Evaluating the efficacy of oxytocin for pain management: An updated systematic review and meta-analysis of randomized clinical trials and observational studies.

Background: There is a need for novel analgesics with favorable risk to benefit profiles. Oxytocin has recently gained attention for its potential analgesic properties. Aim: The aim of this study was to perform an updated systematic review and meta-analysis evaluating the effect of oxytocin for pain management. Method: Ovid MEDLINE, Embase, PsycINFO, CINAHL, and Clinicaltrials.gov were searched for articles reporting on associations between oxytocin and chronic pain management from January 2012 to February 2022. Studies published before 2012 that were identified in our previous systematic review were also eligible. Risk of bias of included studies was assessed. Synthesis of results was performed using meta-analysis and narrative synthesis. Results: Searches returned 2087 unique citations. In total, 14 articles were included that reported on 1504 people living with pain. Results from meta-analysis and narrative review were mixed. Meta-analysis of three studies indicated that exogenous oxytocin administration did not result in a significant reduction in pain intensity relative to placebo (N = 3; n = 95; g = 0.31; 95% confidence interval [CI] -0.10, 0.73). Narrative review provided encouraging evidence that exogenous oxytocin administration reduced pain sensitivity among individuals with back pain, abdominal pain, and migraines. Results suggested that individual difference factors (e.g., sex and chronic pain condition) may influence oxytocin-induced nociception, but the heterogeneity and limited number of studies identified precluded further investigation. Discussion: There is equipoise for the benefit of oxytocin for pain management. Future studies are imperative and should undertake more precise exploration of potential confounds and mechanisms of analgesic action to clarify inconsistency in the literature.

Contexte: Il existe un besoin de nouveaux analgésiques présentant un profil de risque/bénéfice favorable. L'ocytocine a récemment attiré l'attention pour ses propriétés analgésiques potentielles.Objectif: L'objectif de cette étude était d'effectuer une mise à jour d'une revue systématique et une méta-analyse pour évaluer l'effet de l'ocytocine pour la gestion de la douleur.Méthode: Des recherches ont été effectuées dans Ovid MEDLINE, Embase, PsycINFO, CINAHL et Clinicaltrials.gov pour y repérer des articles sur les associations entre l'ocytocine et la prise en charge de la douleur chronique de janvier 2012 à février 2022. Les études publiées avant 2012 qui ont été recensées dans notre revue systématique précédente était également admissibles. Le risque de biais des études incluses a été évalué. Une synthèse des résultats a été réalisée à l'aide d'une méta-analyse et d'une synthèse narrative.Résultats: Les recherches ont permis de recenser 2 087 citations uniques. Au total, 14 articles portant sur 1 504 personnes vivant avec la douleur ont été incluses. Les résultats de la méta-analyse et de l'examen narratif ont été mitigés. Une méta-analyse de trois études a révélé que l'administration d'ocytocine exogène n'avait pas entraîné de réduction significative de l'intensité de la douleur comparativement au placebo (N = 3; n = 95; g = 0,31; Intervalle de confiance à 95 % [IC] −0,10 ; 0,73). L'examen narratif a fourni des preuves encourageantes que l'administration d'ocytocine exogène avait réduit la sensibilité à la douleur chez les personnes souffrant de maux de dos, de douleurs abdominales et de migraines. Les résultats indiquent que les facteurs de différence individuels (par exemple, le sexe et la douleur chronique) peuvent influencer la nociception induite par l'ocytocine, mais le nombre limité d'études recensées et leur hétérogénéité a empêché d'approfondir l'enquête.Discussion: Il existe un équilibre au profit de l'ocytocine pour la prise en charge de la douleur. Il est primordial que d'autres études soient menées afin d'explorer de manière plus précise les facteurs de confusion et les mécanismes de l'action analgésique potentiels et ainsi clarifier l'incohérence dans la littérature.

An experimental study revisiting the link between media attention and breast cancer concern: exploring the role of cognitive fusion.

Research examining the link between media attention and breast cancer concern has been frequently conducted with middle/old-age women, even though young women (<40 years old) have been overrepresented media stories about breast cancer. Accordingly, little is known about young women's emotional reactions to breast cancer media messages and the psychological factors modulating such reactions. This study examined the impact of breast cancer media messages and cognitive fusion on negative affect, fear of breast cancer (FBC), and perceived susceptibility to breast cancer. 207 young women were randomly assigned to watch a low- or high-threat video about breast cancer. A MANCOVA revealed that participants who viewed the high-threat video reported greater negative affect and perceived susceptibility, but not FBC; however, participants in both conditions showed moderate/high FBC. Correlational analyses and a MANOVA showed that participants reporting higher cognitive fusion reported higher negative affect across conditions, as well as higher FBC in the high-threat condition. Taken together, these results suggest that young women may show habituation to alarmist media messages, but may nonetheless construe breast cancer as a significant threat. Moreover, young women showing medium/high cognitive fusion seem more likely to show heightened concern upon exposure to alarmist media messages about breast cancer.

