Catastrophic Thinking Research Articles

Sex differences in pain catastrophizing and its relation to the transition from acute pain to chronic pain

Background and importanceDifferences exist between sexes in pain and pain-related outcomes, such as development of chronic pain. Previous studies suggested a higher risk for pain chronification in female patients. Furthermore, pain catastrophizing is an important risk factor for chronification of pain. However, it is unclear whether sex differences in catastrophic thinking could explain the sex differences in pain chronification.ObjectivesThe aim of this study was to examine sex differences in pain catastrophizing. Additionally, we investigated pain catastrophizing as a potential mediator of sex differences in the transition of acute to chronic pain.Design, settings and participantsAdults visiting one of the 15 participating emergency departments in the Netherlands with acute pain-related complaints. Subjects had to meet inclusion criteria and complete questionnaires about their health and pain.Outcomes measure and analysisThe outcomes in this prospective cohort study were pain catastrophizing (short form pain catastrophizing) and pain chronification at 90 days (Numeric Rating Scale ≥ 1). Data was analysed using univariate and multivariable logistic regression models. Finally, stratified regression analyses were conducted to assess whether differences in pain catastrophizing accounted for observed differences in pain chronification between sexes.Main resultsIn total 1,906 patients were included. Females catastrophized pain significantly more than males (p < 0.001). Multiple regression analyses suggested that pain catastrophizing is associated with pain chronification in both sexes.ConclusionsThis study reported differences between sexes in catastrophic cognitions in the development of chronic pain. This is possibly of clinical importance to identify high-risk patients and ensure an early intervention to prevent the transition from acute to chronic pain.

The Mediating Role of Pain Cognitions and Pain Sensitivity in the Treatment Effect of Perioperative Pain Neuroscience Education in People Undergoing Surgery for Lumbar Radiculopathy

Though perioperative pain neuroscience education (PPNE) positively influences patients’ surgical outcomes, little is known about the mechanisms behind this treatment’s success. Therefore, this study aims to evaluate the potential mediating role of pain cognitions and pain sensitivity in the treatment effect of PPNE on postoperative quality of life in people undergoing surgery for lumbar radiculopathy. This secondary analysis uses data from 120 participants of a randomized controlled trial who were randomized to receive either PPNE or perioperative biomedical education before undergoing surgery for lumbar radiculopathy. Quality of life was assessed 1-year postsurgery using the short form 36-item health survey (SF36) physical and mental component scores. Potential mediators included pain cognitions (ie, kinesiophobia, pain catastrophizing, and hypervigilance) and pain sensitivity (ie, endogenous nociceptive modulation), assessed 6 weeks postsurgery. Mediation models were constructed using structural equation modeling, and 95% confidence intervals (CIs) were calculated using 10,000 bootstrap samples. Analyses show a significant total effect for PPNE (estimate = .464, 95% CI [.105, .825]) and a significant indirect effect via pain catastrophizing on the SF36 physical component (estimate = .124, 95% CI [.001, .293]). No mediating effect was found through the remaining pain cognitions or pain sensitivity measures. Also, no potential mediators were identified for the treatment effect of PPNE on the SF36 mental component. Our findings suggest that pain catastrophizing mediates the treatment effect of PPNE on physical health-related quality of life in people undergoing surgery for lumbar radiculopathy. PerspectiveThis secondary analysis identified pain catastrophizing as a mediator for PPNE in people undergoing surgery for lumbar radiculopathy. More so, its findings indicate that this educational intervention can enhance the postoperative physical health-related quality of life of these patients by addressing their catastrophizing thoughts. Trial registrationClinicaltrials.gov (NCT02630732).

