Two Is Better Than One: Dyadic Coping in the Context of Chronic Pain.

Most experts in pain treatment and research concur that a biopsychosocial view of pain provides the most benefit when attempting to understand this complex clinical issue. However, it is increasingly being recognized that pain research has a far greater focus on the bio- and the psycho- than on the -social aspects of the biopsychosocial model.

Internet videoconferencing delivered cognitive behaviour therapy for generalized anxiety disorder: A randomized controlled trial.

OBJECTIVE: Generalized anxiety disorder (GAD) is a chronic mental health condition that results in significant individual and societal burden. Cognitive-behaviour therapy (CBT) therapy is an effective treatment for GAD, however, many individuals experience logistical barriers when accessing evidence-based care. Remote treatments may help to reduce these barriers, however, currently, there are few studies examining the efficacy of high-intensity remote methods for GAD treatment. The current study aims to examine the efficacy of CBT delivered via videoconferencing (VCBT) for GAD using a randomized controlled trial design comparing an immediate treatment group to a waitlist control. METHOD: Seventy-eight adults (Mage = 36.92; SD = 12.92; 84.4% female) with GAD were enrolled in the study. RESULTS: Those in the treatment group demonstrated a statistically significant reduction in GAD symptoms from pre-treatment to post-treatment (d = 1.03) and pre-treatment to 3-month follow-up (d = 1.50). Large between-group effect sizes were also observed at post-treatment (d = .80). Twenty-five participants (64.10%) in the VCBT group no longer met diagnostic criteria for GAD at post-treatment, and 26/39 (66.67%) no longer met criteria at 3-month follow-up. Ninety-six per cent of participants were satisfied with the treatment. CONCLUSION: The results contribute towards advancing our knowledge on the efficacy and acceptability of VCBT for patients with GAD.

Treatment histories, barriers, and preferences for individuals with symptoms of generalized anxiety disorder.

Generalized anxiety disorder (GAD) is a prevalent and chronic mental health condition, associated with considerable individual and economic burden. Despite the availability of effective treatments, many individuals do not access support. The current study explores treatment histories, barriers to help-seeking, and cognitive behavioral therapy (CBT) treatment preferences for individuals with clinically significant GAD symptoms. The utility of Health Belief Model (HBM) in predicting help-seeking is also examined. A cross-sectional design with 127 participants (Mage = 29.17; SD = 11.86; 80.3% female) was used. Sixty-two percent of participants reported previously seeking psychological treatment, and approximately 28% received CBT in the first instance. The most influential treatment barriers were a desire to solve the problem on one's own (M = 1.96, SD = 0.96), followed by affordability (M = 1.75, SD = 1.15) and feeling embarrassed or ashamed (M = 1.75, SD = 1.06). The most preferred treatment modes were in-person individual treatment (M = 7.59, SD = 2.86) followed by remote treatment via videoconferencing (M = 4.31, SD = 3.55). Approximately 38% of the variance in intention to seek treatment was associated with the HBM variables, with perceived benefit of treatment being the strongest predictor. Results have the potential to inform mental health service delivery by reducing treatment barriers and aligning public health campaigns with benefits of psychological treatments.

Development and validation of the Pain-Induced Comfort Eating Scale in a chronic pain sample.

Background: Chronic pain and higher body weight frequently co-occur. This common comorbidity is thought to be mediated by the use of comfort eating as a strategy for managing both the physical and psychological pain and discomfort associated with flare-ups of chronic pain. Valid and reliable assessment tools are needed to inform the development of effective treatments. Aims: This study aimed to assess the psychometric properties of a new brief measure of pain-induced comfort eating in chronic pain, the Pain-Induced Comfort Eating Scale (PICES). Methods: A sample of 166 patients with chronic pain completed an online test battery including the PICES along with measures of chronic pain and pain-related symptoms, disordered eating, and related psychological factors. Results: Results of exploratory factor analysis revealed a single-factor model for the four-item PICES. Further, the PICES demonstrated evidence of good internal consistency as well as convergent validity with demonstrated correlations with related measures. The results of this study also revealed that comfort eating in chronic pain appears to be related to psychological distress; the PICES correlated more strongly with measures assessing mood and psychological distress compared to interference/intensity of physical pain itself. Scores on the PICES also correlated strongly with measures of uncontrolled and emotional eating. Conclusions: Overall, our results indicate that the PICES provides a valid and useful brief measure of comfort eating in chronic pain that might be useful to inform treatments targeting the comorbid disordered eating practices that can lead to higher body weights in patients with chronic pain.