Fear of breast cancer among young Spanish women: Factor structure and psychometric properties of the Champion breast cancer fear scale.

Heightened fear of breast cancer (FBC) has been linked to increased distress following breast cancer diagnosis and to avoidance of mammography screening. To our knowledge, however, no studies have examined the nature of FBC exclusively among young females, even though they are overrepresented in media stories of breast cancer. Given that no instruments are available to assess FBC in the Spanish language, we sought to 1) evaluate the psychometric properties and factor structure of the Champion Breast Cancer Fear Scale (CBCFS), and 2) offer preliminary data on the nature of FBC among young women. Participants (N = 442, mean age = 21.17, range 17-35) completed the translated CBCFS (CBCFS-es) and the Spanish version of the Short Health Anxiety Inventory. The CBCFS-es demonstrated good concurrent validity, internal consistency, and test-retest reliability. Confirmatory factor analysis showed adequate fit to a one-factor solution. The majority of participants reported considerably high levels of FBC, as 25.34% and 59.73% of them scored above the moderate- and high-FBC cut-offs, respectively. Moreover, FBC could not be explained by general concerns regarding health and illness, given that levels of health anxiety were low. Implications for health education, research, and clinical practice are discussed.

Depression and Anxiety in Patients With Pulmonary Hypertension: The Role of Life Satisfaction and Optimism.

BACKGROUND: Pulmonary hypertension is a highly disabling condition characterized by a progressive increase in pulmonary arterial pressure. Even though pulmonary hypertension may cause great emotional distress, research examining the determinants of patients' emotional well-being has been scarce and has mostly focused on the role of disease-related factors. OBJECTIVES: This study examined whether patients' emotional well-being may be effected by their life circumstances. METHODS: Sixty-four patients with pulmonary hypertension completed measures of symptoms of pulmonary hypertension, functional disability, depression and anxiety symptoms, life satisfaction, optimism, and quality of life (QoL). RESULTS: Clinically-significant symptoms of depression and anxiety were only accurately predicted in 50.5% and 56.5% of patients, respectively, based on disease severity alone. However, the addition of life satisfaction and optimism to the models improved the prediction of depressive and anxiety symptomatology. Further, symptoms of anxiety were a significant predictor of QoL, above and beyond disease severity. CONCLUSIONS: Patients with considerably different levels of disease severity may develop clinically-significant depressive and anxiety symptomatology. This suggests that there is not a perfect correspondence between the level of disease severity and the repercussions thereof across patients. Accordingly, these results suggest that emotional well-being may be better explained by taking into consideration patients' life circumstances, as these may modulate the repercussions of having pulmonary hypertension. The results also showed that anxiety symptoms constituted an extra burden to patients' QoL. The higher prevalence in this sample of clinically-significant symptoms of anxiety, compared to that of depression, suggest that feelings of fear and uncertainty may require special attention among patients with pulmonary hypertension.

Adaptation and Validation of the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) for Use in Spain.

INTRODUCTION AND OBJECTIVES: The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is a patient-reported outcome measure of health-related quality of life and quality of life specific to individuals with pulmonary hypertension (PH). This questionnaire has demonstrated superiority over other instruments assessing similar domains. The objective of the present study was to adapt and validate the Spanish version of the questionnaire. METHODS: The adaptation consisted of 3 stages: translation from English to Spanish using bilingual and lay panels, cognitive debriefing interviews with patients, and assessment of psychometric properties by means of a postal validation survey. RESULTS: The translation panels produced a version of the CAMPHOR that was considered suitable for use by Spanish PH patients. The relevance, comprehensiveness, and acceptability of this version were confirmed in interviews with PH patients. Finally, the validation survey (n = 70) revealed that the 3 CAMPHOR scales (Symptoms, Activities, and Quality of life) showed strong psychometric properties. The internal consistency (Cronbach α) coefficients of the scales were above 0.89, and the test-retest reliability was above 0.87. The convergent and known group validity of the CAMPHOR scales was also demonstrated. CONCLUSIONS: The Spanish version of the CAMPHOR is a valid and reliable instrument for the assessment of health-related quality of life and quality of life in Spanish PH patients. Therefore, it is recommended for use in future research and clinical practice in the Spanish population of PH patients.

The relevance of experiential avoidance in breast cancer distress: insights from a psychological group intervention.

