Scandinavian Journal of Pain最新文献

{"title":"Association between clinical laboratory indicators and WOMAC scores in Qatar Biobank participants: The impact of testosterone and fibrinogen on pain, stiffness, and functional limitation.","authors":"Ovelia Masoud, Linzette Morris, Mohammed Al-Hamdani, Amal Al-Haidose, Atiyeh M Abdallah","doi":"10.1515/sjpain-2024-0045","DOIUrl":"https://doi.org/10.1515/sjpain-2024-0045","url":null,"abstract":"<p><strong>Objectives: </strong>The association between baseline laboratory parameters and experienced well-being in healthy individuals remains uncertain. This study explored the relationship between clinical laboratory profiles and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, stiffness, and physical functional limitation in healthy individuals in Qatar.</p><p><strong>Methods: </strong>Clinical laboratory data were collected from 1,764 Qatar Biobank participants who also completed the WOMAC questionnaire: lipid profiles (high-density lipoprotein, low-density lipoprotein, cholesterol, and triglycerides), endocrine markers (TSH, T3, T4, estradiol, and testosterone), and two inflammatory markers (CRP and fibrinogen). Multiple linear regression was used with 11 clinical indicators as independent variables and the subscale and total WOMAC scores as dependent variables. Multivariate effects of each indicator on the outcomes were assessed, and univariate effects were examined when significant.</p><p><strong>Results: </strong>Testosterone had a significant impact on all WOMAC subscales (pain, stiffness, and functional limitation) and the total WOMAC score. Higher testosterone levels were associated with a reduction in pain (<i>β</i> = -0.03, <i>t</i> = -3.505, <i>p</i> < 0.001, 95% CI = -0.052, -0.015), stiffness (<i>β</i> = -0.01, <i>t</i> = -2.265, <i>p</i> = 0.024, 95% CI = -0.018, -0.001), physical dysfunction (<i>β</i> = -0.08, <i>t</i> = -3.265, <i>p</i> = 0.001, 95% CI = -0.135, -0.034), and total WOMAC scores (<i>β</i> = -0.127, <i>t</i> = -3.444, <i>p</i> < 0.001, 95% CI = -0.199, -0.055). Elevated fibrinogen levels were associated with an increase in stiffness (<i>β</i> = 0.155, <i>t</i> = 2.241, <i>p</i> = 0.025, 95% CI = 0.019, 0.290), physical dysfunction (<i>β</i> = 1.17, <i>t</i> = 2.808, <i>p</i> = 0.005, 95% CI = 0.354, 1.997), and total WOMAC scores (<i>β</i> = 1.610, <i>t</i> = 2.691, <i>p</i> = 0.007, 95% CI = 0.437, 2.784).</p><p><strong>Conclusion: </strong>Testosterone may protect against pain, stiffness, and physical dysfunction, while high fibrinogen levels might be a surrogate of systemic inflammation that enhances stiffness and limits physical function. Measuring multiple clinical and laboratory markers in healthy individuals may enhance our understanding of the molecular mechanisms underlying pain.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"25 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of non-invasive vagus nerve stimulation vs heart rate variability biofeedback interventions for chronic pain conditions: A systematic review.","authors":"Katie Pellow, Jackie Harrison, Paul Tucker, Brent Harper","doi":"10.1515/sjpain-2024-0037","DOIUrl":"10.1515/sjpain-2024-0037","url":null,"abstract":"<p><strong>Objectives: </strong>Autonomic regulation has been identified as a potential regulator of pain via vagal nerve mediation, assessed through heart rate variability (HRV). Non-invasive vagal nerve stimulation (nVNS) and heart rate variability biofeedback (HRVB) have been proposed to modulate pain. A limited number of studies compare nVNS and HRVB in persons with chronic pain conditions. This systematic review compared interventions of nVNS and HRVB in adults with long-standing pain conditions.</p><p><strong>Methods: </strong>PubMed, MEDLINE, CINAHL, SPORTDiscus, Google Scholar, and Cochrane library were used to retrieve the randomized controlled trials for this review between the years 2010 and 2023. Search terms included chronic pain, fibromyalgia, headache, migraine, vagus nerve stimulation, biofeedback, HRV, pain assessment, pain, and transcutaneous.