Evaluating psychosocial contributions to chronic pain outcomes

In the paper

“in a recent analysis of large acupuncture trials revealed that both patient and provider expectations for treatment success were strong predictors of response, with better pretreatment expectations predicting improved post-treatment pain and physical functioning 362, 364.”

What the sources say

• ?Could not verify

  Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.

  cites [362] sourceExperimental — accuracy not yet measured
• ?Could not verify

  The Materials and methods (Primary outcome measure; page unavailable) describe a study of pharmacotherapy for peripheral neuropathic pain, and the Results (Abstract; page unavailable) associate catastrophizing with poorer treatment response. Searches for acupuncture trials and patient or provider pretreatment expectations found no passage in our copy addressing the attributed finding. (LLM, conf=0.77)

  cites [364] sourceExperimental — accuracy not yet measured

In the paper

“Collectively, the biopsychosocial approach describes pain and disability as a multidimensional, dynamic interaction among physiological, psychological, and social factors that reciprocally influence one another, resulting in chronic and complex pain syndromes7, 12.”

What the sources say

• Not checked yetcites [7] source
• Not checked yetcites [12] source

In the paper

“The biopsychosocial model of pain dominates the scientific community’s understanding of chronic pain.”

In the paper

“Historically, the concept of pain, even chronic pain, depended on a linear relationship between identifiable organic pathology and patient-reported symptoms.”

In the paper

“Psychological factors were presumed to be primary mechanistic contributors to pain only in those cases where no identifiable pathology was present and the pain could be labeled as “psychogenic”.”

In the paper

“In the first category, psychosocial processes either exist within an individual as pre-existing “vulnerability” factor [e.g., distress20–22, trauma23, 24] or emerge for the first time in response to the experience of ongoing pain [e.g., fear-avoidance behavior 25, self-efficacy26, 27].”

What the sources say

• Not checked yetcites [20] source
• Not checked yetcites [21] source
• Not checked yetcites [22] source
• Not checked yetcites [23] source
• Not checked yetcites [24]
• Not checked yetcites [25] source
• Not checked yetcites [26] source
• Not checked yetcites [27] source

In the paper

“the report of pain is always subjective, influenced by a broad range of cognitive, behavioral, and affective constructs and processes.”

In the paper

“specific psychosocial characteristics place individuals at elevated risk for the transition from acute to persistent pain, or for the development of pain-related disability in the context of a persisting pain condition 15, 22, 28, 29.”

What the sources say

• Not checked yetcites [15] source
• Not checked yetcites [22] source
• Not checked yetcites [28] source
• Not checked yetcites [29] source

In the paper

“The second category of mechanistic study involves delivery of some type of pain-related intervention that is hypothesized to directly affect a psychological factor, presuming that changing that psychosocial factor (e.g., reducing distress, improving pain-coping, etc) will be associated with a subsequent change in one or more pain-related outcomes.”

What the sources say

• Not checked yetcites [30] source
• Not checked yetcites [31] source

In the paper

“assessment, diagnosis, prognosis, and consequently treatment of the patient with persistent pain requires a broad strategy that examines and incorporates a wide range of psychosocial and behavioral factors in addition to, but not to the exclusion of, biomedical ones.”

In the paper

“patients in the upper half of the distribution of pre-operative depression scores were approximately ⅓ less likely to return to work and, among those who did return, took nearly twice as long post-operatively to begin working again 56.”

What the sources say

• Not checked yetcites [56] source

In the paper

“results of a 20-month longitudinal study indicate that depression and anxiety longitudinally predict pain and pain-related disability, however neither pain nor pain-related disability predicted depression and anxiety 21.”

What the sources say

• Not checked yetcites [21] source

In the paper

“PAIs are aimed at raising positive feelings, cognitions, and behaviors rather than reducing negative ones63.”

What the sources say

• Not checked yetcites [63] source

In the paper

“Dispositional optimism has not only been linked to lower pain sensitivity, but a recent study by Hanssen and colleagues identified that optimism improves pain intensity through its effects on reducing situational pain catastrophizing 57.”

What the sources say

• Not checked yetcites [57] source

In the paper

“These variables are not condition-specific; indeed most have been studied across diagnostic categories with similar results.”

