Laura J. Meyer

Prevalence comparisons of somatic and psychiatric symptoms between community nonpatients without pain, acute pain patients, and chronic pain patients

OBJECTIVES Somatic/psychiatric symptoms are frequently found in chronic pain patients (CPPs). The objectives of this study were to determine 1) which somatic/psychiatric symptoms are more commonly found in acute pain patients (APPs) and CPPs vs community nonpatients without pain (CNPWPs) and 2) if somatic/psychiatric symptom prevalence differs between APPs and CPPs. DESIGN The above groups were compared statistically for endorsement of 15 symptoms: fatigue, numbness/tingling, dizziness, difficulty opening/closing mouth, muscle weakness, difficulty staying asleep, depression, muscle tightness, nervousness, irritability, memory, falling, nausea, concentration, and headaches. RESULTS After controlling for age, gender, and level of pain, APPs and CPPs had a statistically significantly greater prevalence (at a P < 0.01 level) for 11 and 13 symptoms, respectively, vs CNPWPs. After controlling for age, gender, and level of pain, CPPs had a statistically significantly greater prevalence (at a P < 0.01 level) for eight symptoms vs APPs. Symptoms were highly correlated in both APPs and CPPs. CONCLUSIONS CPPs are characterized to a significantly greater extent than comparison groups by somatic/psychiatric symptoms that are highly intercorrelated. This has implications for clinical practice and future research.

Exploration of the Relationship Between Disability Perception, Preference for Death over Disability, and Suicidality in Patients with Acute and Chronic Pain

HYPOTHESIS Passive, active, and historical suicidality are associated with preference for death over disability. DESIGN Community nonpatients without pain, community patients with pain, and patients with acute and chronic pain were compared for endorsement of disability perception and preference for death over disability. Phi correlations and chi-square analyses were calculated between preference for death over disability and six suicidality items representing passive, active, and historical suicidality. Logistic regression was used to predict preference for death over disability in patients with acute and chronic pain. RESULTS For patients with acute and chronic pain, endorsement of preference for death over disability correlated significantly with all six suicidality items. The logistic regression models identified the following variables as predictors for preference for death over disability in patients with acute pain: the Behavior Health Inventory (BHI 2) family dysfunction scale, history of wanting to die, and disability perception. For patients with chronic pain, predictors were the BHI 2 Borderline scale, history of wanting to die, treated fairly by family item, frequent suicide ideation, people I trust turn on me item, and disability perception. Preference for death over disability was a statistically significant predictor in patients with chronic pain for disability perception, recent suicide ideation, having a suicidal plan, and a history of wanting to die but was not a significant predictor for any suicide items in patients with acute pain. CONCLUSION Preference for death over disability is associated with passive and active suicide ideation and historical suicidality in patients with chronic pain.

Exploration of Anger Constructs in Acute and Chronic Pain Patients vs. Community Patients

Objectives:  (1) Determine and compare prevalence of forms of anger (FOA; anger, hostility, aggression, anger‐in, anger‐out, chronic anger) in community nonpatients (n = 478), community patients (n = 158), acute pain patients (APPs; n = 326), chronic pain patients (CPPs; n = 341); and (2) develop FOA predictor models in APPs and CPPs.

Making meaning in a burn peer support group: qualitative analysis of attendee interviews.

There is a paucity of literature on the personal experiences of burn support group members, the members’ perceived benefits of group participation, and the meaning the survivors make of the support they receive. In order to provide effective psychosocial rehabilitation services and to meet the needs of burn survivors, it is important to understand the influence a support group has on its members as well as the personal experiences of those individuals who attend these groups. The purpose of this study was to explore the experiences of burn survivors in a burn survivor support group. Six self-identified burn survivors were interviewed by using a guided in-depth interview technique to explore their experiences in the support group. Key informant interviews and group observations served to triangulate the findings from the individual interviews. The experiences of the group members coalesced around four main themes: acceptance of self, perspective change, value of community, and reciprocity. The findings demonstrated the overall perceived positive impact the support group had on psychosocial recovery. For these members, the group aided the process of adjustment through the encouragement of adaptive coping strategies and the facilitation of community and relationships. Their experiences mirrored much of the literature on psychological growth from adversity. Burn survivors reported unique opportunities that allowed them to integrate their injury into their identity within an encouraging and safe environment. Using these accounts, the authors generated clinical suggestions that may encourage similar growth in other support group settings.