Avaliação biopsicossocial de pacientes com dor lombar de um hospital público no Brasil: estudo transversal observacional

Objective: This study aimed to characterize within the biopsychosocial understanding, patients with low back pain who sought for the physiotherapy service of a public hospital. Methods: Cross-sectional study carried out to assess biopsychosocial aspects related to pain in a public service in an underdeveloped country. To characterize patients with low back pain, considering the biopsychosocial aspect, data were collected regarding socioeconomic condition and lifestyle habits, pain intensity, functionality, considering psychological aspects, kinesiophobia, pain catastrophizing, central sensitization, depression and anxiety, were assessed with specific scales and questionnaires. Results: The study included 300 patients with low back pain, 70% of the sample was composed of women, with a mean age of 54 years and with socioeconomic vulnerability. The sample was marked by the high prevalence of previous treatments and imaging exams, showed an average level of disability and scores on psychological scales that suggest the presence of limiting beliefs and behaviors regarding pain and movement, in addition to 47% present a high risk for persistent disability and poor prognosis. Conclusion: The main descriptive findings of this study were a sample with chronic low back pain, mostly represented by an unemployed population, with low income, low education level, with a high average time of exposure to symptoms, and an average level of disability. With regard to psychosocial factors, a large part of the sample had a high risk of poor prognosis and persistent disability, in addition to scores that suggest the presence of catastrophic thoughts, anxiety, fear of movement, and central sensitization.

Pain relief and associated factors: a cross-sectional observational web-based study in a Quebec cohort of persons living with chronic pain.

Randomized clinical trials are used to evaluate the efficacy of various pain treatments individually, while a limited number of observational studies have portrayed the overall relief experienced by persons living with chronic pain. This study aimed to describe pain relief in real-world clinical settings and to identify associated factors. This exploratory web-based cross-sectional study used data from 1,419 persons recruited in the community. Overall pain relief brought by treatments used by participants was assessed using a 0%-100% scale (10-unit increments). A total of 18.2% of participants reported minimal pain relief (0%-20%), 60.0% moderate to substantial pain relief (30%-60%), and 21.8% extensive pain relief (70%-100%). Multivariable multinomial regression analysis revealed factors significantly associated with greater pain relief, including reporting a stressful event as circumstances surrounding the onset of pain, living with pain for ≥10 years, milder pain intensity, less catastrophic thinking, use of prescribed pain medications, use of nonpharmacological pain treatments, access to a trusted healthcare professional, higher general health scores, and polypharmacy. Factors associated with lower pain relief included surgery as circumstances surrounding pain onset, use of over-the-counter pain medications, and severe psychological distress. In this community sample of persons living with chronic pain, 8 out of 10 persons reported experiencing at least moderate relief with their treatment. The analysis has enabled us to explore potential modifiable factors as opportunities for improving the well-being of persons living with chronic pain.

A Smartphone-Gamified Virtual Reality Exposure Therapy Augmented With Biofeedback for Ailurophobia: Development and Evaluation Study.

To the best of our knowledge, no specialized research has been conducted to address ailurophobia (fear of cats) in Iran or globally. This has driven our project, along with the prevalence of ailurophobia and the absence of a gamified virtual reality exposure therapy (VRET) that incorporates affordable and easily accessible biofeedback (BF) tools. We hypothesize that a gamified VRET augmented with BF will yield more positive effects than a similar device lacking BF. This study primarily focuses on the development and preliminary evaluation of a smartphone-gamified VRET integrated with BF, targeting animal phobia, with a specific case study on ailurophobia. The secondary objectives are using affordable and readily available BF found in devices such as smart bands and smartwatches and creating a mobile virtual reality gamified app to improve patients' adherence to treatments while simultaneously enhancing the app's accessibility, scalability, and outreach. Evaluations encompassed 3 methods. First, we identified the tool's potential positive effects on phobia interventions, exploring 4 effects: intrinsic motivation, simulation of fearful situations, management of stressful circumstances without therapists' presence and mitigation of catastrophic thoughts, and preliminary effects on ailurophobia treatment. Participants were divided into BF and non-BF groups. Second, we gathered user preferences and opinions about the treatment. Third, we conducted heuristic evaluations using 44 heuristics from existing system usability scales assessing user interfaces, virtual reality platforms, and video games' playability. To interpret the data, mean scores; ANOVA, single factor; and ANOVA, 2-factor with replication were used. A total of 29 individuals were identified, of which 10 met the eligibility criteria or were accessible. The smartphone-gamified VRET augmented with BF exhibited better results on the identified effects compared with the non-BF version and contributed to normalizing encounters with cats. Moreover, 41 of the 44 heuristics achieved a percentage above 62%, indicating its potential as a therapeutic product and its ability to enhance patient adherence to treatments. Patient preferences on the treatment and its strengths and weaknesses were provided for further improvement. The tool has the potential to evolve into a comprehensive solution by incorporating various types of cats and their behaviors, simulating environments in which they are commonly found, and enhancing its appeal through an increased sense of adventure without inducing unrealistic fears. By adapting fear elements, the game can be tailored to treat various animal phobias. Phobia-focused games should avoid action and combat scenarios to prevent reinforcement of fear responses. After rigorous evaluation, further exploration is required to provide remote use beyond clinical settings.

