Biomedical subjects

Geert Crombez

Publications and source records attributed to Geert Crombez.

68 records · Page 4Linked to original sources

PubMed2003

How can we learn to live with pain? A Q-methodological analysis of the diverse understandings of acceptance of chronic pain.

An analysis is reported of the variety of understandings available in British culture to understand acceptance of chronic pain. Q-factor analysis is used within a critical framework as Q-methodology. Thirty participants completed the procedure. Eight factors or accounts of accepting chronic pain were derived. These are reported as taking control, living day to day, acknowledging limitations, empowerment, accepting loss of self, more to life than pain, don't fight battles that cannot be won, and spiritual strength. Common features of accepting chronic pain are (1) the acknowledgement that a cure for pain is unlikely, (2) a shift of focus away from pain to non-pain aspects of life, and (3) a resistance to any suggestion that pain is a sign of personal weakness. Where accounts of chronic pain differ is in the extent to which acceptance of pain means a change in core aspects of self. Implications of this study for the study of chronic pain are discussed. In particular, how identity is managed in the context of threatening chronic pain is suggested as a fruitful area of future investigation.

Adaptation, Psychological↗

PubMed2003

The child version of the pain catastrophizing scale (PCS-C): a preliminary validation.

Catastrophizing about pain has emerged as a critical variable in how we understand adjustment to pain in both adults and children. In children, however, current methods of measuring catastrophizing about pain rely on brief subscales of larger coping inventories. Therefore, we adapted the Pain Catastrophizing Scale (Sullivan et al., 1995) for use in children, and investigated its construct and predictive validity in two studies. Study 1 revealed that in a community sample (400 boys, 414 girls; age range between 8 years 9 months and 16 years 5 months) the Pain Catastrophizing Scale for Children (PCS-C) assesses the independent but strongly related dimensions of rumination, magnification and helplessness that are subsumed under the higher-order construct of pain catastrophizing. This three factor structure is invariant across age groups and gender. Study 2 revealed in a clinical sample of children with chronic or recurrent pain (23 girls, 20 boys; age range between 8 years 3 months and 16 years 6 months) that catastrophizing about pain had a unique contribution in predicting pain intensity beyond gender and age, and in predicting disability, beyond gender, age and pain intensity. The function of pain catastrophizing is discussed in terms of the facilitation of escape from pain, and of the communication of distress to significant others.

Adolescent↗

PubMed2003

Acceptance of pain is an independent predictor of mental well-being in patients with chronic pain: empirical evidence and reappraisal.

This paper reports upon: (1) the value of acceptance of pain in predicting well-being in patients suffering from chronic pain and (2) the construct validity of acceptance by comparing two questionnaires designed to measure acceptance (the Chronic Pain Acceptance Questionnaire, CPAQ, unpublished doctoral dissertation, University of Nevada, Reno, NV, 1992 and the Illness Cognitions Questionnaire, ICQ, J Consult Clin Psychol 69 (2001) 1026). The results of two independent cross-sectional studies are reported. Study 1 included 120 patients seeking help in tertiary care settings. In Study 2, 66 patients were recruited from a self-support group for fibromyalgia patients and from a pain clinic. Both studies revealed that acceptance of pain predicted mental well-being beyond pain severity and pain catastrophizing, but did not account for physical functioning. In both instruments, it was found that acceptance of pain was strongly related to engagement in normal life activities and the recognition that pain may not change. Acceptance in both instruments was strongly related to a cognitive control over pain. Study 2 further revealed that the correlation between the CPAQ and the ICQ is moderate, indicating that both instruments measured different aspects of acceptance. It is concluded that acceptance of chronic pain is best conceived of as the shift away from pain to non-pain aspects of life, and the shift away from a search for a cure with an acknowledgement that pain may not change.

Adaptation, Psychological↗

PubMed2003

Implicit attitude towards pictures of back-stressing activities in pain-free subjects and patients with low back pain: an affective priming study.

