Krista Lange

The relation between pain-related fear and disability: A meta-analysis

UNLABELLED Within a biopsychosocial framework, psychological factors are thought to play an important role in the onset and progression of chronic pain. The cognitive-behavioral fear-avoidance model of chronic pain suggests that pain-related fear contributes to the development and maintenance of pain-related disability. However, investigations of the relation between pain-related fear and disability have demonstrated considerable between-study variation. The main goal of the current meta-analysis was to synthesize findings of studies investigating cross-sectional associations between pain-related fear and disability in order to estimate the magnitude of this relation. We also tested potential moderators, including type of measure used, demographic characteristics, and relevant pain characteristics. Searches in PubMed and PsycINFO yielded a total of 46 independent samples (N = 9,579) that reported correlations between pain-related fear and disability among persons experiencing acute or chronic pain. Effect size estimates were generated using a random-effects model and artifact distribution method. The positive relation between pain-related fear and disability was observed to be moderate to large in magnitude, and stable across demographic and pain characteristics. Although some variability was observed across pain-related fear measures, results were largely consistent with the fear-avoidance model of chronic pain. PERSPECTIVE Results of this meta-analysis indicate a robust, positive association between pain-related fear and disability, which can be classified as moderate to large in magnitude. Consistent with the fear-avoidance model of chronic pain, these findings suggest that pain-related fear may be an important target for treatments intended to reduce pain-related disability.

The relationship between stress and delay discounting: a meta-analytic review.

The objective of the present meta-analytic review was two-fold: (a) to address the mixed findings of previous research by determining the relationship between stress and impulsivity; and (b) to examine age differences in this relationship. A total of 16 articles fulfilled the inclusion criteria for the present meta-analysis for a total sample size of 2189 participants (k=22) ranging in age from 36 months to 71 years. Using the statistical software, Comprehensive Meta-Analysis, Version 2.0 – Hedges’s g was computed to estimate the effect size. Results showed that impulsivity was related to stress with a moderate–large effect size (g=0.590). Significant moderating effects were found for the type of stress measure (g=0.592) and the type of discounting measure (g=0.696) used. The current study emphasizes the need for further research on the relationship between stress and discounting as additional findings may aid in improving future prevention and intervention programs for health-risk behaviors.

The relationship between weight and smoking in a national sample of adolescents: Role of gender.

This study sought to investigate the role of weight status and body mass index percentile in risky smoking behaviors in male and female adolescents. Analyses of the data obtained in the 2011 Youth Risk Behavior Surveillance System were conducted. The national sample size included 15,425 adolescents. Questions addressing weight status and smoking behaviors were used in analyses. Significant effects of perceived weight status, weight change status, and body mass index percentile on smoking behaviors were found for both genders. The current findings indicate the importance of accounting for both gender and weight status when developing prevention and cessation programs targeting smoking behaviors.

Examining weight concern and delay discounting in adolescent females.

OBJECTIVE Pediatric obesity is a growing public health concern that contributes to high rates of negative long-term physical and mental health outcomes. Research focused on identifying risk for pediatric obesity has linked delay discounting, or an inclination for immediate rewards, as well as weight concern to individuals with greater Body Mass Index (BMI). The current study seeks to fill a void in the literature by examining how these two variables interact to promote higher BMI in female adolescents. METHOD Adolescent (n=60) females between the ages of 13-19years (mage=17.45, SD=1.74) of age completed the Eating Disorder Examination Questionnaire (EDE-Q) and the Delay Discounting Questionnaire. RESULTS A mediation model examined whether delay discounting accounted for the relationship between weight concern and BMI. Results indicate that in the current study weight concern was negatively related to delay discounting and delay discounting was negatively related to BMI. The overall model revealed that a partial mediation occurred [b=1.28, t(60)=4.92, p<0.01]. DISCUSSION These results suggest that while impulsivity is an important factor to consider, other constructs may also be influential in how weight concerns contribute to greater BMI. Nevertheless, the results indicate that prevention and interventions should identify females with high levels of both weight concern and impulsivity as an increased risk for experiencing pediatric obesity and long-term negative health outcomes.

Effects of weight and gender on a task of inattention.

OBJECTIVE Previous studies have established that obese adolescents possess a stronger tendency to behave more impulsively and be more inattentive than healthy-weight children. Additionally, gender difference in inattention and impulsivity has also been substantiated by previous researchers. The current study examined the relationship between gender, body weight, and inattention and impulsivity in adolescents. It was hypothesized that obese males and females would have more inattentive and impulsive responses than their healthy-weight peers. METHOD Participants were 113 adolescents between the ages of 14 and 19; all participants completed the CPT-II, a measure of inattentive and impulsive response styles. RESULTS Findings indicated that males who were classified as overweight or obese scored higher on inattention than did obese females, healthy-weight males, and healthy-weight females. Additionally, females committed a greater number of commission errors and were less able to distinguish the target stimuli, suggestive of impulsive responding. CONCLUSION These findings indicate a gender difference in regard to impulsive responding, and also reveal an interaction of weight status and gender on inattention. Implications for prevention and treatment are discussed.