Psychodynamic Psychiatry and the Care of Persons with Vision Loss and Blindness.

The authors describe the clinical relevance of the psychiatric concept of bidirectionality when caring for persons with comorbid disorders, and they propose a psychodynamic framework to guide the treatment of persons with vision loss and blindness. Since persons with vision loss have an increased risk of depressive and anxiety disorders, they recommend targeted screening, integrated services, and a biopsychosocial approach to clinical care. The psychoanalytic concept of aphanisis, first described by Ernest Jones and later developed by Lacan and Kohut, is briefly discussed. Common psychotherapy themes in the treatment of persons who experience vision loss from systemic illness include reactivation of memories of past traumas resulting in avoidance, social withdrawal, depressive states, catastrophic thinking, a sense of foreshortened future, anhedonia, and fear of disintegration and invisibility. Psychotherapy also serves to correct negative introjects from ableist societal attitudes.

Characterizing clinical progression in patients with musculoskeletal pain by pain severity and central sensitization-related symptoms

Central sensitization-related symptoms (CSS) are associated with the severity and progression of pain. The relationship between the severity of pain/CSS and clinical progresses remains unclear. This multicenter, collaborative, longitudinal study aimed to characterize the clinical outcomes of patients with musculoskeletal pain by classifying subgroups based on the severity of pain/CSS and examining changes in subgroups over time. We measured the pain intensity, CSS, catastrophic thinking, and body perception disturbance in 435 patients with musculoskeletal pain. Reevaluation of patients after one month included 166 patients for pain intensity outcome and 110 for both pain intensity and CSS outcome analysis. We classified the patients into four groups (mild pain/CSS, severe pain/mild CSS, severe pain/CSS, and mild pain/severe CSS groups) and performed multiple comparison analyses to reveal the differences between the CSS severity groups. Additionally, we performed the adjusted residual chi-square to identify the number of patients with pain improvement, group transition, changing pain, and CSS pattern groups at baseline. The most characteristic result was that the mild and severe CSS groups showed worsening pain. Moreover, many of the group transitions were to the same group, with a few transitioning to a group with mild pain/CSS. Our findings suggest that the severity and improvement of CSS influence pain prognosis.

Phenotypical characterization of exteroceptive sensation and pain symptoms on diabetic patients.

