Biomedical subjects

Geert Crombez

Publications and source records attributed to Geert Crombez.

At least 55 records · Page 3Linked to original sources

PubMed2004

Low back pain, disability and back pain myths in a community sample: prevalence and interrelationships.

This study investigated the prevalence of back pain, disability, and, of most importance, the presence of misconceptions about low back pain (LBP), its diagnosis and treatment in a bicultural community sample (Belgium). Using the Graded Chronic Pain Scale [Pain 50 (1992) 133] persons were classified according to pain intensity and disability in five subgroups. The interrelationship between LBP beliefs and these five subgroups was also investigated. In our sample (n=1624) the 6-month prevalence of low back pain was 41.8%. Only in 8.2% back pain was disabling. Misconceptions about back pain were widespread, even in the group reporting no back pain. The least misconceptions were found to exist in participants with mild LBP without disability. It is suggested that recovery from an episode of acute low back pain is an active process that involves a correction of beliefs about harm, about the need to restrict physical activities and about medical diagnosis and cure. Finally, it is argued that community actions may be useful to correct LBP myths in order to prevent the development of long-term disability due to LBP.

Activities of Daily Living↗

PubMed2004

The Tampa Scale for Kinesiophobia: further examination of psychometric properties in patients with chronic low back pain and fibromyalgia.

The present study attempted to replicate the robustness of a two-factor model of the Tampa Scale for Kinesiophobia (TSK) in chronic low back pain (CLBP) patients and fibromyalgia patients, by means of confirmatory factor analysis. Construct and predictive validity of the TSK subscales were also examined. Results clearly indicated that a two-factor model fitted best in both pain samples. These two factors were labelled somatic focus, which reflects the belief in underlying and serious medical problems, and activity avoidance, which reflects the belief that activity may result in (re)injury or increased pain. Construct validity of the TSK and its subscales was supported by moderate correlation coefficients with self-report measures of pain-related fear, pain catastrophising, and disability, predominantly in patients with CLBP. Predictive validity was supported by moderate correlation coefficients with performance on physical performance tests (i.e., lifting tasks, bicycle task) mainly in CLBP patients. Implications of the results are discussed and directions for future research are provided.

Activities of Daily Living↗

PubMed2004

Implicit alcohol-related cognitions in a clinical sample of heavy drinkers.

Patients undergoing treatment in an alcohol-rehabilitation clinic performed an Extrinsic Affective Simon Task (EAST) and two Implicit Association Tests (IATs) that were designed to measure implicit attitudes toward alcohol or implicit alcohol-arousal associations. The EAST and IAT data indicated that patients had a more negative implicit attitude toward alcohol than toward softdrinks and possessed strong implicit alcohol-arousal associations. Our results replicate and extend those of Wiers et al. (J. Abnormal Psychol 111 (2002) 648).

Adult↗

PubMed2004

Fear-conditioned cues of impending pain facilitate attentional engagement.

AIMS OF STUDY: Selective attention to signals of impending pain allows the avoidance of bodily harm. In order to identify the attentional components involved in the selection of pain signals over competing demands, we used an emotional modification of an exogenous cueing task. METHODS: Fifty-two pain-free volunteers detected visual targets of which the location was correctly or incorrectly predicted by a spatial cue. Cues were emotionally modulated using differential classical conditioning. The conditioned cue (CS+) was sometimes followed by an electrocutaneous stimulus (UCS), thus becoming a pain signal, whereas the UCS never followed the other cue (CS-), referred to as safety signal. RESULTS: Analyses of response times showed that pain signals facilitated the directing of attention to their location in comparison to safety signals. In contrast, pain signals did not impair disengagement of attention from their location in comparison to safety signals. CONCLUSION: It is concluded that attention is more strongly engaged to a signal of impending pain compared with a cue signalling its absence. We explore why disengagement from the pain signal is not impaired compared to the safety signal. The findings are discussed in terms of the defensive importance of pain anticipation.

Adult↗

PubMed2004

Disengagement from pain: the role of catastrophic thinking about pain.

This paper reports an experimental investigation of attentional engagement to and disengagement from pain. Thirty-seven pain-free volunteers performed a cueing task in which they were instructed to respond to visual target stimuli, i.e. the words 'pain' and 'tone'. Targets were preceded by pain stimuli or tone stimuli as cues. Participants were characterized as high or low pain catastrophizers, using self-reports. We found that the effect of cueing upon target detection was differential for high and low pain catastrophizers. Analyses revealed a similar amount of attentional engagement to pain in both groups. However, we also found that participants high in pain catastrophizing had difficulty disengaging from pain, whereas participants low in pain catastrophizing showed no retarded disengagement from pain. Our results provide further evidence that catastrophic thinking enhances the attentional demand of pain, particularly resulting in difficulty disengaging from pain. The clinical implications of these findings are discussed.

