Depression Treatment: The Journey to Chronic Pain: A Grounded Theory of Older Adults’ Experiences of Pain Associated With Leg Ulceration.

The Journey to Chronic Pain: A Grounded Theory of Older Adults’ Experiences of Pain Associated with Leg Ulceration.

Filed under: Depression Treatment

Pain Manag Nurs. 2013 Feb 8;
Taverner T, Closs SJ, Briggs M

This study aimed to develop a grounded theory to describe and explain the experience of pain and its impact, as reported by the individuals who had pain associated with chronic leg ulceration. The Strauss and Corbin grounded theory approach was used. In-depth interviews were undertaken with 11 people aged ?65 years from Leeds in the north of England. All participants were cared for by home care nurses and had painful leg ulceration. The emergent grounded theory centered on a core category of “The journey to chronic pain.” The theory suggested a trajectory consisting of three phases that the patient experiences, where the end result is a chronic pain syndrome. In phase 1, leg ulcer pain has predominantly acute nociceptive properties, and if this is not managed effectively, or ulcers do not heal, persistent pain may develop with both nociceptive and neuropathic properties (i.e., phase 2). If phase 2 pain is not managed effectively, patients may then develop refractory long-term pain (phase 3). Those who progress to phase 3 tend to experience negative consequences such as insomnia, depression, and suicidal ideation. Only when health care professionals understand and acknowledge the persistent and long-term nature of the pain in this patient group can the pain be managed effectively.
HubMed – depression

Internalizing Problems as a Predictor of Change in Externalizing Problems in At-Risk Youth.

Filed under: Depression Treatment

J Clin Child Adolesc Psychol. 2013 Feb 12;
Jarrett M, Siddiqui S, Lochman J, Qu L

Intervention and prevention programs for children with externalizing problems frequently involve children with co-occurring internalizing problems. Little is known about how these co-occurring internalizing problems predict outcomes, particularly for programs involving cognitive-behavioral strategies. The current study examined how a set of child-related risk factors (including anxiety and depressive symptoms) predicted change in parent- and teacher-reported externalizing problems following a school-based preventative intervention for children at risk for externalizing problems. Participants included 112 preadolescent children (ages 9-12) who participated in a study designed to evaluate the efficacy of the Coping Power Program (Lochman & Wells, 2004 ). Participants included 81 boys (68%) who were primarily African American (69%) or Caucasian (30%). Regression analyses were conducted to examine predictors of change in parent- and teacher-reported externalizing problems on the Behavior Assessment System for Children (Reynolds & Kamphaus, 1992 ). Results indicated that greater child depression symptoms (as reported by parent or teacher) were associated with a larger reduction in externalizing behavior problems based on parent or teacher report. This effect was found in both the parent and teacher models and held after controlling for a number of child-oriented baseline variables including baseline aggression. Future research studies should examine whether co-occurring symptoms of depression relate to enhanced changes in externalizing problems following intervention for externalizing problems, particularly when cognitive-behavioral interventions are utilized. In addition, it will be important for studies to examine such effects relative to a control group and/or alternative treatment conditions and to further explore possible mechanisms of change.
HubMed – depression

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