In this paper, it is investigated whether an implicit evaluative-negative attitude towards back-stressing activities exists in pain-free subjects and in chronic low back pain patients. Using an affective priming task, it was investigated whether pictures of threatening back-stressing movements (primes) facilitate (respectively, slow down) the categorisation of subsequent evaluative-negative (evaluative-positive) words (targets). In study 1 using 20 pain-free subjects, the affective priming effect indicated evidence for an implicit negative attitude towards pictures of back-stressing activities. In study 2 using 30 low back pain patients, a reverse priming effect was found. In line with previous research, it is argued that this reverse priming effect is owing to the evaluative extremity of the primes: patients recognize the possibility that extreme primes will interfere with the categorisation of the targets and overcompensate for this possible effect. The implications for the prevention of negative attitudes towards back-stressing activities in non-clinical and clinical samples are discussed.

Adult↗

PubMed2003

Cognitive interference due to food cues in childhood obesity.

Investigated specific information-processing biases for food-relevant stimuli in 34 children, Mage = 13 years, SD = 2 years, M = 177% of ideal weight, SD = 24%, who were completing a residential cognitive-behavioral treatment program for severe obesity and 40 matched control children who were not obese, Mage = 13 years, SD = 2 years, M = 103% of ideal weight, SD = 13%. Participants completed a computerized modified Stroop task, which included food words, negative-emotion words, and control words. Results indicated that children in the obesity group displayed a specific interference effect for food words. It is hypothesized that the observed bias in information processing reflects hypersensitivity for food cues, which can initiate or maintain dysfunctional eating behavior.

Adolescent↗

PubMed2003

A simple and sensitive method to measure timing accuracy.

Timing accuracy in presenting experimental stimuli (visual information on a PC or on a TV) and responding (keyboard presses and mouse signals) is of importance in several experimental paradigms. In this article, a simple system for measuring timing accuracy is described. The system uses two PCs (at least Pentium II, 200 MHz), a photocell, and an amplifier. No additional boards and timing hardware are needed. The first PC, a SlavePC, monitors the keyboard presses or mouse signals from the PC under test and uses a photocell that is placed in front of the screen to detect the appearance of visual stimuli on the display. The software consists of a small program running on the SlavePC. The SlavePC is connected through a serial line with a second PC. This MasterPC controls the SlavePC through an ActiveX control, which is used in a Visual Basic program. The accuracy of our system was investigated by using a similar setup of a SlavePC and a MasterPC to generate pulses and by using a pulse generator card. These tests revealed that our system has a 0.01-msec accuracy. As an illustration, the reaction time accuracy of INQUISIT for a few applications was tested using our system. It was found that in those applications that we investigated, INQUISIT measures reaction times from keyboard presses with millisecond accuracy.

Humans↗

PubMed2002

Attentional functioning in fibromyalgia, rheumatoid arthritis, and musculoskeletal pain patients.

OBJECTIVES: To investigate whether chronic pain patients have deficits in attentional functioning compared with pain-free controls, and whether fibromyalgia patients have larger deficits in attentional functioning compared with rheumatoid arthritis and musculoskeletal pain patients. METHODS: Sixty patients (20 in each of 3 patient groups) and 20 pain-free controls completed measures assessing pain intensity, mood, pain-related disability, somatic awareness, and catastrophic thinking about pain. Attentional functioning was assessed using an age-standardized, ecologically valid test battery. Analyses were made of between-group differences. RESULTS: Sixty percent of patients had at least one score in the clinical range of neuropsychological impairment, independent of demography and mood. Fibromyalgia patients were more anxious and somatically aware than rheumatoid arthritis or musculoskeletal pain patients, but did not show larger attentional deficits than other patient groups. CONCLUSION: All 3 groups of chronic pain patients, regardless of diagnosis, had impaired cognitive functioning on an ecologically sensitive neuropsychological test of everyday attention.

Adult↗

PubMed2002

Expectancy-learning and evaluative learning in human classical conditioning: affective priming as an indirect and unobtrusive measure of conditioned stimulus valence.

