatoid arthritis (RA) has been developed. We investigated the extent to which the frequencies of pain behaviors differentiated patients with RA and patients with chronic low back pain from depressed and nondepressed, pain free, control subjects. The reliability of the pain behavior frequencies of patients with RA across 2 observation sessions also was determined. Total pain behavior scores clearly differentiated patients with RA and low back pain from depressed and nondepressed, pain free, control subjects. Pain behavior observed in patients with RA showed a high degree of stability over time. The results of our study suggest that the behavioral observation method will prove useful in the assessment of RA pain in clinical and research settings.}, Key = {fds273934} } @article{fds273937, Author = {Gil, KM and Keefe, FJ and Crisson, JE and Van Dalfsen, PJ}, Title = {Social support and pain behavior.}, Journal = {Pain}, Volume = {29}, Number = {2}, Pages = {209-217}, Year = {1987}, Month = {May}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(87)91037-2}, Abstract = {Research has shown that social support is generally associated with better adaptation to chronic disease. However, the role that social support plays in adjustment to chronic pain syndromes has received less research attention. The present study was designed to examine the relation of high versus low levels of social support to pain behavior in chronic pain patients. Fifty-one patients with chronic pain completed the Social Support Questionnaire (SSQ) and the McGill Pain Questionnaire. Patients were also observed using a standard observation system to assess pain behaviors. In order to compare pain behaviors displayed by subjects with high versus low levels of social support, a median split was performed on the 2 dimensions of the SSQ: satisfaction with support, and availability of people for support. The results indicated that pain behavior varied as a function of level of satisfaction with social support. Individuals reporting high satisfaction with social support exhibited significantly higher levels of total pain behavior and higher levels of individual pain behaviors such as guarding, rubbing, and bracing. There was no significant difference in total pain behaviors between those high versus low in terms of level of availability of support. There also were no differences between high versus low social support groups in total pain ratings as measured by the McGill Pain Questionnaire. The results are discussed in terms of an operant conditioning perspective on social support. Individuals who are satisfied with the quality of their social support may be satisfied because they receive positive reinforcement from the social environment when they engage in pain behavior.}, Doi = {10.1016/0304-3959(87)91037-2}, Key = {fds273937} } @article{fds273938, Author = {Keefe, FJ and Caldwell, DS and Queen, KT and Gil, KM and Martinez, S and Crisson, JE and Ogden, W and Nunley, J}, Title = {Pain coping strategies in osteoarthritis patients.}, Journal = {J Consult Clin Psychol}, Volume = {55}, Number = {2}, Pages = {208-212}, Year = {1987}, Month = {April}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037//0022-006x.55.2.208}, Abstract = {The present study investigated the relation of pain coping strategies to pain, health status, and psychological distress in a group of osteoarthritis patients with chronic knee pain. Fifty-one patients completed the Coping Strategies Questionnaire (CSQ), the McGill Pain Questionnaire, the Arthritis Impact Measurement Scale (AIMS), and the Symptom Checklist-90 Revised (SCL-90 R). Medical status variables included roentgenograph (x-ray) findings, obesity measures, disability status, and chronicity of pain. Factor analysis of the CSQ revealed two factors (Coping Attempts, Pain Control and Rational Thinking) that accounted for 60% of the variance in CSQ responses. Regression analyses controlling for demographic and medical variables identified the Pain Control and Rational Thinking factor as a significant predictor of the outcome measures. Patients scoring high on this factor had lower pain levels, better health status, and lower levels of psychological distress. © 1987 American Psychological Association.}, Doi = {10.1037//0022-006x.55.2.208}, Key = {fds273938} } @article{fds273939, Author = {Keefe, FJ and Caldwell, DS and Queen, K and Gil, KM and Martinez, S and Crisson, JE and Ogden, W and Nunley, J}, Title = {Osteoarthritic knee pain: a behavioral analysis.}, Journal = {Pain}, Volume = {28}, Number = {3}, Pages = {309-321}, Year = {1987}, Month = {March}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(87)90066-2}, Abstract = {This study used behavioral assessment techniques to analyze pain in osteoarthritis (OA) patients. Eighty-seven OA patients having chronic knee pain served as subjects. Pain behavior was evaluated using a standard observation method and functional impairment was assessed using the Arthritis Impact Measurement Scales. Data analysis revealed that pain and limitations in physical activities were the most common functional impairments and that the most frequently observed pain behavior was guarded movement. Predictive analyses indicated that disability support status and scores on a Pain Control and Rational Thinking factor of the Coping Strategies Questionnaire (CSQ) were predictive of functional impairment. Patients receiving disability support payments were much more functionally limited than those not receiving this financial support. Patients scoring high on the Pain Control and Rational Thinking factor of the CSQ were much less functionally impaired, walked a 5 m course more rapidly and moved from a standing to a sitting or reclining position more quickly than patients scoring low on this factor. The implications of these results for behavioral treatment of OA knee pain are discussed.}, Doi = {10.1016/0304-3959(87)90066-2}, Key = {fds273939} } @article{fds273940, Author = {Anderson, KO and Bradley, LA and McDaniel, LK and Young, LD and Turner, RA and Agudelo, CA and Keefe, FJ and Pisko, EJ and Snyder, RM and Semble, EL}, Title = {The assessment of pain in rheumatoid arthritis. Validity of a behavioral observation method.}, Journal = {Arthritis Rheum}, Volume = {30}, Number = {1}, Pages = {36-43}, Year = {1987}, Month = {January}, ISSN = {0004-3591}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:A1987F990900005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Abstract = {It is difficult to objectively measure pain in rheumatoid arthritis (RA). A behavioral observation method for the assessment of RA pain has been developed. In this study, videotapes were made of 53 RA patients while they performed standardized maneuvers. Trained raters viewed the videotapes and recorded the frequencies of 7 pain behaviors. Clinical and laboratory measures of rheumatoid disease activity also were recorded for each patient. Rheumatology fellows viewed 20 randomly chosen video recordings of the patients and made global estimates of the intensity and unpleasantness of pain. Significant positive correlations were found between total pain behavior scores and measures of disease activity. The fellows' estimates of the intensity and unpleasantness of the patients' pain also were significantly and positively correlated with the total pain behavior scores. The behavioral observation method may be useful in the assessment of RA pain and may be included as an objective outcome measure in clinical trials with RA patients.}, Doi = {10.1002/art.1780300105}, Key = {fds273940} } @article{fds273935, Author = {Gil, KM and Keefe, FJ and Sampson, HA and McCaskill, CC and Rodin, J and Crisson, JE}, Title = {The relation of stress and family environment to atopic dermatitis symptoms in children.}, Journal = {J Psychosom Res}, Volume = {31}, Number = {6}, Pages = {673-684}, Year = {1987}, ISSN = {0022-3999}, url = {http://www.ncbi.nlm.nih.gov/pubmed/3430430}, Abstract = {The relation of stress and family environment to symptom severity in children with atopic dermatitis (AD) was examined. Forty-four children with severe AD and their families completed questionnaires measuring life events, chronic everyday problems and family environment. Measures of symptom severity were collected during medical evaluation and included an estimate of body surface affected by AD, course of AD symptoms over time, medication usage, and scratching intensity during the day and night. Regression analyses indicated that the measures of stress and family environment were important predictors of symptom severity even after controlling for demographic and medical status variables such as age and serum IgE level. These results have important implications for health care professionals working with children who have AD. Future research directions in the area of stress and AD are discussed.}, Doi = {10.1016/0022-3999(87)90016-x}, Key = {fds273935} } @article{fds273936, Author = {Manuel, GM and Roth, S and Keefe, FJ and Brantley, BA}, Title = {Coping with cancer.}, Journal = {J Human Stress}, Volume = {13}, Number = {4}, Pages = {149-158}, Year = {1987}, url = {http://dx.doi.org/10.1080/0097840X.1987.9936808}, Abstract = {This study examined coping strategies in head and neck cancer patients. The relationships between the use of approach and avoidant coping strategies and the physical and emotional distress of 35 newly diagnosed head and neck cancer patients during the early stages of cancer treatment were evaluated. Patients were categorized on the basis of coping strategy at the time of diagnosis and then evaluated twice during the course of their treatment at four- to six-week intervals. Cancer patients who predominantly employed either approach or avoidant strategies had lower initial levels of emotional distress than patients who did not use either of these strategies. Although symptoms of distress decreased in patients using approach or avoidance, symptoms increased for those patients who did not use these strategies. The level of stress for this cancer population is highest at the point of confirmed diagnosis and recedes during the course of treatment. The theoretical and clinical implications of these findings are discussed.