Biomedical subjects

Lynanne McGuire

Publications and source records attributed to Lynanne McGuire.

9 recordsLinked to original sources

PubMed2006

Cognitive-Behavioral self-help for chronic pain.

Cognitive behavioral self-help is a potentially cost-saving method of delivering evidence-based treatment to a wide range of chronic pain patients. This article provides a rationale for self-help and focuses on the effectiveness of self-help in the management of chronic pain, which typically includes some degree of lay leader or professional facilitation. The evidence for these treatments is generally positive (e.g., reductions in pain and pain-related disability) across such illnesses as arthritis, back pain, headache, and temporomandibular joint disorders. When implementing self-help, professionals need to consider individual differences in suitability for using a self-management treatment and evaluate the outcome in the context of a stepped care approach. This article uses three case examples to illustrate the use of cognitive behavioral self-help delivered in the care of scleroderma patients.

Breathing Exercises↗

PubMed2006

Catastrophizing, pain, and social adjustment in scleroderma: relationships with educational level.

OBJECTIVES: Low educational attainment is related to numerous adverse health outcomes, and some evidence suggests that psychosocial variables may mediate education's effects. Moreover, the relationship between psychosocial functioning and health-related outcomes may be moderated by educational level, with individuals lower in formal education being more susceptible to the deleterious effects of negative cognitive and affective states. The present study sought to characterize such interrelationships between educational level and pain-related catastrophizing. METHODS: We investigated the association of self-reported educational level with pain and social disability, we evaluated catastrophizing's potential mediating role in those associations, and we also investigated education as a moderator of catastrophizing's effects on pain and social disability in a sample of patients with scleroderma, a frequently painful autoimmune disorder. RESULTS: First, education-related differences in pain report were accounted for by catastrophizing and depression. Second, after controlling for demographic factors, disease severity, and depressive symptoms, education moderated the relationship between catastrophizing, pain affect, and social function. Specifically, catastrophizing was more highly associated with greater reporting of affective pain among those with less formal education. In addition, catastrophizing inversely correlated with social disruption among individuals with less formal education. DISCUSSION: Collectively, study findings support multiple models of interaction between education and pain-related cognitive/affective functioning, though in both mediational and moderational analyses, lower levels of formal education act as a risk factor for adverse pain-related outcomes.

Adaptation, Psychological↗

PubMed2006

Pain and wound healing in surgical patients.

BACKGROUND: Human and animal laboratory studies have shown that stress delays healing of standardized punch biopsy wounds. PURPOSE: This 5-week prospective study of 17 women who underwent elective gastric bypass surgery addressed the association between postsurgical pain intensity and subsequent healing of a standard 2.0-mm punch biopsy wound. METHODS: Participants were assessed 1 week before surgery, within 3 hr before surgery, 1 to 3 days postsurgery, and at weekly intervals for 4 weeks following surgery. RESULTS: Patient ratings of greater acute postsurgical pain, averaged over Days 1 and 2 postsurgery, and greater persistent postsurgical pain, averaged over 4 weekly postsurgery pain ratings, were significantly associated with subsequent delayed healing of the punch biopsy wound. Presence of depressive symptoms on the day of surgery, pre-existing persistent pain, and medical complications following initial discharge from the hospital were not related to wound healing. Depressive symptoms on the day of surgery and pre-existing persistent pain did predict persistent postsurgical pain intensity. CONCLUSIONS: These findings extend the previous laboratory models of wound healing to a surgical population, providing the first evidence that pain plays an important role in postsurgery wound healing, a key variable in postsurgical recovery.

Adult↗

PubMed2004

Psychotic motivation and the paradox of current research on serious mental illness and rates of violence.

Persuasive empirical support exists for a positive association between serious mental illness (SMI) and rates of violence; a great deal of support is also present for the clinical impression that psychotic symptoms sometimes motivate "symptom-consistent" violence. We propose that the issue of the motivation for violence in the SMI population can be considered independently of the issue of the association between SMI and violence rates. We review much of the current literature on the association between SMI and violence in a framework that emphasizes motivational influences unique to the SMI population. We conclude that the contribution of psychotic motivation to rates of violence in the SMI population is a major research issue. Furthermore, we believe that recognition of the independence of motivational influences and violence rates, and consideration of the impact of treatment on violence, may help explain the paradox of current research: Delusions and hallucinations may motivate violent behavior, but this psychotic motivation may not be reflected in the actual rate of violence.

Delusions↗

PubMed2003

Psychologic factors in scleroderma.

