ORCID Profile
0000-0001-7839-6058
Current Organisations
Caulfield Hospital
,
Institute for Safety Compensation and Recovery Research
,
Monash University
,
Monash University Department of Epidemiology and Preventive Medicine
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Epidemiology | Biological Psychology (Neuropsychology, Psychopharmacology, Physiological Psychology) | Psychology | Public Health and Health Services | Sensory Systems |
Behaviour and Health | Skeletal System and Disorders (incl. Arthritis) | Evaluation of Health Outcomes | Nervous System and Disorders | Injury Control | Health Policy Evaluation
Publisher: BMJ
Date: 26-08-2019
DOI: 10.1136/INJURYPREV-2019-043247
Abstract: Text mining to support screening in large-scale systematic reviews has been recommended however, their suitability for reviews in injury research is not known. We examined the performance of text mining in supporting the second reviewer in a systematic review examining associations between fault attribution and health and work-related outcomes after transport injury. Citations were independently screened in Abstrackr in full (reviewer 1 10 559 citations), and until no more citations were predicted to be relevant (reviewer 2 1809 citations, 17.1%). All potentially relevant full-text articles were assessed by reviewer 1 (555 articles). Reviewer 2 used text mining (Wordstat, QDA Miner) to reduce assessment to full-text articles containing ≥1 fault-related exposure term (367 articles, 66.1%). Abstrackr offered excellent workload savings: 82.7% of citations did not require screening by reviewer 2, and total screening time was reduced by 36.6% compared with traditional dual screening of all citations. Abstrackr predictions had high specificity (83.7%), and low false negatives (0.3%), but overestimated citation relevance, probably due to the complexity of the review with multiple outcomes and high imbalance of relevant to irrelevant records, giving low sensitivity (29.7%) and precision (14.5%). Text mining of full-text articles reduced the number needing to be screened by 33.9%, and reduced total full-text screening time by 38.7% compared with traditional dual screening. Overall, text mining offered important benefits to systematic review workflow, but should not replace full screening by one reviewer, especially for complex reviews examining multiple health or injury outcomes. CRD42018084123.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Wiley
Date: 04-09-2015
DOI: 10.1111/PSYP.12516
Abstract: This study investigated the psychophysiological correlates of the subjective experience of vicarious pain that is, a spontaneous experience of pain when seeing another in pain. Forty-nine healthy, otherwise pain-free in iduals aged 18-55 years completed empathy and anxiety questionnaires and were classified into three groups: vicarious responders with high anxiety (n = 11), vicarious responders with low anxiety (n = 22), and nonresponders (n = 16). Electrophysiological recordings of heart rate variability (HRV) during paced breathing and cognitive stress (serial sevens task) were completed before participants viewed short videos of athletes in states of pain or happiness, taken from Australian League Football matches. Change in beats per minute, relative to neutral scenes, were analyzed for the first 4 s after onset of the painful or happy event. Anxious responders had lower HF-HRV than both other groups, implicating poor parasympathetic regulation specific to states of stress. Both vicarious responder groups had elevated HR at the event onset, regardless of valence. After viewing painful injuries, nonanxious vicarious responders showed sustained HR over time, anxious responders showed HR acceleration with a peak at 3 s after the injury onset, and nonresponders showed a pattern of marked HR deceleration. These findings suggest that vicarious pain in anxious responders is associated with poorly regulated sympathetic arousal via insufficient inhibitory parasympathetic activity, whereas nonanxious persons show sustained arousal. Clearly, multiple mechanisms in the central and peripheral nervous system must play a role in vicarious pain states, and the different manifestations are likely to lead to very different behavioral consequences.
Publisher: Wiley
Date: 08-2015
DOI: 10.1002/JTS.22030
Abstract: Although the experience of vicarious sensations when observing another in pain have been described post utation, the underlying mechanisms are unknown. We investigated whether vicarious sensations are related to posttraumatic stress disorder (PTSD) symptoms and chronic pain. In Study 1, 236 utees completed questionnaires about phantom limb phenomena and vicarious sensations to both innocuous and painful sensory experiences of others. There was a 10.2% incidence of vicarious sensations, which was significantly more prevalent in utees reporting PTSD-like experiences, particularly increased arousal and reexperiencing the event that led to utation (φ = .16). In Study 2, 63 utees completed the Empathy for Pain Scale and PTSD Checklist-Civilian Version. Cluster analyses revealed 3 groups: 1 group did not experience vicarious pain or PTSD symptoms, and 2 groups were vicarious pain responders, but only 1 had increased PTSD symptoms. Only the latter group showed increased chronic pain severity compared with the nonresponder group (p = .025) with a moderate effect size (r = .35). The findings from both studies implicated an overlap, but also ergence, between PTSD symptoms and vicarious pain reactivity post utation. Maladaptive mechanisms implicated in severe chronic pain and physical reactivity posttrauma may increase the incidence of vicarious reactivity to the pain of others.
Publisher: Public Library of Science (PLoS)
Date: 23-08-2017
Publisher: Wiley
Date: 11-02-2014
DOI: 10.1002/WCS.1277
Abstract: Research over the past two decades has begun to identify some of the key mechanisms underlying phantom limb pain and sensations however, this continues to be a clinically challenging condition to manage. Treatment of phantom pain, like all chronic pain conditions, demands a holistic approach that takes into consideration peripheral, spinal, and central neuroplastic mechanisms. In this review, we focus on nonpharmacological treatments tailored to reverse the maladaptive neuroplasticity associated with phantom pain. Recent scientific advances emerging from interdisciplinary research between neuroscience, virtual reality, robotics, and prosthetics show the greatest promise for alternative embodiment and maintaining the integrity of the multifaceted representation of the body in the brain. Importantly, these advances have been found to prevent and reduce phantom limb pain. In particular, therapies that involve sensory and/or motor retraining, most naturally through the use of integrative prosthetic devices, as well as peripheral (e.g., transcutaneous electrical nerve stimulation) or central (e.g., transcranial magnetic stimulation or deep brain stimulation) stimulation techniques, have been found to both restore the neural representation of the missing limb and to reduce the intensity of phantom pain. While the evidence for the efficacy of these therapies is mounting, but well-controlled and large-scale studies are still needed. WIREs Cogn Sci 2014, 5:221-231. doi: 10.1002/wcs.1277 CONFLICT OF INTEREST: The authors have no financial or other relationship that might lead to a conflict of interest. For further resources related to this article, please visit the WIREs website.
Publisher: Wiley
Date: 10-10-2020
DOI: 10.1111/PSYP.13688
Abstract: Understanding the association between autonomic nervous system [ANS] function and brain morphology across the lifespan provides important insights into neurovisceral mechanisms underlying health and disease. Resting‐state ANS activity, indexed by measures of heart rate [HR] and its variability [HRV] has been associated with brain morphology, particularly cortical thickness [CT]. While findings have been mixed regarding the anatomical distribution and direction of the associations, these inconsistencies may be due to sex and age differences in HR/HRV and CT. Previous studies have been limited by small s le sizes, which impede the assessment of sex differences and aging effects on the association between ANS function and CT. To overcome these limitations, 20 groups worldwide contributed data collected under similar protocols of CT assessment and HR/HRV recording to be pooled in a mega‐analysis ( N = 1,218 (50.5% female), mean age 36.7 years (range: 12–87)). Findings suggest a decline in HRV as well as CT with increasing age. CT, particularly in the orbitofrontal cortex, explained additional variance in HRV, beyond the effects of aging. This pattern of results may suggest that the decline in HRV with increasing age is related to a decline in orbitofrontal CT. These effects were independent of sex and specific to HRV with no significant association between CT and HR. Greater CT across the adult lifespan may be vital for the maintenance of healthy cardiac regulation via the ANS—or greater cardiac vagal activity as indirectly reflected in HRV may slow brain atrophy. Findings reveal an important association between CT and cardiac parasympathetic activity with implications for healthy aging and longevity that should be studied further in longitudinal research.
Publisher: Informa UK Limited
Date: 06-12-2021
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.INJURY.2018.03.013
Abstract: Levels of stress post-injury, especially after compensable injury, are known to be associated with worse long-term recovery. It is therefore important to identify how, and in whom, worry and stress manifest post-injury. This study aimed to identify demographic, injury, and compensation factors associated with worry about financial and recovery outcomes 12 months after traumatic injury. Participants (n = 433) were recruited from the Victorian Orthopaedic Trauma Outcomes Registry and Victorian State Trauma Registry after admission to a major trauma hospital in Melbourne, Australia. Participants completed questionnaires about pain, compensation experience and psychological wellbeing as part of a registry-based observational study. Linear regressions showed that demographic and injury factors accounted for 11% and 13% of variance in financial and recovery worry, respectively. Specifically, lower education, discharge to inpatient rehabilitation, attributing fault to another and having a compensation claim predicted financial worry. Worry about recovery was only predicted by longer hospital stay and attributing fault to another. In all participants, financial and recovery worry were associated with worse pain (severity, interference, catastrophizing, kinesiophobia, self-efficacy), physical (disability, functioning) and psychological (anxiety, depression, PTSD, perceived injustice) outcomes 12 months post-injury. In participants who had transport (n = 135) or work (n = 22) injury compensation claims, both financial and recovery worry were associated with sustaining permanent impairments, and reporting negative compensation system experience 12 months post-injury. Financial worry 12 months post-injury was associated with not returning to work by 3-6 months post-injury, whereas recovery worry was associated with attributing fault to another, and higher healthcare use at 6-12 months post-injury. These findings highlight the important contribution of factors other than injury severity, to worry about finances and recovery post-injury. Having a compensation claim, failure to return to work and experiencing pain and psychological symptoms also contribute to elevated worry. As these factors explained less than half of the variance in worry, however, other factors not measured in this study must play a role. As worry may increase the risk of developing secondary mental health conditions, timely access to financial, rehabilitation and psychological supports should be provided to people who are not coping after injury.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.SAPHARM.2018.03.060
Abstract: Inappropriate use of pain medication has serious consequences for older populations. Experts in the field have noted an increase in opioid prescriptions, and opioid-related hospitalisations and deaths among this vulnerable population. In the pursuit of educating pharmacists, physicians, allied healthcare professionals, researchers, academics and the public facing the challenges of chronic pain medication management, 'The Inaugural Monash University School of Public Health and Preventive Medicine (SPHPM) Best Practice in Chronic Pain Medication Management Day Conference' was held in December 2016 at the Alfred Medical Research and Education Precinct (Melbourne, Australia). Fifteen experts presented on aspects of chronic pain epidemiology and current analgesic use in older Australians, and discussed current practice and associated challenges. Presenters highlighted the dramatic increase in opioid prescribing, development of tolerance and withdrawal symptoms, problems with abuse and addiction, increased risk of death from overdose or suicide, potentiation of sedative effects with concurrent use of anxiolytics/hypnotics, and medication ersion. Pharmacists are very accessible to patients and are crucial members of medication management teams. They have the necessary medication expertise to review medication regimens and provide patient education. Towards addressing chronic pain medication management of older populations, pharmacists can contribute in several ways, such as being aware of relevant guidelines and completing further training, contributing to policy and guideline development, participating in multidisciplinary panels, working groups and pain management teams, collaborating on research projects, and educating the community. With regards to opioid medication management, pharmacists are in an ideal position to: monitor prescription dispensing and potential misuse, provide education about overuse, and, if appropriate, provide access to naloxone. In order to fulfil these roles and responsibilities, allied healthcare professionals should be educated and informed, and opportunities for continuing professional education should be available and utilised. Pharmacists should have the necessary knowledge and skills to optimise chronic pain management, and to both deliver and inform policies and guidelines on pharmacological management of chronic pain in older people.