}, Doi = {10.1080/0097840X.1987.9936808}, Key = {fds273936} } @article{fds273941, Author = {Keefe, FJ and Gil, KM}, Title = {Behavioral concepts in the analysis of chronic pain syndromes.}, Journal = {J Consult Clin Psychol}, Volume = {54}, Number = {6}, Pages = {776-783}, Year = {1986}, Month = {December}, ISSN = {0022-006X}, url = {http://dx.doi.org/10.1037//0022-006x.54.6.776}, Abstract = {Behavioral and psychological concepts currently applied to the assessment and treatment of a variety of chronic pain syndromes are reviewed. Operant conditioning principles are commonly used to analyze and modify maladaptive overt behavior patterns such as excessive dependence on narcotics, on bedrest, and on family or health-care professionals. Psychophysiologic concepts that are widely used include the stress-pain hypothesis, the pain-muscle spasm-pain cycle, and the neuromuscular pain model. Interventions for pain based on these concepts include relaxation and biofeedback training. Concepts from cognitive psychology are increasingly being used to evaluate subjective responses to persistent pain. The advantages and disadvantages of these concepts are discussed. Suggestions are also proposed for future research designed to enhance our understanding of chronic pain. © 1986 American Psychological Association.}, Doi = {10.1037//0022-006x.54.6.776}, Key = {fds273941} } @article{fds273943, Author = {Keefe, FJ and Castell, PJ and Blumenthal, JA}, Title = {Angina pectoris in type A and type B cardiac patients.}, Journal = {Pain}, Volume = {27}, Number = {2}, Pages = {211-218}, Year = {1986}, Month = {November}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/3797016}, Abstract = {The type A behavior pattern is characterized by excessive competitive drive, a sense of time urgency, enhanced aggressiveness, hostility and a persistent desire for recognition. Type A behaviour is widely recognized as a risk factor in coronary heart disease. This study investigated whether type As and Bs differ in their experience of pain and pain coping efforts. A group of type A (n = 35) and a group of type B (n = 19) cardiac disease patients served as subjects. All subjects underwent diagnostic treadmill testing and were compared on a variety of pain measures. There were no differences between type As and Bs in age, sex, presence of state or trait anxiety or severity of cardiac disease. Type A patients, however, were much more likely than type Bs to be classified on the New York Heart Association (NYHA) functional angina scale as having more severe pain and functional limitation. Type As were also less likely to use pain coping strategies to deal with their pain. Those who assess pain and functional impairment in cardiac patients using the NYHA scale should be aware that type A personality characteristics may affect their assessments. Type A patients who tend to make little use of pain coping strategies may benefit from systematic training in pain control methods. Additional research is needed to examine whether type A-B differences in pain and pain coping strategies may affect risks of coronary morbidity and mortality.}, Doi = {10.1016/0304-3959(86)90212-5}, Key = {fds273943} } @article{fds273942, Author = {Keefe, FJ and Wilkins, RH and Cook, WA and Crisson, JE and Muhlbaier, LH}, Title = {Depression, pain, and pain behavior.}, Journal = {J Consult Clin Psychol}, Volume = {54}, Number = {5}, Pages = {665-669}, Year = {1986}, Month = {October}, ISSN = {0022-006X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/2945848}, Doi = {10.1037//0022-006x.54.5.665}, Key = {fds273942} } @article{fds273946, Author = {Crisson, J and Keefe, FJ and Wilkins, RH and Cook, WA and Muhlbaier, LH}, Title = {Self-report of depressive symptoms in low back pain patients.}, Journal = {J Clin Psychol}, Volume = {42}, Number = {3}, Pages = {425-430}, Year = {1986}, Month = {May}, ISSN = {0021-9762}, url = {http://www.ncbi.nlm.nih.gov/pubmed/2940266}, Abstract = {Two studies designed to examine the self-report of depressive symptoms in low back pain patients are presented. Symptoms of depression were assessed with the Beck Depression Inventory. In the first study, a sample (N = 134) of patients who presented for neurosurgical evaluation were evaluated. In the second study, a subgroup of patients found to have lumbar disc protrusion were compared to a subgroup with few or no positive physical findings at the time of physical examination. If the cut-off scores recommended by Beck were used, patients in both studies would be classified as mildly depressed. Both studies found that patients were significantly more likely to report somatic than cognitive symptoms of depression. Patients with multiple physical findings or a disc abnormality at the time of operation were not found to be more likely to report somatic symptoms than patients with few physical findings.}, Doi = {10.1002/1097-4679(198605)42:3<425::aid-jclp2270420304>3.0.co}, Key = {fds273946} } @article{fds273947, Author = {McDaniel, LK and Anderson, KO and Bradley, LA and Young, LD and Turner, RA and Agudelo, CA and Keefe, FJ}, Title = {Development of an observation method for assessing pain behavior in rheumatoid arthritis patients.}, Journal = {Pain}, Volume = {24}, Number = {2}, Pages = {165-184}, Year = {1986}, Month = {February}, ISSN = {0304-3959}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:A1986A374200004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Abstract = {Four studies examined the reliability and validity of a behavioral observation method for the assessment of pain associated with rheumatoid arthritis (RA). The major purpose of experiment 1 was to evaluate the interobserver reliability of the observation method. Two observers recorded the frequencies of pain behaviors displayed by 20 RA patients. Each of 3 types of reliability estimates indicated that the pain behavior could be reliably observed. The purpose of experiment 2 was to examine the concurrent validity of the observation system by correlating 53 patients' self-reports of pain with the frequencies of their pain behaviors. Significant and positive correlations were found between patients' total pain behavior and 3 self-report measures of pain and functional disability. Furthermore, unlike the self-reports of pain, total pain behavior was only minimally related to self-report of depression. Experiment 3 was performed in order to assess the observation method's construct validity. Naive observers viewed video recordings of 25 RA patients and made global estimates of patients' pain severity and unpleasantness. Highly significant and positive correlations were found between these global estimates and total pain behavior. In experiment 4, the pain behaviors of 11 RA patients were recorded prior to and immediately following cognitive-behavioral treatment for the reduction of RA pain. There was a significant decrease in total pain behavior from pretreatment to posttreatment. The data indicate that the observation method provides a reliable, valid, and relatively objective measure of RA patient pain behavior. Future validation studies of the observation method are discussed.}, Doi = {10.1016/0304-3959(86)90039-4}, Key = {fds273947} } @article{fds273945, Author = {Keefe, FJ and Gil, KM and Rose, SC}, Title = {Behavioral approaches in the multidisciplinary management of chronic pain: Programs and issues}, Journal = {Clinical Psychology Review}, Volume = {6}, Number = {2}, Pages = {87-113}, Publisher = {Elsevier BV}, Year = {1986}, Month = {January}, ISSN = {0272-7358}, url = {http://dx.doi.org/10.1016/0272-7358(86)90007-3}, Abstract = {Psychological, social, and behavioral factors appear to play an important role in determining how patients adapt to chronic pain. There is a growing consensus among physicians that traditional diagnostic approaches to chronic pain must be expanded to address these factors. Innovative, multidisciplinary programs designed to change behavioral and psychological functioning in chronic pain patients have recently been developed. Disciplines involved include nursing, physical therapy, occupational therapy, psychology, psychiatry, anesthesiology, neurosurgery, and orthopedics. These programs are interesting because they successfully treat many chronic pain patients who previously failed to respond to conventional treatments. This article provides a selective review of behaviorally oriented, multidisciplinary, chronic pain treatment programs. It begins with a consideration of the conceptual foundations of these programs-the mechanisms of chronic pain. Basic elements of several major programs as well as outcome data are described. The paper concludes with a discussion of clinical issues important in evaluating these programs. © 1986.}, Doi = {10.1016/0272-7358(86)90007-3}, Key = {fds273945} } @article{fds273948, Author = {Keefe, FJ and Dolan, E}, Title = {Pain behavior and pain coping strategies in low back pain and myofascial pain dysfunction syndrome patients.