Diabetic neuropathy (DN) is one of the most common complications of diabetes, affecting about half of individuals with the disease. Among the various symptoms of DN, the development of chronic pain stands out and manifests as exacerbated responses to sensorial stimuli. The conventional clinical treatments used for general neuropathy and associated painful symptoms, still brings uncomplete and unsatisfactory pain relief. Patients with neuropathic pain syndromes are heterogeneous. They present with a variety of sensory symptoms and pain qualities which difficult the correct diagnosis of sensory comorbidities and consequently, the appropriate chronic pain management. Herein, we aimed to demonstrate the existence of different sensory profiles on diabetic patients by investigating epidemiological and clinical data on the symptomatology of a group of patients with DN. This is a longitudinal and observational study, with a sample of 57 volunteers diagnosed with diabetes from outpatient day clinic of Hospital Universitário of the University of São Paulo-Brazil. After being invited and signed the Informed Consent Form (ICF), patients were submitted to clinical evaluation and filled out pain and quality of life questionnaires. They also performed quantitative sensory test (QST) and underwent skin biopsy for correlation with cutaneous neuropathology. Data demonstrate that 70% of the studied sample presented some type of pain, manifesting in a neuropathic or nociceptive way, what has a negative impact on the life of patients with DM. We also demonstrated a positive association between pain and anxiety and depression, in addition to pain catastrophic thoughts. Three distinct profiles were identified in the sample, separated according to the symptoms of pain: (i) subjects without pain; (ii) with mild or moderate pain; (iii) subjects with severe pain. We also identified through skin biopsy that diabetic patients presented advanced sensory impairment, as a consequence of the degeneration of the myelinated and unmyelinated peripheral fibers. This study characterized the painful symptoms and exteroceptive sensation profile in these diabetic patients, associated to a considerable level of sensory degeneration, indicating, and reinforcing the importance of the long-term clinical monitoring of individuals diagnosed with DM, regarding their symptom profiles and exteroceptive sensitivity.

Associations of sensory sensitivity, pain catastrophizing, and alexithymia with dental anxiety.

We aimed to reveal interrelationships between alexithymia, catastrophic thinking, sensory processing patterns, and dental anxiety among 460 participants who were registrants of a Japanese research company. Measures used were the Modified Dental Anxiety Scale, the Adult Sensory Profile, the Pain Catastrophizing Scale, and the 20-item Toronto Alexithymia Scale. The interrelationships among the constructs were analyzed using structural equation modeling, adjusting for age, gender, and negative dental treatment experience. Data from 428 participants were used in the analyses. Sensory sensitivity and pain catastrophizing were independently associated with anticipatory and treatment-related dental anxiety, while difficulty identifying feelings was not. In the mediation model, sensory sensitivity and pain catastrophizing served as full mediators between difficulty identifying feelings and the dimensions of dental anxiety (indirect effects were between 0.13 and 0.15). The strength of the associations was 0.55 from difficulty identifying feelings to both pain catastrophizing and sensory sensitivity, and between 0.24 and 0.26 to anticipatory and treatment-related dental anxiety. The association between trait-like phenomena, such as alexithymia, and dental anxiety may be mediated by neurophysiological and cognitive factors such as sensory sensitivity and pain catastrophizing. These findings could be crucial for new and innovative interventions for managing dental anxiety.

Pain characteristics and imagery ability in patients with familial Mediterranean fever

Abstract Objectives Assessing imagery ability could be important for clinicians to understand or speculate on the limit of a patient’s physical ability in chronic pain conditions. We aimed to assess imagery ability that is potentially affected in patients with Familial Mediterranean Fever (FMF). In addition, pain characteristics and associational factors between pain and imagery abilities were examined. Methods Patients with FMF group (n=30) and control group (n=30) were included into the study. Movement Imagery Questionnaire-3 (MIQ-3) was questioned in both groups to assess imagery ability. McGill Pain Questionnaire Form (MPQ) and Pain Catastrophizing Scale (PCS) were used to assess pain. Results There was a statistically significant difference in all sub-scores of the MIQ-3 imagery levels between FMF and the control group (p&lt;0.05). Mean value for PCS was 23.27 ± 12.52 in which 13 (43.3 %) of the patients had higher scores than 30 indicating catastrophic thoughts. Conclusions It was determined that the imagery scores of the patients with FMF were lower than the control group. Patients who had catastrophic thoughts showed more scores in IVI scores indicating that the attention processes of these patients to their bodies might be affected. Further large-scale, long-term, prospective, randomized-controlled studies are needed to confirm these findings.