</p><p><strong>Results: </strong>Ten full-text articles of 1,474 identified were selected for full qualitative synthesis, with a combined population of 813 subjects. There were <i>n</i> = 763 subjects in studies of nVNS and <i>n</i> = 50 subjects for HRVB. Six of the nine nVNS studies looked at headache disorders and migraines (<i>n</i> = 603), with two investigating effects on fibromyalgia symptoms (<i>n</i> = 138) and one the effects on chronic low back pain (<i>n</i> = 22). Of the nVNS studies, three demonstrated significant results in episode frequency, six in pain intensity (PI) reduction, and three in reduced medication use. The HRVB study showed statistically significant findings for reduced PI, depression scores, and increased HRV coherence.</p><p><strong>Conclusion: </strong>Moderate to high-quality evidence suggests that nVNS is beneficial in reducing headache frequency and is well-tolerated, indicating it might be an alternative intervention to medication. HRVB interventions are beneficial in reducing pain, depression scores, use of non-steroidal anti-inflammatory medication, and in increasing HRV coherence ratio. HRVB and nVNS appear to show clinical benefits for chronic pain conditions; however, insufficient literature exists to support either approach.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient characteristics in relation to opioid exposure in a chronic non-cancer pain population.","authors":"Henrik Grelz, Ulf Jakobsson, Patrik Midlöv, Marcelo Rivano Fischer, Åsa Ringqvist","doi":"10.1515/sjpain-2024-0025","DOIUrl":"https://doi.org/10.1515/sjpain-2024-0025","url":null,"abstract":"<p><strong>Objectives: </strong>The efficacy of long-term opioid therapy (LTOT) in treating patients with chronic non-cancer pain (CnCP) is questionable, and the potential risks of adverse effects are well established. The aims were as follows: (1) compare characteristics in patients exposed to LTOT vs non-exposed. (2) Regarding opioid-exposed patients, describe characteristics of patients with risk factors for opioid use disorder or overdose in relation to opioid dosage.</p><p><strong>Method: </strong>A cross-sectional study was conducted at a Swedish tertiary pain rehabilitation clinic serving CnCP patients. The study population comprised 1,604 patients ≥18 years old registered in the Swedish Quality Registry for Pain Rehabilitation between 2018 and 2020. Data on dispensed opioids were extracted from the Swedish Prescribed Drug Register. Dependent variables were as follows: LTOT vs non-LTOT and exposed opioid dosage <50 mg morphine equivalent/day (MME/day) vs ≥50 MME/day.</p><p><strong>Results: </strong>Of the included patients, 681 (42.5%) had at least one dispensation of opioids 180 days prior to assessment, 601 with a calculated opioid dosage ≥1 MME/day, and 424 (26.4%) were exposed to LTOT. The type of opioid prescribed was, in descending order, oxycodone (42.3% of all dispensations), codeine in combination with paracetamol (17.6%), tramadol (13.8%), and morphine (8.1%). A total of 89 cases had dosages of ≥50 MME/day and 430 patient dosages <50 MME/day. Patients exposed to LTOT exhibited an increased odds ratio (OR) of 2.685 (95% CI, 1.942-3.711) for concomitant use of benzodiazepines and male sex (OR, 1.694; 95% CI, 1.227-2.337). Patients receiving doses ≥50 MME/day were all, except one, exposed to LTOT. The concomitant use of benzodiazepines (OR 1.814, 95% CI 1.264-3.331) and male sex (OR, 1.777; 95% CI, 1.178-3.102) indicated a higher OR for opioid doses ≥50 MME/day.</p><p><strong>Conclusions: </strong>LTOT strongly influenced the opioid dose. Furthermore, concomitant benzodiazepine dispensation and male sex were over-represented in patients exposed to LTOT as well as those exposed to opioid doses ≥50 MME/day.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain perception while listening to thrash heavy metal vs relaxing music at a heavy metal festival - the CoPainHell study - a factorial randomized non-blinded crossover trial.","authors":"Anders Holm Welling, Anders Blom Nathansen, Sandra Egedie Lyby Taylor Pitter, Jesper Mølgaard, Anthony Henry Dickenson, Eske Kvanner Aasvang","doi":"10.1515/sjpain-2024-0070","DOIUrl":"10.1515/sjpain-2024-0070","url":null,"abstract":"<p><strong>Objectives: </strong>Music festivals are often a source of joy, but also a risk of injury. While previous studies suggest music can relieve pain, its effect has not been tested in festival settings, nor has the effect of high-energy vs soothing music been compared. We hypothesized that guests at a heavy metal music festival would experience less pain when listening to thrash heavy metal compared to relaxing music, with the effect being influenced by music preference and increased with higher alcohol intake.