Publisher: Center for Open Science
Date: 03-04-2018
Abstract: Understanding the association between autonomic nervous system [ANS] function and brain morphology across the lifespan provides important insights into neurovisceral mechanisms underlying health and disease. Resting state ANS activity, indexed by measures of heart rate [HR] and its variability [HRV] has been associated with brain morphology, particularly cortical thickness [CT]. While findings have been mixed regarding the anatomical distribution and direction of the associations, these inconsistencies may be due to sex and age differences in HR/HRV and CT. Previous studies have been limited by small s le sizes, which impede the assessment of sex differences and aging effects on the association between ANS function and CT. To overcome these limitations, 20 groups worldwide contributed data collected under similar protocols of CT assessment and HR/HRV recording to be pooled in a mega-analysis (N = 1,218 (50.5% female), mean age 36.7 years (range: 12-87)). Findings suggest that the decline in HRV with increasing age is related to a decline in prefrontal CT, particularly in the orbitofrontal cortex. These effects were independent of sex and specific to HRV with no significant association between CT and HR. Greater CT across the adult lifespan may be vital for the maintenance of healthy cardiac regulation via the ANS. Nonetheless, in the absence of longitudinal data, alternative explanations need to be considered. Findings reveal an important association between cortical thickness and cardiac parasympathetic activity with implications for healthy aging and longevity.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2012
Publisher: Wiley
Date: 07-11-2015
DOI: 10.1002/EJP.607
Abstract: Through two studies, we introduce and validate the Empathy for Pain Scale (EPS), which characterizes the phenomenology of empathy for pain, including the vicarious experience of pain when seeing others in pain. In study 1, 406 in iduals completed the EPS and Interpersonal Reactivity Index (IRI). In the EPS, four painful scenarios (witnessing surgery, patient recovering from surgery, assault and accidental injury) were rated for 12 emotional, empathic and sensory responses. In study 2, 59 participants completed the same questionnaires and then watched and rated videos of sporting injuries. In study 1, we identified three factors of the EPS with principal component analysis, which were validated with confirmatory factor analysis: affective distress vicarious pain and empathic concern. The EPS demonstrated good psychometric properties, re-test reliability (n = 105) and concurrent validity. In study 2, we validated the EPS against empathic reactions to the pain of others as displayed in video clips depicting sporting injuries and showed that the scale has unique utility to characterize empathic reactions to pain above general trait empathy measures. Both studies showed that the affective distress and empathic concern subscales of the EPS correlated with measures of cognitive and affective empathy from the IRI, whereas the vicarious pain subscale was only correlated with the personal distress IRI subscale. The EPS is a psychometrically sound new scale that characterizes empathy for pain and vicarious pain. The EPS offers valuable insight to the phenomenological profile of the affective, empathic and sensory dimensions of empathy for pain.
Publisher: Elsevier BV
Date: 06-2010
DOI: 10.1016/J.MEHY.2009.12.009
Abstract: Chronic pain conditions often "mimic" the symptoms of restless legs syndrome (RLS) with worse pain in the evening and upon rest, associated with an urge to move and relief upon movement. We propose that too little has been made of these parallels, with pain conditions resembling RLS being dismissed as mimics. We found, in a large questionnaire study (n=283) on phantom limb perception, a pattern of phantom pain that resembled RLS: utees with nocturnal phantom pain were more likely to report worse pain upon rest and/or lying down, with an urge to move the phantom and/or walk to relieve their pain, and to experience spontaneous limb movements akin to periodic leg movements of RLS. We present the hypothesis that a model of restless legs syndrome may provide new insights into the mechanisms underlying phantom pain, and lead to new mechanism-based phantom pain treatment. In particular, central changes associated with sensory and motor symptoms of RLS, neuropathy, and dopamine may also be involved in those predisposed to experience phantom pain that mimics the symptoms of RLS. Ultimately, restless legs syndrome may indeed be a pain syndrome, and warrants further investigation in chronic pain populations.
Publisher: Cold Spring Harbor Laboratory
Date: 23-12-2022
DOI: 10.1101/2022.12.23.521739
Abstract: Legume-rhizobium signaling during establishment of symbiotic nitrogen fixation restricts rhizobium colonization to specific cells. A limited number of root hair cells allow infection threads to form, and only a fraction of the epidermal infection threads progress to cortical layers to establish functional nodules. Here we use single-cell analysis to define the epidermal and cortical cell populations that respond to and facilitate rhizobium infection. We then identify high-confidence nodulation gene candidates based on their specific expression in these populations, pinpointing genes stably associated with infection across genotypes and time points. We show that one of these, which we name SYMRKL1 , encodes a protein with an ectodomain predicted to be nearly identical to that of SYMRK and is required for normal infection thread formation. Our work disentangles cellular processes and transcriptional modules that were previously confounded due to lack of cellular resolution, providing a more detailed understanding of symbiotic interactions.
Publisher: Springer International Publishing
Date: 2017
Publisher: MDPI AG
Date: 07-10-2020
Abstract: Identifying who might develop disabling pain or poor mental health after injury is a high priority so that healthcare providers can provide targeted preventive interventions. This retrospective cohort study aimed to identify predictors of disabling pain or probable mental health conditions at 12 months post-injury. Participants were recruited 12-months after admission to a major trauma service for a compensable transport or workplace injury (n = 157). Injury, compensation claim, health services and medication information were obtained from the Victorian Orthopaedic Trauma Outcome Registry, Victorian State Trauma Registry and Compensation Research Database. Participants completed questionnaires about pain, and mental health (anxiety, depression, posttraumatic stress disorder) at 12 months post-injury. One third had disabling pain, one third had at least one probable mental health condition and more than one in five had both disabling pain and a mental health condition at 12 months post-injury. Multivariable logistic regression found mental health treatment 3–6 months post-injury, persistent work disability and opioid use at 6–12 months predicted disabling pain at 12 months post-injury. The presence of opioid use at 3–6 months, work disability and psychotropic medications at 6–12 months predicted a mental health condition at 12 months post-injury. These factors could be used to identify at risk of developing disabling pain who could benefit from timely interventions to better manage both pain and mental health post-injury. Implications for healthcare and compensation system are discussed.
Publisher: Wiley
Date: 11-2010
Publisher: Springer Science and Business Media LLC
Date: 27-12-2012
DOI: 10.3758/S13415-011-0080-8
Abstract: Observing noxious injury to another's hand is known to induce corticospinal inhibition that can be measured in the observer's corresponding muscle. Here, we investigated whether acquired pain synesthetes, in iduals who experience actual pain when observing injury to another, demonstrate less corticospinal inhibition than do controls during pain observation, as a potential mechanism for the experience of vicarious pain. We recorded motor-evoked potentials (MEPs) induced at two time points through transcranial magnetic stimulation while participants observed videos of a hand at rest, a hypodermic needle penetrating the skin, a Q-tip touching the skin, and a hypodermic needle penetrating an apple. We compared MEPs in three groups: 7 utees who experience pain synesthesia, 11 nonsynesthete utees who experience phantom limb pain, and 10 healthy controls. Results indicated that the pain synesthete group demonstrated significantly enhanced MEP response to the needle penetrating the hand, relative to the needle not having yet penetrated the hand, as compared with controls. This effect was not observed exclusively in the same muscle where noxious stimulation was applied. We speculate that our findings reflect a generalized response to pain observation arising from hyperactivity of motor mirror neurons not involved in direct one-to-one simulation but, rather, in the representation of another's experience.
Publisher: Springer Science and Business Media LLC
Date: 17-11-2011
DOI: 10.1007/S11065-011-9184-8
Abstract: Body integrity identity disorder (BIID) is characterised by profound experience of incongruity between the biological and desired body structure. The condition manifests in "non-belonging" of body parts, and the subsequent desire to utate, paralyse or disable a limb. Little is known about BIID however, a neuropsychological model implicating right fronto-parietal and insular networks is emerging, with potential disruption to body representation. We argue that, as there is scant systematic research on BIID published to date and much of the research is methodologically weak, it is premature to assume that the only process underlying bodily experience that is compromised is body representation. The present review systematically investigates which aspects of neurological processing of the body, and sense of self, may be compromised in BIID. We argue that the disorder most likely reflects dysregulation in multiple levels of body processing. That is, the disunity between self and the body could arguably come about through congenital and/or developmental disruption of body representations, which, together with altered multisensory integration, may preclude the experience of self-attribution and embodiment of affected body parts. Ulimately, there is a need for official diagnostic criteria to facilitate epidemiological characterisation of BIID, and for further research to systematically investigate which aspects of body representation and processing are truly compromised in the disorder.
