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1.
Phys Biol ; 20(5)2023 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-37364583

RESUMO

Correlation analysis and its close variant principal component analysis are tools widely applied to predict the biological functions of macromolecules in terms of the relationship between fluctuation dynamics and structural properties. However, since this kind of analysis does not necessarily imply causation links among the elements of the system, its results run the risk of being biologically misinterpreted. By using as a benchmark the structure of ubiquitin, we report a critical comparison of correlation-based analysis with the analysis performed using two other indicators, response function and transfer entropy, that quantify the causal dependence. The use of ubiquitin stems from its simple structure and from recent experimental evidence of an allosteric control of its binding to target substrates. We discuss the ability of correlation, response and transfer-entropy analysis in detecting the role of the residues involved in the allosteric mechanism of ubiquitin as deduced by experiments. To maintain the comparison as much as free from the complexity of the modeling approach and the quality of time series, we describe the fluctuations of ubiquitin native state by the Gaussian network model which, being fully solvable, allows one to derive analytical expressions of the observables of interest. Our comparison suggests that a good strategy consists in combining correlation, response and transfer entropy, such that the preliminary information extracted from correlation analysis is validated by the two other indicators in order to discard those spurious correlations not associated with true causal dependencies.


Assuntos
Simulação de Dinâmica Molecular , Ubiquitina , Ubiquitina/química , Entropia , Regulação Alostérica
2.
J Pers ; 91(4): 977-991, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-35037250

RESUMO

OBJECTIVE: Personality involves both trait and state components, personal goals serving a crucial regulatory function for the expression of personality states. The present study investigates the dynamic interplay between conscientiousness-related goals, conscientious personality states, and trait conscientiousness. METHOD: A sample of 244 community participants responded to a baseline survey (T1), a 5-times-a-day Ecological Momentary Assessment (EMA) for 15 days, and a post-EMA survey (T2). RESULTS: Pre-registered multilevel analyses indicated significant contemporaneous positive and negative associations between momentary conscientious and unconscientious goals and state conscientiousness, respectively. Cross-lagged associations also emerged, with goals predicting future states of conscientiousness. A latent growth model was fitted on a subsample of participants (N = 159). Results indicated that change in trait conscientiousness from T1 to T2 was explained by growth in conscientiousness-related goals during the EMA phase, with a mediating effect of growth in state conscientiousness. CONCLUSIONS: Overall, the results corroborate the importance of goals for modeling contemporaneous and cross-lagged personality dynamics, both in short and longer timeframes.


Assuntos
Objetivos , Personalidade , Humanos , Inquéritos e Questionários , Transtornos da Personalidade , Avaliação Momentânea Ecológica
3.
Int J Lang Commun Disord ; 58(4): 1182-1190, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36726040

RESUMO

BACKGROUND: The comprehension profile of people with agrammatism is a debated topic. Syntactic complexity and cognitive resources, in particular phonological short-term memory (pSTM), are considered as crucial components by different interpretative accounts. AIM: To investigate the interaction of syntactic complexity and of pSTM in sentence comprehension in a group of persons with aphasia with and without agrammatism. METHODS & PROCEDURES: A cohort of 30 participants presenting with aphasia was assessed for syntactic comprehension and for pSTM. A total of 15 presented with agrammatism and 15 had fluent aphasia. OUTCOMES & RESULTS: Linear nested mixed-model analyses revealed a significant interaction between sentence type and pSTM. In particular, participants with lower pSTM scores showed a reduced comprehension of centre-embedded object relatives and long coordinated sentences. Moreover, a significant interaction was found between sentence type and agrammatism, with a lower performance for passives within the agrammatic group. CONCLUSIONS & IMPLICATIONS: These results confirm that pSTM is involved in the comprehension of complex structures with an important computational load, in particular coordinated sentences, and long-distance filler gap dependencies. On the contrary, the specific deficit of the agrammatic group with passives is a pure syntactic deficit, with no involvement of pSTM.