The Prevalence of Smokers Within Chronic Pain Patients and Highest Pain Levels Versus Comparison Groups

OBJECTIVES.: The objectives of this study were to (1) compare the prevalence of smoking within chronic pain patients (CPPs) to community non-patients without pain (CNPWP), community patients with pain (CPWP), and acute pain patients (APPs); and (2) compare smokers to nonsmokers within CPPs, APPs, and CPWP for highest pain level. DESIGN.: CNPWP, CPWP, APPs, and CPPs were compared to each other for smoking status (nonsmoker, less than one pack per day, one pack/day or more, any amount per day). Within CPWP, APPs, and CPPs, smokers were also compared to nonsmokers by t-test for highest reported pain level. For both analyses, sub-analyses were performed controlling for age or gender, or race or education. RESULTS.: Utilizing all available patients, the prevalence of smokers within CPPs was significantly greater vs each of the comparison groups (CNPWP, CPWP, APPs). In the sub-analyses, only CPPs who were 38 or younger or male or White, or had some college or above were at greater risk than CPWP for smoking one pack or greater per day. CPP smokers were not significantly more likely than nonsmokers to have higher pain, and this was confirmed in the sub-analyses. CONCLUSIONS.: The prevalence of smokers could be significantly greater within CPPs vs CPWP. CPPs who smoke do not have higher levels of pain than nonsmoking CPPs.

Patient predictor variables for six forms of suicidality

There has been a significant amount of research performed on the relationship between the presence of chronic pain and all forms of suicidality. This study explored which rehabilitation acute pain patient (APP) and rehabilitation chronic pain patient (CPP) variables are predictive of six suicidality items: wanting to die because of pain; wanting to die because life is hard; history of wanting to die; history of suicide attempts; recent frequent suicide ideation; and having a suicidal plan.

Sensitivity and Specificity of the Ohio State University Traumatic Brain Injury Identification Method to Neuropsychological Impairment

Offenders in justice system settings have high rates of traumatic brain injury (TBI) in comparison with the general population. Consequently, justice systems are using screening tools to identify and manage these individuals. Currently, that includes screening for TBI history and gross cognitive impairment. The present study attempted to determine whether the modified Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) was predictive of ongoing cognitive impairment as measured by the Automated Neuropsychological Assessment Metrics (ANAM) Core Battery. If so, the OSU TBI-ID could be used as a stand-alone measure of TBI history and impairment. This study had 223 participants (male = 160, female = 62). Sensitivity and specificity results revealed poor (.65) to very poor (.36) estimates for all OSU TBI-ID indices across all ANAM subtests. This study suggests that screening for lifetime history of TBI does not identify cognitive impairment. Implications for screening policy and future research are discussed.

Attachment Theory and Equine-Facilitated Psychotherapy for Vietnam Veterans

The persistence of chronic post-traumatic stress disorder ( PTSD ) among veterans of the Vietnam War warrants an exploration of new treatment approaches, such as equine-facilitated psychotherapy ( EFP ). The purpose of this study was to use open-ended interviews to explore five Vietnam veterans’ perceptions of their bond with an equine partner during EFP and how it influences their behavior and PTSD symptoms. Questions addressed their relationships with their equine partners, including its development and impact on their interpersonal relationships. Attachment Theory provided a framework for understanding the four main themes that emerged from analysis of the responses: positive changes in thoughts and behaviors, veterans’ beliefs about horses’ cognitions and emotions, emotions and emotional regulation, and interpersonal and interspecies relationships. The authors concluded that EFP may support personal growth and healing because horses serve as attachment figures, provide a secure base for emotional exploration, and encourage non-verbal communication.