Publisher: BMJ
Date: 10-2017
DOI: 10.1136/BMJOPEN-2017-017350
Abstract: Compensable injury increases the likelihood of having persistent pain after injury. Three-quarters of patients report chronic pain after traumatic injury, which is disabling for about one-third of patients. It is important to understand why these patients report disabling pain, in order to develop targeted preventative interventions. This study examined the experience of pain and disability, and investigated their sequential interrelationships with, catastrophising, kinesiophobia and self-efficacy 1 year after compensable and non-compensable injury. Observational registry-based cohort study. Metropolitan Trauma Service in Melbourne, Victoria, Australia. Participants were recruited from the Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry. 732 patients were referred to the study, 82 could not be contacted or were ineligible, 217 declined and 433 participated (66.6% response rate). The Brief Pain Inventory, Glasgow Outcome Scale, EuroQol Five Dimensions questionnaire, Pain Catastrophising Scale, Pain Self-Efficacy Questionnaire, Injustice Experience Questionnaire and the T a Scale of Kinesiophobia. Direct and indirect relationships (via psychological appraisals of pain/injury) between baseline characteristics (compensation, fault and injury characteristics) and pain severity, pain interference, health status and disability were examined with ordinal, linear and logistic regression, and mediation analyses. Injury severity, compensable injury and external fault attribution were consistently associated with moderate-to-severe pain, higher pain interference, poorer health status and moderate-to-severe disability. The association between compensable injury, or external fault attribution, and disability and health outcomes was mediated via pain self-efficacy and perceived injustice. Given that the associations between compensable injury, pain and disability was attributable to lower self-efficacy and higher perceptions of injustice, interventions targeting the psychological impacts of pain and injury may be especially necessary to improve long-term injury outcomes.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2016
Publisher: Informa UK Limited
Date: 12-07-2018
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.NEUBIOREV.2011.09.006
Abstract: Recent research suggests the observation or imagination of somatosensory stimulation in another (e.g., touch or pain) can induce a similar somatosensory experience in oneself. Some researchers have presented this experience as a type of synaesthesia, whereas others consider it an extreme experience of an otherwise normal perception. Here, we present an argument that these descriptions are not mutually exclusive. They may describe the extreme version of the normal process of understanding somatosensation in others. It becomes synaesthesia, however, when this process results in a conscious experience comparable to the observed person's state. We describe these experiences as 'mirror-sensory synaesthesia' a type of synaesthesia identified by its distinct social component where the induced synaesthetic experience is a similar sensory experience to that perceived in another person. Through the operationalisation of this intriguing experience as synaesthesia, existing neurobiological models of synaesthesia can be used as a framework to explore how mechanisms may act upon social cognitive processes to produce conscious experiences similar to another person's observed state.
Publisher: MDPI AG
Date: 23-02-2023
Abstract: Sleep disturbances are common after stroke and may affect recovery and rehabilitation outcomes. Sleep monitoring in the hospital environment is not routine practice yet may offer insight into how the hospital environment influences post-stroke sleep quality while also enabling us to investigate the relationships between sleep quality and neuroplasticity, physical activity, fatigue levels, and recovery of functional independence while undergoing rehabilitation. Commonly used sleep monitoring devices can be expensive, which limits their use in clinical settings. Therefore, there is a need for low-cost methods to monitor sleep quality in hospital settings. This study compared a commonly used actigraphy sleep monitoring device with a low-cost commercial device. Eighteen adults with stroke wore the Philips Actiwatch to monitor sleep latency, sleep time, number of awakenings, time spent awake, and sleep efficiency. A sub-s le (n = 6) slept with the Withings Sleep Analyzer in situ, recording the same sleep parameters. Intraclass correlation coefficients and Bland–Altman plots indicated poor agreement between the devices. Usability issues and inconsistencies were reported between the objectively measured sleep parameters recorded by the Withings device compared with the Philips Actiwatch. While these findings suggest that low-cost devices are not suitable for use in a hospital environment, further investigations in larger cohorts of adults with stroke are needed to examine the utility and accuracy of off-the-shelf low-cost devices to monitor sleep quality in the hospital environment.
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.CORTEX.2018.03.003
Abstract: Phantom limbs are the phenomenal persistence of postural and sensorimotor features of an utated limb. Although immaterial, their characteristics can be modulated by the presence of physical matter. For instance, the phantom may disappear when its phenomenal space is invaded by objects ("obstacle shunning"). Alternatively, "obstacle tolerance" occurs when the phantom is not limited by the law of impenetrability and co-exists with physical objects. Here we examined the link between this under-investigated aspect of phantom limbs and apparent motion perception. The illusion of apparent motion of human limbs involves the perception that a limb moves through or around an object, depending on the stimulus onset asynchrony (SOA) for the two images. Participants included 12 unilateral lower limb utees matched for obstacle shunning (n = 6) and obstacle tolerance (n = 6) experiences, and 14 non- utees. Using multilevel linear models, we replicated robust biases for short perceived trajectories for short SOA (moving through the object), and long trajectories (circumventing the object) for long SOAs in both groups. Importantly, however, utees with obstacle shunning perceived leg stimuli to predominantly move through the object, whereas utees with obstacle tolerance perceived leg stimuli to predominantly move around the object. That is, in people who experience obstacle shunning, apparent motion perception of lower limbs was not constrained to the laws of impenetrability (as the phantom disappears when invaded by objects), and legs can therefore move through physical objects. Amputees who experience obstacle tolerance, however, had stronger solidity constraints for lower limb apparent motion, perhaps because they must avoid co-location of the phantom with physical objects. Phantom limb experience does, therefore, appear to be modulated by intuitive physics, but not in the same way for everyone. This may have important implications for limb experience post- utation (e.g., improving prosthesis embodiment when limb representation is constrained by the same limits as an intact limb).
Publisher: Wiley
Date: 28-03-2017
DOI: 10.1111/PSYP.12865
Abstract: Up to a third of the population experiences pain when seeing another in pain. The mechanisms underlying such vicarious sensory experiences are thought to reflect hyperactive mirror systems (threshold theory) or dysfunctional processing and representation of oneself versus others (self/other theory). This study investigated whether the tendency to experience vicarious pain corresponds to disinhibited physiological reactivity toward other's emotions, and/or greater empathic mimicry of other's physiological state (respiratory behavior) during fear, pain, and positive emotion. Fifty healthy in iduals aged 18-55 years (23 vicarious pain responders) completed empathy- and anxiety-related questionnaires, and a film task. Respiration was measured noninvasively with piezoelectric respiration belts while participants viewed emotional film clips depicting three emotions (fear ain ositive) interspersed with neutral clips. The emotional stimuli depicted scenes in which the characters showed increases or decreases in respiration. The results suggest that vicarious pain responders do not mimic emotional respiratory behavior. Rather, vicarious pain responders had a significantly slower respiration rate for all emotional stimuli (M
Publisher: Springer Science and Business Media LLC
Date: 28-10-2016
Publisher: Oxford University Press (OUP)
Date: 12-05-2012
DOI: 10.1093/SCAN/NSR016
Publisher: Wiley
Date: 21-11-2018
DOI: 10.1002/EJP.1151
Abstract: Persons with chronic pain often report problems with cognitive abilities, such as memory or attention. There is limited understanding of whether objective performance is consistent with subjective reports, and how psychological factors contribute. We aimed to investigate these relationships in a group of patients expressing cognitive concerns, and evaluate the utility of self-report tools for pain management settings. Participants with chronic pain (n = 41) completed standardized neuropsychological tests, and self-report measures of cognitive functioning, pain, mood and sleep, as part of a broader study investigating cognitive performance in pain. Average neuropsychological test performance was subtly below normative means (within one standard deviation). Twenty-five percent of the s le scored substantially below age-adjusted norms on one or more objective tests. There were moderate-to-large associations between objective performance (e.g. Trail-Making B) and subjective cognitive complaints (e.g. Everyday Memory Questionnaire - Revised), controlling for age and education level. This was moderated by anxiety, such that subjective-objective relationships were particularly strong in those with higher anxiety. Poorer test performance was associated with higher pain intensity and catastrophizing. Subjective-objective cognition relationships remained after controlling for catastrophizing. Patients' self-reported cognitive concerns concurred with objectively measured performance, independent of age, education and catastrophizing. Moreover, those with severe anxiety were more accurate in predicting their cognitive performance. The findings highlight some interesting cognition-mood relationships, and suggest that easy-to-administer questionnaires, such as the Everyday Memory Questionnaire - Revised and the Behavior Rating Inventory of Executive Function - Adult Version, may be useful to capture cognitive concerns in clinical settings. Cognitive concerns in chronic pain reflected objective neurocognitive performance. This was moderated by anxiety, such that self-reported cognition was more consistent with objective performance in those with high anxiety. Our findings suggest that reported cognitive concerns should be heeded, and self-report measures may be used clinically to facilitate dialogue about cognitive functioning.
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.CPR.2018.05.001
Abstract: The psychological impacts of injury have significant long-term implications on injury recovery. This review examined the effectiveness of interventions delivered within three months of injury on reducing the severity of posttraumatic stress disorder (PTSD), anxiety and depression symptoms. A systematic search of seven databases (PsycINFO, Medline, Web of Science, CINAHL, Embase, Scopus and Cochrane Library) identified 15,224 records. 212 full-text articles were retrieved, 26 studies were included in narrative synthesis, and 12 studies with lower risk of bias were included in meta-analyses. Prolonged exposure, and cognitive and behavioural interventions elicited improvements in PTSD, anxiety and depression symptoms multidisciplinary interventions improved PTSD and depression symptoms and education-based interventions had little impact on any psychological symptoms. Studies comprising risk stratified or stepped care methods showed markedly greater population impact through better reach, implementation and adoption. Meta-analyses revealed small-medium reductions in PTSD symptoms over the first 12 months postinjury (SMD = 0.32 to 0.49) with clinically meaningful effects in 64% of studies reduced depression symptoms at 0-3 (small effect SMD = 0.34) and 6-12 months postinjury (medium effect SMD = 0.60), with clinically meaningful effects in 40% of studies but no pooled effects on anxiety symptoms at any time. Altogether, exposure- and CBT-based psychological interventions had the greatest impact on PTSD and depression symptoms postinjury when delivered within three months of injury, with risk-stratified, stepped care having the greatest population impact potential.
Publisher: Elsevier BV
Date: 12-2016
Publisher: Springer Science and Business Media LLC
Date: 21-12-2022
DOI: 10.1038/S41586-022-05547-7
Abstract: The testis produces gametes through spermatogenesis and evolves rapidly at both the morphological and molecular level in mammals 1–6 , probably owing to the evolutionary pressure on males to be reproductively successful 7 . However, the molecular evolution of in idual spermatogenic cell types across mammals remains largely uncharacterized. Here we report evolutionary analyses of single-nucleus transcriptome data for testes from 11 species that cover the three main mammalian lineages (eutherians, marsupials and monotremes) and birds (the evolutionary outgroup), and include seven primates. We find that the rapid evolution of the testis was driven by accelerated fixation rates of gene expression changes, amino acid substitutions and new genes in late spermatogenic stages, probably facilitated by reduced pleiotropic constraints, haploid selection and transcriptionally permissive chromatin. We identify temporal expression changes of in idual genes across species and conserved expression programs controlling ancestral spermatogenic processes. Genes predominantly expressed in spermatogonia (germ cells fuelling spermatogenesis) and Sertoli (somatic support) cells accumulated on X chromosomes during evolution, presumably owing to male-beneficial selective forces. Further work identified transcriptomal differences between X- and Y-bearing spermatids and uncovered that meiotic sex-chromosome inactivation (MSCI) also occurs in monotremes and hence is common to mammalian sex-chromosome systems. Thus, the mechanism of meiotic silencing of unsynapsed chromatin, which underlies MSCI, is an ancestral mammalian feature. Our study illuminates the molecular evolution of spermatogenesis and associated selective forces, and provides a resource for investigating the biology of the testis across mammals.