}, Journal = {Pain}, Volume = {24}, Number = {1}, Pages = {49-56}, Year = {1986}, Month = {January}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(86)90025-4}, Abstract = {Pain behavior and pain coping strategies were systematically measured in a group of 32 chronic low back pain (LBP) and 32 myofascial pain dysfunction (MPD) syndrome patients. Both groups reported high levels of psychological distress on the SCL-90R. The LBP patients were significantly less active, took more narcotic and sedative-hypnotic medications, and showed higher levels of motor pain behavior (guarding, rubbing, and bracing) than the MPD patients. The LBP patients used attention diversion, and praying or hoping as pain coping skills to a much greater extent than the MPD patients. The relationship of these findings to prior research is described, and future research needs in this area are identified.}, Doi = {10.1016/0304-3959(86)90025-4}, Key = {fds273948} } @article{fds273944, Author = {Keefe, FJ and Crisson, JE and Maltbie, A and Bradley, L and Gil, KM}, Title = {Illness behavior as a predictor of pain and overt behavior patterns in chronic low back pain patients.}, Journal = {J Psychosom Res}, Volume = {30}, Number = {5}, Pages = {543-551}, Year = {1986}, ISSN = {0022-3999}, url = {http://dx.doi.org/10.1016/0022-3999(86)90026-7}, Abstract = {This study examined the relationship of self-reports of illness behavior to pain ratings and overt pain behaviors in a group of chronic low back pain patients referred for pain management. Illness behavior was measured using the Pilowsky and Spence Illness Behavior Questionnaire (IBQ) and pain behavior was recorded using a standard behavioral observation method. Multivariate regression analyses revealed that scores on the IBQ were highly predictive of a variety of indices of pain and pain behavior. These results were obtained even after controlling for significant demographic and medical status variables. The findings of this study support the utility of the IBQ in the behavioral assessment of chronic pain patients.}, Doi = {10.1016/0022-3999(86)90026-7}, Key = {fds273944} } @article{fds273949, Author = {Keefe, FJ and Manuel, G and Brantley, A and Crisson, J}, Title = {Pain in the head and neck cancer patient: changes over treatment.}, Journal = {Head Neck Surg}, Volume = {8}, Number = {3}, Pages = {169-176}, Year = {1986}, url = {http://dx.doi.org/10.1002/hed.2890080308}, Abstract = {The incidence, severity, and location of pain was evaluated in 30 head and neck cancer patients prior to treatment after the first phase of their treatment and upon the completion of treatment. The incidence of pain was relatively high (40%-70%) and tended to increase slightly over treatment. Patients having advanced disease (stage III or IV) had a higher incidence of pain. Pain severity ratings were stable over treatment. Pain was located close to tumor or incision sites, and a trend for patients to report a greater number of pain sites over treatment was noted. While medical status variables (disease stage and site) were found to predict pain status after the initial phase of cancer treatment, initial pain measurements were more likely to predict pain status at the completion of treatment.}, Doi = {10.1002/hed.2890080308}, Key = {fds273949} } @article{fds273950, Author = {Keefe, FJ and Brantley, A and Manuel, G and Crisson, JE}, Title = {Behavioral assessment of head and neck cancer pain.}, Journal = {Pain}, Volume = {23}, Number = {4}, Pages = {327-336}, Year = {1985}, Month = {December}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(85)90002-8}, Abstract = {Behavioral evaluations of pain were carried out on a sample of 30 head and neck cancer patients before, at the midpoint, and at the end of their treatment. Observations of patients' behavior as they carried out functional activities revealed that patients tended to display their pain primarily through facial expression and to a lesser extent through guarded movement. During the period of treatment there were significant increases in the number of simple daily activities that increased pain, in the time spent sitting each day, and in the number of patients using narcotics. There was also a strong tendency for patients to lose weight and to use a greater number of pain relieving methods. A behavioral dysfunction index based on scores on each of the behavioral measures was clearly related to pain ratings. Measures of pain taken before treatment were highly predictive of behavioral dysfunction index scores recorded at the completion of cancer treatments.}, Doi = {10.1016/0304-3959(85)90002-8}, Key = {fds273950} } @article{fds273951, Author = {Keefe, FJ and Hill, RW}, Title = {An objective approach to quantifying pain behavior and gait patterns in low back pain patients.}, Journal = {Pain}, Volume = {21}, Number = {2}, Pages = {153-161}, Year = {1985}, Month = {February}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(85)90285-4}, Abstract = {Patterns of walking and concomitant pain behavior were compared in a group of chronic low back patients (n = 18) and normal controls (n = 18). Subjects were asked to walk a 5 m course. A transducer placed in the subjects' shoes produced a force proportional signal that permitted measurement of walking parameters. Subjects were videotaped in order to record the occurrence of 5 specific pain behaviors: guarding, bracing, rubbing the painful area, grimacing, and sighing. Data analysis revealed significant differences in walking patterns of the patients and controls. Patients walked more slowly, took shorter steps and did not show the symmetrical gait patterns evident in normal controls. Patients also exhibited much higher levels of pain behavior. The gait of patients receiving disability payments or taking narcotics differed significantly from those who were not. Patients receiving disability payments had significantly longer stride lengths and swing time than patients not receiving disability/financial compensation payments. Patients taking narcotics showed longer single limb support time for the left leg than those who were not. By combining objective measures of gait and motor pain behaviors, clinicians and researchers may be able to more objectively evaluate factors that may affect patient behavior and measure the effects of interventions designed to modify behavior.}, Doi = {10.1016/0304-3959(85)90285-4}, Key = {fds273951} } @article{fds273952, Author = {Urban, BJ and Keefe, FJ and France, RD}, Title = {A study of psychophysical scaling in chronic pain patients.}, Journal = {Pain}, Volume = {20}, Number = {2}, Pages = {157-168}, Year = {1984}, Month = {October}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(84)90097-6}, Abstract = {Chronic pain patients were asked to psychophysically scale two sets of word descriptors (intensity and unpleasantness) using a crossmodality matching procedure with line length and numerical estimates. In 22 patients (group I) descriptor scaling was performed once, in another 20 patients (group II) the procedure was repeated 3 times. 72.7% of patients in group I obtained a correlation of 0.9 or higher when scaling intensity descriptors, but only 18.2% obtained this correlation when scaling unpleasantness words. In group II, an average of 85% of patients reliably scaled intensity words, but only 50% could do so for the unpleasantness descriptors. Patients who reliably judged unpleasantness descriptors generally exhibited a higher level of psychological distress (SCL-90 R). Numerical estimates assigned by patients to individual word descriptors showed a smaller range than obtained from experimental pain studies. There was unequal spacing of values of adjacent descriptors with clustering of words in the low and high ends of the continuum and large gaps in midrange. Results indicate that chronic pain patients in general show a higher incidence of impairment in rendering proportional judgments than a healthy population. In addition, they are more likely to judge pain reliably on an intensity than on an unpleasantness dimension. The difference in performance between scales persists in spite of training and could not be explained by medical history, drug intake, or demographic characteristics. Patients who are unable to render reliable judgments are easily identified. For optimal clinical use words clustering close together should be combined and additional words should be added describing midrange intensities. Conversely, psychophysical scaling techniques may be used to calibrate category or analogue scales of pain.}, Doi = {10.1016/0304-3959(84)90097-6}, Key = {fds273952} } @article{fds273953, Author = {Keefe, FJ and Wilkins, RH and Cook, WA}, Title = {Direct observation of pain behavior in low back pain patients during physical examination.}, Journal = {Pain}, Volume = {20}, Number = {1}, Pages = {59-68}, Year = {1984}, Month = {September}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(84)90811-X}, Abstract = {Trained observers measured the occurrence of 5 behaviors (guarding, bracing, rubbing, grimacing, and sighing) in a group of 80 low back pain patients undergoing physical examination. Bracing was frequently displayed, rubbing, guarding, and grimacing were moderately frequent and sighing was infrequent. Pain behaviors were much more likely to occur when patients were moving than when they were in a static position. The rate of guarding, bracing, and total pain behavior was predicted by physical examination findings and/or number of prior operations. Patients having longer pain histories were also more likely to show guarded movement. Topics for future research in this area are identified, and the utility of behavioral observation for clinicians is discussed.