The publication data currently available has been vetted by Vanderbilt faculty, staff, administrators and trainees. The data itself is retrieved directly from NCBI's PubMed and is automatically updated on a weekly basis to ensure accuracy and completeness.
If you have any questions or comments, please contact us.
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.
Evidence is presented for the utilization of a shortened version of the Arthritis Impact Measurement Scales. The results confirmed that the shortened versions retained adequate internal consistencies, test-retest reliabilities, and both concurrent and predictive validities over a 2 year period which were similar to the original longer versions.
A community-based group of gastroenterologists examined 623 patients (541 prospectively and 82 retrospectively) with endoscopically diagnosed gastric ulcer disease during a 12-month period. Patients averaged 60 years of age; the majority were women (62%). Women were less likely to smoke, abuse alcohol, and were more likely to present with abdominal pain (p less than 0.05). Whereas patients presenting with bleeding or requiring transfusion were less likely to complain of pain (p less than 0.05), they were more likely to be taking aspirin or nonsteroidal anti-inflammatory drugs and have prior history of bleeding (p less than 0.05). Patients with a prior history of ulcer disease were more likely to smoke, present with pain and use acetaminophen (p less than 0.05). Patients with large ulcers were more likely to bleed, present with pain, and obstruct (p less than 0.05). Multiple gastric ulcers were seen in patients taking aspirin or nonsteroidal anti-inflammatory drugs (p less than 0.05).
A recently developed animal model for the L-tryptophan-associated eosinophilia myalgia syndrome was used to examine the small intestine and colon, because there is clinical involvement at these sites in patients. Increased perivascular inflammatory infiltrates rich in degranulating mast cells, eosinophils, and monocytes were seen in the lamina propria of experimental animals when compared with controls. L-Tryptophan-associated disease also shares many clinical features with idiopathic scleroderma/eosinophilic fasciitis, in which there is gastrointestinal involvement as well. These features are similar to those found in the recently described animal model. The apparent morphologic and clinical similarities between these entities suggest that the animal model is suitable for further studying the pathogenesis of the gastrointestinal involvement in all these diseases.
To assess the incidence and relationship of cognitive/intellectual impairments to pain problems, seventy-three adults with musculoskeletal pain seen in a PM&R outpatient clinic were screened using the Neurobehavioral Cognitive Status Examination (NCSE). Subjective pain complaints were assessed using portions of the McGill Pain Questionnaire. Patients with prior diagnoses of neurocognitive problems or those who had taken narcotic analgesics in the last 24 hours were excluded. Results showed that 32 percent of subjects had impaired performance in at least one cognitive domain. Individuals with poorer performance on the NCSE had higher levels of reported pain or disability and psychological distress. Possible factors contributing to poor performance on cognitive tasks include psychological disorders or distress, undiagnosed organic brain dysfunction, social/psychological factors such as education, or a combination of these. Results suggest the need for further research to understand the relationship of poor performance on cognitive tasks to the etiology, maintenance and rehabilitation of pain problems.
We derived a model of appraisal, coping, and adaptation in patients with rheumatoid arthritis (RA) from the more general theory of Lazarus and Folkman (1984) and examined this model using a longitudinal data set spanning 4 years and involving 239 RA patients (of whom 157 contributed to the primary analyses, with the remainder contributing to various follow-up analyses). This model attempted to identify the short- and long-term adaptational consequences of coping as well as the antecedents (appraisals, beliefs, social support, disease activity, etc.) that promote particular coping styles. Interrelations among the variables were examined using path-analytic techniques. Many observed relations were consistent with the model. Significant relations were subjected to more stringent analyses examining the ability of hypothesized causal variables to predict changes in outcome variables 1 year later. These analyses provided additional support for many observed relations and suggested the existence of a vicious cycle involving helplessness appraisals, passive coping with pain, and psychosocial impairment that promotes maladaptation in the face of RA. Theoretical implications, strengths, and limitations of the study are discussed.
Hypertension has been found to be related to decreased sensitivity to painful stimuli. The current study explored whether this relationship extends into the normotensive range of blood pressures. Resting blood pressures were assessed in 60 male normotensives. Subjects then underwent a 1 min finger pressure pain stimulation trial. Pain ratings were inversely related to resting systolic blood pressure. This relationship was unrelated to emotional state or coping styles. Multiple regression analyses indicated that over one-third of the variance in pain ratings can be accounted for by resting blood pressure, coping style, and emotional state.
This research evaluated the relationship between pain and sleep problems, and the role of pain and sleep problems in depression, in a sample of 242 patients who had been diagnosed with definite or classical rheumatoid arthritis (RA). Patients completed the Pain scale of the Arthritis Impact Measurement Scales, the Center for Epidemiological Studies Depression Scale, and self-reports of sleep disturbance at two data waves over a 2-year interval. Cross-sectional multiple regression analysis revealed that the sleep problems variable was independently associated with depression at Time 1. Longitudinal multiple regression analyses demonstrated that prior pain predicted subsequent adverse changes in sleep problems, whereas sleep problems did not affect pain over time, and prior pain and the interaction of high pain and high sleep problems were independently associated with depression from Time 1 to Time 2. These data suggest that pain may exacerbate sleeping difficulty in RA patients, and that both factors may contribute to depression over time.