Publisher: Informa UK Limited
Date: 2017
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.PSYNEUEN.2017.05.028
Abstract: Chronic neck and shoulder pain (CNSP) is a common musculoskeletal disorder in adults, which is linked to hypersensitivity to noxious stimuli. The hormone oxytocin has been implicated as a potential therapeutic for the management of chronic pain disorders, and has been suggested to have sex-specific effects on the salience of threatening stimuli. This study investigated the influence of intranasal oxytocin on the perception of noxious thermal stimuli. Participants were 24 in iduals with CNSP lasting >12months (eight women), and 24 age- and sex-matched healthy, pain-free controls. In a randomised double-blind, placebo-controlled, cross-over study, participants attended two sessions, self-administering intranasal oxytocin (24 IU) in one session, and placebo in another. Participants rated intensity and unpleasantness of thermal heat stimuli at three body sites: the cervical spine, deltoid, and tibialis anterior, on 11-point numerical rating scales. Compared with placebo, intranasal oxytocin increased the perceived intensity of noxious heat stimuli in women with CNSP (Cohen's d=0.71), but not in men with CNSP, or healthy, pain-free controls. Men and women displayed ergent sensitivity across target sites for ratings of pain intensity (partial eta squared=0.12) and pain unpleasantness (partial eta squared=0.24), irrespective of drug condition. Men were more sensitive at the cervical spine and deltoid, whereas women were more sensitive at the tibialis. These findings suggest that oxytocin and endogenous sex hormones may interact to influence the salience of noxious stimuli. The hyperalgesic effects of oxytocin in women suggest that caution should be taken when considering oxytocin in the management of chronic pain. CT-2016-CTN-01313-1 ACTRN12616000532404.
Publisher: Informa UK Limited
Date: 14-09-2023
Publisher: Springer Science and Business Media LLC
Date: 05-05-2017
DOI: 10.1007/S10926-016-9642-5
Abstract: Purpose Traumatic injury is a leading cause of work disability. Receiving compensation post-injury has been consistently found to be associated with poorer return to work. This study investigated whether the relationship between receiving compensation and return to work was associated with elevated symptoms of psychological distress (i.e., anxiety, depression, and posttraumatic stress disorder) and perceived injustice. Methods Injured persons, who were employed at the time of injury (n = 364), were recruited from the Victorian State Trauma Registry, and Victorian Orthopaedic Trauma Outcomes Registry. Participants completed the Hospital Anxiety and Depression Scale, Posttraumatic Stress Disorder Checklist, Injustice Experience Questionnaire, and appraisals of pain and work status 12-months following traumatic injury. Results Greater financial worry and indicators of actual erceived injustice (e.g., consulting a lawyer, attributing fault to another, perceived injustice, sustaining compensable injury), trauma severity (e.g., days in hospital and intensive care, discharge to rehabilitation), and distress symptoms (i.e., anxiety, depression, PTSD) led to a twofold to sevenfold increase in the risk of failing to return to work. Anxiety, post-traumatic stress and perceived injustice were elevated following compensable injury compared with non-compensable injury. Perceived injustice uniquely mediated the association between compensation and return to work after adjusting for age at injury, trauma severity (length of hospital, admission to intensive, and discharge location) and pain severity. Conclusions Given that perceived injustice is associated with poor return to work after compensable injury, we recommend greater attention be given to appropriately addressing psychological distress and perceived injustice in injured workers to facilitate a smoother transition of return to work.
Publisher: Elsevier BV
Date: 2008
DOI: 10.1016/J.NEUBIOREV.2007.07.001
Abstract: Bodily experience is a complex, mostly unconscious, process that requires the integration of multiple sensory inputs. This paper reviews the sensory systems involved in internal representations of the body--primarily the proprioceptive, motor, vestibular, and visual systems. Various neurological disorders are defined by aberrations in bodily experience--including the perceptual ablation or disembodiment of body parts, "filling in" of utated body parts, or reduplication of body parts. These perceptual aberrations are discussed and their implications for the central and peripheral systems involved in updating and retrieving internal representations of the body are highlighted. Bodily perception and egocentric frames of reference can be experimentally manipulated through visual capture (e.g., using rubber limbs), functional adaptation and embodiment of tools and prostheses, and changes in afferent sensory feedback (e.g., through stimulation of muscle spindles). These perceptual illusions are described, and discussed for their implications for the mechanisms underlying bodily perception.
Publisher: Elsevier BV
Date: 11-2021
Publisher: Informa UK Limited
Date: 13-04-2023
Publisher: SAGE Publications
Date: 15-11-2017
Abstract: Research over the past three decades has seen a revived interest in the way the human body—and the way in which it is perceived—interacts with aspects of our experience. Consequently, interoception (i.e. the perception of physiological feedback from the body) has recently been shown to be associated with a wide range of cognitive, emotional, and affective functions, making it broadly relevant to the study of autism spectrum disorder. Although limited qualitative accounts and empirical studies suggest that in iduals with autism spectrum disorder encounter abnormalities when perceiving and integrating physiological feedback from their bodies, other studies have suggested that people with/without autism spectrum disorder do not differ in interoceptive ability after accounting for alexithymia. In this article, we discuss the newly recognized importance of interoception in autism spectrum disorder with a focus on how deficits in the perception of bodily feedback might relate to the core features and co-occuring psychopathology of autism spectrum disorder. Finally, a new integrated theory is advanced which posits that people with autism spectrum disorder may experience a reduced capacity to integrate interoceptive information that may result in a narrow attentional bodily focus and reduced motivational and behavioral drives.
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.NEUBIOREV.2009.10.007
Abstract: This paper reviews the current literature on "empathy for pain", the ability to understand pain observed in another person, in the context of a newly documented form of pain empathy "synaesthesia for pain". In synaesthesia for pain a person not only empathises with another's pain but experiences the observed or imagined pain as if it was their own. Neural mechanisms potentially involved in synaesthesia for pain include "mirror systems": neural systems active both when observing an action, or experiencing an emotion or sensation and when executing the same action, or personally experiencing the same emotion or sensation. For ex le, we may know that someone is in pain in part because observation activates similar neural networks as if we were experiencing that pain ourselves. We propose that synaesthesia for pain may be the result of painful and/or traumatic experiences causing disinhibition in the mirror system underlying empathy for pain. We will discuss this theory in the context of a documented group of utees who experience synaesthesia for pain in phantom limbs.
Publisher: Informa UK Limited
Date: 18-10-2021
DOI: 10.1080/09638288.2021.1988732
Abstract: How people perceive their injury may be associated with recovery. This scoping review used the Common Sense Model of Illness Perceptions (CSM) as a framework to: (1) characterise injury perceptions (2) describe biopsychosocial factors related to injury perceptions, and (3) determine how injury perceptions are associated with recovery outcomes. A broad search strategy was used across eight databases to identify studies exploring injury perceptions and related concepts in adults with traumatic orthopaedic injuries. Two reviewers independently screened and extracted data. Quality appraisal was performed using the Mixed Methods Appraisal Tool. The search yielded 9736 records, of which 22 publications were included 12 quantitative and 10 qualitative studies. Overall, the quality of the evidence was low to moderate. Consistent with the CSM, injury perceptions comprised beliefs relating to the injury diagnosis, consequences, causes, recovery duration, and treatments. Perceptions of injury were multidimensional and influenced by personal, inter-personal, and socio-cultural factors. Negative injury perceptions were associated with worse functional outcomes. Although this review provided some insight into the characteristics of injury perceptions, relationships between injury perceptions and recovery, and characteristics of perceptions across different socio-cultural or clinical settings are still poorly understood.Implications for rehabilitationA person's perception of their injury is complex it emerges from dynamic interactions between personal, interpersonal and socio-cultural elements.People who perceive that their injury represents a threat to them typically report higher pain, negative affect, and worse general health than people with more positive perceptions of injury.Rehabilitation providers should consider how they might positively influence perceptions of traumatic orthopaedic injury.Perceptions of injury might be influenced at the in idual level (e.g., during healthcare encounters), or at a system level, such as through endorsement of codes of practice for rehabilitation clinicians or funding of psychologically informed treatments to help people better understand their injuries.
Publisher: Public Library of Science (PLoS)
Date: 24-01-2020
Publisher: Elsevier BV
Date: 04-2007
DOI: 10.1016/J.BRAINRESREV.2007.01.009
Abstract: Phantom limbs provide valuable insight into the mechanisms underlying bodily awareness and ownership. This paper reviews the complexity of phantom limb phenomena (proprioception, form, position, posture and telescoping), and the various contributions of internal constructs of the body, or body schema, and neuromatrix theory in explaining these phenomena. Specific systems and processes that have received little attention in phantom limb research are also reviewed and highlighted as important future directions, These include prosthesis embodiment and extended physiological proprioception (i.e., the extension of the body's "area of influence" that thereby extends one's innate sense of proprioception, mirror neurons and cross-referencing of the phantom limb with the intact limb (and the related phenomena of perceiving referred sensations and mirrored movements in the phantom form the intact limb). The likely involvements of the body schema and the body-self neuromatrix, mirror neurons, and cross-callosal and ipsilateral mechanisms in phantom limb phenomena all suggest that the perception of a "normal" phantom limb (that is, a non-painful phantom that has the sensory qualities of an intact limb) is more than likely an epiphenomenon of normal functioning, action understanding and empathy, and potentially may even be evolutionarily adaptive and perhaps necessary. Phantom pain, however, may be a maladaptive failure of the neuromatrix to maintain global bodily constructs.
