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
Chronic pain occurs in 23% of the Dutch adult population. Psychological factors like expectancies of pain play a big role in pain and methods that can make these expectancies more positive could...Show moreChronic pain occurs in 23% of the Dutch adult population. Psychological factors like expectancies of pain play a big role in pain and methods that can make these expectancies more positive could greatly improve a patient his quality of life. The aim of this study was to examine the relationship between manipulated outcome expectancies and pain. It was hypothesised that a positive outcome expectancy would result in a higher tolerance of pain. 61 healthy students were randomly divided into two groups, where one group received the positive outcome expectancy manipulation and the other group the control manipulation. This was done by presenting information via a computer screen of which the participants believed was about their psychological factors based on a pain test and a questionnaire, but was only based on the group to which the participant was allocated. Pain tolerance was measured using the Cold Pressor Test, where the participant had to hold his/her hand in the water bath for as long as possible and the duration was the measurement for pain tolerance. Both groups showed equal outcome expectancies, p = .193, which means the manipulation was unsuccessful and both groups had the same belief on how well they could tolerate pain. Unsurprisingly, the total amount of time spent in the CPT between the conditions was also the same, p = .988. The research question remains unanswered as the outcome expectancy manipulation was ineffective. A successful manipulation is needed which could be achieved by telling participants face-to-face by a researcher that they are expected to handle pain well, as this might be more convincing and more effective to increase outcome expectancy. Future research could focus on this aspect. This study has gained insight into the possibility that a manipulation via a computer presentation might not be effective enough to induce a positive outcome expectancy.Show less
Nocebo hyperalgesia is the phenomenon in which negative pain expectations lead to augmented pain experiences. Studies have shown that psychosocial factors might influence nocebo hyperalgesia and...Show moreNocebo hyperalgesia is the phenomenon in which negative pain expectations lead to augmented pain experiences. Studies have shown that psychosocial factors might influence nocebo hyperalgesia and facilitate nocebo responses in clinical settings, thus worsening pain. This study aimed to identify whether social stress, fear of pain and pain catastrophizing influence the magnitude of nocebo hyperalgesia. Higher nocebo hyperalgesic responses were anticipated. Additionally, the potential mediating role of subjective stress was explored. Twenty-five healthy male and female participants were recruited and randomly assigned to the experimental (social stress) and control (no-stress) conditions, which underwent the Trier Social Stress Test (TSST) and a friendly version of it (friendly-TSST), correspondingly. Fear of pain and pain catastrophizing were measured with the Fear of Pain Questionnaire-III and the Pain Catastrophizing Scale. Subjective stress was measured on a 0-10 Numeric Rating Scale. A sham electrical stimulation device was applied to induce nocebo along with negative verbal suggestions of pain worsening. Thermal pain stimuli were paired with ON (nocebo trial) and OFF (control trial) visual signs during the acquisition and testing blocks of nocebo conditioning. The first nocebo and control trials of the testing block were compared to estimate the extent of nocebo hyperalgesia. One-way ANOVA, simple linear regression and mediation analysis with the method of bootstrapping were applied (P < 0.05). The one-way ANOVA was non-significant between the social stress and no-stress conditions (P = 0.74). Regression results were non-significant for fear of pain (B = - 0.38, P = 0.11) and pain catastrophizing (B = - 0.30, P = 0.22). Mediation analysis for subjective stress revealed a non significant indirect effect of - 0.009 (95% BCa CI [-1.10, 0.68]). Our study suggests that social stress does not appear to increase the magnitude of nocebo hyperalgesia and that fear of pain and pain catastrophizing might not predict higher nocebo hyperalgesic responses. In addition, subjective stress may not mediate the relationship between social stress and nocebo hyperalgesia. In conclusion, as social stress, fear of pain, pain catastrophizing and subjective stress can co-occur in clinical practices, future research could examine their potential cumulative effect on nocebo hyperalgesia.Show less
Chronic pain is a highly prevalent condition leading to a variety of health problems in the population. t condition and risk factor contributing to a variety of health problems in the population....Show moreChronic pain is a highly prevalent condition leading to a variety of health problems in the population. t condition and risk factor contributing to a variety of health problems in the population. Self-efficacy and optimism are important psychological resilience factors that support individuals’ coping with pain. This study is aiming to investigate if self-efficacy could be manipulated in order to increase and decrease participants’ pain endurance, as well as the role of optimism in the relationship of self-efficacy and pain endurance. Research questions: Would individuals with increased self-efficacy have higher pain endurance? Is the effect of self-efficacy on pain endurance stronger for individuals with higher optimism scores? 36 individuals were recruited for the experiment. Participants were randomly assigned to high and low self-efficacy groups, and their self-efficacy was manipulated accordingly with verbal suggestions. A manipulation check with a self-report VAS scale was introduced to assess the effect of the manipulations. Pain endurance was measured by a cold pressor task (CPT), while optimism was measured by the Lifestyle Orientation Test - Revised (LOT-R) scale. Pain endurance levels of low and high self-efficacy groups were measured via an independent t-test, and the interaction effect of optimism as a moderator between self-efficacy and pain endurance was investigated via a moderation analysis by PROCESS macro in SPSS. The manipulation check showed no significant difference between the scores of the high self-efficacy group and the low self-efficacy group, t(34) = -1.635, p = 1.111. Results showed that there was no significant difference between the pain endurance levels of the low self-efficacy group and the high self-efficacy group, U = 153, p = .77. The moderation analysis showed that while the model was significant, optimism did not have a significant interaction effect (b = -3.42, t(32) = -.62, p = .54). Even though the study is still in progress; the preliminary results are not in line with the related empirical literature. More active involvement of participants in self-efficacy manipulations, a larger sample size, and further investigating the role of optimism is recommended for further assessing the role of self efficacy and optimism in coping with pain.Show less
