Eline Coppens

A multidimensional model of psychobiological interactions in functional dyspepsia: a structural equation modelling approach

Objective Gastric sensorimotor function, abuse history, ‘trait’ and ‘state’ psychological factors and ‘somatisation’ all play a role in functional dyspepsia (FD) and its associated impaired quality of life (QoL), but their interplay remains poorly understood. We aimed to test a comprehensive, a priori hypothesised model of interactions between these dimensions in FD. Design In 259 FD patients, we studied gastric sensitivity with a barostat. We measured abuse history (sexual/physical, childhood/adulthood), ‘trait’ (alexithymia, trait anxiety) and ‘state’ (positive/negative affect, depression, panic disorder) psychological factors, somatic symptom reporting (somatic symptom count, dyspepsia, irritable bowel syndrome and fatigue symptoms) and QoL (physical, mental) using validated questionnaires. Confirmatory factor analysis (CFA) was used to assess whether four a priori hypothesised latent variables (‘abuse’, ‘trait affectivity’, ‘state affect’ and ‘somatic symptom reporting’) were adequately supported by the data. Structural equation modelling (SEM) was used to test the a priori hypothesised relationships between these latent variables and the observed variables gastric sensitivity and QoL. Results Both the CFA and SEM models fitted the data adequately. Abuse exerted its effect directly on ‘somatic symptom reporting’, rather than indirectly through psychological factors. A reciprocal relationship between ‘somatic symptom reporting’ and ‘state affect’ was found. Gastric sensitivity influences ‘somatic symptom reporting’ but not vice versa. ‘Somatic symptom reporting’ and ‘trait affectivity’ are the main determinants of physical and mental QoL, respectively. Conclusions We present the first comprehensive model elucidating the complex interactions between multiple dimensions (gastric sensitivity, abuse history, ‘state’ and ‘trait’ psychological factors, somatic symptom reporting and QoL) in FD.

Multidisciplinary pain education program (MPEP) for chronic pain patients: preliminary evidence for effectiveness and mechanisms of change

Abstract Objective: There is a need for effective brief interventions in chronic pain patients, and the identification of mechanisms of change. Method: In the present study, we tested the effectiveness of MPEP (Multidisciplinary Pain Education Program), a very brief, four-session cognitive-behaviorally based psycho-educational intervention for chronic pain using a pre-and post-test design. In addition, pre- to post-treatment change scores were calculated to investigate factors associated with change in pain. Participants of the study were 53 patients with chronic non-cancer pain. Primary outcome measures were (1) pain severity, (2) health perception, and (3) severity of depression. Secondary outcome measures included factors that have been implicated in the maintenance of chronic pain and that might be associated with worse treatment outcome: (1) catastrophizing, (2) kinesiophobia, and (3) action-proneness. Results: Findings provided preliminary evidence for the effectiveness of MPEP in that patients showed significant and clinically meaningful improvements in pain symptoms (F = 24.503, p < 0.001, d = 0.59) and action-proneness (F = 178.504, p < 0.001, d = 1.95), and small improvements in health perception (F = 7.116, p < 0.05, d = 0.30). Furthermore, results showed that changes in catastrophizing (β = −0.455, p = 0.001) and severity of depression (β = −0.300, p < 0.05) were independently and significantly associated with changes in pain. However, changes in health perception, kinesiophobia, and action-proneness were not significantly associated with changes in pain (β = 0.203, ns; β = 0.003, ns; and β = 0.154, ns, respectively). Importantly, duration of chronic pain was not related to treatment outcome (β = 0.070, ns). Conclusions: Overall, this study provides preliminary evidence for the effectiveness of MPEP and possible mechanisms through which MPEP is effective. Yet, further research is needed to investigate the efficacy of MPEP.

Self‐Critical Perfectionism Predicts Outcome in Multidisciplinary Treatment for Chronic Pain

Self‐critical perfectionistic personality features have been shown to influence the onset and perpetuation of pain symptoms. However, no study to date has investigated whether these personality features are associated with treatment response in chronic pain.

Prevalence and impact of childhood adversities and post‐traumatic stress disorder in women with fibromyalgia and chronic widespread pain

This study investigates the prevalence of different types of childhood adversities (CA) and posttraumatic stress disorder (PTSD) in female patients with Fibromyalgia or Chronic Widespread Pain (FM/CWP) compared to patients with Functional Dyspepsia (FD) and achalasia. In FM/CWP, we also investigated the association between CA and PTSD on the one hand and pain severity on the other.