</p><p><strong>Methods: </strong>This factorial randomized non-blinded crossover trial assessed pain during a 5°C cold pressor test (CPT) at a heavy metal festival. Participants were randomized to listen to either Slayer's \"Raining Blood\" or Enya's \"Orinoco Flow\" during their first CPT, and the opposite song during the second CPT. The primary outcome was pain during the CPT, assessed as area under the curve (AUC). Music fondness and breath alcohol concentration (BrAC) were measured before each CPT.</p><p><strong>Results: </strong>Forty-five adults, aged 19-58 years, were included, and completed both CPTs. Significantly more pain was reported while listening to Enya (AUC 1,155 [IQR 588-1,507]) vs Slayer (AUC 975 [IQR 682-1,492]) (<i>p</i> = 0.048). Higher BrAC was associated with decreased pain (<i>p</i> = 0.042). Participants with higher fondness of Enya experienced significantly more pain than those who liked the song less (<i>p</i> = 0.021). Fondness of Slayer had no effect on pain perception (<i>p</i> = 0.7).</p><p><strong>Conclusion: </strong>Listening to thrash heavy metal, specifically \"Raining Blood\" by Slayer during painful stimuli results in lower pain intensity than listening to relaxing music in the form of \"Orinoco Flow\" by Enya. The findings' impact on pain in a clinical setting should be explored.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Christmas greetings 2024 from the Editor-in-Chief.","authors":"Mads Werner","doi":"10.1515/sjpain-2024-9998","DOIUrl":"https://doi.org/10.1515/sjpain-2024-9998","url":null,"abstract":"","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of substance use disorder diagnoses in patients with chronic pain receiving reimbursed opioids: An epidemiological study of four Norwegian health registries.","authors":"Torunn Hatlen Nøst, Svetlana Skurtveit, Ingvild Odsbu, Line Pedersen, Petter C Borchgrevink, Marte Handal","doi":"10.1515/sjpain-2024-0059","DOIUrl":"10.1515/sjpain-2024-0059","url":null,"abstract":"<p><strong>Objectives: </strong>Since 2008, patients have had access to reimbursed analgesics, including opioids, for chronic pain in Norway. There is a need for knowledge on the occurrence and trends over time of substance use disorder (SUD) diagnoses among patients who receive reimbursed opioids for chronic pain. The primary aim of this study was to investigate the prevalence of SUD diagnoses in patients with chronic pain using reimbursed opioids from 2010 to 2019 in Norway. The secondary aim was to investigate the prevalence of other mental health diagnoses among those receiving reimbursed opioids in the subgroups with and without SUD diagnoses.</p><p><strong>Methods: </strong>A cross-sectional design utilising data from four Norwegian nationwide registries.</p><p><strong>Results: </strong>The annual number of individuals with SUD diagnoses increased from 377 to 932 from 2010 to 2019, while the annual prevalence of individuals with SUD remained relatively stable at around 5%. There was a higher prevalence for all categories of other mental health diagnoses among individuals with a SUD diagnosis, compared to those without a SUD diagnosis.</p><p><strong>Conclusion: </strong>The prevalence of SUD diagnoses was low in the population using reimbursed opioids for chronic pain in Norway, but the number of patients increased in the study period because the number of individuals receiving reimbursed opioids increased. Patients with a SUD used on average twice the daily doses of opioids compared to patients without a SUD. They were also more likely to have an additional mental health diagnosis.