}, Doi = {10.1016/0304-3959(84)90811-X}, Key = {fds273953} } @article{fds372020, Author = {Keefe, FJ}, Title = {Psychological approaches to the management of pain}, Journal = {Journal of Behavior Therapy and Experimental Psychiatry}, Volume = {15}, Number = {1}, Pages = {88-89}, Publisher = {Elsevier BV}, Year = {1984}, Month = {March}, url = {http://dx.doi.org/10.1016/0005-7916(84)90133-2}, Doi = {10.1016/0005-7916(84)90133-2}, Key = {fds372020} } @article{fds273954, Author = {Keefe, FJ and Bradley, LA}, Title = {Behavioral and psychological approaches to the assessment and treatment of chronic pain.}, Journal = {Gen Hosp Psychiatry}, Volume = {6}, Number = {1}, Pages = {49-54}, Year = {1984}, Month = {January}, ISSN = {0163-8343}, url = {http://dx.doi.org/10.1016/0163-8343(84)90059-8}, Abstract = {This article briefly reviews behavioral and psychologic methods currently used to assess chronic pain patients. Assessment techniques designed to measure pain report, overt behavior patterns, and psychologic functioning are described. A variety of behavioral treatment procedures for chronic pain are also discussed. Treatment techniques can be grouped into two major categories: operant conditioning methods, and self-management strategies. Critical needs for future research are briefly identified.}, Doi = {10.1016/0163-8343(84)90059-8}, Key = {fds273954} } @article{fds273955, Author = {Houpt, JL and Keefe, FJ and Snipes, MT}, Title = {The Clinical Specialty Unit: the use of the psychiatry inpatient unit to treat chronic pain syndromes.}, Journal = {Gen Hosp Psychiatry}, Volume = {6}, Number = {1}, Pages = {65-70}, Year = {1984}, Month = {January}, url = {http://dx.doi.org/10.1016/0163-8343(84)90061-6}, Abstract = {The authors describe a 15-bed psychiatry inpatient unit, the Clinical Specialty Unit (CSU), designed to treat patients with chronic pain syndromes. They argue that the use of psychiatry beds for this purpose is appropriate, given the nature of the chronic pain disorder, but is not without its liabilities. The administrative structure and roles of the multidisciplinary team are described.}, Doi = {10.1016/0163-8343(84)90061-6}, Key = {fds273955} } @article{fds273956, Author = {France, RD and Urban, BJ and Keefe, FJ}, Title = {Long-term use of narcotic analgesics in chronic pain.}, Journal = {Soc Sci Med}, Volume = {19}, Number = {12}, Pages = {1379-1382}, Year = {1984}, ISSN = {0277-9536}, url = {http://dx.doi.org/10.1016/0277-9536(84)90027-3}, Abstract = {The use of narcotic analgesics have been avoided by clinicians in patients with chronic pain syndromes. Uncertainty as to the etiological cause of chronic pain, development of addiction and habituation and associated psychological and behavioral symptoms found in chronic pain states which are not amenable to narcotic medications are the major reasons narcotics are not prescribed. This communication describes the long-term use of low dose narcotic analgesics as a treatment component of a comprehensive pain management program and addresses the questions of whether or not narcotic efficacy is maintained in long-term use, improvement of patients' function is continued and side effects develop as a result of this treatment.}, Doi = {10.1016/0277-9536(84)90027-3}, Key = {fds273956} } @article{fds273958, Author = {Rosenstiel, AK and Keefe, FJ}, Title = {The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment.}, Journal = {Pain}, Volume = {17}, Number = {1}, Pages = {33-44}, Year = {1983}, Month = {September}, ISSN = {0304-3959}, url = {http://dx.doi.org/10.1016/0304-3959(83)90125-2}, Abstract = {Cognitive and behavioral pain coping strategies were assessed by means of questionnaire in a sample of 61 chronic low back pain patients. Data analysis indicated that the questionnaire was internally reliable. While patients reported using a variety of coping strategies, certain strategies were used frequently whereas others were rarely used. Three factors: (a) Cognitive Coping and Suppression, (b) Helplessness, and (c) Diverting Attention or Praying, accounted for a large proportion of variance in questionnaire responses. These 3 factors were found to be predictive of measures of behavioral and emotional adjustment to chronic pain above and beyond what may be predicted on the basis of patient history variables (length of continuous pain, disability status, and number of pain surgeries) and the tendency of patients to somaticize. Each of the 3 coping factors was related to specific measures of adjustment to chronic pain.}, Doi = {10.1016/0304-3959(83)90125-2}, Key = {fds273958} } @article{fds273957, Author = {Surwit, RS and Keefe, FJ}, Title = {The blind leading the blind: problems with the "double-blind" design in clinical biofeedback research.}, Journal = {Biofeedback Self Regul}, Volume = {8}, Number = {1}, Pages = {1-8}, Year = {1983}, Month = {March}, ISSN = {0363-3586}, url = {http://www.ncbi.nlm.nih.gov/pubmed/6882807}, Doi = {10.1007/BF01000531}, Key = {fds273957} } @article{fds273961, Author = {Keefe, FJ}, Title = {Behavioral assessment and treatment of chronic pain: current status and future directions.}, Journal = {J Consult Clin Psychol}, Volume = {50}, Number = {6}, Pages = {896-911}, Year = {1982}, Month = {December}, url = {http://dx.doi.org/10.1037//0022-006x.50.6.896}, Doi = {10.1037//0022-006x.50.6.896}, Key = {fds273961} } @article{fds273959, Author = {Keefe, FJ and Block, AR}, Title = {Development of an observation method for assessing pain behavior in chronic low back pain patients}, Journal = {Behavior Therapy}, Volume = {13}, Number = {4}, Pages = {363-375}, Publisher = {Elsevier BV}, Year = {1982}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(82)80001-4}, Doi = {10.1016/S0005-7894(82)80001-4}, Key = {fds273959} } @article{fds273960, Author = {Keefe, FJ}, Title = {Miniseries on behavioral analysis of chronic pain}, Journal = {Behavior Therapy}, Volume = {13}, Pages = {363-375}, Year = {1982}, Key = {fds273960} } @article{fds273964, Author = {Keefe, FJ and Block, AR and Williams, RB and Surwit, RS}, Title = {Behavioral treatment of chronic low back pain: clinical outcome and individual differences in pain relief.}, Journal = {Pain}, Volume = {11}, Number = {2}, Pages = {221-231}, Year = {1981}, Month = {October}, ISSN = {0304-3959}, url = {http://www.ncbi.nlm.nih.gov/pubmed/6459557}, Abstract = {The response of 111 chronic low back pain patients to a comprehensive behavioral treatment program emphasizing relaxation procedures is examined. Over the course of treatment, significant reductions were obtained on measures of subjective tension, EMG activity, and pain. Many patients also decreased their intake of analgesic/narcotic agents and reported an increase in activity level. In order to examine individual differences in pain relief, the 28 patients who had the greatest decreases in pain were compared to those who had the least decreases in pain. Patients who had the best outcome in terms of pain relief were significantly more likely to show improvements in other outcome measures. In addition, these patients rated their pain initially as more severe, had continuous pain for fewer years, and were less likely to be on disability or to have had multiple surgical procedures. These results are discussed in the light of recent data from other behavioral treatment studies with chronic low back pain patients and implications for behavioral assessment and treatment are discussed.}, Doi = {10.1016/0304-3959(81)90007-5}, Key = {fds273964} } @article{fds273962, Author = {Keefe, FJ and Surwit, RS and Pilon, RN}, Title = {Collagen vascular disease: can behavior therapy help?}, Journal = {J Behav Ther Exp Psychiatry}, Volume = {12}, Number = {2}, Pages = {171-175}, Year = {1981}, Month = {June}, ISSN = {0005-7916}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7276192}, Abstract = {This study examined the efficacy of a simple autogenic and biofeedback treatment package in the management of Raynaud's Phenomenon secondary to diagnosed collagen vascular disease. The patient, diagnosed as suffering from mixed connective tissue disease, had an average of 6.3 vasospastic attacks per day during a 2 week baseline period. The frequency of daily attacks dropped to 4.2 after 10 weeks and 2.5 attacks after 1 yr of training. In addition, the patient displayed a gradual improvement in the ability to maintain digital skin temperature in the presence of ambient cold stress.}, Doi = {10.1016/0005-7916(81)90013-6}, Key = {fds273962} } @article{fds273963, Author = {Keefe, FJ and Schapira, B and Williams, RB}, Title = {EMG-assisted relaxation training in the management of chronic low back pain}, Journal = {American Journal of Clinical Biofeedback}, Volume = {4}, Number = {2}, Pages = {93-103}, Year = {1981}, Month = {January}, Abstract = {This study examines the short and long-term effects of EMG-assisted relaxation training in a series of 18 chronic low back pain patients. All patients had a minimum of six laboratory training sessions and were asked to practice on their own what they were learning in the laboratory. The results indicated that patients showed significant decreases in EMG activity within and across sessions as a function of training. Significant decreases in subjective ratings of tension were obtained within and across training sessions and there was a significant drop in daily ratings of tension taken outside of the lab environment over the course of treatment. The patients also showed a significant decrease in levels of pain within each training session. While there was a tendency for daily pain ratings to decrease over the course of treatment, this did not reach statistical significance. However, by the end of the first six laboratory sessions, 15 out of 18 patients reported experiencing regular decreases in pain while practicing their relaxation skills outside of the lab. At one year follow-up, 9 out of 13 patients responding had maintained initial therapeutic gains.