El papel de las emociones en el patrón de secuenciación de actividades: un estudio experimental / The role of affect in pacing: an experimental study

Las personas con dolor crónico cambian la forma de realizar las actividades cotidianas, diferenciándose diversos patrones, entre ellos, la secuenciación de actividades (pacing). La bibliografía acerca de la relación entre pacing y afecto muestran resultados contradictorios. El objetivo de este estudio fue contrastar experimentalmente, en una muestra de 145 estudiantes, si la inducción de afecto positivo vs negativo influía en la elección del tipo de “pacing” (“pacingpara aumentar la productividad” y “pacingpara reducir el dolor”) cuando los participantes eran expuestos a dolor, controlando las variables optimismo y catastrofismo. Los resultados de la regresión logística multinomial no mostraron relación entre las variables. El pacing es una estrategia de intervención presente en todos los modelos de intervención en dolor crónico y, por tanto, es relevante seguir profundizando acerca del rol del afecto en relación al mismo.(AU)

People with chronic pain often change the way they carry out their daily activities according to different patterns, among which are pacing strategies. Cross-sectional studies on the association between pacing andaffectshow contradictory results. The study aim was to experimentally test whether the induction of positive affect vs negative affect would influence the choice of the type of pacing (pacing to increase productivity or pacing to reduce pain) when the participants were exposed to pain, while controlling for the variables optimism and catastrophism. The study participants comprised a sample of 145 undergraduates. The results ofmultinomial logistic regression showed that there was no association between the variables. Pacing is an intervention strategy in all chronic pain intervention models, and thus it is relevant to continue investigating the role of affect in relation to pacing.(AU)

Variables psicológicas implicadas en el abuso o consumo indebido de opioides en pacientes con dolor crónico no oncológico / Psychological variables involved in opioid abuse or misuse in patients with chronic non-cancer pain

Las variables psicológicas permiten predecir el riego de abuso de los opioidesde prescripción. El objetivo del presente estudio ha sido analizar el valor predictivode algunas de ellas. Concretamente se ha analizado la asociación del humor deautoafirmación, el neuroticismo, la extraversión, la presencia de síntomas deansiedad y/o depresión, y la intensidad de dolor percibido con el potencial abuso yel uso indebido de opioides. Participaron 60 pacientes con dolor crónico nooncológico, con una media de edad de 60 años, en su mayoría mujeres (77%) ycasados (78%). Se realizaron dos análisis de regresión lineal múltiple por pasos. Losresultados señalan a los síntomas de ansiedad y/o depresión como únicas variablesrelacionadas con el potencial abuso y el actual uso indebido de los opioides deprescripción. Se concluye la importancia de llevar a cabo una evaluación psicológicaprevia al inicio de una terapia farmacológica con opioides. Y, en el caso de detectarsíntomas de ansiedad o depresión en estos pacientes, sería necesario solucionarestos problemas antes de la prescripción de opioides. (AU)

Psychological variables can be used to predict the risk of prescription opioidabuse. The aim of the present study was to analyse the predictive value of a set ofthese variables. Specifically, we analysed the association between the potentialabuse and misuse of opioids and self-affirming mood, neuroticism, extraversion,anxiety and/or depression symptoms, and perceived pain intensity. The samplecomprised 60 patients with chronic non-oncological pain (mean age= 60 years;77% women, 78% married). Two stepwise multiple linear regression analyses wereperformed. The results indicate that anxiety and/or depression symptoms were theonly variables associated with the potential abuse and current misuse ofprescription opioids. We suggest the need for prior psychological assessmentbefore deciding to initiate pharmacological therapy with opioids. Any anxiety or depression symptoms in these patients should be addressed before prescribingopioids. (AU)

Pain Acceptance Creates an Emotional Context That Protects against the Misuse of Prescription Opioids: A Study in a Sample of Patients with Chronic Noncancer Pain.

There is solid evidence of an association between several psychological flexibility processes, particularly pain acceptance, and adaptation to chronic pain. However, there are relatively few studies on the relationship between pain acceptance and opioid misuse in chronic pain patients. Thus, the aim of the present study was to test a hypothetical model in which pain acceptance would regulate pain sensations and pain-related thoughts and emotions, which would be related to opioid misuse. The sample comprised 140 chronic pain patients attending two hospitals. All patients were receiving pharmacological treatment, including opioid analgesics. Structural equation modelling analyses showed a significant association between higher pain acceptance and lower pain intensity and catastrophizing, and lower levels of anxiety and depression. Only higher anxiety and depression were significantly associated with increased opioid misuse. The results suggest that levels of anxiety, depression, and pain acceptance must be assessed before opioids are prescribed. Pain acceptance implies a relationship with internal events that protects against anxiety and depression and thus against opioid misuse. Acceptance and Commitment Therapy appears to be particularly appropriate for these patients.