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  • 1.
    Agerström, Jens
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Stening, Kent
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Axman, Olof
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Pain here and now: physical pain impairs transcendence of psychological distance2019In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 12, p. 961-968Article in journal (Refereed)
    Abstract [en]

    Background: The ability to traverse psychological distance by going beyond the experienced reality of the self, here and now, is fundamental for effective human functioning. Yet, little is known about how physical pain affects transcendence of psychological distance. Using a construal level theory framework of psychological distance, the current research examines the hypothesis that pain impairs people's ability to traverse any kind of psychological distance whether it be temporal, social, and spatial distance, or the hypothetical. Methods: Using the cold pressor test, 151 participants participated in an experiment where they were either induced with acute pain (treatment group) or no pain (control group) while completing a battery of questions measuring to what extent their current thoughts were transcending psychological distance. Results: The results were largely consistent with the hypothesis. Relative to the control group, pain induced participants showed significantly less transcendence of past temporal distance, social distance, spatial distance, and the hypothetical. Furthermore, greater self-reported pain intensity was significantly associated with less transcendence of temporal (past and future), social, and spatial distance. Conclusion: Physical pain impairs the ability to traverse psychological distance. The research has practical implications for the pain clinic and for pain-afflicted individuals in everyday life.

  • 2.
    Ericson, Lisa
    et al.
    Nordic Health Economics AB.
    Ambring, Anneli
    Björholt, Ingela
    Dahm, Peter
    Opioid rotation in patients initiated on oxycodone or morphine: a register study.2013In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 6, p. 379-86Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Strong opioids are recommended for the treatment of moderate to severe pain. However, some patients do not achieve a successful treatment outcome due to intolerable adverse events and/or inadequate analgesia, thus may benefit from switching to another opioid, a procedure known as "opioid rotation." The type of opioid at treatment initiation may influence the risk of opioid rotation and the objective of this study was to assess such rotation after treatment initiation with two alternative treatments, controlled-release (CR) oxycodone versus CR morphine in patients suffering from non-cancer pain.

    METHOD: The study reported here was a real-life study based on Swedish register data: the Prescribed Drug, National Patient, and Cause of Death registers. The captured data cover the entire Swedish population treated in specialist care. A statistical analysis plan was agreed and signed before data were accessed.

    RESULTS: Data from 50,223 cases were included in the analyses. The risk of rotation was 19% higher in patients initiating treatment with morphine compared with oxycodone (hazard ratio 1.19; 95% confidence interval 1.11-1.27; P < 0.001), after adjusting for such baseline variables that were both significantly correlated with the outcome variable (time to rotation) and significantly different between the groups; age at index date, osteoarthritis and number of pain-related drugs.

    CONCLUSION: Patients with non-cancer pain who initiated treatment with CR morphine had a higher risk of opioid rotation than patients initiated with CR oxycodone.

  • 3.
    Gunnarsson, Helena E. M.
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. Helsa Vårdcent, Osby.
    Agerström, Jens
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Clinical pain, abstraction, and self-control: being in pain makes it harder to see the forest for the trees and is associated with lower self-control2018In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 11, p. 1105-1114Article in journal (Refereed)
    Abstract [en]

    Objectives: Although abstract thinking is a fundamental dimension of human cognition, it has received scant attention in research on pain and cognition. We hypothesized that physical pain impairs abstraction, because when people experience pain at high intensity levels, attention becomes concretely focused on the self in the here and now, where little else matters than finding relief for the pain they are currently experiencing. We also examined the relationship between pain and self-control, predicting that pain would debilitate self-control. Patients and methods: Abstraction and self-reported self-control were assessed in 109 patients with musculoskeletal pain. The influence of specific pain qualities, such as pain intensity, pain interference with daily activities, pain duration, and pain persistence, was examined. Furthermore, we assessed other factors (e.g., anxiety, depression, and fatigue) that could be assumed to play a role in the pain experience and in cognitive performance. Results: Higher pain intensity and persistence were associated with less abstract thinking. Furthermore, self-control decreased with greater pain intensity, persistence, and self-reported pain interference with daily activities. Self-reported depressive symptoms mediated the overall relationship between pain and self-control. Conclusion: Abstraction is compromised in patients reporting higher pain intensity and persistence. Different dimensions of pain also predict lower self-control although depression seems to account for the relationship between overall pain and self-control. The current study is the first to report an association between clinical musculoskeletal pain and abstraction. The results suggest that pain patients may suffer from a broader range of cognitive disadvantages than previously believed.

  • 4.
    Gunnarsson, Helena E. M.
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. Neron HSU AB, Osby.
    Grahn, Birgitta
    Lund University ; Reg Skåne ; Reg Kronoberg.
    Agerström, Jens
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Impaired psychomotor ability and attention in patients with persistent pain: a cross-sectional comparative study2016In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 9, p. 825-835Article in journal (Refereed)
    Abstract [en]

    Background and aims: Patients with pain have shown cognitive impairment across various domains. Although the pain qualities vary among patients, research has overlooked how cognitive performance is affected by the duration and persistence of pain. The current study sought to fill this gap by examining how qualitatively different pain states relate to the following cognitive functions: sustained attention, cognitive control, and psychomotor ability. Patients and methods: Patients with musculoskeletal pain in primary care were divided into three pain groups: acute pain (duration <3 months), regularly recurrent pain (duration >3 months), and persistent pain (duration >3 months). These groups were then compared with healthy controls. The MapCog Spectra Test, the Color Word Test, and the Grooved Pegboard Test were used to measure sustained attention, cognitive control, and psychomotor ability, respectively. Results: Patients with persistent pain showed significantly worse sustained attention and psychomotor ability compared with healthy controls. The acute pain group showed a significant decrease in psychomotor ability, and the regularly recurrent pain group showed a significant decrease in sustained attention. These results remained unchanged when age, education, and medication were taken into account. Conclusion: Persistent musculoskeletal pain seems to impair performance on a wider range of cognitive tasks than acute or regularly recurrent pain, using pain-free individuals as a benchmark. However, there is some evidence of impairment in psychomotor ability among patients with acute pain and some impairment in sustained attention among patients with regularly recurrent pain.

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