The Central Sensitization Inventory Measures Thoughts and Emotions.

To determine if the Central Sensitization Inventory questionnaire (CSI) functions as a mental health measure among a cross-section of people seeking musculoskeletal specialty care, we asked: (1) What is the association of CSI total score and item groupings identified in factor analysis with mental health measures? and (2) What is the association between specific CSI items that represent each factor well and specific mental health measures? One hundred and fifty-seven adults seeking specialty care for musculoskeletal symptoms completed the CSI, a measure of catastrophic thinking, and 3 measures of distress (symptoms of health anxiety, general anxiety, and depression). Exploratory factor analysis was used to identify item groupings. Exploratory factor analysis identified 4 item groupings (factors): (1) thoughts and feelings (mental health), accounting for 52% of the variation in the CSI, (2) urinary and visual symptoms (15%) (3) body aches (10%), and (4) jaw pain (8.1%). More than half the variation in both the CSI total score (51%) and the thoughts and feelings factor (57%) were accounted for by variation in measures of catastrophic thinking and distress. Specific items that account for large amounts of the variation in the CSI also had notable correlations with mental health measures. The strong relationship between the CSI and thoughts and emotions suggests that the CSI functions largely as a mental health measure. If the concept of central sensitization is to help people get and stay healthy, it will depend on evidence that central sensitization can be measured and quantified distinct from mental health.

Дослідження психічних феноменів в структурі хронічного болю: депресія, тривога, катастрофізація. Огляд літератури.

Introduction. Chronic pain is associated with a plethora of negative personal and social consequences, including impaired functioning, disability, increased suicidality, and mortality. Modern medicine views pain as a complex phenomenon, and the prevailing biopsychosocial model of disease development allows us to take a broader look at the issue of pain, and thoroughly evaluate all components of the pathological process, thus subsequently reducing the impacts of negative biological, psychological, and social factors. An increasing body of research indicates the growing role of psychological factors such as depression, anxiety, and catastrophizing in influencing the perception, course of pain disorder, as well as the quality of life of patients with chronic pain. However, unfortunately, the significance of psychological factors remains incompletely recognized by patients, and sometimes even by healthcare providers. Objective. The aim of the study was to explore the role of catastrophizing and negative emotions in the structure of chronic pain and, based on the analysis of scientific sources, to select diagnostic methodologies for appropriate screening of these psychological phenomena. Materials. Literature review on the topic. Results. As a result of the analysis of scientific sources, the following methodologies were chosen for studying psychological phenomena in chronic pain. The Pain Catastrophizing Scale (PCS) was selected for studying catastrophic thoughts in patients with chronic pain. The Hospital Anxiety and Depression Scale (HADS) was chosen for screening depression and anxiety. Conclusions. Depression, anxiety, and catastrophizing are potential indicators of an unfavorable prognosis for individuals coping with chronic pain. The combination of these factors may hinder progress in combating inflammatory processes, prolong postoperative rehabilitation periods, worsen overall functioning, and lead to disability. Further exploration of negative impact factors such as depression, anxiety, and catastrophizing promises to reveal new mechanisms for providing personalized pain relief to individuals suffering from chronic pain.

Psychometric properties of the Japanese version of the Insomnia Catastrophizing Scale and relationship of insomnia severity with catastrophic thoughts, safety behaviors, and dysfunctional beliefs