Assuntos
Afasia de Broca , Compreensão , Memória de Curto Prazo , Humanos , Afasia de Broca/psicologia , Idioma , Semântica
4.
J Pers Assess ; 104(3): 335-346, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34282977

RESUMO

This study presents the adaptation to the Italian context of the Relationship Profile Test (RPT; Bornstein & Languirand), a self-report measure of Destructive Overdependence (DO), Dysfunctional Detachment (DD), and Healthy Dependency (HD). The RPT was administered to a community sample of 661 nonclinical Italian adults together with the Attachment Style Questionnaire, the Relational-Interdependent Self-Construal Scale, the Rosenberg Self-Esteem Scale, the Self-Compassion Scale, the Positive Affect-Negative Affect Scale, and the Toronto Alexithymia Scale. A randomly selected subset of participants (n = 67) completed the RPT again approximately 5 months after the first administration. The factor structure of the RPT obtained in the main sample was compared with that obtained in a sample of 603 adult participants from the US and was found to be similar. Internal consistency for DO, DD, and HD scores in the Italian sample fell between the acceptable to good range, and test-retest reliability coefficients were all above .70. The three scales yielded the expected pattern of correlations with theoretically related constructs, documenting good criterion validity. Findings are discussed in light of the literature on the RPT as a measure of interpersonal dependency and detachment. Suggestions for future research are offered.


Assuntos
Comparação Transcultural , Relações Interpessoais , Adulto , Nível de Saúde , Humanos , Itália , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
5.
Int J Clin Pract ; 75(12): e14829, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34510668

RESUMO

OBJECTIVES: The aim of the present study was to develop and validate the CoronaVirus-Disease-2019 (COVID-19) Questionnaire (COVID-Q), a novel symptom questionnaire specific for COVID-19 patients, to provide a comprehensive evaluation that may be helpful for physicians, and evaluate the questionnaire's performance in identifying subjects at higher risk of testing positive. MATERIALS AND METHODS: Consecutive non-hospitalised adults who underwent nasopharyngeal-throat swab for severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) detection at Treviso Hospital in March 2020, were enrolled. Subjects were divided into positive (cases) and negative (controls). All subjects answered the COVID-Q. Patients not able to answer COVID-Q because of clinical conditions were excluded. Parallel Analysis and Principal Component Analysis identified items measuring the same dimension. The Item Response Theory (IRT)-based analyses evaluated the functioning of item categories, the presence of clusters of local dependence among items, item fit within the model and model fit to the data. RESULTS: Answers obtained from 230 cases (113 males; mean age 55 years, range 20-99) and 230 controls (61 males; mean age 46 years, range 21-89) were analysed. Six components were extracted with parallel analysis: asthenia, influenza-like symptoms, ear and nose symptoms, breathing issues, throat symptoms, and anosmia/ageusia. The final IRT models retained 27 items as significant for symptom assessment. The total questionnaire's score was significantly associated with positivity to the molecular test: subjects with multiple symptoms were more likely to be affected (P < .001). Older age, male gender presence of breathing issues and anosmia/ageusia were significantly related to positivity (P < .001). Comorbidities had not a significant association with the COVID-19 diagnosis. CONCLUSION: COVID-Q could be validated since the evaluated aspects were overall significantly related to infection. The application of the questionnaire to clinical practice may help to identify subjects who are likely to be affected by COVID-19 and address them to a nasopharyngeal swab in order to achieve an early diagnosis.


Assuntos
Ageusia , COVID-19 , Adulto , Idoso , Idoso de 80 Anos ou mais , Teste para COVID-19 , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Inquéritos e Questionários , Adulto Jovem
6.
Biophys J ; 118(9): 2319-2332, 2020 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-32320674

RESUMO

The nuclear morphology of eukaryotic cells is determined by the interplay between the lamina forming the nuclear skeleton, the chromatin inside the nucleus, and the coupling with the cytoskeleton. Nuclear alterations are often associated with pathological conditions as in Hutchinson-Gilford progeria syndrome, in which a mutation in the lamin A gene yields an altered form of the protein, named progerin, and an aberrant nuclear shape. Here, we introduce an inducible cellular model of Hutchinson-Gilford progeria syndrome in HeLa cells in which increased progerin expression leads to alterations in the coupling of the lamin shell with cytoskeletal or chromatin tethers as well as with polycomb group proteins. Furthermore, our experiments show that progerin expression leads to enhanced nuclear shape fluctuations in response to cytoskeletal activity. To interpret the experimental results, we introduce a computational model of the cell nucleus that explicitly includes chromatin fibers, the nuclear shell, and coupling with the cytoskeleton. The model allows us to investigate how the geometrical organization of the chromatin-lamin tether affects nuclear morphology and shape fluctuations. In sum, our findings highlight the crucial role played by lamin-chromatin and lamin-cytoskeletal alterations in determining nuclear shape morphology and in affecting cellular functions and gene regulation.