In the paper

“Several studies found that patients reporting positive general social support but lacking solicitous responses to pain were less likely to develop persistent phantom limb pain post-amputation and report lower levels of physical dysfunction 85, 107, 109.”

What the sources say

• Not checked yetcites [85] source
• Not checked yetcites [107] source
• Not checked yetcites [109] source

In the paper

“Guillory and colleagues101 found that a text message-based social support intervention was effective in reducing pain severity and interference and increasing positive affect.”

What the sources say

• Not checked yetcites [101] source

In the paper

“experimental pain studies that demonstrate receiving social support during a pain task not only attenuates blood pressure, heart rate, and cortisol reactivity, but is also associated with reduced pain intensity and unpleasantness ratings and increased pain threshold 98–100.”

What the sources say

• Not checked yetcites [98] source
• Not checked yetcites [99] source
• Not checked yetcites [100] source

In the paper

“According to a metaanalysis of 23 studies, more than 50% of people diagnosed with TBI report chronic pain complaints 80, likely due to the associated physical injuries at the time of the TBI81.”

What the sources say

• Not checked yetcites [80] source
• Not checked yetcites [81] source

In the paper

“It remains unclear whether the association between trauma and later chronic pain is the result of the trauma or is driven by affective, cognitive, and behavioral responses to the traumatic event (e.g. fear and avoidance).”

In the paper

“there is significant comorbidity as well as symptom convergence between PTSD and TBI 82–84.”

What the sources say

• Not checked yetcites [82] source
• Not checked yetcites [83] source
• Not checked yetcites [84] source

In the paper

“some childhood stressful events such as prolonged hospitalization are associated with chronic pain in adulthood while childhood surgery conferred no additional risk, despite the likelihood that surgery is a painful and distressing experience for children 67.”

What the sources say

• Not checked yetcites [67] source

In the paper

“PTSD, a psychiatric condition resulting from exposure to a traumatic event and characterized by hyperarousal, avoidance, and reexperiencing, is not only a risk factor for chronic pain 71, 72, but is associated with increased risk for the transition from acute to chronic pain.”

What the sources say

• Not checked yetcites [71] source
• Not checked yetcites [72]

In the paper

“According to the stress-buffering hypothesis, negative consequences of stressors on health outcomes can be buffered by social support 86.”

What the sources say

• Not checked yetcites [86] source

In the paper

“parental pain catastrophizing is strongly related to the development of children’s persistent pain following major surgery 115, and to the child’s disability 116.”

What the sources say

• Not checked yetcites [115] source
• Not checked yetcites [116] source

In the paper

“compared to males, females demonstrate a decreased threshold and tolerance for pain and increased pain intensity and unpleasantness for heat, cold, ischemic, and pressure pain 150, 161–164”

What the sources say

• Not checked yetcites [150] source
• Not checked yetcites [161] source
• Not checked yetcites [162] source
• Not checked yetcites [163] source
• Not checked yetcites [164] source

In the paper

“Such discordance is likely to be common, especially in light of the “invisible” nature of pain, and it can have deleterious effects on patient satisfaction and adherence to treatment regimens 147.”

What the sources say

• Not checked yetcites [147] source

In the paper

“Lack of social support at work, dissatisfaction with co-workers, and interactions with the disability compensation system are among the most potent predictors of pain-related work disability 89, 131, 132.”

What the sources say

• Not checked yetcites [89] source
• Not checked yetcites [131] source
• Not checked yetcites [132] source

In the paper

“musculoskeletal pain, rheumatoid arthritis, gastrointestinal, neuropathic, facial pain and headache are all more prevalent among females compared to males 156–160.”

What the sources say

• Not checked yetcites [156] source
• Not checked yetcites [157] source
• Not checked yetcites [158] source
• Not checked yetcites [159] source
• Not checked yetcites [160] source

In the paper

“Individuals with anxious or insecure attachment styles are at elevated risk for poorer mental and physical health 128, for reduced engagement in physical activity 129, and for less treatment- related improvement in affective outcomes among patients participating in a multidisciplinary treatment program 130.”

What the sources say

• Not checked yetcites [128] source
• Not checked yetcites [129] source
• Not checked yetcites [130] source

In the paper

“In a review, Unruh 155 found that, compared to men, women are more likely to experience recurrent pain, more severe pain, more frequent pain, and longer-lasting pain.”