BackgroundThis study aimed to clarify the reliability and validity of the Japanese version of the Insomnia Catastrophizing Scale (ICS) and to examine the relationship between insomnia severity and insomnia-related cognitive factors. MethodsA total of 786 participants were recruited via an online survey and classified into the insomnia group (n = 342) and healthy group (n = 444). The insomnia group comprised individuals who self-reported meeting the diagnostic criteria for chronic insomnia disorder in the third edition of the International Classification of Sleep Disorders. ResultsThe ICS is used to independently assess nighttime (ICS–N) and daytime (ICS-D) catastrophic thoughts, and item response theory revealed that each ICS-N and ICS-D item can adequately assess catastrophic thoughts during the night and day, respectively. The internal consistency and test-retest reliability of the ICS-N and ICS-D were good. Further, the ICS-N and ICS-D had a significant positive correlation with insomnia severity, hyperarousal, sleep-related safety behaviors, dysfunctional beliefs about sleep, and anxiety symptoms. Multiple regression analyses with insomnia severity as the dependent variable in the insomnia group demonstrated that catastrophic thoughts were more strongly associated with insomnia severity than sleep-related safety behaviors and dysfunctional beliefs about sleep. The interaction between nighttime catastrophic thoughts and sleep-related safety behaviors increased insomnia severity. ConclusionsThe Japanese versions of ICS-N and ICS-D were found to be superior in measuring insomnia-related catastrophic thoughts and to have high reliability and validity. Furthermore, these findings more clearly demonstrate that the catastrophic thoughts may be an important associated factor of insomnia.

Contralateral Arm Pain as a Sign of Distress Regarding Symptoms

Background: Pain intensity and magnitude of incapability are associated with common unhelpful thoughts about symptoms such as catastrophic thinking and kinesiophobia. To determine whether reports of pain in the upper limb contralateral to a non-trauma condition were associated with unhelpful thoughts, we measured the relationship between pain intensity in the opposite limb and levels of unhelpful thinking. Methods: In a cross-sectional study, 152 new and return patients seeking care of an upper-limb musculoskeletal condition completed measures of upper-extremity-specific magnitude of capability, pain intensity of the involved and contralateral arms, unhelpful thoughts regarding symptoms, symptoms of distress regarding symptoms, and general symptoms of depression. Factors associated with contralateral and ipsilateral pain intensity and upper-extremity-specific magnitude of capability were assessed using multivariable statistics. Results: In bivariate analysis, contralateral arm pain was associated with symptoms of distress regarding pain, but not in multivariable analysis. Accounting for potential confounding in negative binominal regression analysis, greater pain intensity of the affected side was independently associated with greater feelings of distress regarding symptoms and no prior surgery. Greater upper-extremity-specific capability was independently associated with less distress regarding symptoms, married/partnered, men, and no prior surgery. Conclusions: The observation that greater pain intensity in the opposite arm was associated with greater distress regarding symptoms suggests that, in combination with other verbal and non-verbal signs of distress, patient concerns about pain in the contralateral limb can help direct patients and surgeons to evidence-based care strategies for alleviating stress regarding symptoms.

Religiosity, Anxiety, Depression, and Suicidal Ideation in Brazilian Patients with Sickle Cell Disease

Introduction: Sickle cell disease (SCD) is an inherited hemoglobinopathy that can evolve with time, in some individuals, as a debilitating chronic pain syndrome with emotional dysfunctions. Objective: To evaluate different types of religiosities: organizational (ORA), non-organizational (NORA), and intrinsic religiosity (IR), and their correlation with mental health in individuals with SCD. The variables analyzed were depression, anxiety, and catastrophic and suicidal thoughts. Method: This is a descriptive cross-sectional study, which is part of a crossover randomized clinical trial. We recruited adults among individuals with SCD from Bahia-Brazil. We used: Duke's religiosity index, Hospital Anxiety and Depression Scale (HADS), and Brazilian Portuguese Pain Catastrophizing Scale (BP-PCS) data. The Spearman correlation and Fisher exact test were used for statistics considering alpha 95%. Results: Of the 131 individuals approached for participation, 75 completed all questionnaires with genotype HbSS and HbSC. Of them, 49 (65,3%) were women, with an average age of 34.13 +10.02, 66 (88.0%) self-declared black, 63 (84.0%) declared to belong to a religious group, 67 (89.3%) with a high form of religious involvement. The mean of intense pain was 3.86 + 2.74; 40 (53.33%) had anxiety, 25 (33.33%) had depression, and 15 (20.0%) declared having suicidal thoughts. There was a negative correlation between depression and IR (r = -0.240, p = 0.038) and a correlation between average pain and NORA (r = 0.301, p = 0.009). An association between NORA and chronic pain was verified (p = 0.023), OR (p &lt; 0.001), NORA (p = 0.042), and IR (p = 0.004) with evangelical SCD subjects. Conclusion: This study highlights the need for mental health care in patients with SCD due to the high rates of anxiety and depression, with the need to include religiosity since it is a frequent and important element in the lives of people with SCD.&#x0D;