Publisher: Public Library of Science (PLoS)
Date: 05-06-2017
Publisher: Wiley
Date: 25-05-2016
DOI: 10.1002/EJP.895
Abstract: There is evidence that sensitivity to noxious stimuli differs between the sexes and across the body, but few studies have investigated differences in the perception and experience of acute pain stimuli across the body in healthy in iduals. We recruited 52 healthy participants, aged 18-36 (50% men) and administered 39, 42 and 45 °C stimuli at four body sites bilaterally to examine differences in the experience of pain intensity and unpleasantness between body sites via an 11-point numerical rating scale. Noxious and innocuous thermal heat stimuli were perceived as significantly more intense when delivered to the wrist (M = 3.98, SD = 1.93) and back (M = 4.07, SD = 1.98) compared to the shoulder (M = 3.45, SD = 1.91) and leg (M = 3.46, SD = 1.87). Pain unpleasantness ratings yielded similar findings stimuli were perceived as more unpleasant when administered to the wrist (M = 2.83, SD = 1.93) and lower back (M = 3.04, SD = 2.11) compared to the shoulder (M = 2.63, SD = 1.85) and leg (M = 2.26, SD = 1.82). These findings suggest that painful thermal stimuli delivered to the wrist and back are perceived as more intense and unpleasant compared with other body sites in healthy persons. These differences may be due to variations in receptor density, or the relative importance of these sites for daily living and survival. Moreover, these insights are helpful for the design of studies investigating pain experience in healthy persons in experimental or clinical settings. WHAT DOES THIS STUDY ADD?: We tested sensitivity to acute suprathreshold thermal stimulations across a range of body sites to investigate for potential variability. We found significant differences in the perceived intensity and unpleasantness of noxious and innocuous thermal stimuli at the wrist and lower back, compared with the shoulder and leg. These results suggest that pain experience is driven by receptor density or the relative functional importance of these sites.
Publisher: Informa UK Limited
Date: 2023
Publisher: Oxford University Press (OUP)
Date: 03-2015
DOI: 10.1111/PME.12586
Abstract: In iduals seeking treatment for chronic pain in multidisciplinary pain management services are typically already on high doses of pain medications. This cross-sectional cohort study of patients with long-term chronic pain examined profiles of polypharmacy and pain medication-related harm exposure. Multidisciplinary pain management service. The cohort comprised 224 patients taking medications for their pain (1-9 medications mean = 3.19) with an average pain duration of 10.33 years. The Medication Quantification Scale III (MQS-III) was used to examine potential harm exposure. We generated detriment scores for simple analgesics, adjunctive therapies (e.g., anticonvulsants), opioids, and benzodiazepines. The total MQS-III score was correlated with the total number of medications, but not with age. Almost 10% of patients took medications from all four categories, with most taking medications from two (37%) to three (35%) classes. Eighty percent of patients were taking opioids, accounting for 41% of total MQS scores. Five primary profiles of potential medication-related harms were identified: high harm from all medication categories (N = 12) above average harm from single category-simple analgesics (N = 76), adjunctive analgesics (N = 59), or opioids (N = 46) and above average opioid and benzodiazepine harm (N = 31). While treatment with multiple medications for synergistic or adjunctive effects may assist in medical management of chronic pain, this approach generates increased potential harm exposure. We show that the majority of detriment comes from medications other than opioids and highlight the importance of profiling all pain medications contributing to polypharmacy in clinical pain studies.
Publisher: Springer Science and Business Media LLC
Date: 03-2005
DOI: 10.1007/S10578-004-6461-2
Abstract: The structure of lay people's concepts of childhood mental disorder was investigated in a questionnaire study and examined for convergence with the Diagnostic and Statistical Manual (DSM-IV). Eighty-four undergraduates who had no formal education in abnormal psychology rated 54 conditions--36 DSM-IV childhood disorders and 18 non-disorders--on features proposed in technical definitions of mental disorder. The lay concept of childhood mental disorder was narrower than the DSM-IV, although most conditions were perceived to warrant professional help. Three dimensions described beliefs about childhood psychopathology: social deviancy, harmful dysfunction, and harmful environment. Harmful dysfunction was related to mental disorder and help seeking judgments.
Publisher: American Psychological Association (APA)
Date: 08-2022
DOI: 10.1037/REP0000453
Abstract: Purpose/Objective Research: This study aimed to examine patterns of pain and mental health after injury, and the patient characteristics associated with reductions in those symptoms. This registry-based observational cohort study included all people ≥ 16 years old hospitalized for unintentional injuries from 2007 to 2014 who were included in the Victorian State Trauma Registry or Victorian Orthopaedic Trauma Outcomes Registry, survived to 12-months postinjury and did not have severe brain injury or spinal cord injury ( Four classes were identified: (1) Low pain and mental health problems (49-54%) (2) mental health problems only (11-12%) (3) pain problems only (18-23%) and (4) pain and mental health problems (16-17%). Most people stayed within the same class over time, or transitioned to fewer problems. People who transitioned to lower problems had higher socioeconomic status (e.g., higher education level, higher neighborhood-level advantage, and employment), better preinjury health (e.g., no disability or substance use condition) and noncompensable injuries. Reduced pain and mental health symptoms and related impairments were primarily associated with nonmodifiable biological, social, or economic characteristics. People with persistent symptoms were often already living with social disadvantage preinjury, and may have benefited from risk screening and proactive interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Publisher: Oxford University Press (OUP)
Date: 16-09-2019
DOI: 10.1093/PM/PNZ209
Abstract: This study aimed to characterize the population prevalence of pain and mental health problems postinjury and to identify risk factors that could improve service delivery to optimize recovery of at-risk patients. This population-based registry cohort study included 5,350 adult survivors of transport-related major trauma injuries from the Victorian State Trauma Registry. Outcome profiles were generated separately for pain and mental health outcomes using the “pain or discomfort” and “anxiety or depression” items of the EuroQol Five Dimensions Three-Level questionnaire at six, 12, and 24 months postinjury. Profiles were “resilient” (no problems at every follow-up), “recovered” (problems at six- and/or 12-month follow-up that later resolved), “worsening” (problems at 12 and/or 24 months after no problems at six and/or 12 months), and “persistent” (problems at every follow-up). Most participants had persistent (pain/discomfort, N = 2,171, 39.7% anxiety/depression, N = 1,428, 26.2%) and resilient profiles (pain/discomfort, N = 1,220, 22.3% anxiety/depression, N = 2,055, 37.7%), followed by recovered (pain/discomfort, N = 1,116, 20.4% anxiety/depression, N = 1,025, 18.8%) and worsening profiles (pain/discomfort, N = 956, 17.5% anxiety/depression, N = 948, 17.4%). Adjusted multinomial logistic regressions showed increased risk of problems (persistent, worsening, or resolved) vs no problems (resilient) in relation to female sex, middle age, neighborhood disadvantage, pre-injury unemployment, pre-injury disability, and spinal cord injury. People living in rural areas, motorcyclists, pedal cyclists, and people with head, chest, and abdominal injuries had lower risk of problems. Targeted interventions delivered to people with the risk factors identified may help to attenuate the severity and impact of pain and mental health problems after transport injury.
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1016/J.NEUROPSYCHOLOGIA.2010.07.029
Abstract: Synaesthesia for pain is a phenomenon where a person experiences pain when observing or imagining another in pain. Anecdotal reports of this type of experience have most commonly occurred in in iduals who have lost a limb. Distinct from phantom pain, synaesthesia for pain is triggered specifically in response to pain in another. Here, we provide the first preliminary investigation into synaesthesia for pain in utees to determine the incidence and characteristics of this intriguing phenomenon. Self-referring utees (n=74) answered questions on synaesthesia for pain within a broader survey of phantom pain. Of the participants, 16.2% reported that observing or imagining pain in another person triggers their phantom pain. Further understanding of synaesthesia for pain may provide a greater insight to abnormal empathic function in clinical populations as well as therapeutic intervention for at risk groups.
Publisher: Elsevier BV
Date: 11-2015
DOI: 10.1016/J.CONCOG.2015.07.010
Abstract: We examined changes in pain sensitivity in the rubber hand illusion (RHI). Experiment 1 investigated changes in pain tolerance immediately after a "healthy" and "wounded" RHI when immersing the hand in a cold pressor ice bath. There was 19% increased pain tolerance and increased perception detection threshold after the healthy RHI, but 11% reduction after the wounded RHI. Experiment 2 examined pain experience during the wounded RHI with capsaicin-induced hyperalgesia. Pain intensity and unpleasantness was higher on the illusion arm during the synchronous RHI, compared with asynchronous trials. There was no change in pain experience on the control arm, and both arms had similar pain sensitivity after the experiment. Our results highlight the impact of embodying a substitute limb on pain, with increased tolerance and reduced tactile sensitivity when the fake limb is healthy and apparently pain-free, but increased pain sensitivity when the self-attributed limb appears to be wounded.
Publisher: Springer Science and Business Media LLC
Date: 09-12-2019
DOI: 10.1007/S10926-019-09867-W
Abstract: Purpose To characterise associations between fault attribution and work participation and capacity after road traffic injury. Methods People aged 15-65 years, working pre-injury, without serious brain injury, who survived to 12 months after road traffic injury were included from two Victorian trauma registries (n = 2942). Fault profiles from linked compensation claims were defined as no other at fault, another at fault, denied another at fault, claimed another at fault, and unknown. Claimant reports in the denied and claimed another at fault groups contradicted police reports. Patients reported work capacity (Glasgow outcome scale-extended) and return to work (RTW) at 6, 12 and 24 months post-injury (early and sustained RTW, delayed RTW (≥ 12 months), failed RTW attempts, no RTW attempts). Analyses adjusted for demographic, clinical and injury covariates. Results The risk of not returning to work was higher if another was at fault [adjusted relative risk ratio (aRRR) = 1.67, 95% confidence interval (CI) 1.29, 2.17] or was claimed to be at fault (aRRR = 1.58, 95% CI 1.04, 2.41), and lower for those who denied that another was at fault (aRRR = 0.51, 95% CI 0.29, 0.91), compared to cases with no other at fault. Similarly, people had higher odds of work capacity limitations if another was at fault (12m: AOR = 1.49, 95% CI 1.24, 1.80 24m: 1.63, 95% CI 1.35, 1.97) or was claimed to be at fault (12m: AOR = 1.54, 95% CI 1.16, 2.05 24m: AOR = 1.80, 95% CI 1.34, 2.41), and lower odds if they denied another was at fault (6m: AOR = 0.67, 95% CI 0.48, 0.95), compared to cases with no other at fault. Conclusion Targeted interventions are needed to support work participation in people at risk of poor RTW post-injury. While interventions targeting fault and justice-related attributions are currently lacking, these may be beneficial for people who believe that another caused their injury.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.NEULET.2012.09.036
Abstract: 'Mirror pain' describes when the observation of another's pain experience induces a personal experience of pain. It has been suggested that mirror pain could result from changes in neural excitability or inhibition. In this study we used transcranial magnetic stimulation (TMS) to investigate motor cortical excitability in lower-limb utees who experience mirror pain. Using paired-pulse TMS to assess motor cortical inhibition (CI) and cortical facilitation (CF), recordings were taken from the right first dorsal interosseus in lower-limb utees who experience mirror pain (MP+), lower-limb utees who do not experience mirror pain (MP-), and non- utee controls. No differences in CI or CF were observed between the MP+ and both control groups. Thus, when not paired with a pain-related stimulus, changes in motor cortical excitability do not appear to contribute to the experience of mirror pain in lower-limb utees.
