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Recent research: six studies on the long-term effects of abuse & deprivation

Here are half a dozen studies on the long-term effects of various forms of abuse & deprivation.  Paras et al systematically reviewed the association between a history of sexual abuse and a lifetime diagnosis of a somatic disorder.  They found significant links with functional gastrointestinal disorders, nonspecific chronic pain, psychogenic seizures, and chronic pelvic pain.  When analysis was restricted to studies where sexual abuse was defined as rape, they also found an association with fibromyalgia.  Abstracts and links, for this research paper and the further papers described, can be found lower down this page.   

NICE guidelines – early management of persistent non-specific low back pain

I'm a bit slow on reporting this, but at the end of May the UK's National Institute for Health and Clinical Excellence (NICE) published a guideline on "Early management of persistent non-specific low back pain".   I've blogged before about NICE.  They publish very widely with, for example, 82 guidelines on musculoskeletal disorders generally.  They have also recently launched NHS evidence which aims " ... to provide easy access to a comprehensive evidence base for everyone in health and social care who takes decisions about treatments or the use of resources - including clinicians, public health professionals, commissioners and service managers - thus improving health and patient care. It will build on NICE's significant international reputation for developing high quality evidence-based guidance.

Handouts & questionnaires for pain information & assessment (1st post)

For many years my work split fairly evenly between helping people with psychological difficulties and helping people with pain problems.  Quite a few people were troubled with both.  In the last several years I have done much less work with pain, although I still see some people for overall pain management.  This has been partly because I was trying to keep up-to-date with too many fields, so stepping back from pain work made sense.  It has also been partly because the flourishing of research into happiness & wellbeing has fascinated me and taken up time.  Here are a collection of pain-associated assessment and information sheets that I accumulated over the years.  They are obviously relevant for work with pain, and some (e.g. one year symptom diary) can be adapted for work with stress & psychological difficulties. 

IBS severity score & background - this is a scale that was used by Professor Whorwell and his research team in Manchester.

Ways of coping: theory & personal experience

In blog postings earlier this month, I've talked about supporting my Mum after her recent couple of strokes.  She's been shipped through three different hospitals and now is more peaceful in a nursing home.  It's sad - very sad at times - and it's great that she seems more comfortable, better looked after, and more content.  I definitely feel easier too.  Less weight on my shoulders, less emotional aching.

Recent research: two papers on mindfulness & four on sleep

Here are two papers on mindfulness and four on sleep.  The Kuyken et al paper is important.  It compares mindfulness-based cognitive therapy (MBCT) with continuation antidepressants in the prevention of relapse in recurrent depression.  The results are great - "Relapse/recurrence rates over 15-month follow-ups in MBCT were 47%, compared with 60% in the m-ADM (maintenance antidepressant) group (hazard ratio = 0.63; 95% confidence interval: 0.39 to 1.04).  MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains."  I have been cautious in my enthusiasm for MBCT (see previous post) but this is exactly the kind of research that we need to help clarify MBCT's potential further.  The second paper on mindfulness is lower key.  It is a mention of its potential in enhancing sexuality.  It makes sense - see last month's posts on the effects of meditation training on experiencing positive emotions - but the relevant research is still in its early stages. 

Barbara Fredrickson’s recent research study on loving-kindness meditation (third post)

What are some implications for using forms of mind training for ourselves and for teaching others?  Reading this research study leads me to think about optimum amount of time spent practising these methods, the importance of encouraging application during daily life.  I discuss these issues in this blog posting.  It would also be fascinating and helpful to look at the challenge of maintaining the practices over time, and to consider how different forms of mind training can be directed at different targets - for example, easing symptoms, encouraging particular positive emotions (e.g. compassion, gratitude & contentment), targeting specific key wellbeing needs (e.g. self-determination theory's autonomy, competence & relatedness), and helping people live their personal values.

Pain assessment & information 2

From the place where we are right/Flowers will never grow/In the spring.

The place where we are right/Is hard and trampled/Like a yard.

But doubts and loves/Dig up the world/Like a mole, a plow/And a whisper will be heard in the place/Where the ruined/House once stood.

 

- Yehuda Amichai

This section

Pain assessment & information

We awaken in others the same attitude of mind we hold toward them.

- Elbert Hubbard

For many years my work split fairly evenly between helping people with psychological difficulties and helping people with pain problems.  Quite a few people were troubled with both.  In the last several years I have done much less work with pain, although I still see some people for overall pain management.  This has been partly because I was trying to keep up-to-date with too many fields, so stepping back from pain work made sense.  It has also been partly because the flourishing of research into happiness & wellbeing has fascinated me and taken up time.  Here are a collection of pain-associated assessment and information sheets that I accumulated over the years.  They are obviously relevant for work with pain, and some (e.g. one year symptom diary) can be adapted for work with stress & psychological difficulties. 

Both negative & positive emotions can be functional or dysfunctional

Unpleasant, negative emotions can be highly functional. For example, anxious hypervigilance in a dangerous situation can keep me on my toes, very aware of potential threats and more able to react rapidly and appropriately. Healthy anger when I am being taken advantage of can help me respond strongly and assertively to protect my rights. In her book "Productive & Unproductive Depression" the psychotherapist Emmy Gut suggested that even depression can at times be functional. She wrote " ... in the wilderness in which the human race developed its current genetic characteristics, individuals who had the capacity to respond to dangerous or otherwise significant circumstances with an adequate set of emotions, and acted accordingly, had a better chance to survive, to have children, and to raise them than individuals who were deficient in that respect."

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