Effect of Catastrophic Thinking on the Analgesic Effect of Electroacupuncture.

Patients with chronic pain and high-level catastrophic thoughts often do not respond to acupuncture. This may be related to hypofunctioning of the dorsolateral prefrontal cortex and the descending pain inhibitory system. Therefore, we examined the relationship between the level of catastrophic thinking and the analgesic effect of electroacupuncture using the pain catastrophizing scale (PCS). We also evaluated the descending pain inhibitory system using conditioned pain modulation (CPM) and offset analgesia (OA). The relationship between catastrophic thinking and the descending pain inhibitory system was also examined. After testing the hospital anxiety and depression scale and the PCS in 14 healthy adults, the current pain threshold (CPT), CPM, and OA were measured, in order, before the intervention. Thereafter, electroacupuncture was applied to 3 limbs (the dominant hand and both lower extremities) at 4 Hz, and to the scalp at 100 Hz, for 30 minutes, and the CPT was measured again immediately after the intervention. The difference in the CPT before and after the intervention was taken as the analgesic effect. The participants were divided into 2 groups, the H-PCS group (≥16 points) and the L-PCS group (≤15 points), according to the PCS score, and the analgesic effects of electroacupuncture were significantly different (P = 0.04). However, no relationship was found between the PCS score and the CPM (r = -0.02, P = 0.94) and OA effects (r = -0.19, P = 0.49). It was suggested that people with high-level catastrophic thinking may find it difficult to obtain the analgesic effects of electroacupuncture.

Катастрофическое сознание: краткий обзор проблемы

This article presents the relevant for the modern worldview sphere of philosophical reflection on the interaction between consciousness and reality as well as on the way thinking matches its content. The author takes a historical look at the ideas concerning the controversial problems of consciousness, from the views of Confucius and Socrates to the reasoning of modern authors about certain aspects of consciousness leading all subsequent human activity to catastrophic results. In the context of this issue, various approaches to the interaction of human and society with the outside world are demonstrated, as well as the historically developed views on harmonization (the idea of the cosmos as an orderly system of world order in ancient Greece and the laws of Heaven in Chinese pre-philosophy). The paper traces the origins of understanding those aspects of people’s attitude towards property in which one can find the basis for the catastrophic consciousness characteristic of our time. The formation and functioning of “names” in the system of existence is considered, which is presented in the theoretical principles developed by A.F. Losev. In addition, the paper analyses ideas about the possibility of achieving harmony in human relationships in the system of social existence and in the psychology of behaviour of crowds and individuals, as well as the existential views of the latter leading to actions with catastrophic attitudes. Moreover, the theoretical positions of D.S. Sommer and M.K. Mamardashvili’s school are compared. V.P. Vizgin’s article on catastrophic thinking and its main forms of manifestation is considered in detail. This paper uses comparative methods, historical analysis and interdisciplinary synthesis in combination with the techniques of abstraction and analogy

Effectiveness of a multimodal treatment approach for a woman in her 60s with Charcot-marie-tooth disease and scoliosis

Charcot-Marie-Tooth disease, also known as hereditary peripheral neuropathy, is a rare disorder that causes muscle atrophy and sensory abnormalities. The disease can cause many difficulties in the patient's daily life, especially as muscle atrophy and deformity progresses, making it difficult to walk and maintain balance. This study details the effects of treatment on a woman in her 60s with Charcot-Marie-Tooth disease and severe scoliosis. The treatment approach incorporated a multifaceted approach of increasing skin mobility and range of motion, eliminating catastrophic thoughts, reducing muscle tension, and controlling body weight. During the 3-month treatment period, the patient's primary symptoms, including back pain and joint instability were significantly relieved. In particular, the elimination of catastrophic thoughts and weight control contributed significantly to improving the patient’s quality of life. The results of this study suggest the effectiveness of a multimodal treatment approach for the patient with Charcot-Marie-Tooth disease and scoliosis.

