Biomedical subjects

Geert Crombez

Publications and source records attributed to Geert Crombez.

At least 19 recordsLinked to original sources

PubMed2006

The fear-avoidance model of musculoskeletal pain: current state of scientific evidence.

Research studies focusing on the fear-avoidance model have expanded considerably since the review by Vlaeyen and Linton (Vlaeyen J. W. S. & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85(3), 317--332). The fear-avoidance model is a cognitive-behavioral account that explains why a minority of acute low back pain sufferers develop a chronic pain problem. This paper reviews the current state of scientific evidence for the individual components of the model: pain severity, pain catastrophizing, attention to pain, escape/avoidance behavior, disability, disuse, and vulnerabilities. Furthermore, support for the contribution of pain-related fear in the inception of low back pain, the development of chronic low back pain from an acute episode, and the maintenance of enduring pain, will be highlighted. Finally, available evidence on recent clinical applications is provided, and unresolved issues that need further exploration are discussed.

Affect↗

PubMed2006

Antisociality, underarousal and the validity of the Concealed Information Polygraph Test.

The Concealed Information Polygraph Test has been advocated as the preferred method for the physiological detection of deception. In this study, we further examined the validity of the Concealed Information Test in antisocial individuals. Physiological responding to concealed information was assessed in 48 male prisoners, and compared with responding in 31 male community volunteers. Based upon the association between antisociality and autonomic hyporesponsivity, lower detection rates were expected in the prisoners. Participants were questioned on five personally significant items (e.g., day of birth), instructed to deny recognition of this information, and promised a financial reward when able to hide recognition. Prisoners showed reduced autonomic reactivity in comparison to the community volunteers. This hyporesponsivity had little impact on the sensitivity of the Concealed Information Test. Detection efficiency in the prisoners was significantly above chance (d=2.67; a=0.82; 79%), and did not differ significantly from that obtained in the community volunteers (d=3.04; a=0.85; 87%). The present data support the validity of the Concealed Information Test in criminal populations.

Adult↗

PubMed2006

Brief report: The accuracy of parents for the thoughts and feelings of their adolescent suffering from chronic fatigue: a preliminary study of empathy.

OBJECTIVE: This study examined the actual and estimated empathic accuracy (EA) of the parents of adolescents with chronic fatigue syndrome (CFS). METHODS: The actual EA of both parents (n = 24) was assessed in relation to the thoughts and feelings of their child (n = 14) about CFS and about other life events. Adolescents were also asked to estimate the parents' EA. RESULTS: For the actual EA, both parents were significantly less accurate regarding the adolescent's thoughts and feelings about CFS than about other life events. Fathers were just as empathically accurate as mothers. For the estimated EA, however, results indicated that adolescents perceived their mother to be more empathically accurate than their father. Actual EA and estimated EA about CFS were negatively correlated for fathers, not for mothers. CONCLUSIONS: Results are discussed in terms of the importance of assessing EA in relation to other dimensions of empathic understanding and distress in the observer.

Adolescent↗

PubMed2006

An experimental investigation on attentional interference by threatening fixations of the neck in patients with chronic whiplash syndrome.

Previous studies using a primary task procedure have demonstrated that an experimental pain stimulus interrupts ongoing task performance in healthy volunteers and patients, and that this interruption is intensified by catastrophic thinking about pain and the perceived threat value of the pain stimulus. However, no studies have investigated the interruption of attention by relevant threatening stimuli in specific patient samples. In the present study, 40 patients with chronic whiplash syndrome and 40 healthy controls performed a primary task while simultaneously a potentially threatening neck fixation (i.e., extension and rotation) was imposed. Pain catastrophizing, fear of movement/(re)injury, hypervigilance, and depression were assessed. The patients showed a more pronounced deterioration of performance compared to controls when the neck rotation and extension fixations were introduced. Within the groups, neither catastrophic thinking nor fear predicted the magnitude of the performance deterioration.

Anxiety↗

PubMed2006

The risk of being fearful or fearless of falls in older people: an empirical validation.

