This study explores the association between subjective feeling of stress and pain experience in the context of the COVID-19 pandemic with a focus on characteristics known to trigger a physiological ...stress response sense of low control, threat to ego, unpredictability and novelty (STUN).
This exploratory longitudinal convergent mixed methods design consisted of online questionnaires over three time points (before, during and after the 1st wave of the COVID-19 pandemic) (
= 49) and qualitative interviews (
= 27) during the 1st wave of the pandemic on distinct samples of individuals living with chronic pain (CP). Both types of data sources were mixed upon integration using joint display.
Mean pain intensity scores remained stable across time points, while pain unpleasantness and pain interference scores significantly improved. Global impression of change scores measured during the first wave of the pandemic do not entirely concord with pain scores evolution. Two thirds of participants reported a global deterioration of their pain condition at the beginning of the pandemic. Stress and pain catastrophizing before the pandemic were associated with pain scores throughout the pandemic; while most specific measures of stress due to the novel, uncontrollable, unpredictable and threatening nature of the pandemic were not. Qualitative data demonstrated that the deterioration reported in pain status reflected additional dimensions, including spatial expansion of the painful area, reduced access to treatments and challenges in adapting pain management strategies.
Helping individuals to negotiate stressful aspects of the pandemic might help offset the negative impacts of stress on pain status in this context or other important life events.
Research on postconcussive symptoms (PCS) following early childhood concussion has been hindered by a lack of measures suitable for this age group, resulting in a limited understanding of their ...evolution in young children.
To document PCS in the first 3 months after early childhood concussion using a developmentally appropriate measure.
This cohort study used data collected at 3 Canadian and 1 US urban pediatric emergency departments (EDs) and 8 Canadian daycares from December 2018 to December 2022 as part of the Kids' Outcomes and Long-Term Abilities (KOALA) project, a prospective, multicenter, longitudinal cohort study. Participants included children aged 6 to 72 months with early childhood concussion or orthopedic injury (OI) or uninjured children from the community to serve as controls. Data were analyzed from March 2023 to January 2024.
Concussion sustained between ages 6 and 72 months.
Primary outcomes were cognitive, physical, behavioral and total PCS assessed prior to injury (retrospectively), acutely (within 48 hours), and at 10 days, 1 month, and 3 months after injury or recruitment through caregiver observations using the Report of Early Childhood Traumatic Injury Observations & Symptoms inventory. Group comparisons were analyzed using ordinal regression models.
The study included 303 children (mean SD age, 35.8 20.2 months; 152 50.2% male). Of these, 174 children had a concussion (mean SD age, 33.3 19.9 months), 60 children had an OI (mean SD age, 38.4 19.8 months) and 69 children were uninjured controls (mean SD age, 39.7 20.8 months). No meaningful differences were found between the concussion and comparison groups in retrospective preinjury PCS. Significant group differences were found for total PCS at the initial ED visit (concussion vs OI: odds ratio OR, 4.33 95% CI, 2.44-7.69; concussion vs control: OR, 7.28 95% CI, 3.80-13.93), 10 days (concussion vs OI: OR, 4.44 95% CI, 2.17-9.06; concussion vs control: OR, 5.94 95% CI, 3.22-10.94), 1 month (concussion vs OI: OR, 2.70 95% CI, 1.56-4.68; concussion vs control: OR, 4.32 95% CI, 2.36-7.92), and 3 months (concussion vs OI: OR, 2.61 95% CI, 1.30-5.25; concussion vs control: OR, 2.40 95% CI, 1.36-4.24). Significant group differences were also found for domain-level scores (cognitive, physical, behavioral) at various time points.
In this early childhood cohort study, concussion was associated with more PCS than OIs or typical development up to 3 months after injury. Given the limited verbal and cognitive abilities typical of early childhood, using developmentally appropriate manifestations and behaviors is a valuable way of tracking PCS and could aid in concussion diagnosis in young children.
Variation in magnitude of cognitive decline in later life is a central feature of human aging. The more severe forms of dementias, such as Alzheimer's disease, clearly define one end of the spectrum. ...However, among those showing no obvious signs of clinical dementia there are considerable individual differences. Thus, although evidence for learning, memory, and language loss appears in some individuals as early as 50–55 years of age, many people continue to function alertly well into their 90s. These individuals exemplify what Rowe and Kahn (1987) have termed “successful” aging. The wide variability in CNS aging, often a nuisance factor in studies, are becoming a major focus for brain aging research (e.g., Gage
et al., 1984; Gallager and Pelleymounter, 1988; Aitken and Meaney, 1990; Issa
et al., 1990). Our studies over the past few years have added support to the idea that individual differences in hypothalamic-pituitary-adrenal (HPA) activity can account for part of the variation seen in neurological function among the elderly. In this article we discuss the evidence for the idea that adrenal glucocorticoids can compromise hippocampal function and, thus, produce cognitive impairments, as well as the potential mechanisms for these effects.
Chronic pain is a major health problem, afflicting one in four Canadians, with more women living with chronic pain. The study aims at documenting the impacts of the COVID-19 pandemic among ...individuals living with chronic pain depending on gender and at exploring gender role expectations of pain in relation to pain interference. Participants (N = 49) filled out questionnaires before, during and after the first wave of the COVID-19 pandemic, documenting their loneliness, distress, pandemic-related restrictions, pain and gender role expectations of pain. It was expected that women would be more affected by the pandemic. Results (p > .05) do not indicate gender differences, nor associations between gender role expectations and pain interference. Further research is needed to broaden our knowledge regarding gender differences in chronic pain and to address health inequalities.
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