Factors Associated With Chronic Pain Intensity in U.S. Army Soldiers.

Chronic pain is prevalent among U.S. military personnel and veterans. The effectiveness of evidence-based pain treatments can be boosted with knowledge of factors associated with chronic pain perception. This study examined the factors that influence soldiers' self-rating of their chronic pain intensity. The study design was a retrospective review of the intake questionnaire from 203 soldiers seen at an Interdisciplinary Pain Management Center. The intake covered various aspects of soldiers' chronic pain experience, including pain intensity, interference in functioning, emotional sequelae, and pain-related catastrophic thinking. Pain intensity and impact were measured using the Defense and Veterans Pain Rating Scale. The mood was measured using the depression (Patient Health Questionnaire [PHQ]-9) and the anxiety (Generalized Anxiety Disorder-7) scales from the PHQ. Pain-related catastrophic thinking was measured using the Pain Catastrophizing Scale (PCS). Pain interference was assessed using a five-item scale that inquired about concentration, life and recreation enjoyment, task performance, and socializing. Data were analyzed using descriptive statistics and linear regression analyses. The mean duration of pain was 34.73 ± 38.66 months. Regression analysis using scores from the PHQ-9, Generalized Anxiety Disorder-7, three PCS subscales (rumination, magnification, and helplessness), and pain interference scale as predictors showed that pain interference and PCS helplessness factors were significant predictors of average pain rating (R2 = 24%, P < .001). Pain interference in functioning and pain-related thoughts of helplessness accounted for a significant degree of the variance in soldiers' self-rating of their chronic pain. The findings suggest that added attention should be directed at helping patients boost their self-efficacy in using pain-coping methods to improve their functioning and address the perception of helplessness about their pain.

Chronic Pain andChildhood Adversity Experiences Among U.S. Military Personnel.

Chronic pain in a military population is prevalent, is costly, and can limit daily activities and affect soldier readiness. It has been associated with childhood adversity (CA) within the veteran, adult, and pediatric populations. Given the need to maximize soldier resiliency, an examination of the link between CA and chronic pain in an active duty population for a better understanding that informs treatment options is warranted. The analytic sample comprised 32 men and 8 women drawn from a retrospective review of 203 intake assessments at an interdisciplinary pain management center. We identified a group (CA) of 20 patients who reported a history of pre-adolescent sexual abuse or living in an "abusive" childhood home and compared it with a control group (no-CA) of 20 patients, matched for age, gender, pain history duration, and pain problem. Validated measures were used to assess pain intensity, interference in functioning and well-being, emotional sequelae of pain as reflected in symptoms of depression and anxiety, and pain-related catastrophic thinking. Data were analyzed using descriptive statistics and independent samples t-test analyses. Differences in current, worst, and average pain ratings were non-significant between groups. The CA group reported significantly greater effect of pain on mood (mean: 6.20 versus 4.25, P < .02) and showed a trend toward higher pain interference in functioning (mean: 17.70 versus 15.05, P = .053). The CA patients had significantly more serious depression (mean: 12.65 versus 4.50, P < .001) and anxiety symptoms (mean: 10.60 versus 2.35, P < .001) and significantly higher pain catastrophizing tendency (mean: 30.05 versus 20.50, P < .03). Overall, the findings suggest that childhood trauma should be considered by providers when treating depression and anxiety in soldiers with chronic pain. Being mindful of trauma-informed care may have implications, perhaps, for cases perceived as treatment resistant.