Assuntos
Cromatina , Progéria , Núcleo Celular , Citoesqueleto , Fibroblastos , Células HeLa , Humanos , Lamina Tipo A/genética , Progéria/genética
7.
J Creat Behav ; 54(1): 62-74, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32728265

RESUMO

The scientific approach to the study of creative problem solving has shifted from using classic insight problems (e.g., the Nine-dots problem), towards sets of problems that have more robust psychometric properties, such as the Remote Associate Test (RAT). Because it is homogeneous, compact, quickly solvable, and easy to score, the RAT has been used more frequently in recent creativity studies. We applied the Item Response Theory (IRT) to develop an Italian version of this task. The final 51-item test was reliable (α = .89) and provided information over a wide range of ability levels, as revealed by the IRT analysis. The RAT correlated with five measures of creative performance: The Raven's Standard Progressive Matrices (SPM), three classic insight problems, a set of anagrams purposefully developed, the fluency and flexibility scores of the Alternative Uses Task (AUT), and the Creative Achievements Questionnaire (CAQ). The new measure provided is meant to encourage the study of creativity and problem solving in the Italian language.

8.
J Pers ; 87(6): 1250-1263, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30854652

RESUMO

OBJECTIVE: We employed the network methodology to explore the connections between the Dark Triad (DT) traits with Mental Toughness (MT) and the degree to which they account for perceived stress beyond the Big Five (B5). METHOD: Network analyses were undertaken to explore connections between the DT, MT, and perceived stress, independently in two samples, and in the combined dataset; and whether B5 factors are responsible for the connections that emerged in the original network. RESULTS: DT and MT traits improved the prediction of perceived stress above the B5. Furthermore, narcissism occupied a strategic position in the network acting as a bridge between prosocial and "dark" sides of personality. The pattern of network connections could not be explained by B5 traits alone. CONCLUSIONS: The results suggest that there is more to personality than what can be captured by the B5 and that broadening the domain of personality beyond the B5 can improve the prediction of important outcomes, such as perceived stress. Narcissism is a unique trait and studying its connection with MT may be the key to moving forward from a dichotomous way of perceiving personality traits, as beneficial or malevolent, to focusing on a dynamic continuum of personality.


Assuntos
Transtorno da Personalidade Antissocial/fisiopatologia , Narcisismo , Personalidade/fisiologia , Resiliência Psicológica , Estresse Psicológico/fisiopatologia , Adulto , Feminino , Humanos , Maquiavelismo , Masculino
10.
J Pers Assess ; 100(6): 621-629, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29617170

RESUMO

We argue that clinical information related to an object-relations model of personality pathology can be used by untrained and clinically inexperienced students to rate personality-disordered patients on the Level of Personality Functioning Scale (LPFS). To do so, 73 clinically inexperienced undergraduate students were asked to assess personality functioning of 10 female inpatients using the LPFS from audio recordings of the Structured Interview of Personality Organization (STIPO). LPFS ratings showed acceptable interrater reliability. Moreover, LPFS ratings were significantly associated with external measures of severity of personality pathology (number of DSM-IV-TR personality disorders) as assessed by experienced clinicians. Finally, the students' ratings were also associated with the level of personality organization as measured by experienced clinicians using the STIPO. Our findings confirm that untrained raters can reliably assess personality pathology by rating the LPFS based on material from the STIPO. Implications related to the use of the STIPO as a tool for the assessment of personality pathology according to the DSM-5 Alternative model are discussed.