It has been argued that in classical conditioning two processes might be operative. First, one may learn that the conditioned stimulus (CS+) is a valid predictor for the occurrence of the biologically negative or positive event (US; expectancy-learning). Second, one may learn to perceive the conditioned stimulus itself as a negative or positive stimulus, depending on the valence of the event it has been associated with (evaluative learning). Until the present, however, both forms of learning have been investigated using rather different conditioning procedures. Using a differential aversive conditioning preparation with pictures of human faces as CSs and an electrocutaneous stimulus as US, we were able to demonstrate that both forms of learning can co-occur. Moreover, the extent of evaluative learning in this aversive conditioning procedure did not significantly differ from the amount of evaluative learning in an evaluative conditioning procedure with positive and negative adjectives as USs, which was administered to the same participants. In the present study evaluative learning was not only indexed by direct evaluative ratings, but we introduced affective priming as an indirect and unobtrusive, reaction time based measure of stimulus valence. Finally, imagery instructions during acquisition did not facilitate expectancy-learning nor evaluative learning.

Adult↗

PubMed2002

Exposure to physical movement in chronic back pain patients: no evidence for generalization across different movements.

This study investigated whether the effects of exposure to one movement generalize towards another dissimilar movement in patients with low back pain. Thirty-nine patients (11 male, 28 female; mean age=43.49 yrs) were requested to perform two movements twice, i.e. bending forward and straight leg raising. During each of the four trials, baseline pain, expected pain and experienced pain were recorded. Analyses revealed that patients initially overpredicted pain, but after exposure the overprediction was readily corrected. This exposure effect did not generalize towards another dissimilar movement. The above pattern of results was only characteristic for patients reporting a high frequency of catastrophic thinking about pain. Low pain catastrophizers did not overpredict pain. The results are discussed in terms of the view that exposure may be better conceived of as the learning of exceptions to a general rule.

Adult↗

PubMed2002

A confirmatory factor analysis of the Pain Catastrophizing Scale: invariant factor structure across clinical and non-clinical populations.

This study examined the factor structure of the Pain Catastrophizing Scale in three different Dutch-speaking samples: 550 pain-free students, 162 chronic low back pain patients, and 100 fibromyalgia patients. Confirmatory factor analyses were used to compare three different models of pain catastrophizing (one factor, two oblique factors, three oblique factors), and to investigate the invariance of the factor structure across the three different samples. The results indicated that a three-factor oblique model with a four-item rumination factor, a three-item magnification factor, and a six-item helplessness factor provided the best fit to the data in the three samples. Furthermore, it was found that this model could be considered as invariant across three samples (pain-free students, chronic low back pain patients, and fibromyalgia patients) and across gender, indicating that the same processes are measured in different subgroups.

Adaptation, Psychological↗

PubMed2002

Retarded disengagement from pain cues: the effects of pain catastrophizing and pain expectancy.

This paper reports an experimental investigation of engagement with and disengagement from a threatening cue of pain. As most paradigms in pain research only provide an overall index of attentional deployment by pain-related information, a new paradigm was developed that allowed an independent investigation of engagement with and disengagement from pain cues. Forty pain-free volunteers performed a cueing task in which they had to detect pain targets and tone targets as quickly and as accurately as possible. The target stimuli were preceded by pain cues (the word 'pain'), tone cues (the word 'tone'), or neutral cues (a series of the character 'X') at stimulus onset asynchrony (SOA: stimulus interval between cue onset and target onset) levels of 100, 500, or 900 ms. There was no contingency between the type of cue and the type of target. Catastrophic thinking about pain and the predictive value of the cues were assessed by self-reports. Results can be summarized as follows: When a cue correctly primed a target, attention was optimally engaged in the identification of the target irrespective of the threatening context of the cue or target. However, when pain was cued and did not occur, there was retardation in disengagement from the pain cue. This retardation was more pronounced and extended across time in those high in catastrophic thinking about pain. On examination it appeared that catastrophic thinking about pain may operate by a protection of the belief that the cue for pain is a valid one, despite experience to the contrary.