BACKGROUND: Research on the implication of experiential avoidance in the aetiology and maintenance of diverse forms of psychopathology has grown considerably over the last 10 years. However, the potential contribution of experiential avoidance to cancer-related distress has received limited attention. Accordingly, the objective of this study was to examine the association between experiential avoidance, symptoms of anxiety and depression, and quality of life (QoL) during the course of a psychological group intervention for women with breast cancer. METHODS: Fifty-four women with breast cancer participated in a psychological group intervention designed to reduce distress and improve QoL. Participants completed measures of experiential avoidance, anxiety and depressive symptoms, and QoL upon the first and last sessions. RESULTS: A path analysis revealed that, after controlling for baseline measures, smaller reductions in experiential avoidance during the course of the intervention predicted smaller reductions in anxiety and depressive symptoms. Also, experiential avoidance had a negative indirect effect on QoL via depressive symptoms. CONCLUSIONS: Experiential avoidance may perpetuate the emotional problems commonly found in women with breast cancer and attenuate improvements associated with participation in psychological interventions. Implications for clinical practice in psycho-oncology are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

Factors influencing intention to help and helping behaviour in witnesses of bullying in nursing settings.

The role played by witnesses of bullying in nursing settings remains little studied, despite their potential relevance in explaining the onset and development of bullying. The objective of this study was to develop a model to account for witnesses' intention to help and helping behaviour in response to bullying in a nursing setting. Three hundred and thirty-seven witnesses completed self-report measures of variables predicting intention to help and helping behaviour. A full structural model was constructed using structural equation modelling. The intention to help victims was elicited by tension, group identity, support to peers' initiative to intervene and absence of fear of retaliation. However, engagement in helping behaviour was only predicted by the absence of fear of retaliation. This study shows that witnesses of bullying in nursing settings do not remain impassive, but their experienced discomfort and intention to help victims is not sufficient to predict helping behaviour. Fear of possible retaliation if intervening in favour of victims constitutes a crucial factor explaining witnesses' hesitation to help victims. Several implications for the implementation of policies directed at eradicating bullying in nursing settings are discussed.

Oxytocin and pain: a systematic review and synthesis of findings.

OBJECTIVES: A review of the literature was conducted to assess the association between oxytocin (OT) and pain. METHODS: PsychInfo, PubMed, and Medline (EBSCO) research databases were searched for peer-reviewed articles written between 1950 and 2012. Of a total of 1166 articles returned, 50 (9 human, 33 animal, and 8 spinal cord samples) met full inclusion criteria and were included in the review. RESULTS: OT had a reliable effect as defined by increasing pain tolerance in 29 of 33 animal studies reviewed. This effect persisted across central and peripheral modes of administration and type of noxious stimulus used (eg, heat, electric). The results suggest that OT acts as an analgesic for acute pain in animals. Preliminary research with humans offers consistent evidence to suggest that OT decreases pain sensitivity, though the reliability and stability of such effects cannot yet be determined. Although the findings are encouraging, there is a need for methodologically rigorous work in humans where OT is administered centrally. DISCUSSION: Further research seems to be warranted as the existence of biologically and psychologically plausible mechanisms linking OT and pain have been well supported using animal models with limited but encouraging human research. Implications and recommendations are discussed. Findings from this research may inform therapeutic methods for the management of pain.

Attention-deficit hyperactivity disorder and cardiac vagal control: a systematic review.

Attention-deficit hyperactivity disorder (ADHD) is characterized by behavioural disinhibition, deficient emotional self-regulation, inattention, and hyperactivity. The constellation of deficits found in children with ADHD implicates autonomic dysregulation characterized by deficient control of the heart by parasympathetic influences. While it is generally assumed that autonomic regulation of the heart is impaired during ADHD, the information pertaining to this dysregulation is limited. A systematic review of three databases was conducted between January and March 2012 for peer reviewed publications examining the relationship between cardiac vagal control (CVC) and ADHD without comorbid psychopathology. 19 articles were reviewed with only 6 meeting inclusion criteria. Findings were not unanimous but suggested that children with unmedicated ADHD experienced lower levels of CVC than did healthy controls. It was difficult to evaluate whether children with ADHD exhibited a different pattern of withdrawal and application of CVC than did normal controls. Findings suggested CVC reactivity depended on the task employed but children with ADHD experienced dampened CVC reactivity during tasks that involved self-regulation and emotion regulation. Finally, medication acted to correct the autonomic imbalance experienced by children with ADHD but did not bring this imbalance into normal levels. Given that so few studies were identified, no firm conclusions can be made, and there is a clear need for additional research in this area. Recommendations for future research are discussed.