}, Key = {fds273963} } @article{fds372021, Author = {KEEFE, FJ}, Title = {BEHAVIORAL MEDICINE - PRACTICAL APPLICATIONS IN HEALTH-CARE - MELAMED,BG, SIEGEL,LJ}, Journal = {CONTEMPORARY PSYCHOLOGY}, Volume = {26}, Number = {12}, Pages = {929-929}, Publisher = {AMER PSYCHOLOGICAL ASSOC}, Year = {1981}, Month = {January}, Key = {fds372021} } @article{fds273966, Author = {Keefe, FJ and Blumenthal, JA}, Title = {The life fitness program: A behavioral approach to making exercise a habit}, Journal = {Journal of Behavior Therapy and Experimental Psychiatry}, Volume = {11}, Number = {1}, Pages = {31-34}, Publisher = {Elsevier BV}, Year = {1980}, Month = {January}, ISSN = {0005-7916}, url = {http://dx.doi.org/10.1016/0005-7916(80)90048-8}, Abstract = {Difficulty in maitaining exercise regimens over long time periods is a common problem. This study examined the efficacy of a combination of stimulus control and self- reinforcement procedures in the acquisition and maintenance of a walking exercise program using a multiple baseline design. The intervention strategy was introduced sequentially to each of three middle-aged, overweight males. Levels of exercise increased in a regular and gradual fashion following introduction of the behavioral treatment techniques. Improvement was maintained over a two-year period. © 1980.}, Doi = {10.1016/0005-7916(80)90048-8}, Key = {fds273966} } @article{fds273965, Author = {Keefe, FJ and Surwit, RS and Pilon, RN}, Title = {Biofeedback, autogenic training, and progressive relaxation in the treatment of Raynaud's disease: a comparative study.}, Journal = {J Appl Behav Anal}, Volume = {13}, Number = {1}, Pages = {3-11}, Year = {1980}, ISSN = {0021-8855}, url = {http://www.ncbi.nlm.nih.gov/pubmed/6988380}, Abstract = {Twenty-one female patients suffering from diagnosed idiopathic Raynaud's Disease were trained to raise digital skin temperature using either autogenic training, progressive muscle relaxation, or a combination of autogenic training and skin temperature feedback. Patients were instructed in the treatment procedures in three one-hour group sessions spaced one week apart. All patients were instructed to practice what they had learned twice a day at home. Patients kept records of the frequency of vasospastic attacks occurring over a four-week baseline period, and during the first four weeks and the ninth week of training. In addition, patients underwent four laboratory cold stress tests during which they were instructed to maintain digital temperature as the ambient temperature was slowly dropped from 26 degrees to 17 degrees C. Cold stress tests were given during week 1 of baseline and during weeks 1, 3, and 5 of training. No significant differences between the three behavioral treatment procedures were obtained. In addition, the ability of patients to maintain digital temperature during the cold stress challenge showed significant improvement from the first to the last tests. Symptomatic improvement was maintained by all patients nine weeks after the start of training. The implications of these findings for the behavioral treatment of Raynaud's Disease are discussed.}, Doi = {10.1901/jaba.1980.13-3}, Key = {fds273965} } @article{fds273792, Author = {Keefe, FJ and Surwit, RS and Pilon, RN}, Title = {A 1-year follow-up of Raynaud's patients treated with behavioral therapy techniques.}, Journal = {J Behav Med}, Volume = {2}, Number = {4}, Pages = {385-391}, Year = {1979}, Month = {December}, ISSN = {0160-7715}, url = {http://www.ncbi.nlm.nih.gov/pubmed/548581}, Abstract = {The purpose of this study was to assess to what degree learned control of digital temperature and vasospastic attacks can be retained by Raynaud's patients over a full year period. Subjects were 19 patients suffering from diagnosed idiopathic Raynaud's disease who had undergone behavioral training. These patients had been trained to increase digital temperature using either autogenic training, biofeedback, or a combination of autogenic training and temperature biofeedback. Results indicated that the mean number of vasospastic attacks per day occurring 1 year after training was approximately equal to the number occurring at the end of the initial training (1.2-1.3 per day). Patient satisfaction with the treatment program was above average (3.5 on a 5-point scale). The patients' ability to maintain digital temperature during the cold stress challenge was imparied, however. At 1-year follow-up, digital temperature readings taken in the laboratory were identical to baseline levels.}, Doi = {10.1007/BF00844742}, Key = {fds273792} } @article{fds273969, Author = {Gordon, SB and Lerner, LL and Keefe, FJ}, Title = {Responsive parenting: an approach to training parents of problem children.}, Journal = {Am J Community Psychol}, Volume = {7}, Number = {1}, Pages = {45-56}, Year = {1979}, Month = {February}, url = {http://dx.doi.org/10.1007/BF00893162}, Abstract = {Two behavior modification groups for parents of problem children between the ages of two and ten were conducted along the lines of the Responsive Teaching Model. The two groups met for 10 and 8 weeks, respectively, with six families represented in each group. In Responsive Parenting (RP), parents are taught to observe and measure their children's problematic behavior. Subsequently, each parent develops a home project designed to modify this behavior; 11 of the 12 parents developed a successful home project. In addition, the attendance was approximately 90% and the completion of weekly assignments was close to 100%. Paper-and-pencil measures revealed that the parents were very satisfied with the parent-training group and rated their children as improved on a bipolar adjective checklist. These results are discussed with regard to implications for the delivery of mental health services for children. Future research directions are delineated.}, Doi = {10.1007/BF00893162}, Key = {fds273969} } @article{fds273968, Author = {Keefe, FJ and Gardner, ET}, Title = {Learned control of skin temperature: Effects of short- and long-term biofeedback training}, Journal = {Behavior Therapy}, Volume = {10}, Number = {2}, Pages = {202-210}, Publisher = {Elsevier BV}, Year = {1979}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(79)80037-4}, Abstract = {Two studies assessed the extent to which learned control over finger temperature could be developed. In Experiment I subjects received a short-term (five-session) biofeedback training regimen to decrease or increase temperature. Analyses of temperature data for the training periods revealed highly significant between-group differences. Subjects in the Increase condition displayed increases of up to 2.5°F, while subjects in the Decrease condition displayed decreases of up to 2.9°F. Ability to produce the required changes in temperature was found to improve as a function of training. Experiment II evaluated the effect of longer term training to increase temperature (20 sessions). Significant within-session increases in finger temperature were obtained after 3 days of training. There was no significant improvement in temperature control with further training, however. These studies indicate that voluntary control over digital temperature can be established, but that the magnitude of temperature changes is small even with extended feedback training. © 1979 Association for Advancement of Behavior Therapy.}, Doi = {10.1016/S0005-7894(79)80037-4}, Key = {fds273968} } @article{fds273967, Author = {Keefe, FJ and Surwit, RS and Pilon, R}, Title = {A one-year follow-up of Raynaud's patients treated with behavior therapy techniques}, Journal = {Journal of Behavioral Medicine}, Volume = {2}, Pages = {285-291}, Year = {1979}, Key = {fds273967} } @article{fds273973, Author = {Keefe, FJ}, Title = {Biofeedback vs. instructional control of skin temperature.}, Journal = {J Behav Med}, Volume = {1}, Number = {4}, Pages = {383-390}, Year = {1978}, Month = {December}, url = {http://dx.doi.org/10.1007/BF00846694}, Abstract = {The purpose of this study was twofold: (1) to determine the effects of instructions vs. biofeedback on the development of skin temperature self-control and (2) to assess how well learned control over temperature can be retained over time. Sixty female subjects were assigned to one of six groups: (1) response-specific instructions plus feedback, (2) thermal suggestions plus feedback, (3) instructions to rest plus feedback, (4) response-specific instructions without feedback, (5) thermal suggestions without feedback, and (6) instructions to rest without feedback. All subjects participated in five training sessions on 5 consecutive days and two follow-up sessions spaced 1 week and 2 weeks after training. Subjects given either feedback and response-specific instructions, feedback and thermal suggestions, or no feedback and thermal suggestions were able to produce significant increases in digital skin temperature consistently after three training sessions. Subjects in these groups retained the ability to control skin temperature both 1 and 2 weeks after training. Subjects in the remaining conditions showed no evidence of learned control over skin temperature.}, Doi = {10.1007/BF00846694}, Key = {fds273973} } @article{fds273971, Author = {Rosen, RC and Keefe, FJ}, Title = {The measurement of human penile tumescence.