Pain, which substantially impacts one’s quality of life, is affected by various factors, including outcome expectancies. Although the effect of outcome expectancies has been studied extensively on...Show morePain, which substantially impacts one’s quality of life, is affected by various factors, including outcome expectancies. Although the effect of outcome expectancies has been studied extensively on pain perception, their impact on pain tolerance -defined as the ability to withstand a maximum pain intensity stimulus before seeking relief- remains mostly unknown. Furthermore, underlying mechanisms, that may be at play are not fully understood. This study aims to examine the role of induced outcome expectancies for pain tolerance, and the moderating role of optimism. It was hypothesized that the participants of the high outcome expectancy condition who received verbal suggestions about the expected outcome would exhibit higher pain tolerance than those in the neutral condition group, who did not receive any verbal suggestions. Additionally, optimism, comprised of positive outcome expectancies for the future, was hypothesized to moderate the relationship between outcome expectancies and pain tolerance meaning that outcome expectancies would decrease one’s sensitivity to pain more when optimism is high. The study’s factorial 2x2 between-subjects design involved randomizing healthy adults into a neutral control and high outcome expectancy condition group. Outcome expectancies were manipulated through verbal suggestions and assessed using a visual analog scale about the expected intensity of the upcoming stimulus. A Cold Pressor Test was used to assess pain tolerance, and dispositional optimism was measured by the Life Orientation Test-Revised. The analysis revealed no significant difference in expected intensity ratings between the two groups, suggesting a need for further improvement of the effectiveness of verbal suggestions. Similarly, no significant difference was observed in pain tolerance between the two groups and optimism did not demonstrate a moderating effect on the relationship between induced outcome expectancies and pain tolerance. Future research may further explore cognitive and psychological mechanisms while taking into account personal traits that may be responsible for the association between outcome expectancies and pain perception and tolerance.Show less
Objective: The goal of the current study is to investigate and quantify the association of the demographic factors of age and sex as risk factors in the psychosocial domain of post-intensive care...Show moreObjective: The goal of the current study is to investigate and quantify the association of the demographic factors of age and sex as risk factors in the psychosocial domain of post-intensive care syndrome (PICS) by conducting a meta-analysis and systematic review. It is expected that the current meta-analysis will shed more light on which patients are more likely to experience (increased) psychosocial problems post-intensive care based on these two demographic factors. This is needed to continue to improve and optimise the care for intensive care survivors. The hypotheses being postulated are that female sex and older age are respective risk factors for developing problems in the psychosocial domain of PICS. Review methods: The psychosocial domain of PICS was defined as anxiety, depression, or post-traumatic stress disorder (PTSD) after intensive care. PubMed, Web of Science, and Embase were searched for relevant articles and the selection of articles was based on the algorithm of ASReview. 22 relevant articles were selected. Of the included studies, 15 studies reported relevant information on the relation between sex and post-intensive care psychosocial problems, and 12 of the included studies reported relevant information on the relation of age and post-intensive care psychosocial problems. For the demographic factor of sex, a meta-analysis was conducted with odds ratios. The demographic factor of patient age was studied by conducting a systematic review because the available data did not lend itself to statistical pooling. Results: Log OR was calculated for female sex in comparison to male sex for the odds of experiencing psychosocial problems after intensive care with a result of 2.58 [2.03; 3.28]. Odds ratios calculated for anxiety, depression, and PTSD all show female patients to be more than two times as likely to suffer from these conditions compared to males. In the systematic review for patient age, eight of the studies reported younger patients being more at risk of developing psychosocial problems after intensive care, while four show older patients being more at risk for general psychosocial problems after intensive care. When it comes to the individual studied disorders, four studies found that younger patients were more at risk for anxiety, and two found older patients to be more at risk. For depression, three studies found younger patients to be more at risk, and four studies found older patients to be more at risk. For PTSD, seven studies found younger patients to be more at risk, and three studies found older patients to be more at risk. Conclusions: Statistical pooling and analysis show that women’s odds of developing these problems are more than twice as high compared to their male counterparts. For patient age, statistical analysis was not possible in the current study. Overall, eight studies stated that younger patients were more at risk, and four studies stated that older patients were more at risk of developing negative psychosocial outcomes after intensive care. Much variation of disorder prevalence and severity is seen between studies and types of disorders, preventing the possibility of drawing a uniform conclusion on the matter. It is unclear what factors cause these variances. These results found in the current study give more insight in which demographic groups of ICU patients are more likely to require additional care for psychosocial problems after hospital release. In future research, the underlying reasons that cause these trends in demographic groups should be investigated.Show less