Assuntos
Determinação da Personalidade/normas , Transtornos da Personalidade/diagnóstico , Personalidade , Escalas de Graduação Psiquiátrica/normas , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Estudantes/estatística & dados numéricos
11.
J Pers ; 84(4): 493-509, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-25808415

RESUMO

The purpose of this research is to quantitatively compare everyday situational experience around the world. Local collaborators recruited 5,447 members of college communities in 20 countries, who provided data via a Web site in 14 languages. Using the 89 items of the Riverside Situational Q-sort (RSQ), participants described the situation they experienced the previous evening at 7:00 p.m. Correlations among the average situational profiles of each country ranged from r = .73 to r = .95; the typical situation was described as largely pleasant. Most similar were the United States/Canada; least similar were South Korea/Denmark. Japan had the most homogenous situational experience; South Korea, the least. The 15 RSQ items varying the most across countries described relatively negative aspects of situational experience; the 15 least varying items were more positive. Further analyses correlated RSQ items with national scores on six value dimensions, the Big Five traits, economic output, and population. Individualism, Neuroticism, Openness, and Gross Domestic Product yielded more significant correlations than expected by chance. Psychological research traditionally has paid more attention to the assessment of persons than of situations, a discrepancy that extends to cross-cultural psychology. The present study demonstrates how cultures vary in situational experience in psychologically meaningful ways.


Assuntos
Comparação Transcultural , Personalidade , Psicometria/estatística & dados numéricos , Q-Sort/estatística & dados numéricos , Comportamento Social , Adulto , Austrália/etnologia , Canadá/etnologia , China/etnologia , Europa (Continente)/etnologia , Feminino , Humanos , Japão/etnologia , Masculino , República da Coreia/etnologia , África do Sul/etnologia , Estados Unidos/etnologia , Adulto Jovem
12.
Behav Res Methods ; 48(2): 664-85, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26148823

RESUMO

Rebus puzzles and compound remote associate problems have been successfully used to study problem solving. These problems are physically compact, often can be solved within short time limits, and have unambiguous solutions, and English versions have been normed for solving rates and levels of difficulty. Many studies on problem solving with sudden insight have taken advantage of these features in paradigms that require many quick solutions (e.g., solution priming, visual hemifield presentations, electroencephalography, fMRI, and eyetracking). In order to promote this vein of research in Italy, as well, we created and tested Italian versions of both of these tests. The data collected across three studies yielded a pool of 88 rebus puzzles and 122 compound remote associate problems within a moderate range of difficulty. This article provides both sets of problems with their normative data, for use in future research.


Assuntos
Testes Neuropsicológicos , Resolução de Problemas/fisiologia , Adulto , Feminino , Humanos , Itália , Idioma , Masculino , Variações Dependentes do Observador , Adulto Jovem
13.
Int J Psychol ; 51(1): 33-9, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26010199

RESUMO

Personality psychology has made enormous progresses over the years by accumulating empirical evidence on how patterns of stable individual differences in behaviours can be clustered systematically at different levels of abstraction (i.e. traits and facets) and how they can predict important consequential outcomes. At the same time, functionally orientated researchers have accumulated a vast body of knowledge on environment-behaviour relations and the underlying behavioural principles, that is, abstract descriptions of the way in which behaviour is a function of elements in the past and present environment. We explore a functional perspective on personality that attempts to bridge the two domains and to exploit the best of both worlds. From this functional perspective, personality refers to the impact of the individual on different types of environment-behaviour relations as well as on the way other factors moderate those relations. We discuss the potential of this functional perspective on personality to organise existing scientific knowledge and inspire future research.


Assuntos
Transtornos da Personalidade/psicologia , Personalidade , Meio Social , Humanos
14.
Res Child Adolesc Psychopathol ; 52(3): 443-455, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37947955

RESUMO

Early maladaptive traits are predictive of later borderline personality pathology (BPP), but little is known about their dynamic interplay over time. This is an important issue to address, however, as significant differences in the 'clinical weight' of various traits constituting the early BPP trait phenotype may inform the field on important target constructs from an early intervention perspective. Therefore, the current study aims to uncover the complex dependencies between BPP traits across the crucial developmental period of childhood and adolescence, by using longitudinal network analysis. Both between- and within-person networks were constructed to identify how early mother-reported borderline-related traits are connected across a timespan of six years (ntime 1 = 718, Mtime1 = 10.73 years, SDtime1 = 1.39, 55.1% girls). Overall, the temporal network suggested various trait interdependencies, with internalizing traits being particularly influential in the development of the BPP trait network structure. At the same time, externalizing traits likely inhibit the negative effects of these core traits. In addition, results also revealed that internalizing and externalizing clusters of early borderline-related traits are linked through emotional lability. Implications of these findings are discussed in view of the change mechanisms at play and potential targets for early intervention.