Acoustic Stimulation↗

PubMed2002

Exposure to physical movements in low back pain patients: restricted effects of generalization.

Whether the effects of exposure to 1 movement generalize to another dissimilar movement was investigated in 37 patients with low back pain (15 men, 22 women). Two movements were executed twice: bending forward while standing and lifting 1 leg while lying down. During each trial, baseline pain, expected pain, and experienced pain were recorded. Similar ratings for perceived harm were obtained. Analyses revealed an initial over prediction of pain, but after exposure the overprediction was readily corrected. This exposure effect did not generalize toward another dissimilar movement. These results were only characteristic for patients with catastrophic thinking about pain. Low pain catastrophizers did not overpredict pain. There were no effects of exposure on perceived harm. Exposure may profitably be conceived of as the learning of exceptions to a general rule.

Activities of Daily Living↗

PubMedDate not supplied

Hypervigilance to pain in fibromyalgia: the mediating role of pain intensity and catastrophic thinking about pain.

OBJECTIVE: To investigate the mediating role of pain intensity, catastrophic thinking about pain, and negative affectivity in explaining enhanced attention for pain in patients with fibromyalgia. METHODS: Sixty-four patients with fibromyalgia and 46 patients with chronic low back pain completed self-report instruments of vigilance to pain, negative affectivity, and catastrophic thinking about pain. These measures, along with diagnostic group and pain intensity, were entered into a partial correlational analysis to investigate which variables mediate the relationship between diagnostic group (fibromyalgia vs. chronic low back pain) and vigilance to pain. RESULTS: Fibromyalgia patients reported significantly greater vigilance to pain than patients with chronic low back pain. They also reported higher pain intensity, more negative affectivity, and more catastrophic thinking about pain than patients with chronic low back pain. Vigilance to pain was correlated significantly with pain intensity, negative affectivity, and catastrophic thinking about pain. Further analyses revealed that pain intensity and catastrophic thinking about pain, but not negative affectivity, mediated the relationship between diagnostic group and vigilance to pain. CONCLUSION: Fibromyalgia patients report a heightened vigilance to pain. This vigilance is not a unique characteristic of fibromyalgia but is related to the intensity of pain and catastrophic thinking about pain.

Adult↗

PubMedDate not supplied

Confirmatory factor analysis of the Tampa Scale for Kinesiophobia: invariant two-factor model across low back pain patients and fibromyalgia patients.

OBJECTIVES: (1) To investigate the factor structure of the Tampa Scale for Kinesiophobia (TSK) in a Dutch-speaking sample of chronic low back pain (CLBP) patients using confirmatory factor analysis, (2) to examine whether the internal structure of the TSK extends to another group of fibromyalgia (FM) patients, and (3) to investigate the stability of the factor structure in both patient groups using multi-sample analysis. PATIENTS AND METHODS: TSK-data from 8 studies collected in Dutch and Flemish chronic pain patients were pooled. For 188 CLBP patients and 89 FM patients, complete data were available. Confirmatory factor analyses were performed to assess 4 models of kinesiophobia, and to examine which factor model provided the best fit. Furthermore, a multi-sample analysis was performed to investigate the stability of the factor structure in both patient groups. RESULTS: For both CLBP and FM patients, the 2-factor model containing the factors "activity avoidance" and "pathologic somatic focus" was superior as compared with the 4-factor model containing the factors "harm," "fear of (re)injury." "importance of exercise," and "avoidance of activity". Moreover, the 2-factor model was found to be invariant across CLBP and FM patients, indicating that this model is robust in both pain samples. DISCUSSION: As the 2-factor structure provided the best fit of the data in both patient samples, we recommend to use this version of the TSK and its 2 subscales in both clinical practice and research. Based on the content of the items, the subscales were labeled "Harm" and "Fear-avoidance."

Adult↗