Jacques Grisart

Development and validation of the neuropathic pain symptom inventory

&NA; This study describes the development and validation of the Neuropathic Pain Symptom Inventory (NPSI), a new self‐questionnaire specifically designed to evaluate the different symptoms of neuropathic pain. Following a development phase and a pilot study, we generated a list of descriptors reflecting spontaneous ongoing or paroxysmal pain, evoked pain (i.e. mechanical and thermal allodynia/hyperalgesia) and dysesthesia/paresthesia. Each of these items was quantified on a (0–10) numerical scale. The validation procedure was performed in 176 consecutive patients with neuropathic pain of peripheral (n=120) or central (n=56) origin, recruited in five pain centers in France and Belgium. It included: (i) assessment of the test–retest reliability of each item, (ii) determination of the factorial structure of the questionnaire and analysis of convergent and divergent validities (i.e. construct validity), and (iii) evaluation of the ability of the NPSI to detect the effects of treatment (i.e. sensitivity to change). The final version of the NPSI includes 10 descriptors (plus two temporal items) that allow discrimination and quantification of five distinct clinically relevant dimensions of neuropathic pain syndromes and that are sensitive to treatment. The psychometric properties of the NPSI suggest that it might be used to characterize subgroups of neuropathic pain patients and verify whether they respond differentially to various pharmacological agents or other therapeutic interventions.

Conscious and automatic uses of memory in chronic pain patients.

&NA; Memory deficits in chronic pain patients are frequently observed. The objective of this study was to explore memory performances of chronic pain patients by using the Process Dissociation Procedure developed by Jacoby (J. Mem. Lang. 30 (1991) 513). This procedure permits to separate the contribution of controlled processes from automatic processes operating within a memory task. The results show a significant decrease of controlled processes in chronic pain patients. Furthermore for both groups, automatic processes contribute in a similar extent to the memory performance. The estimates of controlled processes in the chronic pain patients are significantly related to the fear of pain and catastrophizing beliefs. This is interpreted as a sign of interference between the attention consumed by pain experience (namely fear related to pain) and the attention to be allocated to the memory task.

Behavioral and Representational Components of “Hyperactivity” in Fibromyalgia Syndrome Patients

ABSTRACT Hyperactive premorbid lifestyle is frequently reported by fibromyalgia patients. The present study investigates the original assumption that hyperactive lifestyle could be viewed as a two-sided concept, with a representational side (ones own attitude toward activities) and a behavioural one (effective engagement in many activities). Twenty-four patients diagnosed with fibromyalgia were recruited together with their significant others [SOs]. A group of 24 healthy control participants was matched with the fibromyalgia group for gender, age, educational level, and type of profession. The aims of the study were to (1) compare ratings of fibromyalgia patients and SOs, and (2) compare ratings of patients and controls on past and present behavioral and representational components of hyperactivity. No differences were observed between patients and SOs. For the comparison between patients and controls, patients scored significantly higher on representational components of past hyperactivity, but lower on representational components of current hyperactivity. For past behavioral hyperactivity, patients and controls did not differ, except that patients had less time devoted to resting activities and sleep. The discussion emphasises the need for a systematic assessment of both representational and behavioral components of hyperactivity and argues for a better identification of related pathogenic mechanisms.

Adaptation et validation en français d’un questionnaire d’attitudes vis-à-vis de la douleur chronique: étude préliminaire

RésuméLes représentations que le patient a de sa douleur, de ses répercussions fonctionnelles, des traitements et de sa capacité à gérer sa situation sont devenus des éléments centraux dans l’évaluation psychologique du patient douloureux chronique. Peu d’outils validés et spécifiques à l’évaluation des aspects psychologiques de la douleur chronique existent actuellement en français. Cet article rapporte la procédure utilisée pour l’adaptation en français du «Survey of Pain Attitudes» (SOPA) et la première étape de validation (analyse factorielle et consistance interne) du questionnaire en français.SummaryThe beliefs of the chronic pain patients about their pain, the functional limitations, their coping skills and treatment’s expectations are central in the psychological assessment of chronic pain. Few reliable tools designed for a specific assessment of the psychological aspects of chronic pain are available for french-speaking practitioners. This article reports the procedure used for the adaptation into french of the «Survey of Pain Attitudes» (SOPA) and the first stage of the validation (factorial analysis and internal consistency) of the french version of the SOPA.

Determinants of representational and behavioral hyperactivity in patients with fibromyalgia syndrome

Fibromyalgia is associated with a premorbid hyperactivity. This study examines how contextual and personality factors contribute to premorbid hyperactivity. A total of 45 patients completed questionnaires. The results show that the number of children and the basic bodily needs neglect (and their interaction) explain nearly 50 percent of the variance of hyperactivity. The neglect toward bodily needs completely mediates the relation between self-oriented perfectionism and hyperactivity. This study suggests that hyperactivity itself would not have a pathological value, but that the neglect of basic bodily needs would represent a vulnerability factor in a hyperactive premorbid lifestyle in fibromyalgia patients.