Adult attachment, anxiety, and pain self-efficacy as predictors of pain intensity and disability

Pain self-efficacy and anxiety have each been shown to contribute substantially to pain intensity and pain-related disability. Although adult attachment theory has been related separately to chronic pain, anxiety, and self-efficacy, it has not before been investigated with either pain self-efficacy or anxiety in the context of chronic pain. This study investigated the interrelations between these aspects of the chronic pain experience and their relative contributions towards pain intensity and disability. A clinical sample of 152 chronic pain patients participated in this study, completing self-report measures of attachment, self-efficacy, pain intensity, and disability, prior to attending a multidisciplinary pain clinic. Results revealed that fearful and preoccupied (anxious) attachment categories were associated with low pain self-efficacy, while high scores on the attachment dimension of comfort with closeness were linked with high pain self-efficacy, particularly for males. Insecure attachment (whether defined in terms of categories or dimensions) was related to higher levels of anxiety. Pain self-efficacy proved a stronger predictor of pain intensity than did anxiety and was a stronger predictor of disability than pain intensity or anxiety. In addition, comfort with closeness moderated the associations between pain self-efficacy and disability, pain self-efficacy and pain intensity, and anxiety and disability. Together, these findings support the value of adopting an attachment theoretical approach in the context of chronic pain. Treatment considerations and future research directions are considered. (c) 2006 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Sitting posture affects pelvic floor muscle activity in parous women: An observational study

Question Do different sitting postures require different levels of pelvic floor and abdominal muscle activity in healthy women? Design Observational study. Participants Eight parous women with no pelvic floor dysfunction. Outcome measures Bilateral activity of pelvic floor muscles (assessed vaginally) and two abdominal muscles, obliquus internus abdominis and obliquus externus abdominis, during three sitting postures. Results There was a significant increase in pelvic floor muscle activity from slump supported sitting (mean 7.2% maximal voluntary contraction, SD 4.8) to both upright unsupported sifting (mean 12.6% maximal voluntary contraction, SD 7.8) (p = 0.01) and very tall unsupported sitting (mean 24.3% maximal voluntary contraction, SD 14.2) (p = 0.004). Activity in both abdominal muscles also increased but did not reach statistical significance. Conclusion Both unsupported sitting postures require greater pelvic floor muscle activity than the supported sitting posture.

Searches and content of the OTseeker database: Informing research priorities

BACKGROUND. A strategic and prioritized approach to occupational therapy research is needed, particularly given the limited research funding available. Comparing occupational therapists' information needs with the research evidence available can potentially inform research debate within the profession. This study aimed to identify research topics most often sought by users of the OTseeker database and to compare these with the quantity of topics available in the database. METHOD. A random sample of keyword search terms submitted to OTseeker (n = 4,500) was coded according to diagnostic and intervention categories, and compared with the amount of research contained in OTseeker in 2004. RESULTS. Most frequently sought topics were relevant to the diagnostic categories of pediatric conditions (19%), neurology and neuromuscular disorders (17%), and mental health (17%). Most frequently sought intervention topics included modes of service delivery, sensory interventions, and physical modalities. Although many frequently sought topics had a correspondingly high volume of research in OTseeker, a few areas had very little content (e.g., fine motor skill acquisition, autistic spectrum disorder). This information is offered to inform discussions about research priorities and resource allocation for research within occupational therapy.