Acoustic Stimulation↗

PubMed2004

The role of neuroticism, pain catastrophizing and pain-related fear in vigilance to pain: a structural equations approach.

The present study aimed at clarifying the precise role of pain catastrophizing, pain-related fear and personality dimensions in vigilance to pain and pain severity by means of structural equation modelling. A questionnaire survey was conducted in 122 patients with chronic or recurrent low back pain. Results revealed that pain catastrophizing and pain-related fear mediated the relationship between neuroticism and vigilance to pain. Furthermore, vigilance to pain was found to be associated with heightened pain severity. Finally, we found that neuroticism moderated the relationship between pain severity and catastrophic thinking about pain. The results strongly support the idea that vigilance to pain is dependent upon catastrophic thinking and pain-related fear. Neuroticism is best conceived of as a vulnerability factor; it lowers the threshold at which pain is perceived as threatening, and at which catastrophic thoughts about pain emerge.

Adult↗

PubMed2004

Adolescent chronic pain: patterns and predictors of emotional distress in adolescents with chronic pain and their parents.

Adolescents with chronic pain also report severe disability and emotional distress. A clinical sample of 80 adolescents and accompanying parents were investigated to first measure the extent of distress, and second to investigate the relationships between adolescent distress, parental distress and adolescent coping. Measures of pain intensity, anxiety, depression, disability and coping were obtained from adolescents. Parents completed measures including their own anxiety, depression and parenting stress. Overall, adolescents reported high levels of disability, depression and anxiety, and parents reported high levels of depression, anxiety and parenting stress. Multiple regression analyses revealed that the best predictors of adolescent emotional distress were the extent to which the adolescents catastrophize and seek social support to cope with the pain. There were no clear predictors of parental anxiety or depression but the specific pattern of parenting stress was best predicted by the younger age of the adolescent, the greater the chronicity of the problem, and the greater the extent of adolescent depression. These findings suggest that emotional coping is a critical variable in the distress associated with adolescent chronic pain. It is argued that adolescent emotional coping may best be understood within a relational context of seeking emotional support.

Adaptation, Psychological↗

PubMed2004

Distraction from chronic pain during a pain-inducing activity is associated with greater post-activity pain.

The aim of this study was to investigate the effects of distraction from pain during and after a pain-inducing lifting task in a sample of chronic low back pain (CLBP) patients. Fifty-two CLBP patients (25 males, 27 females; mean age=46.30 years) performed a pain-inducing lifting task twice, once alone and once with a simultaneous cognitive distraction task. The results revealed that (1) distraction had no effect upon self-reported pain during the lifting task, (2) distraction had a paradoxical effect of more pain immediately after the lifting task, (3) both pain-related fear and pain catastrophizing did not moderate the effects of distraction on pain, but (4) catastrophic thinking about pain during the lifting task was related to more vigilance to pain and less engagement in the distracting task. Further investigation of the catastrophizing data showed that the effect of catastrophizing about pain during the lifting task on the cognitive distraction task was mediated by the amount of attention paid to pain. Clinical implications of these findings are discussed.

Activities of Daily Living↗

PubMed2004

The anticipation of pain modulates spatial attention: evidence for pain-specificity in high-pain catastrophizers.

Recent studies have suggested that the anticipation of pain may modulate spatial attention. However, it is possible that this modulation reflects a general effect of anticipating somatosensory stimulation, without being pain-specific. In the present study, we therefore compared the effect of the anticipation of somatosensory stimulation on spatial attention between two groups, using conditioned signals in a spatial cueing paradigm. In the pain group, signals predicted painful electrocutaneous stimulation, whereas in the control group, signals predicted non-painful vibrotactile stimulation. Tests between both groups showed that attentional engagement was equally facilitated by the anticipation of somatosensory stimulation in both groups. Interestingly, disengagement of attention was more retarded by the anticipation of pain than by the anticipation of non-painful vibrotactile stimulation in participants high in catastrophic thinking about pain. Theoretical and clinical implications of these findings are discussed.

Adolescent↗

PubMed2004

Acceptance of the unpleasant reality of chronic pain: effects upon attention to pain and engagement with daily activities.