What the sources say

• Not checked yetcites [155] source

In the paper

“Anxiety, which is associated with increased clinical pain and experimental pain sensitivity 161, 207”

What the sources say

• Not checked yetcites [161] source
• Not checked yetcites [207] source

In the paper

“Compared with males, females demonstrate increased sensitivity to pain-induced muscle reflexes 165 and show increased pupil dilation 166 as well as amplified cerebral activation in response to pain 167.”

What the sources say

• Not checked yetcites [165] source
• Not checked yetcites [166] source
• Not checked yetcites [167] source

In the paper

“Compared to males, females exhibit a more pronounced temporal summation response 172–174 suggesting differences in the central processing of nociceptive stimuli.”

What the sources say

• Not checked yetcites [172] source
• Not checked yetcites [173] source
• Not checked yetcites [174] source

In the paper

“Several studies indicate the DNIC response is more pronounced in males than females, suggesting better functioning of the endogenous pain inhibitory system among males 176–178.”

What the sources say

• Not checked yetcites [176] source
• Not checked yetcites [177] source
• Not checked yetcites [178] source

In the paper

“women show a higher μ opioid receptor binding at rest while men exhibit greater μ- opioid receptor binding in response to experimentally induced pain 192”

What the sources say

• Not checked yetcites [192] source

In the paper

“Males often adopt the masculine gender norm of increased pain tolerance while females adopt a norm accepting pain as a normal part of life 193.”

What the sources say

• Not checked yetcites [193] source

In the paper

“has been suggested as a potential mediator of sex differences in pain sensitivity 208.”

What the sources say

• Not checked yetcites [208]

In the paper

“Using the Gender Role Expectation of Pain (GREP) questionnaire, Robinson and colleagues found that women were considered more sensitive to pain, less enduring of pain, and more willing to report pain compared to men 194, 198, 200.”

What the sources say

• Not checked yetcites [194] source
• Not checked yetcites [198] source
• Not checked yetcites [200]

In the paper

“a recent study demonstrated that males endorsing greater masculine gender traits are more likely to participate pain studies, offering a potential explanation for sex differences in pain responses 199.”

What the sources say

• Not checked yetcites [199] source

In the paper

“studies demonstrating similar prevalence across prepubescent males and females for conditions such as migraine and temporomandibular disorders with differences in prevalence emerging after puberty 149, 182–184.”

What the sources say

• Not checked yetcites [149] source
• Not checked yetcites [182] source
• Not checked yetcites [183] source
• Not checked yetcites [184]

In the paper

“sex differences in pain threshold were no longer significant after controlling for willingness to report pain and sex differences in temporal summation of heat pain was partially mediated by willingness to report pain 200.”

What the sources say

• Not checked yetcites [200]

In the paper

“However, it remains unclear whether depression mediates the sex differences in pain perception.”

In the paper

“several studies have shown that anxiety is positively correlated with pain sensitivity among males, but not females 211, 212”

What the sources say

• Not checked yetcites [211] source
• Not checked yetcites [212] source

In the paper

“Depression, which is highly comorbid with pain, is also more prevalent in women than men; among individuals with depression, women are more likely to report pain complaints than men 213, 214”

What the sources say

• Not checked yetcites [213] source
• Not checked yetcites [214]

In the paper

“Black individuals are more prone than non-Hispanic Whites to experience hypertension and show cardiovascular reactivity to pain, which may, in turn, influence their pain perception 230.”

What the sources say

• Not checked yetcites [230] source

In the paper

“Approximately 20% of individuals with chronic pain also have depression, while less than 7% of the general population experiences this disorder, and these findings hold not just for the U.S. but around the world 231–235.”

What the sources say

• Not checked yetcites [231] source
• Not checked yetcites [232] source
• Not checked yetcites [233] source
• Not checked yetcites [234] source
• Not checked yetcites [235] source

In the paper

“Similar findings have been noted for Asian Americans, who report a greater intensity of daily joint pain than non-Hispanic whites, and who demonstrate enhanced sensitivity to thermal and mechanical pain stimuli applied in a laboratory setting 225, 226.”