Publisher: Frontiers Media SA
Date: 2013
Publisher: SAGE Publications
Date: 2010
DOI: 10.1068/P6519
Abstract: The bodily boundaries in utees may seem to be more malleable than in non- utees, given the propensity for a phantom limb to embody a mirror-reflected hand. However, in the present investigation, in which phantom-limb illusions within body space are induced and manipulated, we found that perceiving phantom sensations and illusory embodiment does not require utation. Surprisingly, in the present modified rubber-hand illusion, we found that simultaneous stroking or stimulation of the participant's target hand was not necessary to induce illusions of embodiment and corresponding perceptual illusions. We tested this upper-limb paradigm in fourteen upper-limb utees and twenty-six controls (including fourteen lower-limb utees). We propose a model for embodiment of a rubber or real hand passively observed in a mirror. In this model, passive observation of the hand in the mirror triggers body representations (body image and body schema), most likely through activation of the posterior parietal cortex and temporo-parietal junction. Activity in these regions heightens awareness of peripersonal space and increases tactile sensitivity, and may subsequently enhance perception of illusory touch and embodiment. Furthermore, sense of embodiment may be more apparent to the participant when the hand is threatened however, embodiment may even be strengthened when the motor system is engaged, evoking motor schemata to support the more easily induced perceptual embodiment via body image.
Publisher: Springer Science and Business Media LLC
Date: 14-10-2016
DOI: 10.3758/S13414-016-1217-1
Abstract: There is growing evidence that enhanced sensitivity to painful clinical procedures and chronic pain are related to greater sensitivity to other sensory inputs, such as bitter taste. We examined cross-modal sensitivities in two studies. Study 1 assessed associations between bitter taste sensitivity, pain tolerance, and fear of pain in 48 healthy young adults. Participants were classified as non-tasters, tasters and super-tasters using a bitter taste test (6-n-propythiouracil PROP). The latter group had significantly higher fear of pain (Fear of Pain Questionnaire) than tasters (p=.036, effect size r = .48). There was only a trend for an association between bitter taste intensity ratings and intensity of pain at the point of pain tolerance in a cold pressor test (p=.04). In Study 2, 40 healthy young adults completed the Adolescent/Adult Sensory Profile before rating intensity and unpleasantness of innocuous (33 °C), moderate (41 °C), and high intensity (44 °C) thermal pain stimulations. The sensory-sensitivity subscale was positively correlated with both intensity and unpleasantness ratings. Canonical correlation showed that only sensitivity to audition and touch (not taste/smell) were associated with intensity of moderate and high (not innocuous) thermal stimuli. Together these findings suggest that there are cross-modal associations predominantly between sensitivity to exteroceptive inputs (i.e., taste, touch, sound) and the affective dimensions of pain, including noxious heat and intolerable cold pain, in healthy adults. These cross-modal sensitivities may arise due to greater psychological aversion to salient sensations, or from shared neural circuitry for processing disparate sensory modalities.
Publisher: BMJ
Date: 19-04-2020
DOI: 10.1136/INJURYPREV-2019-043195
Abstract: Understanding the impact of comorbidity on health outcomes is important given that comorbidities can affect survival, morbidity, service delivery costs and healthcare utilisation. However, little is known about the types of comorbidities affecting specific health outcomes after minor to moderate road trauma. This study involved 1574 participants who claimed injury compensation following transport-related injury. Cross sectional data were collected. Health outcomes were assessed using the EQ-5D-3L specific domains and summary score. Twelve self-reported pre-existing chronic conditions were assessed using a multivariate logistic regression, adjusting for demographic and injury characteristics. Out of 1574 participants, only 17 (1%) participants reported no pre-existing comorbidities, 72% reported one, 13% reported two and 14% reported three or more comorbidities. Hypertension (15%), depression (14%) and anxiety (14%) were the most commonly reported comorbidities, followed by arthritis (13%), chronic pain (11%) and asthma (11%). Participants with a history of arthritis (adjusted odds ratio [AOR] 1.90, 95% CI 1.24 to 2.91) chronic back pain (AOR 1.59, 95% CI, 1.04 to 2.43) other chronic pain (AOR 2.73, 95% CI 1.42 to 4.24) depression (AOR 2.55, 95% CI 1.60 to 4.05) and anxiety (AOR 2.08, 95% CI 1.32 to 3.26) were at increased risk of poorer health outcomes, after controlling for age, gender, type of injury and time since injury. This study found that comorbidities such as arthritis, chronic back pain, other chronic pain, depression and anxiety significantly increase the odds of poorer health postinjury, regardless of the time since injury. Regular screening of comorbid conditions may help identify people likely to have poorer outcomes, thereby enabling the implementation of interventions to optimise health despite the presence of comorbidities.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2016
DOI: 10.1097/AJP.0000000000000342
Abstract: Motor vehicle collisions (MVC) are a major cause of injury, which frequently lead to chronic pain and prolonged disability. Several studies have found that seeking or receiving financial compensation following MVC leads to poorer recovery and worse pain. We evaluated the evidence for the relationship between compensation and chronic pain following MVC within a biopsychosocial framework. A comprehensive search of 5 computerized databases was conducted. Methodological quality was evaluated independently by 2 researchers according to formal criteria, and discrepancies were resolved with a third reviewer. We identified 5619 studies, from which 230 full-text articles were retrieved and 27 studies were retained for appraisal. A third of studies (37%) were of low quality, and 44% did not measure or control for factors such as injury severity or preinjury pain and disability. Most studies (70%) reported adverse outcomes, including all of the highest quality studies. Engagement with compensation systems was related to more prevalent self-reported chronic pain, mental health disorders, and reduced return to work. Recovery was poorer when fault was attributed to another, or when a lawyer was involved. Five studies compared Tort “common law” and No-Fault schemes directly and concluded that Tort claimants had poorer recovery. Although causal relationships cannot be assumed, the findings imply that aspects of loss, injustice, and secondary mental health outcomes lead to chronic pain following MVC. Further robust prospective research is required to understand the complex relationship between compensation systems and pain following road trauma, particularly the role of secondary mental health outcomes.
Publisher: Springer Science and Business Media LLC
Date: 25-05-2021
Publisher: Wiley
Date: 19-01-2016
DOI: 10.1113/JP271498
Publisher: Springer Science and Business Media LLC
Date: 25-05-2011
Abstract: We describe the case of a patient who experienced phantom pain that began 42 years after right above-the-knee utation. Immediately prior to phantom pain onset, this long-term utee had experienced, in rapid succession, cancer, hemicolectomy, chemotherapy, and thrombotic occlusion. Very little has been published to date on the association between chemotherapy and exacerbation of neuropathic pain in utees, let alone the phenomenon of bringing about pain in utees who have been pain-free for many decades. While this patient presented with a unique profile following a rare sequence of medical events, his case should be recognized considering the frequent co-occurrence of osteomyelitis, chemotherapy, and utation. A 68-year-old Australian Caucasian man presented 42 years after right above-the-knee utation with phantom pain immediately following hemicolectomy, thrombotic occlusion in the utated leg, and chemotherapy treatment with leucovorin and 5-fluorouracil. He exhibited probable hyperalgesia with a reduced pinprick threshold and increased stump sensitivity, indicating likely peripheral and central sensitization. Our patient, who had long-term nerve injury due to utation, together with recent ischemic nerve and tissue injury due to thrombosis, exhibited likely chemotherapy-induced neuropathy. While he presented with unique treatment needs, cases such as this one may actually be quite common considering that osteosarcoma can frequently lead to utation and be followed by chemotherapy. The increased susceptibility of utees to developing potentially intractable chemotherapy-induced neuropathic pain should be taken into consideration throughout the course of chemotherapy treatment. Patients in whom chronic phantom pain then develops, perhaps together with mobility issues, inevitably place greater demands on healthcare service providers that require treatment by various clinical specialists, including oncologists, neurologists, prosthetists, and, most frequently, general practitioners.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.NEUBIOREV.2015.03.004
Abstract: There is growing evidence that chronic pain conditions can have an associated central pathology, involving both cortical reorganisation and an incongruence between expected and actual sensory-motor feedback. While such findings are primarily driven by the recent proliferation of neuroimaging studies, the psychophysical tasks that complement those investigations have received little attention. In this review, we discuss the literature that involves the subjective appraisal of body representation in patients with chronic pain. We do so by examining three broad sensory systems that form the foundations of the sense of physical self in patients with common chronic pain disorders: (i) reweighting of proprioceptive information (ii) altered sensitivity to exteroceptive stimuli and, (iii) disturbed interoceptive awareness of the state of the body. Such findings present compelling evidence for a multisensory and multimodal approach to therapies for chronic pain disorders.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2017
DOI: 10.1097/AJP.0000000000000423
Abstract: Cognitive functioning is commonly disrupted in people living with chronic pain, yet it is an aspect of pain that is often not routinely assessed in pain management settings, and there is a paucity of research on treatments or strategies to alleviate the problem. The purpose of this review is to outline recent research on cognitive deficits seen in chronic pain, to give an overview of the mechanisms involved, advocate cognitive functioning as an important target for treatment in pain populations, and discuss ways in which it may be assessed and potentially remediated. A narrative review. There are several options for remediation, including compensatory, restorative, and neuromodulatory approaches to directly modify cognitive functioning, as well as physical, psychological, and medication optimization methods to target secondary factors (mood, sleep, and medications) that may interfere with cognition. We highlight the potential to enhance cognitive functions and identify the major gaps in the research literature.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.INJURY.2018.08.008
Abstract: Persistent pain and mental health conditions often co-occur after injury, cause enormous disability, reduce social and economic participation, and increase long-term healthcare costs. This study aimed to characterise the incidence, profile and healthcare cost implications for people who have a treated mental health condition, persistent pain, or both conditions, after compensable transport injury. The study comprised a population cohort of people who sustained a transport injury (n = 74,217) between 2008 to 2013 and had an accepted claim in the no-fault transport compensation system in Victoria, Australia. Data included demographic and injury characteristics, and payments for treatment and income replacement from the Compensation Research Database. Treated conditions were identified from 3 to 24-months postinjury using payment-based criteria developed with clinical and compensation system experts. Criteria included medications for pain, anxiety, depression or psychosis, and services from physiotherapists, psychologists, psychiatrists, and pain specialists. The data were analysed with Cox Proportional Hazards regression to examine rates of treated conditions, and general linear regression to estimate 24 month healthcare costs. Overall, the incidence of treated mental health conditions (n = 2459, 3.3%) and persistent pain (n = 4708, 6.3%) was low, but rates were higher in those who were female, middle aged (35-64 years), living in metropolitan areas or neighbourhoods with high socioeconomic disadvantage, and for people who had a more severe injury. Healthcare costs totalled more than $A707 M, and people with one or both conditions (7.7%) had healthcare costs up to 7-fold higher (adjusting for demographic and injury characteristics) in the first 24 months postinjury than those with neither condition. The incidence of treated mental health and persistent pain conditions was low, but the total healthcare costs for people with treated conditions were markedly higher than for people without either treated condition. While linkage with other public records of treatment was not possible, the true incidence of treated conditions is likely to be even higher than that found in this study. The present findings can be used to prioritise the implementation of timely access to treatment to prevent or attenuate the severity of pain and mental health conditions after transport injury.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-01-2018
DOI: 10.1097/J.PAIN.0000000000001150
Abstract: Chronic pain is associated with reduced efficiency of cognitive performance, and few studies have investigated methods of remediation. We trialled a computerised cognitive training protocol to determine whether it could attenuate cognitive difficulties in a chronic pain s le. Thirty-nine adults with chronic pain (mean age = 43.3, 61.5% females) were randomised to an 8-week online course (3 sessions/week from home) of game-like cognitive training exercises, or an active control involving watching documentary videos. Participants received weekly supervision by video call. Primary outcomes were a global neurocognitive composite (tests of attention, speed, and executive function) and self-reported cognition. Secondary outcomes were pain (intensity interference), mood symptoms (depression anxiety), and coping with pain (catastrophising self-efficacy). Thirty participants (15 training and 15 control) completed the trial. Mixed model intention-to-treat analyses revealed significant effects of training on the global neurocognitive composite (net effect size [ES] = 0.43, P = 0.017), driven by improved executive function performance (attention switching and working memory). The control group reported improvement in pain intensity (net ES = 0.65, P = 0.022). Both groups reported subjective improvements in cognition (ES = 0.28, P = 0.033) and catastrophising (ES = 0.55, P = 0.006). Depression, anxiety, self-efficacy, and pain interference showed no change in either group. This study provides preliminary evidence that supervised cognitive training may be a viable method for enhancing cognitive skills in persons with chronic pain, but transfer to functional and clinical outcomes remains to be demonstrated. Active control results suggest that activities perceived as relaxing or enjoyable contribute to improved perception of well-being. Weekly contact was pivotal to successful program completion.
