Pain catastrophizing (PC) and pain-related self-efficacy (PSE) have both been shown to be associated with patient function in individuals with chronic pain, but the extent to which they may contribute independent variance to the prediction of pain and pain interference has been rarely examined. We conducted a secondary analysis of baseline data from a randomized controlled clinical trial with 177 individuals with chronic low back pain and/ or chronic pain associated with multiple sclerosis, muscular dystrophy, acquired amputation, and/ or spinal cord injury. We hypothesized PSE and PC would each be associated with pain interference (BPI), over and above the variance they share with each other and with a measure of pain intensity (0-10 NRS). Linear regression analyses revealed PC and PSE were each uniquely associated with BPI, after accounting for their shared variance and NRS. PC and PSE together accounted for substantial variance in BPI, over and above pain intensity, ΔR² = .20, F(1,170) = 59.74, p < .001, PC (B = 0.35, p < .001) and PSE (B = -0.20, p < .01). The findings indicate PSE and PC may play unique roles in adjustment to chronic pain, although PC may have larger effects. Conclusions regarding the causal role of PSE and PC on patient function cannot be determined from this cross-section study. However, future research should evaluate temporal and possible causal associations between PC, PSE, and subsequent changes in BPI and other important pain-related domains. Findings from such research would inform the potential importance of targeting these variables to maximize treatment benefits in individuals with chronic pain.

Prior research has established that the occurrence of headache in adolescence is more likely if one or more parents have a headache history. However, little is known about the prevalence of non-headache (i.e. musculoskeletal or abdominal) pain history among parents of adolescents with headaches, and whether adolescent headache characteristics (frequency, pain intensity, functional disability) differ among different parental pain histories. This analysis aimed to characterize the parental pain history of adolescents with recurrent migraine and tension-type headaches and examine if differences in parental pain history predicted different adolescent headache characteristics. 238 adolescents (mean age = 14.64 years (SD = 1.86), 67% female) who reported at least 10 headaches days per month completed a 28-day headache diary and a self-report questionnaire on headache-related disability. Parents (mean age = 44.06 years, SD = 6.04; 94% mothers) completed a pain history checklist. Results indicated that most parents had a positive pain history (78%). Parental musculoskeletal pain (55%) was just as prevalent as parental headache (54%; χ²(N = 226) = .098, p = .754), but abdominal pain (27%) was significantly less common (Headache: χ²(N = 227) = 30.306, p < .001; Musculoskeletal pain: χ²(N = 226) = 44.298, p < .001). Most parents reported pain at one site (35%), followed by two sites (29%), having no pain (23%), and pain at all three sites (14%). Adolescent headache characteristics were similar between parents with or without a pain history and when parents had a headache and/or musculoskeletal pain history, and were not associated with the number of parental pain sites (ps > .05). These findings indicate that any connection between parental and adolescent pain characteristics may be more complicated than a simple direct relationship. Future research should examine whether the characteristics of parental pain (e.g., parental pain intensity) are associated with headache characteristics in adolescents.

 The number of older adults ≥65 years with bothersome pain has increased in the past decade due to an increase in population size and life expectancy of older adults. Amongst several factors studied that may contribute to pain prevalence, socioeconomic status(SES) has been concluded in most studies to be more directly associated with pain prevalence rather than race/ethnicity. The objective of this project was to determine how physical function, due to pain, varies by race/ethnicity. We conducted a retrospective secondary analysis on the National Health & Trends Study(NHATS) to determine how Short Physical Performance Battery (SPPB) scores and secondary pain outcomes differed by race/ethnicity amongst participants who reported bothersome pain in 2011. Baseline race/ethnicity characteristics were gathered to characterize cohort. SPPB score and secondary outcomes for white(NH), black(NH), and hispanics were described for Rounds 1&2. Weighted, regression analysis were performed on SPPB scores to adjust for covariates using survey features. Results show a meaningful difference of SPPB scores among racial/ethnic groups that prompts for more research as to what factors may play a role in differences on the impact of pain on physical function by race/ethnicity.