Contexte : La douleur chronique et un poids corporel élevé coexistent fréquemment.On pense que cette comorbidité commune est médiée par la consommation d'aliments de réconfort comme stratégie de gestion de la douleur physique et psychologique, ainsi que de l'inconfort associé aux poussées de douleur chronique. Des outils d'évaluation valides et fiables sont nécessaires pour informer le développement de traitements efficaces.Objectifs : Cette étude visait à évaluer les propriétés psychométriques d'une nouvelle mesure brève de la consommation d'aliments de réconfort induite par la douleur chronique, l'Échelle de consommation d'aliments de réconfort induite par la douleur (PICES).Méthodes : Un échantillon de 166 patients souffrant de douleur chronique se sont soumis à une batterie de tests en ligne comprenant le PICES, de même que des mesures de la douleur chronique et des symptômes liés à la douleur, des troubles alimentaires et des facteurs psychologiques associés.Résultats : Les résultats de l'analyse factorielle exploratoire ont révélé un modèle à un seul facteur pour le PICES à quatre éléments. De plus, le PICES a démontré une bonne cohérence interne ainsi qu'une validité convergente avec des corrélations démontrées avec des mesures connexes. Les résultats de cette étude ont également révélé que la consommation d'aliments de réconfort dans les cas de douleur chronique semble être liée à la détresse psychologique; le PICES était plus fortement corrélé aux mesures évaluant l'humeur et la détresse psychologique que l'interférence/l'intensité de la douleur physique elle-même. Les scores obtenus pour le PICES étaient également fortement corrélés avec des mesures de la consommation alimentaire incontrôlée et émotionnelle.Conclusions : Dans l'ensemble, nos résultats indiquent que l'échelle PICES constitue une mesure brève, valide et utile de la consommation d'aliments de réconfort par les patients souffrant de douleur chronique qui pourrait être utile pour informer les traitements ciblant les pratiques alimentaires comorbides qui peuvent conduire à la douleur. Les traitements ciblant les troubles alimentaires comorbides qui peuvent conduire à un poids corporel plus élevé chez les patients souffrant de douleur chronique pourraient s'en inspirer.

Saltwater intrusion and human health risks for coastal populations under 2050 climate scenarios.

Populations consuming saline drinking water are at greater risk of high blood pressure and potentially other adverse health outcomes. We modelled data and used available datasets to identify countries of higher vulnerability to future saltwater intrusion associated with climate change in 2050 under Representative Concentration Pathways (RCP)4.5 and RCP8.5. We developed three vulnerability criteria to capture geographies with: (1) any coastal areas with projected inland saltwater intrusion of ≥ 1 km inland, (2) > 50% of the population in coastal secondary administrative areas with reliance on groundwater for drinking water, and 3) high national average sodium urinary excretion (i.e., > 3 g/day). We identified 41 nations across all continents (except Antarctica) with ≥ 1 km of inland saltwater intrusion by 2050. Seven low- and middle-income countries of higher vulnerability were all concentrated in South/Southeast Asia. Based on these initial findings, future research should study geological nuances at the local level in higher-risk areas and co-produce with local communities contextually appropriate solutions to secure equitable access to clean drinking water.

'What doesn't kill you. . .': A qualitative analysis of factors impacting the quality of life of people living with HIV.

Despite viral suppression, people living with HIV (PLHIV) report lower quality of life (QoL) than the general population, negatively impacting treatment adherence and wellbeing. This qualitative study explored factors influencing QoL of PLHIV. Participants completed a QoL questionnaire, with cut-off scores used to allocate participants into Low-Moderate QoL (n = 11) or High-Very High QoL (n = 10) focus groups. Thematic analysis indicated convergence across factors perceived to impact QoL, with some notable discrepancies. Socioeconomic stability, social connection and support, maintaining good health, adaptive attitudes and reduced impact of stigma were perceived to improve QoL, while obstacles to connection, ageing and poor HIV literacy in the general population were perceived to worsen QoL in both groups. The Low-Moderate QoL group alone identified socioeconomic stressors and ongoing burden of negative life experiences worsened their QoL. Results are presented in the context of local and global HIV health strategies, with implications for clinical management noted.

Improving the representativeness of UK's national COVID-19 Infection Survey through spatio-temporal regression and post-stratification.

Population-representative estimates of SARS-CoV-2 infection prevalence and antibody levels in specific geographic areas at different time points are needed to optimise policy responses. However, even population-wide surveys are potentially impacted by biases arising from differences in participation rates across key groups. Here, we used spatio-temporal regression and post-stratification models to UK's national COVID-19 Infection Survey (CIS) to obtain representative estimates of PCR positivity (6,496,052 tests) and antibody prevalence (1,941,333 tests) for different regions, ages and ethnicities (7-December-2020 to 4-May-2022). Not accounting for vaccination status through post-stratification led to small underestimation of PCR positivity, but more substantial overestimations of antibody levels in the population (up to 21 percentage points), particularly in groups with low vaccine uptake in the general population. There was marked variation in the relative contribution of different areas and age-groups to each wave. Future analyses of infectious disease surveys should take into account major drivers of outcomes of interest that may also influence participation, with vaccination being an important factor to consider.