Assuntos
Transtorno da Personalidade Borderline , Transtornos da Personalidade , Feminino , Humanos , Adolescente , Masculino , Transtorno da Personalidade Borderline/psicologia , Fenótipo , Transtornos do Humor , Sintomas Afetivos
15.
Psychol Aging ; 39(5): 578-587, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38934925

RESUMO

The COVID-19 pandemic was not only a biological challenge, but it also took a toll on the psychological and social well-being of older adults, especially those in nursing homes. This study aims to uncover the impact of the pandemic on the biopsychosocial well-being of nursing home residents, including the role of COVID-19 positivity and social contacts. Using a sample of 247 individuals in two Northern Italian nursing homes over 3 years (2018-2021), the study analyzed a broad range of biopsychosocial variables and traced the frequency of social contacts during the lockdown. The results showed a concerning trend of worsening well-being over time during the pandemic, irrespective of COVID-19 positivity. Surprisingly, the frequency of contacts with family caregivers did not seem to have a protective role, and worsening conditions were associated with an increase in subsequent social contacts. These findings shed light on the dynamics of the biopsychosocial well-being of institutionalized individuals, and they have significant public health implications. By disentangling the roles of the pandemic period, COVID-19 positivity, and social contacts, this study provides insights into the worsening of neuropsychiatric symptoms, as well as functional and clinical indicators, in nursing home residents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
COVID-19 , Casas de Saúde , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Masculino , Feminino , Estudos Longitudinais , Idoso , Idoso de 80 Anos ou mais , Itália/epidemiologia , Instituição de Longa Permanência para Idosos , Saúde Mental
16.
Cyberpsychol Behav Soc Netw ; 27(1): 28-36, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38197837

RESUMO

Immersive virtual reality (IVR) technology provides several educational affordances that make it a valuable tool for learning, especially from a constructivist learning perspective. Combined with the increasing availability of Metaverse social platforms, such as ENGAGE and AltSpace VR, where students and teachers can meet and work together, IVR may transform how students learn and interact with educational content. However, little is known about students' attitudes toward IVR in education. To address this gap, we surveyed 329 undergraduate students from different universities in Italy. We used the Unified Theory of Acceptance and Use of Technology (UTAUT) to predict students' intention to adopt IVR for learning. We further explored the role that different individual factors, including students' learning styles, affordances perceptions, and personal innovativeness, have on their attitudes toward IVR. A hierarchical multiple regression analysis revealed that the four constructs of the UTAUT, namely performance expectancy, effort expectancy, social influence, and facilitating conditions were the strongest predictors of students' intention to use IVR in education and that individual factors only had little impact on it. Based on these results, this study provides helpful indications for researchers and educators who wish to introduce IVR effectively in educational contexts. Given the new possibilities provided by Metaverse applications based on IVR technology for learning, it is indeed crucial to fully understand the attitudes different stakeholders in education have toward adopting this technology in educational contexts.


Assuntos
Aprendizagem , Realidade Virtual , Humanos , Universidades , Estudantes , Intenção
17.
PNAS Nexus ; 3(7): pgae221, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38979080

RESUMO

Throughout the 21st century, economic inequality is predicted to increase as we face new challenges, from changes in the technological landscape to the growing climate crisis. It is crucial we understand how these changes in inequality may affect how people think and behave. We propose that economic inequality threatens the social fabric of society, in turn increasing moralization-that is, the greater tendency to employ or emphasize morality in everyday life-as an attempt to restore order and control. Using longitudinal data from X, formerly known as Twitter, our first study demonstrates that high economic inequality is associated with greater use of moral language online (e.g. the use of words such as "disgust", "hurt", and "respect'). Study 2 then examined data from 41 regions around the world, generally showing that higher inequality has a small association with harsher moral judgments of people's everyday actions. Together these findings demonstrate that economic inequality is linked to the tendency to see the world through a moral lens.