PURPOSE: To investigate the risk of being fearful or fearless of falls in older people. METHODS: Using a force plate, postural control in different sensory and rhythmic conditions was measured in 263 community-dwelling older people. Other assessments included fear of falling, and handgrip strength. Fall incidence was assessed at baseline and during a one-year follow-up period. RESULTS: Logistic regression analysis revealed that increased lateral sway in near-tandem stance with eyes open (OR = 5.33; p < 0.01) and a worse performance on anteroposterior rhythmic weight shifts (OR = 0.65; p < 0.05) were related to falls. Univariate analyses revealed that older people with inappropriate high fear of falling according to their fall incidence had worse balance capacities on the rhythmic weight shifts (p < 0.05) but had similar static balance and physical capacities. Older people with inappropriate low fear of falling had a better hand grip (p < 0.05) but equally worse balance capacities than the comparison group. CONCLUSIONS: The results indicate the importance of lateral stability in relation to falls. They also suggest a substantial impact of inappropriate fear of falling on physical performance. Inappropriate high fear of falling may result in worse performance during dynamic balance tests, whereas older people with inappropriate low fear seem to overrate their capacities because of higher strength.

Accidental Falls↗

PubMed2006

Do children with obesity implicitly identify with sedentariness and fat food?

We investigated whether youngsters with obesity (n=39) differed from a control group (n=39) in their self-reported attitudes towards and in their implicit identification with physical activity and food. Self-reported attitudes were assessed using a rating scale; implicit identification was assessed using a self-concept Implicit Association Task (IAT). Results revealed a marked group difference on the implicit identification with food: Only youngsters without obesity identified themselves more with non-fat food than with fat food.

Adolescent↗

PubMed2006

Finding a solution to the problem of pain: conceptual formulation and the development of the Pain Solutions Questionnaire (PaSol).

We report the development of the Pain Solutions Questionnaire (PaSol), an instrument designed to measure assimilative (efforts at changing or solving pain) and accommodative (accepting that pain cannot be solved, and changing life goals) responses to the problems associated with pain. Data were collected from 476 adults suffering from chronic pain. Exploratory and confirmatory factor analyses resulted in a 14-item instrument with an adequate oblique 4-factor structure: (1) Solving Pain scale (4 items), (2) Meaningfulness of Life Despite Pain scale (5 items), (3) Acceptance of the Insolubility of Pain scale (3 items), and (4) Belief in a Solution scale (2 items). The validity of the PaSol was further tested by its value in explaining disability and affective distress after controlling for the effects of the demographic characteristics and pain severity. The Meaningfulness of Life Despite Pain scale was important in explaining disability and affective distress. The Solving Pain scale had a unique and independent contribution in explaining affective distress. Results are discussed in terms of how a persistence in assimilative coping, even though the pain problem is insoluble, may increase hypervigilance, catastrophizing, distress and disability.

Adaptation, Psychological↗

PubMed2006

Parental catastrophizing about their child's pain. The parent version of the Pain Catastrophizing Scale (PCS-P): a preliminary validation.

Numerous studies have found evidence for the role of catastrophizing about pain in adjustment to pain in both adults and children. However, the social context influencing pain and pain behaviour has been largely ignored. Especially in understanding the complexities of childhood pain, family processes may be of major importance. In line with the crucial role of pain catastrophizing in explaining adjustment and disability in adults and children, this study investigates the role of parental catastrophic thinking about their child's pain in explaining child disability and parental distress. To study parental catastrophizing, a parent version of the Pain Catastrophizing Scale (PCS-P) was developed. An oblique three-factor structure emerged to best fit the data in both a sample of parents of schoolchildren (N=205) and in a sample of parents of children with chronic pain (N=107). Moreover, this three-factor structure was found to be invariant across both parent samples. Further, in the clinical sample, parents' catastrophic thinking about their child's pain had a significant contribution in explaining (a) childhood illness-related parenting stress, parental depression and anxiety, and (b) the child's disability and school attendance, beyond the child's pain intensity.

Adaptation, Psychological↗

PubMed2006

Why women prefer epidural analgesia during childbirth: the role of beliefs about epidural analgesia and pain catastrophizing.

This study investigated the reasons that might lead women to choose or not choose epidural analgesia as a strategy for the management of pain in childbirth. In our sample 55% of 114 women chose EA. Logistic regression resulted in a statistical model with four unique and independent predictors: Parity status and the fear of the side effects of EA each reduced the odds of choosing EA by half, whereas the desire to have a pain-free childbirth and positive experiences with EA of family and friends each doubled the odds of choosing EA. Pain catastrophizing was not related to EA use. The lack of an interrelationship between pain catastrophizing and EA use is probably due to an ambivalent attitude towards EA in pain catastrophizers. Pain catastrophizing was positively associated with the fear of being overwhelmed by labour pain and tendencies to avoid the pain, but also positively with the fear of pain during the insertion of the EA needle. Pain catastrophizing was also strongly related to recommendations to use EA from others, in particular from the midwife and from the gynecologist. Results are discussed in terms of the social impact of pain catastrophizing.