This paper investigates whether acceptance was related to less attention to pain, and to more engagement with daily activities. The results of two studies are reported. In a first cross-sectional study, 501 chronic pain patients completed self-report instruments on pain severity, attention to pain and acceptance. In a second diary study, 62 patients with chronic pain reported pain intensity, attention to pain and characteristics of goal-directed behaviour 8 times a day using an experience sampling method. Acceptance was measured using a self-report instrument. It was found that acceptance was related to less attention to pain (study 1 and study 2), more engagement with daily activities, a higher motivation to complete activities and a better efficacy to perform daily activities (study 2). Results are discussed in terms of how a positive life despite pain may be preserved by a flexible adjustment of personal goals to current limitations and adversities.

Activities of Daily Living↗

PubMed2004

Catastrophic thinking about pain increases discomfort during internal atrial cardioversion.

OBJECTIVES: This study investigated whether pain catastrophizing is associated with distress and perceived disability in patients with atrial fibrillation, whether pain catastrophizing predicts pain and fear during a medical procedure of atrial cardioversion, and whether pain catastrophizing influences the effects of an opioid analgesic during internal cardioversion. METHODS: A secondary analysis is performed upon data from a double-blind placebo-controlled trial during which the effect of intranasal butorphanol tartrate (INB) was evaluated in patients with atrial fibrillation using a step-up internal atrial cardioversion protocol. Before the procedure, patients completed measures of pain catastrophizing, mood, distress and perceived disability. After each shock, patients completed measures of pain and fear. RESULTS: We found that pain catastrophizing predicted the affective pain rating of the first shock, and the fear increase during subsequent shocks. There was no effect of INB. However, when controlling for the differences in pain catastrophizing, INB significantly reduced fear as compared to placebo. This suggests that the effects of INB during atrial cardioversion were overshadowed by the effects of pain catastrophizing. CONCLUSIONS: It is recommended that in future atrial cardioversion trials, stratification based on pain catastrophizing be performed. Reducing catastrophizing thinking about pain through cognitive-behavioral techniques are likely to reduce levels of fear during internal atrial cardioversion and may increase the effectiveness of concomitant analgesics.

Adult↗

PubMed2004

Psychometric evaluation of the Pain Anxiety Symptoms Scale (PASS) in chronic pain patients.

This study examined psychometric properties of the Pain Anxiety Symptoms Scale (PASS), a measure of pain-related fear. A recently developed shortened version of the PASS, the PASS-20, was also investigated. Previously reported factor structures of the PASS were tested by means of confirmatory factor analysis. Results indicated that all models fitted adequately but that a five-factor solution fitted slightly better compared to the other models tested. The four-factor solution of the PASS-20 was tested by means of confirmatory factor analysis and results indicated adequate fit. Moreover, the four-factor solution of the PASS-20 was invariant among fibromyalgia and low-back pain patients. Convergent validity of the original PASS and the PASS-20 was good and internal consistency reliability adequate to excellent. The suitability of the original PASS and the PASS-20 are discussed and directions for future research are provided.

Anxiety↗

PubMed2004

Does imminent threat capture and hold attention?

According to models of attention and emotion, threat captures and holds attention. In behavioral tasks, robust evidence has been found for attentional holding but not for attentional capture by threat. An important explanation for the absence of attentional capture effects is that the visual stimuli used posed no genuine threat. The present study investigated whether visual cues that signal an aversive white noise can elicit attentional capture and holding effects. Cues presented in an attentional task were simultaneously provided with a threat value through an aversive conditioning procedure. Response latencies showed that threatening cues captured and held attention. These results support recent views on attention to threat, proposing that imminent threat captures attention in everyone.

Attention↗

PubMed2004

Autonomic and behavioral responding to concealed information: differentiating orienting and defensive responses.

A mock crime experiment was conducted to examine whether enhanced responding to concealed information during a polygraph examination is due to orienting or defensive responding. Thirty-six undergraduate students enacted one of two mock crimes. Pictures related to both crimes were presented while heart rate, magnitude of the skin conductance response, and reaction times to a secondary probe were measured. Compared to control pictures, participants showed heart rate deceleration and enhanced electrodermal responding to pictures of the crime they had committed. Probe reaction times did not differ significantly between crime and control pictures. The present findings support the idea that the orienting reflex accounts for the enhanced responding to concealed information. Theoretical and practical implications of the orienting account are discussed.

Adult↗

PubMed2004

Differences in trauma symptoms and family functioning in intra-and extrafamilial sexually abused adolescents.

