J. Eyer

The Learning About My Pain study protocol: Reducing disparities with literacy-adapted psychosocial treatments for chronic pain, a comparative behavioral trial

Chronic pain is a critical public health problem that affects over 100 million Americans. Medical pain treatments carry undesirable side effects, whereas low-risk psychosocial treatments offer notable benefits, in combination or in isolation. This report presents the protocol for the Learning About My Pain study, one of the first comparative-effectiveness trials funded by the Patient-Centered Outcomes Research Institute. Adhering to published standards for clinical trials (e.g. Standard Protocol Items: Recommendations for Intervention Trials), it provides an overview of the trial (n = 294), comparing cognitive-behavioral and education pain interventions to usual care, and a detailed description of how its methodology reduces the risks from bias.

A review of contemporary assessment tools for use with transgender and gender nonconforming adults

There is increasing recognition of the need for culturally sensitive services for individuals who identify as transgender and gender nonconforming (TGNC), and only recently have empirical studies appeared in the literature that inform best practices for TGNC people. Competent, culturally appropriate clinical services and research depend upon methodologically sound assessment of key constructs, but it is unclear whether appropriate self-report or clinician-rated assessment tools for adults exist. This article reviewed existing published measures to identify areas of strength as well as existing gaps in the available research. The search strategy for this systematic review identified any published article describing a self-report or clinician-rated scale for assessing transgender-related concerns. Each measure was reviewed for information on its scope, reliability, validity, strengths, limitations, and source. The majority of these questionnaires was developed with the TGNC communities and targeted important factors that affect quality of life for TGNC people. Limitations included limited evidence for validity, reliability, and sensitivity to change. Overall, the field is moving in the direction of TGNC-affirming assessment, and promising measures have been created to monitor important aspects of quality of life for TGNC people. Future research should continue to validate these measures for use in assessing clinical outcomes and the monitoring of treatment progress.

Spiritual Openness, Revisiting a Potentially Important Aspect of Spirituality: Scale Review and Revision

Religiousness and spirituality (R/S) exert important influences on individuals across a range of domains. Spiritual Openness is theoretically linked with the personality trait of Openness to Experience, suggesting promise for future research. Using responses from 366 undergraduates on the Spiritual Experience Index-Revised (SEI-R: subscales of Spiritual Openness and Spiritual Support), analyses evaluated and revised the SEI-R, deleting poor items and generating a 10-item measure. The new SEI-S exhibits better psychometric properties and reduced participant burden, and subscales displayed a curvilinear relationship in which increases in Spiritual Openness showed a trade-off in levels of Spiritual Support.

Cued self-awareness and speech fluency

The present study investigated the potential influence of cued attention to self on speaking behavior. Forty-five undergraduate participants completed three tasks: watching a movie clip, telling a story, and completing button-pressing tasks, including a cognitive Stroop-like task. Each task was presented to participants in the presence and absence of video of their own behavior. During each task, indicators of autonomic arousal were acquired, including skin conductance and heart rate. Results showed that autonomic arousal was greater during speaking than movie-watching, and Stroop compared to baseline tasks. The presence of the video resulted in reduced performance, as marked by a greater frequency of speech disfluencies during speaking and increased reaction time during button-pressing tasks. However, the presence of the video was not associated with greater autonomic arousal. Results indicate that cued attention to self can lead to performance decrements, but not increases in autonomic arousal.

The relationship of sociodemographic and psychological variables with chronic pain variables in a low-income population

Abstract Chronic pain is a pervasive condition that is complicated by economic, educational, and racial disparities. This study analyzes key factors associated with chronic pain within an understudied and underserved population. The sample is characterized by a triple disparity with respect to income, education/literacy, and racial barriers that substantially increase the vulnerability to the negative consequences of chronic pain. The study examined the pretreatment data of 290 participants enrolled in the Learning About My Pain trial, a randomized controlled comparative effectiveness trial of psychosocial interventions (B.E.T., Principal Investigator, Patient-Centered Outcomes Research Institute Contract No. 941; clinicaltrials.gov identifier NCT01967342) for chronic pain. Hierarchical multiple regression analyses evaluated the relationships among sociodemographic (sex, age, race, poverty status, literacy, and education level) and psychological (depressive symptoms and pain catastrophizing) variables and pain interference, pain severity, and disability. The indirect effects of depressive symptoms and pain catastrophizing on the sociodemographic and pain variables were investigated using bootstrap resampling. Reversed mediation models were also examined. Results suggested that the experience of chronic pain within this low-income sample is better accounted for by psychological factors than sex, age, race, poverty status, literacy, and education level. Depressive symptoms and pain catastrophizing mediated the relationships between age and pain variables, whereas pain catastrophizing mediated the effects of primary literacy and poverty status. Some reversed models were equivalent to the hypothesized models, suggesting the possibility of bidirectionality. Although cross-sectional findings cannot establish causality, our results highlight the critical role psychological factors play in individuals with chronic pain and multiple health disparities.

Well-being as a moderator of response to a memory intervention in community-living seniors

with mild cognitive impairment. Accordingly, we created the Gray MattersRCT pilot study to test an evidence-based, multidomain lifestyle intervention among middle-aged persons with normal cognition, designed to encourage healthy lifestyle behavior changes. Methods:The six-monthGray Mattersintervention utilized a custom smartphone app, wearable activity monitor and booster events/classes targeting physical activity, food choices, social engagement, cognitive stimulation, sleep quality and stress management, all associated with lowering Alzheimer’s risk. A feedback survey covering a range of quantitative measures and a series of open-ended questions was administered to treatment group participants. 83 of 100 participants responded;, average age was 54.8 (SD-6.7) years, 35% were male, 98% were Caucasian and 82% held college degrees. Results: Participants reported regularly using study-associated technology over the 6-month period: Nike Fuelband (M 1⁄4 5.51 months, 6.78 days/week, 8.04 times/day); Smartphone app (M 1⁄4 5.38 months, 5.98 days/week, 1.94 times/day); study website (M 1⁄4 3.20 months, 1.40 days/week, 0.53 times/day). Participants reported attendance at 0-12 of 39 booster events (M1⁄42.2, SD1⁄43.0) and communicating with coaches 0-5 times/month (M1⁄41.6, SD1⁄41.5); however, 47.0% of participants deemed this ineffective, 24.1% as somewhat effective and only 13.3% as very effective. Overall, participants reported that: (a) the Fuel Band had a “great deal of” (34.9%) or “some” (41.0%) effect; (b) the smartphone app had a “great deal of” (30.1%) or “some” (47.0%) effect; (c) the study website had a “great deal of” (8.4%) or “some” (42.2%) effect; (d) personal coaches had a “great deal of” (7.2%) or “some” (21.7%) effect; and (e) booster events had a “great deal of” (20.5%) or “some” (39.8%) effect. Open-ended survey responses recommended improvements in technology training, coaching, access to lab results and initial study orientation. Conclusions:Results indicated that treatment group participants received the Gray Matters intervention positively, manifesting high levels of engagement with study protocols and technology adoption. Future analyses will consider how user experiences and intervention “dosage” is associated with lifestyle changes made over the intervention period.