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting opioid toxicity: Cellular effects of six commonly used opioids.","authors":"Erik Nylander, Frida Stam, Lenka Katila, Sofia Zelleroth, Jennifer Birgersson, Fred Nyberg, Mathias Hallberg, Alfhild Grönbladh","doi":"10.1515/sjpain-2024-0038","DOIUrl":"10.1515/sjpain-2024-0038","url":null,"abstract":"<p><strong>Objectives: </strong>There is an ongoing opioid crisis in the United States where the illicit and non-medical use of prescription opioids is associated with an increasing number of overdose deaths. Few studies have investigated opioid-induced effects on cell viability, and comparative studies are limited. Here, we examine the toxicity of six commonly used opioids: methadone, morphine, oxycodone, hydromorphone, ketobemidone, and fentanyl with respect to mitochondrial and membrane function <i>in vitro</i>.</p><p><strong>Methods: </strong>The opioids were tested in four different cell cultures: primary cortical cell cultures, human neuroblastoma SH-SY5Y cells, and both differentiated and undifferentiated neuroblastoma/glioma hybrid NG108-15 cells. The mitochondrial activity was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and the membrane integrity was assessed by measuring the leakage of lactate dehydrogenase. To compare the different opioids, the toxic dose (TD₅₀) was calculated.</p><p><strong>Results: </strong>The results displayed a similar trend of opioid-reduced cell viability in all four cell cultures. The most toxic opioid was methadone, followed by fentanyl, while morphine was overall ranked as the least toxic opioid displaying little to no negative impact on cell viability. The remaining opioids varied in rank between the different cell types.</p><p><strong>Conclusion: </strong>This <i>in vitro</i> study highlights opioid-dependent variations in toxicity across all four tested cell types, with methadone emerging as the most potent opioid.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of social exclusion on pain perception and heart rate variability in healthy controls and somatoform pain patients.","authors":"Fabrice Kleber, Andreas Reif, Moritz de Greck","doi":"10.1515/sjpain-2024-0042","DOIUrl":"10.1515/sjpain-2024-0042","url":null,"abstract":"<p><strong>Objectives: </strong>The overlapping neural networks of social and physical pain have been investigated intensively in recent years. It was postulated that triggering social pain might result in greater physical pain. Nonetheless, how this affects somatoform pain disorder has not yet been considered. Since an increased pain processing activity is reported in these patients, the investigation of social exclusion and its effect on this group seems interesting. Hence, the aim of this study was to compare the influence of social exclusion on healthy controls and patients with somatoform pain disorder.</p><p><strong>Methods: </strong>Nineteen patients with somatoform pain disorder and 19 healthy controls were examined. Cyberball, a virtual ball-tossing paradigm, was used to experimentally induce social exclusion and inclusion. To measure effects on pain perception, pressure pain thresholds and heart rate variability (HRV) were recorded after each round of cyberball. Demographic data, pain medication, and potential psychosocial moderators were collected by questionnaires.</p><p><strong>Results: </strong>After social exclusion, pressure pain thresholds were significantly reduced in healthy controls (<i>p</i> < 0.01) as well as somatoform pain patients (<i>p</i> < 0.05), while HRV increased only in patients with somatoform pain disorder (<i>p</i> < 0.05) indicating increased parasympathetic activity.</p><p><strong>Conclusion: </strong>This study is the first to analyse the effects of social exclusion on pain perception in somatoform pain disorder. While the reduction in pressure pain thresholds is in line with the social pain literature, the effects on HRV could be interpreted as a form of pain regulation mechanism. However, further research is needed to investigate the role of parasympathetic activity in socially excluded somatoform pain patients.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain catastrophizing levels differentiate between common diseases with pain: HIV, fibromyalgia, complex regional pain syndrome, and breast cancer survivors.","authors":"Reetta Sipilä, Eija Kalso, Harriet Kemp, Teemu Zetterman, Fabiola Escolano Lozano, Andrew S C Rice, Frank Birklein, Violeta Dimova","doi":"10.1515/sjpain-2024-0049","DOIUrl":"10.1515/sjpain-2024-0049","url":null,"abstract":"<p><strong>Objectives: </strong>Pain catastrophizing is a core psychological factor determining pain experience. We addressed the question of whether patients with different pain syndromes group into different pain catastrophizing phenotypes.