Nuno Monteiro da Rocha Bravo Ferreira

Basic emotion profiles in healthy, chronic pain, depressed and PTSD individuals

OBJECTIVES To compare self-reports of five basic emotions across four samples: healthy, chronic pain, depressed and post-traumatic stress disorder (PTSD), and to investigate the extent to which basic emotion reports discriminate between individuals in healthy or clinical groups. METHODS In total, 439 participants took part in this study: healthy (n = 131), chronic pain (n = 220), depressed (n = 24) and PTSD (n = 64). The participants completed the trait version of the Basic Emotion Scale. Basic emotion profiles were compared both within each group and between the healthy group and each of the three other groups. Discriminant analysis was used to assess the extent to which basic emotions can be used to classify the participants as belonging to the healthy group or one of the clinical groups. RESULTS In the healthy group, happiness was experienced more than any other basic emotion. This was not found in the clinical groups. In comparison to the healthy participants, the chronic pain group experienced more fear, anger and sadness, the depressed group reported more sadness and the PTSD group experienced all of the negative emotions more frequently. Discriminant analysis revealed that happiness was the most important variable in determining whether an individual belonged to the healthy group or one of the clinical groups. Anger was found to further discriminate between depressed and chronic pain individuals. CONCLUSION The findings demonstrate that basic emotion profile analysis can provide a useful foundation for the exploration of emotional experience both within and between healthy and clinical groups. 

The relationship between acceptance, catastrophizing and illness representations in chronic pain

Cognitive‐ and acceptance‐based approaches are used to help people live with chronic pain. Little is known about how these constructs relate to each other. In this study, we examined how cognitive representations of chronic pain relate to interpersonal styles such as catastrophizing and the behavioural process of acceptance of chronic pain. This study further examined how these processes relate to emotional and physical functioning in chronic pain.

Mental imagery in chronic pain: Prevalence and characteristics

Research into mental imagery has increased our understanding of a range of psychological problems. However, there has been little study into the spontaneous mental images experienced in response to chronic pain. This study aimed to explore the prevalence and characteristics of these pain‐related mental images.

Pilot study of Acceptance and Commitment Therapy for Irritable Bowel Syndrome: A preliminary analysis of treatment outcomes and processes of change

Background The aim of this study was to investigate the efficacy and proposed processes of change of acceptance and commitment therapy (ACT) in improving the outcomes of irritable bowel syndrome (IBS). Methods A total of 56 consecutive patients recruited from a specialist clinic were included in the study and completed an ACT treatment protocol (one-day group workshop plus self-help manual). Assessments of process (acceptance of IBS) and outcome variables (symptom severity, avoidance behaviours, quality of life, and gastrointestinal anxiety) were carried at four time points (assessment, pre-treatment, post-treatment, and follow-up). Results A significant increase in the acceptance of IBS and improvement in all outcome variables was observed from pre- to post-treatment and follow-up (effect sizes medium to large). Improvements in all outcomes were associated with increases in acceptance of IBS. Changes in acceptance of IBS from pre- to post-treatment were a significant predictor of improvements in outcomes from pre-treatment to follow-up. Conclusions Results support the efficacy of a brief ACT protocol in improving IBS outcomes and maintaining therapy effects at six-month follow-up. Preliminary support for the treatment process proposed was also found.

New psychological therapies for irritable bowel syndrome: mindfulness, acceptance and commitment therapy (ACT)