18.
Sci Rep ; 13(1): 1703, 2023 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-36717666

RESUMO

The diffusion-weighted NMR signal acquired using Pulse Field Gradient (PFG) techniques, allows for extrapolating microstructural information from porous materials and biological tissues. In recent years there has been a multiplication of diffusion models expressed by parametric functions to fit the experimental data. However, clear-cut criteria for the model selection are lacking. In this paper, we develop a theoretical framework for the interpretation of NMR attenuation signals in the case of Gaussian systems with stationary increments. The full expression of the Stejskal-Tanner formula for normal diffusing systems is devised, together with its extension to the domain of anomalous diffusion. The range of applicability of the relevant parametric functions to fit the PFG data can be fully determined by means of appropriate checks to ascertain the correctness of the fit. Furthermore, the exact expression for diffusion weighted NMR signals pertaining to Brownian yet non-Gaussian processes is also derived, accompanied by the proper check to establish its contextual relevance. The analysis provided is particularly useful in the context of medical MRI and clinical practise where the hardware limitations do not allow the use of narrow pulse gradients.

19.
Assessment ; 30(8): 2510-2532, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-36794796

RESUMO

The HEXACO model divides the space of personality into six main dimensions: Honesty-Humility, Emotionality, eXtraversion, Agreeableness (vs. anger), Conscientiousness, and Openness to Experience. Despite the lexical foundation, no validated adjective-based instruments are available yet. This contribution describes the newly developed HEXACO Adjective Scales (HAS), a 60 adjectives instrument to measure the six main personality dimensions. Study 1 (N=368) proceeds to the first pruning of a large set of adjectives to identify potential markers. Study 2 (N=811) delineates the final list of 60 adjectives and provides benchmarks for the new scales' internal consistency, convergent/discriminant, and criterion validity. Study 3 (N=411) confirms the HAS factorial structure, internal consistency, and criterion validity. The study also provides evidence of temporal stability (test-retest reliability) and convergence between raters (peer/self-evaluation). The HAS shows excellent psychometric properties and constitutes a valuable tool for assessing the HEXACO personality dimensions using adjectives.


Assuntos
Transtornos da Personalidade , Personalidade , Humanos , Psicometria , Reprodutibilidade dos Testes , Inventário de Personalidade
20.
Am J Phys Med Rehabil ; 102(7): 571-576, 2023 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-36882316

RESUMO

OBJECTIVE: Chronic low back pain (CLBP) is the leading cause of disability worldwide, and several factors have been proposed as potential causes or cofactors. The aim of this study was to explore their direct and indirect relations to understand CLBP and identify relevant rehabilitation targets. METHODS: A total of 119 patients with CLBP and 117 chronic pain-free individuals were assessed. A network analysis approach was used to explore the complexity of CLBP by assessing the relations between pain intensity, disability, functionality (physical, social, and psychological), age, body mass index, and education level. RESULTS: The network analysis revealed the independence of pain and disability related to CLBP from age, sex, and body mass index. Crucially, pain intensity and disability are directly and strongly connected in chronic pain-free individuals, but not in patients with CLBP. Psychosocial functioning is related to pain intensity and disability indirectly through the mediation of one's general health perception and perceived physical functionality. CONCLUSION: Clinicians should pay more attention to perceived physical functionality and psychosocial factors as they are tightly linked to CLBP. Indeed, pain intensity seems a suboptimal rehabilitation target. This study suggests that a biopsychosocial approach is much needed to investigate CLBP, but it also warns against overestimating the direct impact of each potential contributor. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Recognize the relation of pain intensity, disability, and loss of function in patients with CLBP; (2) Determine the impact of the most common biological and psychosocial factors in addressing the assessment of chronic back pain patients; and (3) Enhance confidence in selecting the relevant outcomes for the assessment of patients with CLBP following a multidimensional assessment. LEVEL: Advanced. ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should only claim credit commensurate with the extent of their participation in the activity.


Assuntos
Dor Crônica , Pessoas com Deficiência , Dor Lombar , Humanos , Modalidades de Fisioterapia , Pessoas com Deficiência/psicologia , Medição da Dor
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