</p><p><strong>Methods: </strong>A total of 727 patients with chronic pain associated with four primary syndromes: Breast cancer (BC) survivors (<i>n</i> = 400), fibromyalgia (FM, <i>n</i> = 52), complex regional pain syndrome (CRPS, <i>n</i> = 155), and HIV (<i>n</i> = 120) were first studied for differences in levels of pain catastrophizing (Pain Catastrophizing Scale, PCS) and pain intensity by analysis of variance. Subsequently, individual scores of the PCS subscales \"rumination\", \"magnification,\" and \"helplessness\" from the pooled cohorts were submitted to multivariate k-means clustering to explore subgroups.</p><p><strong>Results: </strong>Three clusters defined by the level of catastrophizing were identified. The \"low catastrophizing\" cluster (<i>n</i> = 377) included most of the BC patients (71.0%) and the \"moderate catastrophizing\" cluster (<i>n</i> = 256) most of the FM patients (61.5%). HIV (31.9%) and CRPS (44.7%) patients were over-represented in the \"high catastrophizing\" cluster (<i>n</i> = 94) with the highest catastrophizing tendencies in all dimensions. These patients reported more helplessness than the patients in the two other clusters.</p><p><strong>Conclusions: </strong>The primary syndrome causing the pain has an impact on self-reported pain-related catastrophizing. Helplessness is a predominant feature in HIV and CRPS patients and therefore an important target in pain rehabilitation.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To speak or not to speak? A secondary data analysis to further explore the context-insensitive avoidance scale.","authors":"Pernilla Abrahamsson, Katja Boersma, Monica Buhrman","doi":"10.1515/sjpain-2024-0039","DOIUrl":"10.1515/sjpain-2024-0039","url":null,"abstract":"<p><strong>Objectives: </strong>Inflexibly relying on avoidance of expression may increase and perpetuate pain-related emotional distress in patients with chronic pain. The context-insensitive avoidance (CIA) scale was recently developed to measure the degree to which patients avoid expressing their pain and distress in social situations. This study explored the psychometric properties of the CIA scale in a new sample.</p><p><strong>Methods: </strong>This study uses baseline data from a treatment trial for <i>n</i> = 115 patients with chronic pain and co-occurring emotional distress. Reliability and construct and criteria validity were studied using the same instruments as in the original psychometric study and further explored in two new measures. A series of multiple regression analyses were conducted to assess the relationship between the CIA scale and criteria variables compared to the other psychological constructs.</p><p><strong>Results: </strong>The CIA scale showed good reliability. Significant correlations between high scores on the CIA scale and low scores on self-compassion and activity engagement could be replicated. Significant correlations between high scores on the CIA scale and high scores of pain intensity and pain interference could also be replicated. In the exploring part of this study, validity was extended to general problems with emotion regulation and to satisfaction with life in general and contact with friends but not to satisfaction with family, partner, or sexual life. Avoidance of expression was the only significant predictor of pain intensity.</p><p><strong>Conclusion: </strong>This study could replicate acceptable psychometric properties of a scale measuring CIA of expression. As in the original study, avoidance of expression was associated with increased suffering. Clinically, this instrument may be used to identify patients who may otherwise remain in aggravating silence. Theoretically, it introduces the important concept of context sensitivity to the field of chronic pain. Limitations include uncertainty about causal relationships, and that several important social situations were not examined.</p>","PeriodicalId":47407,"journal":{"name":"Scandinavian Journal of Pain","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}