Publisher: Wiley
Date: 08-2011
DOI: 10.1016/J.EJPAIN.2011.01.005
Abstract: Phantom phenomena are frequent following utation, but how this often painful experience is modified or triggered by spontaneous events or sensations often puzzles utees and clinicians alike. We explored triggers of phantom phenomena in a heterogeneous s le of 264 upper and lower limb adult utees with phantom sensations. Participants completed a structured questionnaire to determine the prevalence and nature of the triggers of phantom phenomena. The four categories of triggers identified include: (a) a quarter of participants experiencing psychological, emotional or autonomic triggers (b) half experiencing behavioral triggers, "forgetting" the limb's absence and attempting to use the phantom (c) one-fifth experiencing weather-induced triggers and (d) one-third experiencing sensations referred from parts of the body. Upper limb utees and were more likely to experience weather-induced phantom phenomena than lower limb utees and upper and lower limb utees were equally likely to experience referred sensations from the genitals, contradicting the homuncular remapping hypothesis. Traumatic utees were more likely to report emotional triggers. Further, while those with emotional triggers exhibited poorer acceptance of the limitations of utation, they were more likely to employ adaptive coping mechanisms. Finally, habitual "forgetting" behaviors were most common soon after utation, whereas other more adaptive schemata (e.g., self-defense) were equally likely to be performed at any time following utation. Various likely inter-related mechanisms are discussed in relation to phantom triggers. Ultimately, optimizing stump and neuroma management, as well as restoring function of central networks for pain, limb movement, and utation-related memories, should help manage spontaneously triggered phantom phenomena.
Publisher: Public Library of Science (PLoS)
Date: 27-01-2021
DOI: 10.1371/JOURNAL.PONE.0245636
Abstract: Road traffic injuries are a leading cause of morbidity and mortality globally. Understanding circumstances leading to road traffic injury is crucial to improve road safety, and implement countermeasures to reduce the incidence and severity of road trauma. We aimed to characterise crash characteristics of road traffic collisions in Victoria, Australia, and to examine the relationship between crash characteristics and fault attribution. Data were extracted from the Victorian State Trauma Registry for motor vehicle drivers, motorcyclists, pedal cyclists and pedestrians with a no-fault compensation claim, aged = 16 years and injured 2010–2016. People with intentional injury, serious head injury, no compensation claim/missing injury event description or who died = 12-months post-injury were excluded, resulting in a s le of 2,486. Text mining of the injury event using QDA Miner and Wordstat was used to classify crash circumstances for each road user group. Crashes in which no other was at fault included circumstances involving lost control or avoiding a hazard, mechanical failure or medical conditions. Collisions in which another was predominantly at fault occurred at intersections with another vehicle entering from an adjacent direction, and head-on collisions. Crashes with higher prevalence of unknown fault included multi-vehicle collisions, pedal cyclists injured in rear-end collisions, and pedestrians hit while crossing the road or navigating slow traffic areas. We discuss several methods to promote road safety and to reduce the incidence and severity of road traffic injuries. Our recommendations take into consideration the incidence and impact of road trauma for different types of road users, and include engineering and infrastructure controls through to interventions targeting or accommodating human behaviour.
Publisher: MDPI AG
Date: 29-10-2021
Abstract: Road trauma remains a significant public health problem. We aimed to identify sub-groups of motor vehicle collisions in Victoria, Australia, and the association between collision characteristics and outcomes up to 24 months post-injury. Data were extracted from the Victorian State Trauma Registry for injured drivers aged ≥16 years, from 2010 to 2016, with a compensation claim who survived ≥12 months post-injury. People with intentional or severe head injury were excluded, resulting in 2735 cases. Latent class analysis was used to identify collision classes for driver fault and blood alcohol concentration (BAC), day and time of collision, weather conditions, single vs. multi-vehicle and regional vs. metropolitan injury location. Five classes were identified: (1) daytime multi-vehicle collisions, no other at fault (2) daytime single-vehicle predominantly weekday collisions (3) evening single-vehicle collisions, no other at fault, 36% with BAC ≥ 0.05 (4) sunrise or sunset weekday collisions and (5) dusk and evening multi-vehicle in metropolitan areas with BAC 0.05. Mixed linear and logistic regression analyses examined associations between collision class and return to work, health (EQ-5D-3L summary score) and independent function Glasgow Outcome Scale - Extended at 6, 12 and 24 months. After adjusting for demographic, health and injury characteristics, collision class was not associated with outcomes. Rather, risk of poor outcomes was associated with age, sex and socioeconomic disadvantage, education, pre-injury health and injury severity. People at risk of poor recovery may be identified from factors available during the hospital admission and may benefit from clinical assessment and targeted referrals and treatments.
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.JPAIN.2016.03.005
Abstract: Awareness of limb position is derived primarily from muscle spindles and higher-order body representations. Although chronic pain appears to be associated with motor and proprioceptive disturbances, it is not clear if this is due to disturbances in position sense, muscle spindle function, or central representations of the body. This study examined position sense errors, as an indicator of spindle function, in participants with unilateral chronic limb pain. The s le included 15 in iduals with upper limb pain, 15 with lower limb pain, and 15 sex- and age-matched pain-free control participants. A 2-limb forearm matching task in blindfolded participants, and a single-limb pointer task, with the reference limb hidden from view, was used to assess forearm position sense. Position sense was determined after muscle contraction or stretch, intended to induce a high or low spindle activity in the painful and nonpainful limbs, respectively. Unilateral upper and lower limb chronic pain groups produced position errors comparable with healthy control participants for position matching and pointer tasks. The results indicate that the painful and nonpainful limb are involved in limb-matching. Lateralized pain, whether in the arm or leg, does not influence forearm position sense. Painful and nonpainful limbs are involved in bilateral limb-matching. Muscle spindle function appears to be preserved in the presence of chronic pain.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2011
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2017
DOI: 10.1097/PR9.0000000000000622
Abstract: Chronic pain is common after traumatic injury and frequently co-occurs with posttraumatic stress disorder (PTSD) and PTSD symptoms (PTSS). This study sought to understand the association between probable PTSD, PTSS, and pain. Four hundred thirty-three participants were recruited from the Victorian Orthopaedic Trauma Outcomes Registry and Victorian State Trauma Registry and completed outcome measures. Participants were predominantly male (n = 324, 74.8%) and aged 17-75 years at the time of their injury (M = 44.83 years, SD = 14.16). Participants completed the Posttraumatic Stress Disorder Checklist, Brief Pain Inventory, Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire, T a Scale of Kinesiophobia, EQ-5D-3L and Roland-Morris Disability Questionnaire 12 months after hospitalization for traumatic injury. Data were linked with injury and hospital admission data from the trauma registries. Those who reported having current problems with pain were 3 times more likely to have probable PTSD than those without pain. Canonical correlation showed that pain outcomes (pain severity, interference, catastrophizing, kinesiophobia, self-efficacy, and disability) were associated with all PTSSs, but especially symptoms of cognition and affect, hyperarousal, and avoidance. Posttraumatic stress disorder symptoms, on the contrary, were predominantly associated with high catastrophizing and low self-efficacy. When controlling for demographics, pain and injury severity, depression, and self-efficacy explained the greatest proportion of the total relationship between PTSS and pain-related disability. Persons with both PTSS and chronic pain after injury may need tailored interventions to overcome fear-related beliefs and to increase their perception that they can engage in everyday activities, despite their pain.