Adolescence alcohol use and opioid addiction in adults are systemic issues afflicting the world, and thus, it is important to elucidate the long-term individual and relational consequences of both substance abuse disorders. The purpose of this experiment was to examine the long-term consequences of voluntary adolescent alcohol use on morphine tolerance, fentanyl self-administration, and the effects of previous opioid exposure on fentanyl self-administration in adulthood. Using a preclinical model to examine this hypothesis, adolescent rats had access to alcohol in gelatin form for twenty days, after which a three week withdrawal period occured. Morphine was then administered intraperitoneally for five days and morphine tolerance was measured by a tail-flick test for those five days. Finally, fentanyl self-administration occured in an operant chamber and self-administration will be measure by the amount of fentanyl consumed. My expected results were that adolescent alcohol use will increase morphine tolerance as evidenced by decreased tail-flick time, and fentanyl self-administration will also be increased. Additionally, I expect that previous opioid exposure will increase fentanyl self-administration. Future research should examine the neurobiological mechanisms by which adolescent alcohol use increases morphine tolerance and fentanyl self-administration and how previous opioid exposure increases fentanyl self-administration since these biological mechanism are not well understood.

Postoperative pain is common and associated with adverse short and long-term outcomes. Previous studies have identified preoperative pain as a predictor of postoperative pain, but persistent preoperative pain in the breast in women undergoing surgery for breast cancer has not been well explored. This cross-sectional observational study aimed to (1) identify demographic and clinical characteristics associated with preoperative breast pain and (2) determine the relationship between occurrence and location of persistent preoperative pain (in the breast, elsewhere, or both locations) and acute postoperative pain outcomes in women undergoing surgery for breast cancer. The study leveraged clinical and patient-reported outcome data collected by the multinational registry PAIN OUT between January 2011 and December 2018. Subgroups of women were identified based on occurrence and location of persistent preoperative pain (i.e., no persistent preoperative pain, preoperative pain in the breast, preoperative pain elsewhere, preoperative pain in the breast and elsewhere). 1,883 women at 62 participating institutions, aged 62 ± 14 years, who underwent surgery for breast cancer provided data. Controlling for pertinent demographic, clinical, and pharmacological characteristics, the independent relationship between persistent preoperative pain and acute postoperative pain intensity was evaluated. In general, women with preoperative breast pain had a higher body mass index and higher prevalence of affective disorder and women with preoperative pain elsewhere were older, had more comorbidities and a higher prevalence of hypertension. Persistent preoperative breast pain occurrence was associated with more severe acute postoperative pain and pain interference. Controlling for covariates, women with persistent preoperative pain in the breast (with or without pain elsewhere) experienced more severe acute postoperative pain, particularly compared to patients without persistent preoperative pain. Preoperative identification and targeted intervention of these subgroups at risk for severe acute postoperative pain following breast surgery may eventually enhance the recovery trajectory for breast cancer patients.

Treatments that can make lasting positive changes can also produce lasting negative ones. Both pharmacological and non-pharmacological pain interventions are used for both children and adults with chronic pain. However, adverse events are often underreported in psychological compared to pharmacological clinical trials. This study examines whether randomized controlled trials (RCTs) of psychological treatments for chronic pain in adults and children: 1) outlined a methodology for measuring adverse events, and 2) reported adverse events. We also aimed to develop a framework for assessing adverse events in psychological trials for chronic pain management. We included articles derived from three recent Cochrane reviews with a total of N = 40 adult trials and N = 23 pediatric trials (N = 15 in-person delivered and N = 8 remote/internet delivered). Each study was examined for whether: (1) a methodology for measuring adverse events was included, and (2) adverse events were reported. Of the 40 adult trials for chronic pain, only 10% (N = 4) included a methodology for measuring adverse events, and 25% (N = 10) reported adverse events. Of the 15 in-person pediatric trials, only 13% (N = 2) included a methodology and 47% (N = 7) reported adverse events. Of the eight remotely delivered pediatric trials, 13% (N = 1) included a methodology and 25% (N = 2) reported adverse events. The majority of published RCT’s over the past 10 years for psychological treatments for both adult and pediatric chronic pain failed to report adverse events in their results, and even fewer outlined assessment methodologies. Our next step is to provide a framework that will guide researchers in assessing adverse events in clinical trials of psychological treatments for chronic pain. Improved identification of adverse events will improve understanding of the safety of psychological treatments for children and adults with chronic pain.