The current goal of treatment in irritable bowel syndrome (IBS) focuses primarily on symptom management and attempts to improve quality of life. Several treatments are at the disposal of physicians; lifestyle and dietary management, pharmacological treatments and psychological interventions are the most used and recommended. Psychological treatments have been proposed as viable alternatives or compliments to existing care models. Most forms of psychological therapies studied have been shown to be helpful in reducing symptoms and in improving the psychological component of anxiety/depression and health-related quality of life. According to current NICE/NHS guidelines, physicians should consider referral for psychological treatment in patients who do not respond to pharmacotherapy for a period of 12 months and develop a continuing symptom profile (described as refractory irritable bowel syndrome). Cognitive behavioral therapy (CBT) is the best studied treatment and seems to be the most promising therapeutic approach. However, some studies have challenged the effectiveness of this therapy for irritable bowel syndrome. One study concluded that cognitive behavioral therapy is no more effective than placebo attention control condition and another study showed that the beneficial effects wane after six months of follow-up. A review of mind/body approaches to irritable bowel syndrome has therefore suggested that alternate strategies targeting mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance-based approaches. In this article we review these new psychological treatment approaches in an attempt to raise awareness of alternative treatments to gastroenterologists that treat this clinical syndrome.

The influence of psychological flexibility on life satisfaction and mood in muscle disorders.

PURPOSE/OBJECTIVE Acceptance and commitment therapy (ACT), a newer type of behavior therapy that targets psychological flexibility, may have particular utility in the context of muscle disorders. However, there has been no formal investigation of psychological flexibility in this population. This longitudinal observational study investigated whether psychological flexibility is cross-sectionally related to, and prospectively influential on, life satisfaction and mood in muscle disorders. METHODS Data were collected via online questionnaire batteries, completed at baseline and then repeated 4 months later. Cross-sectional and prospective regression analyses examined relationships between validated measures of disability level, psychological flexibility (experiential avoidance, cognitive fusion, and valued living) and illness perceptions (a psychological variable with known influence in muscle disorders), and outcomes (life satisfaction, anxiety, and depression). RESULTS A sample of 137 people with a range of muscle disorders participated. In cross-sectional analyses, psychological flexibility explained significant unique variance in addition to illness perceptions (ΔR2 = 0.17-0.34, p < .001). In prospective analyses, psychological flexibility alone was predictive of change in life satisfaction (ΔR2 = 0.04, p = .01) and anxiety (ΔR2 = 0.03, p = .04) over 4 months. No independent variables were predictive of change in depression over 4 months, and disability level had no significant influence on outcomes. CONCLUSIONS Psychological flexibility influences important outcomes in muscle disorders. Experimental studies are required to establish if increased psychological flexibility leads to improved outcomes. (PsycINFO Database Record

Depression and physical disability in chronic pain: The mediation role of emotional intelligence and acceptance

Objective Emotional intelligence (EI) and acceptance have previously been identified as potential factors in the adjustment to chronic pain (CP). This study examined the associations between CP experiences, depression, and physical disability. It further investigated the mediating effect of EI and acceptance in the relationship between CP experiences, depression, and physical disability and how this changes with the duration of the CP. Method A cross‐sectional design, employing validated questionnaires, was used to measure pain experience, physical disability, depression, EI, and acceptance in 133 CP patients. Results All variables were found to be significantly associated in theoretically predicted ways. The relationship between CP experiences and depression was mediated by both factors, as high EI and acceptance promoted a decreased influence of pain on depression. By contrast, the relationship between CP experiences and physical disability was mediated by acceptance, but not by EI. Further, the temporal stability analysis of this mediation model showed that long‐term CP patients are better able to make use of these factors. Conclusions The relationship between the experience of pain and depression or physical disability seems to be significantly mediated by factors such as EI and acceptance. This study lends further support to the development of more encompassing models that take both control and non‐control variables into account when conceptualising the adjustment to CP. Theoretical and clinical implications are discussed.

Mental imagery in chronic pain

Research into mental imagery has increased our understanding of a range of psychological problems. However, there has been little study into the spontaneous mental images experienced in response to chronic pain. This study aimed to explore the prevalence and characteristics of these pain‐related mental images.

Mental imagery in chronic pain: Prevalence and characteristics: Mental imagery in chronic pain

Research into mental imagery has increased our understanding of a range of psychological problems. However, there has been little study into the spontaneous mental images experienced in response to chronic pain. This study aimed to explore the prevalence and characteristics of these pain‐related mental images.