Adaptation, Psychological↗

PubMed2006

Components of attentional bias to threat in high trait anxiety: Facilitated engagement, impaired disengagement, and attentional avoidance.

There is a wealth of evidence demonstrating enhanced attention to threat in high trait anxious individuals (HTA) compared with low trait anxious individuals (LTA). In two experiments, we investigated whether this attentional bias is related to facilitated attentional engagement to threat or difficulties dis-engaging attention from threat. HTA and LTA undergraduates performed a modified exogenous cueing task, in which the location of a target was correctly or incorrectly cued by neutral, highly and mildly threatening pictures. Results indicate that at 100 ms picture presentation, HTA individuals more strongly engaged their attention with and showed impaired disengagement from highly threatening pictures than LTA individuals. In addition, HTA individuals showed a stronger tendency to attentional avoidance of threat at the 200 and 500 ms picture presentation. These data provide evidence for differential patterns of anxiety-related biases in attentive processing of threat at early versus later stages of information processing.

Adolescent↗

PubMed2006

Hypervigilance to learned pain signals: a componential analysis.

UNLABELLED: We report 2 experiments investigating hypervigilance to pain signals in healthy individuals. In order to allow a detailed analysis, we decomposed attention in 3 different processes: 1) initial shifting, 2) engagement, and 3) disengagement. We used a spatial cueing paradigm in which the location of targets is validly or invalidly predicted by spatial cues. In the first experiment, cues were differentially conditioned to create pain signals, allowing the investigation of engagement and disengagement of attention. Because this procedure does not allow an adequate isolation of the shift component, we introduced a new adaptation of the spatial cueing paradigm in the second experiment, in which targets instead of cues were differentially conditioned. We replicated previous findings, showing enhanced engagement to and retarded disengagement from pain signals compared to control signals. In addition, we demonstrated that participants were still hypervigilant to pain signals after extinction. We were not able to demonstrate speeded shifting to pain signals. Instead we found a generally faster detection of pain signals compared to control signals. We conclude that hypervilance to pain signals does not emerge as rapid initial shifting to the pain signal but rather as enhanced processing once it is detected. Theoretical and clinical implications of these findings are discussed. PERSPECTIVE: We investigated the fundamental processes associated with hypervigilance to pain. Our findings suggest that treatment approaches using attention techniques should not focus on preventing patients to shift their attention to the pain but rather on diminishing the threat value and learning to disengage from their pain.

Adolescent↗

PubMed2006

Well-being in patients with chronic fatigue syndrome: the role of acceptance.

OBJECTIVE: Research in chronic pain patients has shown that accepting the chronic nature of their illness is positively related to quality of life. The aim of this study was to investigate whether acceptance is also associated with better well-being in patients suffering from chronic fatigue syndrome (CFS). METHODS: Ninety-seven patients completed a battery of questionnaires measuring fatigue, functional impairment, psychological distress, and acceptance. RESULTS: Results indicated that acceptance has a positive effect upon fatigue and psychological aspects of well-being. More specifically, acceptance was related to more emotional stability and less psychological distress, beyond the effects of demographic variables, and fatigue severity. CONCLUSION: We suggest that promoting acceptance in patients with CFS may often be more beneficial than trying to control largely uncontrollable symptoms.

Activities of Daily Living↗

PubMed2006

The measurement of competitive anxiety during balance beam performance in gymnasts.

The purpose of the present study was to investigate competitive anxiety during balance beam performance in gymnasts. Competitive anxiety was assessed continuously by heart rate monitoring and by retrospective self-report of nervousness in eight female national level gymnasts during their balance beam routine during one competition and two training sessions. A significant negative correlation was found between the score of the retrospective self-report of nervousness and performance during the routine. There were no significant differences in performance score by the judges between the three test sessions. There were also no differences in the retrospective self-report of nervousness. However, heart rate was significantly higher during the competition session than during the training sessions. The potential value of the retrospective report of nervousness for the study of critical events during gymnastic performance is illustrated. The results are discussed in the light of catastrophe theory.

Adolescent↗

PubMed2006

Psychophysiological analysis (PSPHA): a modular script-based program for analyzing psychophysiological data.

