Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive & Negative Affect, Alexithymia, Pain Catastrophizing.., 2018, Duschek et al

[Inara]

I suppose there are people somewhere who might have some degree of understanding

Yes, I agree with you. From my own experience, though, you only really understand if you know chronic pain. Before that, compassion and empathy will help, although they're rare.

I heard a story about a woman who broke her leg; it was nearly an open fracture. Due to adrenaline she didn't feel pain at the beginning, and so she refused to wait for the emergency doctor with pain meds. During the drive to the hospital the pain came.
I thought someone who knows pain would have chosen to wait for pain medication. Only someone who doesn't know PAIN thinks it won't be so bad.

 

[shak8]

Pain catastrophizing...Pain IS a catastrophe! I don't mean mild pain that can be easily ignored. I mean PAIN. Pain is draining. And if it's chronic, if you don't have pain meds or they don't work or whatever, it is only natural to get desperate over time. Because whenever you're awake, it's there. And if you wanna sleep, it doesn't let you. You can't function properly. Life quality is immensely reduced. This is not catastrophizing, it's reality for those with pain. And for those without pain - they should just shut up. Makes me so angry, sorry.

"They should just shut up." Love that. Because I worked as a nurse and a tad in research, I tend to overlook glaring fissures in researchers' work. Not any more.

And as my son said, "Psychology isn't science."

 

[shak8]

Just one more thing.
On the second page of this is an instrument used to measure the degree of catastrophizing.

(On the first page is the Widespread Pain Index (used in fibromyalgia research as an instrument to remove those patients with low widespread pain index scores from the diagnosis of fibro.)

https://professional.oregonpainguid...tes/2/2017/05/Fibromyalgia_Screening_Tool.pdf

 

[Milo]

i wonder how we can protest the catastrophizing scale.

 

[Snowdrop]

Here is the origin of that scale:

http://sullivan-painresearch.mcgill.ca/pdf/pcs/PCSManual_English.pdf

More on that here:

https://psycnet.apa.org/doiLanding?doi=10.1037/1040-3590.7.4.524

My guess is that it's very likely that people who are in pain for longer have a different response than those in pain of shorter duration. For some pain is a permanent feature.

 

[lansbergen]

Due to adrenaline she didn't feel pain at the beginning, and so she refused to wait for the emergency doctor with pain meds. During the drive to the hospital the pain came.

/

That reminds me of my daughter. In a horse jumping contest she and the horse fell in one of the obstacles.

Firstaid said she could start in te next run. She said she was okay and did but in the car on our way home she got pain. Went to the hospital and they found her clavicle was broken.

 

[shak8]

Here is the origin of that scale:

http://sullivan-painresearch.mcgill.ca/pdf/pcs/PCSManual_English.pdf

More on that here:

https://psycnet.apa.org/doiLanding?doi=10.1037/1040-3590.7.4.524

My guess is that it's very likely that people who are in pain for longer have a different response than those in pain of shorter duration. For some pain is a permanent feature.

thanks for the link of the original theory. Interesting reading. there's always a difference between what the originator of a theory states from what subsequent researchers do: simplify and distort the theory.

The original theory states: it might or it may increase pain. I found it interesting that when someone in pain agitates his family or "community" that may make things worse.

I'd say ditto for any family member's emotional distress (please keep it to yourself, as much as you can, because it distresses your family and close friends).

I would think that longterm pain patients (me, included), find ways to stop complaining about the pain to others and to themselves, especially. Unless the pain is severe, then, well...all bets are off.

 

[shak8]

In the introduction of the study:

"In exploratory correlation analysis in the FMS sample, lower cognitive performance was associated with higher pain severity, depression, anxiety, negative affect, alexithymia and pain catastrophizing, as well as lower self-esteem and positive affect. However, in regression analyses, pain, self-esteem, alexithymia, and pain catastrophizing explained the largest portion of the variance in performance. While interference effects of clinical pain in cognition have been previously described, the present findings suggest that affective factors also substantially contribute to the genesis of cognitive impairments. They support the notion that affective disturbances form a crucial aspect of FMS pathology, whereas strategies aiming to improve emotional regulation may be a beneficial element of psychological therapy in the management of FMS."

I'll have to do some homework, but is regression analysis a worthy tool in this already "exploratory correlation analysis" ? Sounds dubious to me. But maybe a researcher will chime in (meanwhile I look up regression analysis in correlation analysis).

 

[Snowdrop]

I have a couple of observations.

If I was to fill in a questionnaire since it would be about pain it may not ask (and I wouldn't think to mention it) about tinnitus for example. I think that tinnitus has some effect on my cognition alongside pain but other factors like this may not be considered perhaps?

Also, I rarely think about my pain that much except to consider when and how often to use pain reliever but lately it has occurred to me that being in a state of constant dehydration (where no amount of fluid supplementing makes it better) that maybe this dehydrated state causes pain. Anybody know if this is a possibility?

 

[Milo]

This came from Invest in ME presentation. They can keep on doing harm by studying catastrophization and behaviors related to chronic pain with tremendous unmet health care needs, or they can start doing science and look at what antigen causes this reaction in mice and how to treat it.

 

[Snow Leopard]

Nonsense like this (mistaking correlation for causation) makes me so angry.

The study is notable for making hundreds of statistical comparisons without using any sort of corrected alpha...

https://en.wikipedia.org/wiki/Multiple_comparisons_problem

They acknowledge it, but didn't bother to fix the problem... Amateur hour anyone?

Moreover, caution is required in the interpretation of the results of the exploratory correlation analysis considering the increased risk of alpha errors due to the high number of computed correlations.

 

[rvallee]

The study is notable for making hundreds of statistical comparisons without using any sort of corrected alpha...

https://en.wikipedia.org/wiki/Multiple_comparisons_problem

They acknowledge it, but didn't bother to fix the problem... Amateur hour anyone?

The trick is not to care or bother with the consequences. If you just ignore the bad stuff, everything is good! Positive psychology! No harm done! Oops, I mean: no, harm done!