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Biomedical subjects

Robert Gatchel

Publications and source records attributed to Robert Gatchel.

5 recordsLinked to original sources
PubMed2006

Emotional distress and medication use in two acute pain populations: jaw and low back.

The present study was undertaken to compare emotional distress and functional ability between two common pain populations--acute jaw pain (JAW; n = 135) and acute low back pain (LB; n = 71). Patient groups were evaluated and compared on a variety of biopsychosocial measures, including the Beck Depression Inventory (BDI), Multidimensional Pain Inventory (MPI), Characteristic Pain Intensity (CPI), and Ways of Coping Questionnaire. Specific diagnoses were assessed using the Structured Clinical Interview of the Diagnostic and Statistical Manual (DSM-IV)--I and II, and rates of Axis I and II diagnoses in these groups were further compared to base rates in the general population. Additionally, medication usage was evaluated to determine group differences. Results revealed that JAW patients had lower BDI and CPI scores, as well as a higher level of functioning on the Global Assessment of Functioning assessed by the DSM-IV. Both acute pain groups also had significantly more Axis I and II disorders than the general population. Additionally, it was found that the JAW group used more benzodiazepines, while the LB group used more schedule II narcotics. A logistic regression model created from these variables found a six-factor model, composed of the CPI, MPI coping style anomalous, Ways of Coping problem-solving, Global Assessment of Functioning, anxiety disorders, and Cluster C personality disorder diagnoses, that differentiated the JAW from the LB group. Overall, these findings suggest that the differences identified between these two groups should be considered in developing tailored treatments for individuals with acute low back and jaw pain.

Activities of Daily Living↗
PubMed2005

Improving return to work research.

BACKGROUND: Despite considerable multidisciplinary research on return to work (RTW), there has been only modest progress in implementation of study results, and little change in overall rates of work disability in developed countries. METHODS: Thirty RTW researchers, representing over 20 institutions, assembled to review the current state of the art in RTW research, to identify promising areas for further development, and to provide direction for future investigations. RESULTS AND CONCLUSION: Six major themes were selected as priority areas: early risk prediction; psychosocial, behavioral and cognitive interventions; physical treatments; the challenge of implementing evidence in the workplace context; effective methods to engage multiple stakeholders; and identification of outcomes that are relevant to both RTW stakeholders and different phases of the RTW process. Understanding and preventing delayed RTW will require application of new concepts and study designs, better measures of determinants and outcomes, and more translational research. Greater stakeholder involvement and commitment, and methods to address the unique challenges of each situation are required.

Humans↗
PubMed2005

Integrating psychosocial and behavioral interventions to achieve optimal rehabilitation outcomes.

INTRODUCTION: Psychosocial factors are important contributors to work disability associated with musculoskeletal conditions. The primary objectives of this paper were 1) to describe different psychosocial interventions that have been developed to prevent prolonged work disability, and 2) to identify future research directions that might enhance the impact of programs targeting psychosocial risk factors for work disability. METHODS: Selective review of scientific literature on psychosocial and behavioral interventions and work disability. RESULTS: Most prior interventions focused on psychosocial risk factors that exist primarily within the individual (e.g., pain catastrophizing, beliefs, expectancies). Successful disability prevention will require methods to assess and target psychosocial risk factors "outside" of the individual (e.g., interpersonal conflict in the workplace, job stress, etc.) using cost-effective, multipronged approaches. Research to explore interactions among different domains of psychosocial risk factors in relation to RTW outcomes is needed. Challenges to effective secondary prevention of work disability include developing competencies to enable a range of providers to deliver interventions, standardization of psychosocial interventions, and maximizing adherence to intervention protocols. CONCLUSION: Effective secondary prevention of work disability will require research to develop cost-effective, multipronged approaches that concurrently target both worker-related and workplace psychosocial risk factors.

Adaptation, Psychological↗
PubMed2005

Bioterrorism, stress, and pain: the importance of an anticipatory community preparedness intervention.

This article reviews the accumulating scientific evidence demonstrating the negative impact caused by a cataclysmic event, such as bioterrorism, on the mental health of a community. Moreover, the potential mental health problems created by the continuing threat of possible future events are discussed. This close link among disaster events, stress, pain, and psychopathology is presented from a biopsychosocial perspective. Although there are now efforts being systematically developed to prepare for possible future biological or chemical terrorism events, there is currently also a critical need for early mental health intervention in response to future attacks to decrease psychiatric sequelae, especially workforce illness and morbidity. In this article, examples of such emergency bioterrorism preparedness, incorporating a major focus on mental health issues, are reviewed. Although these are now recognized needs, there is still not a concerted effort to prepare the population for the mental health sequelae that would be produced by such events.

Adaptation, Psychological↗