CB interventions have been shown to reduce pain and improve psychosocial functioning in patients who have chronic illnesses, particularly chronically painful rheumatologic syndromes. These interventions are typically administered by specially trained professionals and are conducted during weekly individual or group sessions. When focused on pain and chronic illness, these interventions seem to have, at best, small effects on depression. Data from the headache literature and recent data about patients who have dental/facial pain indicate that minimal-contact CB therapy, the combination of some professional contact with audiotaped and written materials, may reduce pain in many patients, but the impact on functioning is less clear. Future studies should examine the impact of CB interventions on pain, depression, concerns about disfigurement, and physical and psychosocial functioning in scleroderma. Such knowledge is necessary for the optimal care of persons who have this debilitating illness. Although complicated, the advent of disease-specific interventions that are administered by way of the Internet may prove particularly useful in a rare illness, such as scleroderma. Psychologic factors with demonstrated relevance to scleroderma include pain, depression, and distress about disfigurement, physical function, and social function. Although these dimensions of quality of life are interrelated, pain, depression, and distress about disfigurement are common and may respond to psychologic interventions.

Adaptation, Psychological↗

PubMed2002

Psychoneuroimmunology: psychological influences on immune function and health.

This review focuses on human psychoneuroimmunology studies published in the past decade. Issues discussed include the routes through which psychological factors influence immune function, how a stressor's duration may influence the changes observed, individual difference variables, the ability of interventions to modulate immune function, and the health consequences of psychosocially mediated immune dysregulation. The importance of negative affect and supportive personal relationships are highlighted. Recent data suggest that immune dysregulation may be one core mechanism for a spectrum of conditions associated with aging, including cardiovascular disease, osteoporosis, arthritis, Type 2 diabetes, certain cancers, and frailty and functional decline; production of proinflammatory cytokines that influence these and other conditions can be stimulated directly by negative emotions and indirectly by prolonged infection.

Health Promotion↗

PubMed2002

Emotions, morbidity, and mortality: new perspectives from psychoneuroimmunology.

Negative emotions can intensify a variety of health threats. We provide a broad framework relating negative emotions to a range of diseases whose onset and course may be influenced by the immune system; inflammation has been linked to a spectrum of conditions associated with aging, including cardiovascular disease, osteoporosis, arthritis, type 2 diabetes, certain cancers, Alzheimer's disease, frailty and functional decline, and periodontal disease. Production of proinflammatory cytokines that influence these and other conditions can be directly stimulated by negative emotions and stressful experiences. Additionally, negative emotions also contribute to prolonged infection and delayed wound healing, processes that fuel sustained proinflammatory cytokine production. Accordingly, we argue that distress-related immune dysregulation may be one core mechanism behind a large and diverse set of health risks associated with negative emotions. Resources such as close personal relationships that diminish negative emotions enhance health in part through their positive impact on immune and endocrine regulation.

Adaptation, Psychological↗

PubMed2002

Depressive symptoms and lymphocyte proliferation in older adults.

In an 18-month prospective study, community-dwelling older adults, including both spousal caregivers of dementia patients and noncaregiving controls, were examined. Participants were selected on the basis of the presence or absence of chronic depressive symptoms that exceeded a cutoff score for clinically relevant depressive symptoms on a self-report symptom measure. Compared with nondepressed older adults, those with chronic, mild depressive symptoms had poorer T cell responses to 2 mitogens from baseline to follow-up. Additionally, among individuals with depressive symptoms, older age was associated with the poorest blastogenic response to the mitogens at follow-up. These findings extend the association between depression and immune function to community-dwelling older adults with chronic, mild depressive symptoms.

Aged↗

PubMedDate not supplied

Psychoneuroimmunology and psychosomatic medicine: back to the future.

OBJECTIVE: Although psychological modulation of immune function is now a well-established phenomenon, much of the relevant literature has been published within the last decade. This article speculates on future directions for psychoneuroimmunology research, after reviewing the history of the field. METHODS: This review focuses on human psychoneuroimmunology studies published since 1939, particularly those that have appeared in Psychosomatic Medicine. Studies were clustered according to key themes, including stressor duration and characteristics (laboratory stressors, time-limited naturalistic stressors, or chronic stress), as well as the influences of psychopathology, personality, and interpersonal relationships; the responsiveness of the immune system to behavioral interventions is also addressed. Additionally, we describe trends in populations studied and the changing nature of immunological assessments. The final section focuses on health outcomes and future directions for the field. RESULTS: There are now sufficient data to conclude that immune modulation by psychosocial stressors or interventions can lead to actual health changes, with the strongest direct evidence to date in infectious disease and wound healing. Furthermore, recent medical literature has highlighted a spectrum of diseases whose onset and course may be influenced by proinflammatory cytokines, from cardiovascular disease to frailty and functional decline; proinflammatory cytokine production can be directly stimulated by negative emotions and stressful experiences and indirectly stimulated by chronic or recurring infections. Accordingly, distress-related immune dysregulation may be one core mechanism behind a diverse set of health risks associated with negative emotions. CONCLUSIONS: We suggest that psychoneuroimmunology may have broad implications for the basic biological sciences and medicine.

Adaptation, Psychological↗