}, Journal = {Psychophysiology}, Volume = {15}, Number = {4}, Pages = {366-376}, Year = {1978}, Month = {July}, url = {http://dx.doi.org/10.1111/j.1469-8986.1978.tb01393.x}, Abstract = {The techniques of penile measurement have been developed in numerous laboratories in Europe, Australia, and the United States. Most researchers now use either circumference or volumetric devices, depending on the research rationale. Thermistors have not been adequately evaluated. This paper reviews the important measurement issues associated with each device, as well as relevant construction information. Examples of applied research are provided. With respect to overall efficacy of the transducers, the authors recommended volumetric procedures where precision of measurement is of critical importance. However, for efficacy and ease of use the circumference devices, particularly the mercury-in-rubber gauge, appear optimal. Penile tumescence measurement is of fundamental importance in determining basic parameters of the psychophysiological process of human sexual arousal.}, Doi = {10.1111/j.1469-8986.1978.tb01393.x}, Key = {fds273971} } @article{fds273972, Author = {Keefe, FJ and Surwit, RS}, Title = {Electromyographic biofeedback: behavioral treatment of neuromuscular disorders.}, Journal = {J Behav Med}, Volume = {1}, Number = {1}, Pages = {13-24}, Year = {1978}, Month = {March}, ISSN = {0160-7715}, url = {http://www.ncbi.nlm.nih.gov/pubmed/556109}, Abstract = {Electromyographic biofeedback is becoming widely used to help patients regain voluntary control of specific muscles affected by neuromuscular disorders. Electromyographic feedback training has been employed in the rehabilitation of patients affected by poliomyelitis, cerebrovascular accident, torticollis, nerve injury, temporomandibular joint syndrome, bruxism, and other disorders. While EMG biofeedback appears to be a promising treatment technique, the research literature on its effectiveness consists mainly of uncontrolled case reports and clinical trials. It is concluded that new studies with more sophisticated design and more careful control are needed to demonstrate that EMG biofeedback makes a unique contribution to the treatment of neuromuscular disorders. Research is needed to identify relevant patients characteristics predictive of success, specify appropriate muscle groups for the treatment of particular disorders, determine how feedback can be most efficiently combined with more conventional techniques in achieving a therapeutic effect, and establish meaningful criteria of success in the treatment of neuromuscular disorders.}, Doi = {10.1007/BF00846583}, Key = {fds273972} } @article{fds304931, Author = {Surwit, RS and Keefe, FJ}, Title = {Frontalis EMG feedback training: An electronic panacea?}, Journal = {Behavior Therapy}, Volume = {9}, Number = {5}, Pages = {779-792}, Publisher = {Elsevier BV}, Year = {1978}, Month = {January}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(78)80008-2}, Abstract = {Studies dealing with the application of frontalis EMG feedback to the treatment of a variety of disorders are reveiwed. Successful applications of frontalis EMG feedback training have been reported in the treatment of muscle contraction headaches, asthma, essential hypertension, insomnia, chronic anxiety, phobias, and cerebral palsy. While available evidence does suggest that frontalis EMG feedback training may be helpful in the treatment of these disorders, these effects are equivalent but not superior to those that can be obtained using more conventional and less costly treatment techniques such as relaxation training. In addition, there appears to be a lack of clear rationale for the use of frontalis as a training site in treatment of these disorders. It is concluded that claims made about the clinical advantages of frontalis EMG biofeedback as compared to other methods of relaxation are not scientifically justified. © 1978 Association for Advancement of Behavior Therapy.}, Doi = {10.1016/S0005-7894(78)80008-2}, Key = {fds304931} } @article{fds273970, Author = {Surwit, RS and Keefe, FJ}, Title = {Frontalis EMG biofeedback: An electronic panacea?}, Journal = {Behavior Therapy}, Volume = {9}, Number = {5}, Pages = {779-792}, Year = {1978}, ISSN = {0005-7894}, url = {http://dx.doi.org/10.1016/S0005-7894(78)80008-2}, Abstract = {Studies dealing with the application of frontalis EMG feedback to the treatment of a variety of disorders are reveiwed. Successful applications of frontalis EMG feedback training have been reported in the treatment of muscle contraction headaches, asthma, essential hypertension, insomnia, chronic anxiety, phobias, and cerebral palsy. While available evidence does suggest that frontalis EMG feedback training may be helpful in the treatment of these disorders, these effects are equivalent but not superior to those that can be obtained using more conventional and less costly treatment techniques such as relaxation training. In addition, there appears to be a lack of clear rationale for the use of frontalis as a training site in treatment of these disorders. It is concluded that claims made about the clinical advantages of frontalis EMG biofeedback as compared to other methods of relaxation are not scientifically justified. © 1978 Association for Advancement of Behavior Therapy.}, Doi = {10.1016/S0005-7894(78)80008-2}, Key = {fds273970} } @article{fds273974, Author = {Keefe, FJ}, Title = {Conditioning changes in differential skin temperature.}, Journal = {Percept Mot Skills}, Volume = {40}, Number = {1}, Pages = {283-288}, Year = {1975}, Month = {February}, url = {http://dx.doi.org/10.2466/pms.1975.40.1.283}, Abstract = {8 male Ss were presented with visual and auditory analog feedback regarding the difference between forehead and finger temperature. 4 Ss were instructed to raise the temperature of their finger in comparison with the forehead, while a second group of 4 Ss was instructed to lower the temperature of their finger in comparison with the temperature of the forehead. After 12 15-min. training sessions all Ss were able to produce changes in differential skin temperature in the specified direction. Differential changes in skin temperature correlated highly with changes in absolute finger temperature. These results are discussed as relevant to the clinical application of skin temperature control.}, Doi = {10.2466/pms.1975.40.1.283}, Key = {fds273974} } %% Papers Published @article{fds137767, Title = {Fillingim, R.B., Keefe, F.J., Light, K.C., Booker, D.K., & Maixner, W. The influence of gender and psychological factors on pain perception. Journal of Gender, Culture, and Health, 1996, 1, 21-36.}, Year = {1996}, Key = {fds137767} } @article{fds137768, Title = {Keefe, F.J. Cognitive behavioral therapy for managing pain. The Clinical Psychologist, 1996, 49, 4-5..}, Year = {1996}, Key = {fds137768} } @article{fds137769, Title = {Keefe, F.J., Lefebvre, J., & Starr, K. From the gate control theory to the neuromatrix: Revolution or evolution. Pain Forum, 1996, 5, 143-145.}, Year = {1996}, Key = {fds137769} } @article{fds137770, Title = {Kornguth, P.J., Keefe, F.J., & Conaway, M.R. Pain during mammography: Characteristics and relationship to demographic and medical variables. Pain, 1996, 66,187-194.}, Year = {1996}, Key = {fds137770} } @article{fds137771, Title = {Weiner, D., Pieper, C., McConnell, E., Martinez, S., & Keefe, F. Pain measurement in elders with chronic low back pain: Traditional and alternative approaches. Pain (1996), 67,461-468.}, Year = {1996}, Key = {fds137771} } @article{fds137772, Title = {Schwartz, C.E., Chesney, M.A., Irvine, J., & Keefe, F.J. The control group dilemma in clinical research: Applications for psychosocial and behavioral medicine trails. Psychosomatic Medicine (in press)}, Year = {1996}, Key = {fds137772} } @article{fds137773, Title = {Keefe, F.J., Lefebvre, J.C., Maixner, W., Salley, A.N., & Caldwell, D.S. Self-efficacy for arthritis pain: Relationship to perception of thermal laboratory pain stimuli. Arthritis Care and Research (in press).}, Year = {1996}, Key = {fds137773} } @article{fds137774, Title = {Keefe, F.J., & Caldwell, D.S. Cognitive behavioral interventions. In S.Wegener, B. Belza, & E. Gall (Eds.) Primer on Clinical Care in Rheumatoid Disease. Atlanta, GA: Arthritis Foundation, 1996, Ch. 10, pp. 59-64.}, Year = {1996}, Key = {fds137774} } @article{fds137791, Title = {Schanberg, L.E., Keefe, F.J., Lefebvre, J.C., Kredich, D.W., & Gil, K.M. Pain coping strategies in children with juvenile primary fibromyalgia syndrome: Correlation with pain, physical function, and psychological distress. Arthritis Care and Research, 1996, 9, 89-96.}, Year = {1996}, Key = {fds137791} } @article{fds137792, Title = {Keefe, F.J. & Goli, V. A practical guide to biobehavioral assessment and treatment of chronic pain. Journal of Practical Psychiatry and Behavioral Health 1996, 3, 151-161.}, Year = {1996}, Key = {fds137792} } @article{fds137793, Title = {Francis J. Keefe, David S. Caldwell, Donald Baucom, Al Salley, Elwood Robinson, Kelly Timmons, Pat Beaupre, James Weisburg, and Michael Helms. Spouse-assisted coping skills training in the management of osteoarthritis knee pain. Arthritis Care and Research 1996, 9, 279-291.}, Year = {1996}, Key = {fds137793} } @article{fds137794, Title = {Francis J. Keefe, Susmita Kashikar-Zuck, Julie Opiteck, Elizabeth Hage. Lorien Dalrymple, and James Blumenthal. Pain in arthritis and musculoskeletal disorders: The role of coping skills training and exercise interventions. Journal of Orthopedic and Sports Physical Therapy, 1996, 24, 279-290.}, Year = {1996}, Key = {fds137794} } @article{fds137795, Title = {Beaupre, P., Keefe, F.J., Lester, N., Affleck, G., Frederickson, B, & Caldwell, D.S. A Computer-assisted observational method for assessing spouses' judgments of osteoarthritis patients' pain. Psychology, Health, & Medicine (in press)}, Year = {1996}, Key = {fds137795} } @article{fds137796, Title = {Keefe, F.J. & Caldwell, D.S. Cognitive behavioral control of arthritis pain. Medical Clinics of North America (in press)}, Year = {1996}, Key = {fds137796} } @article{fds137797, Title = {James Weisberg & Francis J. Keefe. Personality disorders in the chronic pain population: Basic concepts, empirical findings, and clinical implications. Pain Forum (in press).