What the sources say

• Not checked yetcites [225] source
• Not checked yetcites [226] source

In the paper

“Black patients are less likely to receive effective treatment and more likely than Whites to rate their depression as severe and disabling 237–241.”

What the sources say

• Not checked yetcites [237] source
• Not checked yetcites [238] source
• Not checked yetcites [239] source
• Not checked yetcites [240] source
• Not checked yetcites [241] source

In the paper

“Beyond psychological distress, pain-specific factors such as appraisals, expectations, and coping are also related to pain sensitivity and may influence the race differences observed in the pain experience.”

In the paper

“Multiple published studies have suggested that a greater degree of perceived daily racial discrimination is associated with elevated rates of chronic pain and enhanced sensitivity to pain in the laboratory among samples of African-American participants 252–254.”

What the sources say

• Not checked yetcites [252]
• Not checked yetcites [253] source
• Not checked yetcites [254] source

In the paper

“An abundance of evidence links depression and anxiety to chronic pain and increased pain sensitivity 11, 13, 32, 41.”

What the sources say

• Not checked yetcites [11] source
• Not checked yetcites [13] source
• Not checked yetcites [32]

In the paper

“In addition to the socioeconomic strain often associated with minority status, Black individuals are frequently exposed to racism 248–250.”

What the sources say

• Not checked yetcites [248] source
• Not checked yetcites [249] source
• Not checked yetcites [250] source

In the paper

“Although Blacks are less likely than non-Hispanic Whites to report experiencing depression and anxiety, the chronicity of Major Depressive Disorder is higher among Black individuals than Caucasians, and Black patients are less likely to receive effective treatment and more likely than Whites to rate their depression as severe and disabling 237–241.”

What the sources say

• Not checked yetcites [237] source
• Not checked yetcites [238] source
• Not checked yetcites [239] source
• Not checked yetcites [240] source
• Not checked yetcites [241] source

In the paper

“Black individuals demonstrate a lower tolerance and report higher pain intensity and unpleasantness ratings than non-Hispanic Whites during experimental pain tasks 162, 221–224”

What the sources say

• Not checked yetcites [162] source
• Not checked yetcites [221] source
• Not checked yetcites [222] source
• Not checked yetcites [223]
• Not checked yetcites [224] source

In the paper

“Another hypothesis relates to sociocultural factors that cause chronic stress, especially in Black individuals.”

In the paper

“catastrophizing is associated with higher pain levels, poorer physical functioning and disability, and increased pain interference 13, 32, 278, 279.”

What the sources say

• Not checked yetcites [13] source
• Not checked yetcites [32]
• Not checked yetcites [278] source

In the paper

“Likewise, hoping and praying is also correlated with higher levels of disability, more pain interference, and increased pain severity 280–283.”

What the sources say

• Not checked yetcites [280] source
• Not checked yetcites [281]
• Not checked yetcites [282] source
• Not checked yetcites [283] source

In the paper

“recent evidence suggests that catastrophizing may be the principal psychosocial driver of persistent pain symptoms, statistically mediating the prospective influence of factors such as anxiety on post-operative pain outcomes 302.”

What the sources say

• Not checked yetcites [302] source

In the paper

“Active coping strategies, for example, have been linked to positive affect, better psychological adjustment, and decreased depression while passive strategies are linked to poorer outcomes such as increased pain and depression 258, 267–270.”

What the sources say

• Not checked yetcites [258] source
• Not checked yetcites [267] source
• Not checked yetcites [268] source
• Not checked yetcites [269] source
• Not checked yetcites [270] source

In the paper

“Differences in pain coping are associated with differences in pain intensity, adjustment to chronic pain, and psychological and physical functioning 85, 263–266.”

What the sources say

• Not checked yetcites [85] source
• Not checked yetcites [263] source
• Not checked yetcites [264] source
• Not checked yetcites [265] source
• Not checked yetcites [266] source

In the paper

“Further, catastrophizing is a risk factor for the development of chronic pain, pain-related disability, increased healthcare costs, and increased pain sensitivity for low back pain and joint pain 13.”

What the sources say

• Not checked yetcites [13] source

In the paper

“Vlaeyen and colleagues suggest that avoidance behavior persists due to certain beliefs, such as catastrophic cognitions 25, 337, 338.”