This study investigated to what extent abuse-related symptoms and family functioning are related to intra- or extrafamilial sexual abuse. One hundred adolescents (12 to 18 years old) were recruited shortly after disclosure of the abuse. Information from the participants was obtained through self-report questionnaires and a semistructured interview. Fifty-three percent of the adolescents reported clinically significant symptoms. Data did not support the idea that intrafamilial sexually abused adolescents report more symptoms than extrafamilial sexually abused adolescents. Type of abuse did not account for the differences and variety of reported symptoms or for differences in family functioning. Family functioning-in particular, lack of cohesion- was an independent contributor to internalizing trauma-related problems.

Adolescent↗

PubMed2003

The role of social support in well-being and coping with self-reported stressful events in adolescents.

OBJECTIVE: This study investigated the role that social support plays in well-being and in coping after a stressful event in a group of non-clinical adolescents. Furthermore, this study aimed at replicating the finding that adolescents who reported sexual abuse reported more symptoms and less adequate coping strategies than adolescents who reported another type of stressful event or no stressful episode. METHOD: Eight hundred and twenty adolescents between 12 and 18 years of age filled out questionnaires assessing social support (Social Support Questionnaire, Sarason, Shearin, Pierce, & Sarason, 1987), trauma-related symptoms (Trauma Symptom Checklist for Children, Briere, 1996), behavior problems (Youth Self-Report, Achenbach, 1991), and coping (How I Cope Under Pressure Scale, Ayers, Sandler, West, & Roosa, 1996). RESULTS: 42% of the adolescents reported a stressful experience, and 4.4% reported sexual abuse. Sexually abused adolescents reported more stress-related symptoms and used more avoidance and fewer support-seeking coping strategies than the other adolescents. The main-effect hypothesis of social support was sustained, but social support did not moderate the relation between a stressful event and coping. Yet, a trend was found suggesting that high support from the family was associated with less avoidance coping and more support-seeking in adolescents who reported a non-sexually abusive, stressful event. CONCLUSIONS: Our findings show that a highly perceived availability of social support is directly associated with fewer trauma-related symptoms, especially in adolescents who are non-sexually abused. For adolescents who reported a sexual or another type of stressful event, social support did not play a different role in coping.

Adaptation, Psychological↗

PubMed2003

The paradoxical effects of suppressing anxious thoughts during imminent threat.

In line with the ironic processing theory of Wegner (Psychol. Rev. 101 (1994) 34), it is often argued that the suppression of anxiety-related thoughts results in a paradoxical increase of anxiety and thought intrusions, both after and during the thought suppression. In a sample of undergraduate students (14 men, 18 women), we investigated the effects of suppressing anxious thoughts about an imminent painful electrocutaneous stimulus. During thought suppression, self-reported anxiety and frequency of anxious thoughts did not increase, and duration of anxious thoughts decreased. After thought suppression, participants experienced an increase in self-reported anxiety and the frequency of anxious thoughts. There was no effect upon thought duration. The results support the idea that suppression of anxiety-related thoughts may result in a paradoxical increase in anxiety, and may cause and/or maintain anxiety problems.

Adolescent↗

PubMed2003

Avoidant coping as a mediator between self-reported sexual abuse and stress-related symptoms in adolescents.

OBJECTIVE: This study investigated to what extent the more severe consequences of sexual trauma in adolescents are mediated by coping strategies. Furthermore, this study explored differences in symptoms, self-esteem and coping in a group that reported sexual abuse, in a group that reported another stressful experience, and in a group that reported no stressful episode until now. METHOD: Nine-hundred seventy adolescents aged 11-19 years were asked to complete self-report questionnaires assessing traumatic symptoms (Trauma Symptom Checklist, Briere, 1996); self-image (Self-Description Questionnaire II, Marsh, 1990) and coping (How I Cope Under Pressure Scale, Ayers, Sandler, West, & Roosa, 1996). RESULTS: Seventy-two percent of the participants reported a lifetime prevalence of a stressful event. Participants who reported sexual abuse (10%) reported more traumatic symptoms and more avoidant coping strategies than the adolescents who reported another type of stressful event. Results revealed that avoidant coping is a mediator between sexual abuse and the severity of symptoms. CONCLUSIONS: Sexually abused adolescents exhibited more symptoms and used more avoidant coping strategies than adolescents in the other groups. Avoidant coping can be seen as a mediator between a sexual stressful event and the consequent stress-related symptoms. Results reveal the importance of assessment and consideration of coping strategies in prevention and in therapeutic interventions.

Adaptation, Psychological↗