Publisher: SAGE Publications
Date: 2010
DOI: 10.1068/P6582
Abstract: Pain synaesthetes experience pain in a presensitised region when observing or imagining another person in pain. We conducted an upper-limb embodiment study using a modified rubber-hand illusion in which lower-limb utees originally participated as control subjects for the upper-limb utees. While we found all subjects experienced topographic illusory sensations, we also serendipitously found that lower-limb utee pain synaesthetes experienced pain or a motor response in their phantom leg when the embodied hand was threatened (eg with a retractable knife, mousetrap, or syringe) or submitted to high-frequency stimulation (eg vibration). Embodiment illusions were brought about by touching, manipulating, or threatening a rubber or real hand which was observed through a mirror so that it was superimposed upon the target hand (phantom hand for upper-limb utees, or real hand in others). Participants included eight pain synaesthetes (six lower-limb utees, one upper-limb utee, and one non utee), and thirty-one controls (eight lower-limb utees, twelve upper-limb utees, and eleven non- utees). We documented participant's subjective reports, together with quantitative measures including the Questionnaire Measure of Emotional Empathy. We found no association between pain synaesthesia and empathy scores. On the basis of related literature we suggest that pain synaesthetes likely experienced phantom-leg pain because (a) the motor system was already engaged during visual capture (b) threatening stimuli, to which they are hyper-vigilant, triggered avoidance or ‘escape’ motor schemata and (c) there could be no feedback confirming that initiated motor schemata for the phantom limb were successfully performed. Ultimately, we have further defined this new condition, synaesthesia for pain, as not only having a sensory pain component, but also a key motor component, manifesting itself in avoidance, contraction, and withdrawal ‘actions’.
Publisher: Informa UK Limited
Date: 16-06-2015
DOI: 10.1080/17588928.2015.1053853
Abstract: Ward and Bannisy's proposed conceptual framework-Threshold Theory and Self-Other Theory-for mirror touch synesthesia are welcomed as an explanation of mechanisms giving rise to innocuous vicarious phenomena. Herein we propose that these vicarious, or synesthetic, experiences should be considered along a spectrum of experiences, from innocuous through to noxious or threatening sensations. In particular, we would like to see these theories considered within a broader framework to explain the multitude of vicarious experiences that seem to share fundamental neurophysiological and trait characteristics.
Publisher: Wiley
Date: 12-2010
DOI: 10.1111/J.1532-5415.2010.03191.X
Abstract: To investigate the effect of a referral-based targeted multifactorial falls prevention intervention on the occurrence of recurrent falls and injuries in older people presenting to an emergency department (ED) after a fall and discharged directly home from the ED. Randomized controlled trial. Assessors of outcomes were unaware of group allocation. Seven EDs in metropolitan Melbourne, Australia. Inclusion criteria were community dwelling, aged 60 and older, presenting to an ED after a fall, and discharged directly home. Exclusion criteria were unable to follow simple instructions or walk independently. Targeted referrals to existing community services and health promotion recommendations, based on the falls risk factors found in a baseline assessment. Primary outcome measures were falls and resultant injuries occurring over the 12-month follow-up period. Falls and injury data were collected using falls calendars supported by medical record reviews. Three hundred sixty-one participants were randomized to the standard care group and 351 to the intervention group. No significant difference was found between the two groups over the 12-month follow-up period in number of fallers (relative risk (RR)=1.11, 95% confidence interval (CI)=0.95-1.31] or number of participants sustaining an injury from a fall (RR=1.06, 95% CI=0.86-1.29). This study does not support the use of a referral-based targeted multifactorial intervention program to reduce subsequent falls or fall injuries in older people who present to an ED after a fall.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2011
Publisher: Elsevier BV
Date: 09-2011
Publisher: Elsevier BV
Date: 12-2018
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.NEUBIOREV.2015.04.013
Abstract: In an acute environment pain has potential protective benefits. However when pain becomes chronic this protective effect is lost and the pain becomes an encumbrance. Previously unheralded substances are being investigated in an attempt to alleviate the burden of living with chronic pain. Oxytocin, a neuropeptide hormone, is one prospective pharmacotherapeutic agent gaining popularity. Oxytocin has the potential to modulate the pain experience due to its ubiquitous involvement in central and peripheral psychological and physiological processes, and thus offers promise as a therapeutic agent. In this review, we discuss previous effective applications of oxytocin in pain-free clinical populations and its potential use in the modulation of pain experience. We also address the slowly growing body of literature investigating the administration of oxytocin in clinical and experimentally induced pain in order to investigate the potential mechanisms of its reported analgesic actions. We conclude that oxytocin offers a potential novel avenue for modulating the experience of pain, and that further research into this area is required to map its therapeutic benefit.
Publisher: Wiley
Date: 27-05-2017
DOI: 10.1111/PSYP.12895
Abstract: Empathy involves both affective and cognitive components whereby we understand, and express concerns for, the experiences of others. Women typically have superior trait empathy compared with men, which seems to have a neurological basis with sex differences in the structure and function of neural networks involved in empathy. This study investigated sex differences in empathy for pain using the Empathy for Pain Scale, and examined whether these trait differences were associated with disruptions in autonomic regulation, specifically via the parasympathetic nervous system (measured through the square root of the mean squared differences of successive R-R intervals RMSSD) both at rest and during a socioevaluative stress task (i.e., the serial sevens task). Compared with men, women reported higher empathic concern (Cohen's r = .25) and affective distress (Cohen's d = 0.65) toward another in pain. In both men and women, there was a decrease in lnRMSSD in the stress task compared to rest. Sex moderated the relationship between resting lnRMSSD and self-reported empathic concern. Specifically, there was no clear association between empathic concern and lnRMSSD in men whereas in women there was a negative relationship, with lower resting lnRMSSD associated with higher empathic concern, and higher lnRMSSD associated with lower levels of empathic concern that were similar to men. These findings suggest that empathic feelings may result from poorer psychophysiological regulation, and concur with previous research displaying sex-specific relationships between resting heart rate variability and emotion regulation abilities.
Publisher: CSIRO Publishing
Date: 2007
DOI: 10.1071/AH070642
Abstract: This study aimed to explore how older people and health professionals conceptualise health in older age. Thirty-six older people and 41 health professionals participated in 10 focus groups (five with older people and five with health professionals) and discussed concepts of health, the modifiable aspects of health, and barriers and motivators to undertaking health-promoting behaviour change. Both older people and health professionals were found to conceptualise health in a holistic manner. While health professionals tended to place the source of poor health on failures of social connectedness and poor service delivery, older people stressed the importance of taking ownership of one?s own health and actively seeking out health promoting activities and services.
Publisher: Oxford University Press (OUP)
Date: 27-01-2021
DOI: 10.1093/PM/PNAB011
Abstract: This study examined which patient characteristics are associated with traveling further to attend a metropolitan, publicly funded pain management service, and whether travel distance was associated with differences in treatment profile, duration, and percentage of appointments attended. Cross-sectional observational cohort study. Patients ≤70 years of age with a single referral between January 2014 and June 2018 who had not died within 12 months of their first appointment and who had a usual place of residence were included (N = 1,684 mean age = 47.2 years 55.5% female). Travel distance was calculated with the HERE Routing API on the basis of historical travel times for each scheduled appointment. Median travel time was 27.5 minutes (Q1, Q3: 12.5, 46.2). Ordinal regression showed that women had 20% lower odds of traveling further, but people who were overweight or obese (odds ratio [OR] = 1.4–2.3), unemployed (OR = 1.27), or taking higher opioid dosages (OR = 1.79–2.82) had higher odds of traveling further. People traveling & minutes had fewer treatment minutes (median = 143 minutes) than people living within 15 minutes of the pain clinic (median = 440 minutes), and a smaller proportion of those traveling & minutes attended group programs vs. medical appointments only (n = 35, 17.0%) relative to those living within 15 minutes of their destination (n = 184, 32.6%). People living 16–30 minutes from the clinic missed the highest proportion of appointments. Although people traveling further for treatment may be seeking predominantly medical treatment, particularly opioid medications, the present findings highlight the need to further explore patient triage and program models of care to ensure that people living with persistent disabling pain can access the same level of care, regardless of where they live.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2016
DOI: 10.1097/AJP.0000000000000313
Abstract: People with chronic pain may experience impairments in high-level cognitive skills, particularly executive functions. Such impairments are not adequately measured in most clinical pain management settings yet could be a key influence on everyday functioning. We administered a well-validated, well-normed self-report measure to determine which aspects of executive functioning are compromised in the daily experience of patients with chronic pain, and whether these are associated with pain severity, medications, and mood. Sixty-three patients attending a multidisciplinary pain management clinic, and 66 pain-free age-matched and sex-matched controls, completed the Behavior Rating Inventory of Executive Function, Adult version (BRIEF-A). The BRIEF-A measures 9 aspects of executive function: Inhibit, Shift, Emotional Control, Initiate, Self-Monitor, Working Memory, Plan/Organize, Task Monitor, and Organization of Materials. Patients completed a battery of mood and pain-related measures. Profile analysis revealed that patients with chronic pain reported significantly greater overall executive function impairments than controls. The patients showed greatest impairments on Working Memory and Emotional Control subscales, with more than half scoring in the clinically elevated range. A significant proportion of the variance in these scores was explained by total medication detriment (but not opioids alone), negative emotional states, and pain interference. Pain intensity and duration were not strong predictors of reported executive dysfunction. Multiple factors impact on self-reported executive problems in this population. Specific deficits in Working Memory and Emotional Control have implications for patient engagement with treatment, and retention of information provided in therapy. A screening tool like the BRIEF-A may be useful in pain management settings.
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.PNPBP.2017.08.016
Abstract: Heart rate variability (HRV) refers to variation in the interval between successive heart beats. Low HRV is an indicator of potential autonomic nervous system dysfunction. People with chronic pain often display autonomic dysregulation, especially in the parasympathetic nervous system. The hormone oxytocin has been shown to increase HRV in non-clinical s les, but its potential impact on HRV in persons with chronic pain is unknown. This study investigated the impact of intranasal oxytocin on HRV in persons with chronic neck and shoulder pain. Participants included 24 in iduals with chronic neck and shoulder pain lasting >12months and 24 age- and sex-matched pain-free controls. In a randomised double-blind, placebo-controlled, cross-over study, participants self-administered intranasal oxytocin (24IU) in one session, and placebo in another, before HRV was recorded at rest and during a mental arithmetic task. Intranasal oxytocin did not influence HRV at rest. However, compared to placebo, intranasal oxytocin elicited small decreases in low-frequency and high-frequency HRV in both groups during the mental arithmetic task. These results suggest that intranasal oxytocin may enhance the salience of the mental arithmetic task, leading to reduced engagement of the parasympathetic nervous system when completing the task. Further investigation and replication of these findings are required to improve our understanding of the effects of intranasal oxytocin on autonomic functioning both at rest and under cognitive stress.
Location: Australia
Location: Australia
Start Date: 2012
End Date: 2015
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2015
End Date: 2015
Funder: Faculty of Medicine, Nursing and Health Sciences, Monash University
View Funded ActivityStart Date: 01-2017
End Date: 12-2020
Amount: $381,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 05-2013
End Date: 12-2016
Amount: $310,173.00
Funder: Australian Research Council
View Funded Activity