}, Year = {1996}, Key = {fds137797} } @article{fds137798, Title = {Lester, N. , Lefebvre, J.C. & Keefe, F.J. Pain in young adults-III: Comparison of three coping assessment methods. Clinical Journal of Pain (in press).}, Year = {1996}, Key = {fds137798} } @article{fds137799, Title = {Weisberg, J.N., & Keefe, F.J. Methodological considerations for diagnosis of personality disorders in chronic pain patients. Pain Forum (in press)}, Year = {1996}, Key = {fds137799} } @article{fds137800, Title = {Keefe, F.J., Affleck, G., Lefebvre, J.C., Starr, K., Caldwell, D.S., & Tennen, H. Coping strategies and coping efficacy in rheumatoid arthritis: A daily process analysis. Pain (in press).}, Year = {1996}, Key = {fds137800} } @article{fds137801, Title = {Fillingim, R.B., Maixner, W., & Keefe, F.J. Ischemic but not thermal pain sensitivity varies across the menstrual cycle. Psychosomatic Medicine (in press).}, Year = {1996}, Key = {fds137801} } @article{fds137802, Title = {Keefe, F.J. & Egert, J. A cognitive-behavioral perspective on patients with cumulative trauma disorders. In S.L. Sauter & S.D. Moon. Psychosocial Aspects of Musculoskeletal Disorders in Office Work. Durham, N.C.: Taylor & Francis (1996), p. 159-176.}, Year = {1996}, Key = {fds137802} } @article{fds137803, Title = {Keefe, F.J., Beaupre, P.M., & Gil, K.M. Group therapy for patients with chronic pain. In D.C. Turk & R.J. Gatchel (Eds.) Psychological Treatments for Pain: A Practitioner's Handbook New York: Guilford Pressm, 1996.}, Year = {1996}, Key = {fds137803} } @article{fds137804, Title = {Keefe, F.J., Holzberg, A.D., & Beaupre, P.M. Contributions of pain behavior assessment and pain assessment to the development of pain clinics. In M.J.M. Cohen & J.N. Campbell (Eds.) Pain Treatment Centers: A Practical and Conceptual Reappraisal. Progress in Pain Research and Management., 1996,Vol., 7., 79-100.}, Year = {1996}, Key = {fds137804} } @article{fds137805, Title = {Keefe, F.J., Beaupre, P.M., Weiner, D.K., & Siegler, I.C. Pain in older adults: A cognitive-behavioral perspective. In B.R. Ferrell, & B. Ferrel (Eds.) Pain in the Elderly. Seattle, WA: IASP Press, 1996, p. 11-20.}, Year = {1996}, Key = {fds137805} } @article{fds137806, Title = {Keefe, F.J., Kashikar-Zuck, S., & Caldwell, D.S. Coping strategies for the patient with osteoarthritis. In M. Doherty, K. Brandt, & S. Lohmander. Textbook on Osteoarthritis. Oxford University Press (in press).}, Year = {1996}, Key = {fds137806} } @article{fds137762, Title = {Williams, D.A., Urban, B., Keefe, F.J., Shutty, M.S., & France, R. Cluster Analyses of Pain Patients' Responses to the SCL-90R. Pain, 1995, 61, 81-91..}, Year = {1995}, Key = {fds137762} } @article{fds137763, Title = {Keefe, F.J., Lefebvre, J.C., & Beaupre, P.M. The MMPI in chronic pain: Security blanket or sound investment. Pain Forum, 1995, 4, 101-103.}, Year = {1995}, Key = {fds137763} } @article{fds137764, Title = {Keefe, F.J. & Goli, V. A practical guide to biobehavioral assessment and treatment of chronic pain. Journal of Practical Psychiatriy and Behavioral Health (in press)}, Year = {1995}, Key = {fds137764} } @article{fds137765, Title = {In Press Chapters}, Year = {1995}, Key = {fds137765} } @article{fds137766, Title = {Keefe, F.J., & Caldwell, D.S. Cognitive behavioral interventions. In S.Wegener, B. Belza, & E. Gall (Eds.) Primer on Clinical Care in Rheumatoid Disease. Atlanta, GA: Arthritis Foundation (in press.)}, Year = {1995}, Key = {fds137766} } @article{fds137782, Title = {Lefebvre, J.C., Lester, N., & Keefe, F.J. Pain in young adults-II: The use and perceived effectiveness of pain coping strategies. Clinical Journal of Pain , 1995, 11, 36-44.}, Year = {1995}, Key = {fds137782} } @article{fds137783, Title = {Lane, J.D., Lefebvre, J., Rose, J.E., & Keefe, F.J. Effects of cigarette smoking on responses to thermal pain. Experimental and Clinical Psychopharmacology, 1995, 3, 140-147.}, Year = {1995}, Key = {fds137783} } @article{fds137784, Title = {Edens, J.L., Wilson, J.J., Gil, K.M., & Keefe, F.J. Critical issues in pain management training for psychologists. American Pain Society Journal (in press)}, Year = {1995}, Key = {fds137784} } @article{fds137785, Title = {Kornguth, P.J., Keefe, F.J., & Conaway, M.R. Pain during mammography: Characteristics and relationship to demographic and medical variables. Pain (in press)}, Year = {1995}, Key = {fds137785} } @article{fds137786, Title = {Lester, N. & Keefe, F.J. Coping with chronic pain. In A. Baum, C. McManus, S. Newman, J. Weinman, & R. West. Cambridge Handbook of Psychology, Health and Medicine. Cambridge, England: Cambridge University Press (in press).}, Year = {1995}, Key = {fds137786} } @article{fds137787, Title = {Keefe, F.J. & Egert, J. A cognitive-behavioral perspective on patients with cumulative trauma disorders. In S.L. Sauter & S.D. Moon. Psychosocial Aspects of Musculoskeletal Disorders in Office Work. Durham, N.C.: Taylor & Francis (in press).}, Year = {1995}, Key = {fds137787} } @article{fds137788, Title = {Keefe, F.J., Beaupre, P.M., & Gil, K.M. Group therapy for patients with chronic pain. In D.C. Turk & R.J. Gatchel (Eds.) Psychological Treatments for Pain: A Practitioner's Handbook New York: Guilford Press (in press)}, Year = {1995}, Key = {fds137788} } @article{fds137789, Title = {Keefe, F.J., Beaupre, P.M., Weiner, D.K., & Siegler, I.C. Pain in older adults: A cognitive-behavioral perspective. In B.R. Ferrell, & B. Ferrel (Eds.) Pain in the Elderly. Seattle, WA: IASP Press.}, Year = {1995}, Key = {fds137789} } @article{fds137790, Title = {Keefe, F.J., Kashikar-Zuck, S., & Caldwell, D.S. Coping strategies for the patient with osteoarthritis. In M. Doherty, K. Brandt, & S. Lohmander. Textbook on Osteoarthritis. Oxford University Press (in press).}, Year = {1995}, Key = {fds137790} } @article{fds137779, Title = {Keefe FJ, Hauck ER, Egert J, Rimer B, Kornguth P: Mammography pain and discomfort: A cognitive-behavioral perspective. Pain 56: 247-260, 1994.}, Year = {1994}, Key = {fds137779} } @article{fds137780, Title = {Giorgino KB, Blalock SJ, DeVellis RF, Devellis BM, Keefe FJ, Jordan JM: Appraisal and coping with theumatoid arthritis related problems across three areas: Household activities, leisure activities and pain management. Arthritis Care and Research 7: 20-28, 1994.}, Year = {1994}, Key = {fds137780} } @article{fds137781, Title = {Keefe, F.J. & Lefebvre, J. Pain behavior concepts: Controversies, current status, and future directions. In G. Gebhart, D.L., Hammond, & T.S. Jensen (Eds) Proceedings of the VIIth World Congress on Pain. New York: Elsevier (1994) pp. 127-148.}, Year = {1994}, Key = {fds137781} } @article{fds137761, Title = {Keefe FJ, Van Horn Y: Cognitive-behavioral treatment of rheumatoid arthritis pain: Understanding and enhancing maintenance of treatment gains. Arthritis Care and Research 6: 213-222, 1993.}, Year = {1993}, Key = {fds137761} } @article{fds137777, Title = {Tota-Faucette ME, Gil KM, Williams DA, Keefe FJ, Goli V: Predictors of response to pain management treatment: The role of family environment and changes in cognitive processes. Clinical Journal of Pain 9: 115-123, 1993.}, Year = {1993}, Key = {fds137777} } @article{fds137778, Title = {Parker JC, Bradley LA, Devellis RM, Gerber LH, Holman HR, Keefe FJ, Lawrence TS, Liang M, Lorig KR, Nicassio PM, Revenson TA, Rogers MP, et al. Biopsychosocial contributions to the management of arthritis disability: Proceedings from an NIDRR-sponsored conference. Arthritis and rheumatism 36: 885-889, 1993.}, Year = {1993}, Key = {fds137778} } @article{fds137776, Title = {Keefe FJ, Dunsmore J, Burnett R: Behavioral and cognitive-behavioral approaches to chronic pain: Recent advances and future directions. Journal of Consulting and Clinical Psychology 60: 528-536, 1992.}, Year = {1992}, Key = {fds137776} } @article{fds137775, Title = {Keefe FJ, Caldwell DS, Williams DA, Gil KM, et al.: Pain coping skills training in the management of osteoarthritic knee pain: A comparative study. Behavior Therapy 21: 49-62, 1990.}, Year = {1990}, Key = {fds137775} } @article{fds137760, Title = {Keefe FJ, Manuel JC, Brantley AB, Crisson JE: Pain in the head and neck cancer patient: Changes over treatment. Head and Neck Surgery 8: 169-176, 1986.}, Year = {1986}, Key = {fds137760} } @article{fds137759, Title = {Rosentiel AK, Keefe FJ: The use of coping strategies in chronic low back pain patients: Relationship to patient characteristics and current adjustment Pain 17: 33-44, 1983.}, Year = {1983}, Key = {fds137759} } @article{fds137758, Title = {Keefe FJ, Block AR: Development of an observation method for assessing pain behavior in chronic low back pain patients. Behavior Therapy 13: 363-375, 1982.