In psychophysiological research, complex tailor-made and interactive analyses of biosignals (e.g., skin conductance, heart rate, and respiration) are often required. Moreover, a synchronization between experimental stimuli and psychophysiolgical responses is necessary. In this article, we present Psychophysiological Analysis (PSPHA), a modular script-based program for analyzing biosignals in the time domain. The modules can be integrated in a VBScript, and a wizard allows easy adaption of parameters. PSPHA is a free, interactive, and flexible program for analyzing the data of psychophysiological experiments.

Electronic Data Processing↗

PubMed2005

The role of extinction and reinstatement in attentional bias to threat: a conditioning approach.

We investigated the effects of extinction and reinstatement on attentional bias to fear-conditioned signals in healthy individuals using an emotional modification of a spatial cueing paradigm. Spatial cues were emotionally modulated using differential conditioning. The CS+ was sometimes followed by an aversive electrocutaneous stimulus (UCS), whereas the CS- was never followed by the UCS. During a subsequent extinction phase no UCS was presented anymore. The reinstatement phase started with one or four unpredicted UCS-only trials for half of the participants (reinstatement group). For the other half there were no additional UCS presentations (control group). We found that attention was biased to threat signals during acquisition. This biased attention largely disappeared during extinction. During the reinstatement phase attentional bias to threat signals re-emerged in the reinstatement group, but not in the control group.

Adolescent↗

PubMed2005

Worrying about chronic pain. An examination of worry and problem solving in adults who identify as chronic pain sufferers.

Worry is a common feature of chronic pain. The purpose of this study was to examine the extent of worry experienced by adults with chronic pain, and to explore features of problem solving associated with worry and chronic pain. A further purpose was to investigate whether there were differences in worry and problem solving for those presenting at a pain clinic for treatment, compared to those who identified as chronic pain sufferers but who were not presenting for treatment. A final purpose was to examine whether the extent of worry and problem solving attitudes helped to predict the primary clinical features of chronic pain such as intensity, disability and depressive mood. One hundred and eighty five adults with chronic pain provided completed questionnaires assessing worrying, problem solving, pain severity, disability, catastrophic thinking and depressive mood. Analyses showed that worry and problem solving approaches sampled in this study were not abnormal. Furthermore, no differences were found between the clinical and non-clinical sample for worrying and problem solving. In relation to the predictive value of worrying and problem solving, analyses revealed that only worrying had a unique contribution in explaining depressive mood. The results are discussed within a context of a model of worry and chronic pain, in which worry about chronic pain may be functioning to promote awareness of an insoluble problem.

Adaptation, Psychological↗

PubMed2005

Pain and pain-related fear are associated with functional and social disability in an occupational setting: evidence of mediation by pain-related fear.

This study examined the role of work-related, psychosocial and psychological factors in predicting functional and social disability in working employees. In a cross-sectional design, 890 working employees (reporting at least 1 day of back pain during the past year) completed self-report measures of back pain, disability, pain-related fear, negative and positive affectivity, job satisfaction, job stress and physical work load. Regression analyses revealed that pain intensity was a strong predictor of functional (beta = .69, p < .001) and social disability (beta = .67, p < .001). Fear of (re)injury due to movement (beta = .25, p < .001; beta = .28, p < .001) had additional predictive value in both models. Further, (singular) mediation tests indicated that fear for (re)injury partially mediated the relation between pain intensity and disability, and between negative affectivity and disability. Finally, path analyses revealed both fear and pain intensity as mediators between negative affectivity and disability. Overall, our findings point at the relevance of the cognitive-behavioral model of avoidance in occupational settings.

Adult↗

PubMed2005

The impact of chronic pain on adolescents: a review of previously used measures.

OBJECTIVE: To review the use of instruments to assess the impact of adolescent chronic pain, focussing on the development of instruments, the domains covered, psychometric properties, and published use with adolescent chronic pain patients. METHODS: Systematic literature searching recovered 706 articles, yielding 116 relevant articles, employing a total of 43 separate measurement instruments, which were subjected to content analysis. RESULTS: Most instruments were in the psychological domain (n = 22), with a self-report format (n = 36). Thirty instruments were specifically developed for adolescent populations; only 12 instruments had psychometric evaluation with adolescent chronic pain patients. The median use of any one instrument in published studies was two. Clinically relevant psychometric data were missing for many instruments. CONCLUSIONS: There is a diversity of instrumentation with some pockets of depth of use, but some domains of chronic pain experience with no routine assessment. Further development of the knowledge base of measurement of the impact of chronic adolescent pain is necessary.

Adolescent↗