What the sources say

• Not checked yetcites [25] source
• Not checked yetcites [337] source
• Not checked yetcites [338] source

In the paper

“Pain-related expectations also influence the experience of pain as well as treatment outcomes.”

What the sources say

• Not checked yetcites [346] source
• Not checked yetcites [347] source

In the paper

“both solicitous and punishing responses to pain are associated with higher pain intensity 108 and increased depressive symptoms 106, 340, suggesting these social factors may be a mechanism by which catastrophizing affects pain outcomes.”

What the sources say

• Not checked yetcites [108] source
• Not checked yetcites [106] source
• Not checked yetcites [340]

In the paper

“Generalized positive outcome expectancy, or dispositional optimism 348–350, is related to increased feelings of control, the use of more active coping strategies, and better functional performance 91, 351–353.”

What the sources say

• Not checked yetcites [348] source
• Not checked yetcites [349] source
• Not checked yetcites [350] source
• Not checked yetcites [91] source
• Not checked yetcites [351] source
• Not checked yetcites [352] source
• Not checked yetcites [353] source

In the paper

“associations between catastrophizing and perceived solicitous responses 339, 340, 343, perceived instrumental support 103, and perceived critical responses to pain 106 have been observed.”

What the sources say

• Not checked yetcites [339] source
• Not checked yetcites [340]
• Not checked yetcites [343] source

In the paper

“Expectations are related to overall well-being and the development of chronic pain and are also a critical component of responses to treatment for both placebo and active treatments 346,347.”

What the sources say

• Not checked yetcites [346] source
• Not checked yetcites [347] source

In the paper

“In samples of adults and children with chronic headaches, pain-related self-efficacy is associated with less disability, better functioning, and fewer depressive symptoms 370, 371.”

What the sources say

• Not checked yetcites [370] source
• Not checked yetcites [371] source

In the paper

“Self-efficacy, or an individual’s belief in his ability to perform a behavior or achieve a desired outcome 26, 273, determines thoughts, feelings, and behaviors in stressful situations and affects one’s ability to cope successfully when confronted with challenges 367, 368.”

What the sources say

• Not checked yetcites [26] source
• Not checked yetcites [273] source
• Not checked yetcites [367] source

In the paper

“Pain-related self-efficacy, a protective factor for patients with persistent pain and a resiliency factorfor children, adolescents, and adults with chronic pain 270, predicts functional pain outcomes.”

What the sources say

• Not checked yetcites [270] source

In the paper

“A growing number of neuroimaging studies have suggested that variability in catastrophizing is associated with individual differences in the functional brain response to a variety of stimuli, as well as potential alterations in brain morphology 359, 384, 387, 389–395.”

What the sources say

• Not checked yetcites [359] source
• Not checked yetcites [384] source
• Not checked yetcites [387] source

In the paper

“Likewise, Mindfulness-based Stress Reduction (MBSR) has similar effects on self-efficacy, with no significant differences between CBT and MBSR in their effect on improving self-efficacy 376”

What the sources say

• Not checked yetcites [376] source

In the paper

“it is important to acknowledge that psychological and social factors are not solely secondary reactions to persistent pain; rather, they form an interactive complex of biopsychosocial processes that characterizes chronic pain.”

In the paper

“A study in patients with chronic low back pain reported that patients had exaggerated and abnormal amygdala connectivity with central executive network structures, and this connectivity was most exaggerated in patients with the greatest pain catastrophizing 385.”

What the sources say

• Not checked yetcites [385] source

In the paper

“Moreover, the context in which individuals reside will also have an important role.”

In the paper

“negative affective responses to pain, and pain-related catastrophizing are as prominent in adolescent patients 400–402”

What the sources say

• Not checked yetcites [400] source
• Not checked yetcites [401] source
• Not checked yetcites [402] source

In the paper

“a very recent study in patients with fibromyalgia reported reduced connectivity between periaqueductal gray (a critical hub for pain-inhibitory circuits) and prefrontal regions, and the patients highest in catastrophizing showed the highest degree of anti-correlation between these regions 395.”

What the sources say

• Not checked yetcites [395] source

In the paper

“Since chronic pain persists overtime, each of these areas will, in turn, affect the experience and reporting of pain and related symptoms.”