}, Year = {1982}, Key = {fds137758} } %% Chapters in Books @misc{fds322761, Author = {Somers, TJ and Keefe, FJ and Kothadia, S and Pandiani, A}, Title = {Dealing with cancer pain: Coping, pain catastrophizing, and related outcomes}, Booktitle = {Cancer Pain: From Molecules to Suffering}, Year = {2015}, Month = {June}, ISBN = {9780931092817}, Key = {fds322761} } @misc{fds330873, Author = {Lester, N and Keefe, FJ and Rumble, ME}, Title = {Coping with chronic pain}, Pages = {50-55}, Booktitle = {Cambridge Handbook of Psychology, Health and Medicine, Second Edition}, Publisher = {Cambridge University Press}, Year = {2014}, Month = {January}, ISBN = {9780511543579}, url = {http://dx.doi.org/10.1017/CBO9780511543579.012}, Abstract = {Chronic pain is a problem that affects millions of individuals every year. Much of chronic pain is associated with significant progressive degenerative disease. Such diseases include arthritis and cancer, and involve prolonged severe pain which may be only partially ameliorated through the use of analgesic medication. This chapter examines the ways in which individuals cope with chronic pain. We describe how pain coping is conceptualized and measured and discuss what has been learned about adaptive and maladaptive methods for coping with chronic pain. We conclude with an exploration of new directions for research in this area. Coping with chronic pain Coping has been defined as the process of managing stressful situations, either external or internal, that are viewed as taxing an individual’s adaptive resources (Lazarus & Folkman, 1984). The ways in which individuals view or appraise potentially stressful situations is an important component of this process definition of coping. In chronic pain, the ways in which a patient views pain are particularly important in their reactions to pain. Individuals may view pain as unpredictable and feel very little control over pain flares. Conversely, they may view pain as a constant irritation but one that can often be dealt with successfully. Coping with pain can be thought of as cognitions and behaviours that serve to manage or decrease the sensation of pain and distress caused by pain. Within this basic framework, researchers have formulated several models of pain-coping.}, Doi = {10.1017/CBO9780511543579.012}, Key = {fds330873} } @misc{fds330874, Author = {Waters, SJ and Dixon, KE and Perri, LC and Keefe, FJ}, Title = {Pain assessment}, Pages = {300-304}, Booktitle = {Cambridge Handbook of Psychology, Health and Medicine, Second Edition}, Publisher = {Cambridge University Press}, Year = {2014}, Month = {January}, ISBN = {9780511543579}, url = {http://dx.doi.org/10.1017/CBO9780511543579.065}, Abstract = {Over the past four decades, approaches to the assessment of chronic pain have evolved substantially within the field of behavioural medicine. During this time, it has become apparent that what we label as ‘pain’ is the result of complex interactions among biological, psychological and social factors. The gate control theory of pain (Melzack & Wall, 1965) supports this paradigm in that it confirms that pain is a complex experience involving sensory–discriminative, evaluative–cognitive and affective–motivational components, thus emphasizing the role of the central nervous system in nociceptive perception and processing. Further, the gate control theory provides a foundation for the development and refinement of integrated pain assessment models, such as the biopsychosocial model of pain (Turk, 1996). The biopsychosocial model of pain acknowledges that the experience of pain often is the result of physiological changes occurring after peripheral nociceptive stimulation (Turk, 1996). However, this model also emphasizes that the pain experience is modulated by individual differences in various cognitive, affective, behavioural and social factors. People with the same level of underlying nociceptive stimulation may differ in their pain experience depending on the importance of any factor at any given time during the course of the disease or condition (Asmundson & Wright, 2004). Thus, assessing pain necessitates the examination of relations among various factors across a variety of levels (Stoney & Lentino, 2000). During the latter part of the twentieth century, Melzack (1999) proposed an expanded model of pain which further highlights the role of psychological processes in pain.}, Doi = {10.1017/CBO9780511543579.065}, Key = {fds330874} } @misc{fds355633, Author = {Bennell, KL and Wrigley, TV and Keefe, FJ and Hinman, RS}, Title = {Behavioral rehabilitation approaches in osteoarthritis}, Pages = {649-678}, Booktitle = {The Handbook of Behavioral Medicine}, Year = {2014}, Month = {January}, ISBN = {9781118453995}, url = {http://dx.doi.org/10.1002/9781118453940.ch31}, Abstract = {Exercise and weight loss if overweight or obese are key components in the management of osteoarthritis (OA), but attention to adherence is important for long-term benefits. Conservative behavioral strategies for OA include patient education, use of braces, orthotics, gait aids, and appropriate footwear. Gait retraining to reduce knee load requires further research before it can be recommended in clinical practice. Of the psychological interventions, pain-coping skills training, with and without spouse involvement, has been shown to be effective in people with knee OA.}, Doi = {10.1002/9781118453940.ch31}, Key = {fds355633} } @misc{fds328088, Author = {Naylor, MR and Seminowicz, DA and Somers, TJ and Keefe, FJ}, Title = {Pain imaging}, Pages = {439-467}, Booktitle = {Handbook of Pain and Palliative Care: Biobehavioral Approaches for the Life Course}, Publisher = {Springer New York}, Year = {2013}, Month = {January}, ISBN = {9781441916501}, url = {http://dx.doi.org/10.1007/978-1-4419-1651-8_27}, Doi = {10.1007/978-1-4419-1651-8_27}, Key = {fds328088} } @misc{fds372587, Author = {Keefe, FJ}, Title = {Acute Pain: A Psychosocial Perspective}, Pages = {41-52}, Booktitle = {Acute Pain Management}, Publisher = {Cambridge University Press}, Year = {2009}, Month = {April}, ISBN = {9780521874915}, url = {http://dx.doi.org/10.1017/cbo9780511576706.006}, Doi = {10.1017/cbo9780511576706.006}, Key = {fds372587} } @misc{fds273574, Author = {Keefe, FJ}, Title = {Acute pain: A psychosocial perspective}, Pages = {41-52}, Booktitle = {Acute Pain Management}, Publisher = {Cambridge University Press}, Year = {2009}, Month = {January}, ISBN = {9780521874915}, url = {http://dx.doi.org/10.1017/CBO9780511576706.005}, Abstract = {Our understanding of the psychosocial aspects of pain has advanced considerably since the early 1980s. Much has been learned about psychosocial factors that influence pain and psychosocial interventions that can enhance pain control. Recently, there has been growing interest in applying the psychosocial perspective to enhance our understanding and ability to treat acute pain. This chapter focuses specifically on psychosocial aspects of acute pain. The chapter is divided into four sections. The first section provides a conceptual background on psychosocial aspects of acute pain. The second section highlights research on the role of psychosocial factors in acute pain. The third summarizes the results of recent studies testing the efficacy of psychosocial interventions for acute pain. The chapter concludes with a discussion of future directions for work in this important area. Conceptual Background: Traditionally, acute pain has been understood using a biomedical model. According to this model, acute pain is a warning signal that results from nociceptive input as a result of tissue damage or injury. In the biomedical approach, careful assessments are conducted to identify sources of tissue damage or injury that are causing pain. Medical and/or surgical interventions designed to correct or ameliorate underlying tissue damage or injury are then carried out to eliminate or reduce pain. In the biomedical model, psychosocial factors play a secondary role in that they are viewed simply as responses to pain itself.}, Doi = {10.1017/CBO9780511576706.005}, Key = {fds273574} } @misc{fds273575, Author = {Keefe, FJ and Abernethy, AP and Wheeler, JL and Somers, TJ}, Title = {Psychological interventions for cancer pain}, Pages = {343-353}, Booktitle = {Cancer Pain: Assessment and Management, Second Edition}, Year = {2009}, Month = {January}, ISBN = {9780521879279}, url = {http://dx.doi.org/10.1017/CBO9780511642357.019}, Abstract = {Over the past 15 years, psychological interventions have emerged as a useful adjunct to medical approaches to cancer pain management. Psychological interventions offer several advantages in cancer pain management. First, they can enhance patients' sense of self-efficacy (i.e., confidence) in their own abilities to control pain. Increased self-efficacy for pain control has been linked to lower psychological distress, less interference of pain with daily activities, and improved quality of life. Second, psychological interventions teach patients skills that can be applied to many of the day-to-day challenges of living with persistent pain, such as coping with pain flares, managing emotional reactions to pain (e.g., anxiety, fear, depression), and maintaining an active and rewarding life despite having pain. Third, psychological interventions and pain medications may have synergistic effects for cancer patients and produce an array of benefits (e.g., decreased pain, improved mood, enhanced interpersonal interactions) that may not be achieved by alone. Finally, psychological interventions may offer a viable pain management option for patients who respond poorly or have difficulty tolerating pain medications. This chapter provides an introduction to psychological approaches to managing cancer pain. The chapter is divided into three sections. The first section highlights the challenges of cancer pain. This section emphasizes the fact that psychological interventions for pain are delivered in the context of multiple ongoing challenges faced by persons having cancer pain.}, Doi = {10.1017/CBO9780511642357.019}, Key = {fds273575} } @misc{fds330871, Author = {Patton, LL and Griffiths, PJ}, Title = {Foreward}, Pages = {xi-xii}, Booktitle = {Brannon M. Wheeler's Applying the Canon in Islam: The Authorization and Maintenance of Interpretive Reasoning in Hanafi Scholarship}, Publisher = {Albany: State University of New York Press}, Year = {1996}, ISBN = {9780128005385}, url = {http://dx.doi.org/10.1016/B978012800538506001-5}, Doi = {10.1016/B978012800538506001-5}, Key = {fds330871} } | |
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