<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Amtmann, Dagmar</style></author><author><style face="normal" font="default" size="100%">Askew, Robert L</style></author><author><style face="normal" font="default" size="100%">Kim, Jiseon</style></author><author><style face="normal" font="default" size="100%">Chung, Hyewon</style></author><author><style face="normal" font="default" size="100%">Ehde, Dawn M</style></author><author><style face="normal" font="default" size="100%">Bombardier, Charles H</style></author><author><style face="normal" font="default" size="100%">Kraft, George H</style></author><author><style face="normal" font="default" size="100%">Jones, Salene M</style></author><author><style face="normal" font="default" size="100%">Johnson, Kurt L</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Pain affects depression through anxiety, fatigue, and sleep in multiple sclerosis.</style></title><secondary-title><style face="normal" font="default" size="100%">Rehabil Psychol</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Anxiety Disorders</style></keyword><keyword><style  face="normal" font="default" size="100%">Chronic Pain</style></keyword><keyword><style  face="normal" font="default" size="100%">Cross-Sectional Studies</style></keyword><keyword><style  face="normal" font="default" size="100%">Depressive Disorder</style></keyword><keyword><style  face="normal" font="default" size="100%">Fatigue</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Middle Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Multiple Sclerosis</style></keyword><keyword><style  face="normal" font="default" size="100%">Quality of Life</style></keyword><keyword><style  face="normal" font="default" size="100%">Sleep Wake Disorders</style></keyword><keyword><style  face="normal" font="default" size="100%">Surveys and Questionnaires</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2015</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2015 Feb</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">60</style></volume><pages><style face="normal" font="default" size="100%">81-90</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;OBJECTIVE: Over a quarter million individuals in the United States have multiple sclerosis (MS). Chronic pain and depression are disproportionately high in this population. The purpose of this study was to examine the relationship between chronic pain and depression in MS and to examine potentially meditational effects of anxiety, fatigue, and sleep. METHOD: We used cross-sectional data from self-reported instruments measuring multiple symptoms and quality of life indicators in this study. We used structural equation modeling to model direct and indirect effects of pain on depression in a sample of 1,245 community-dwelling individuals with MS. Pain interference, depression, fatigue, and sleep disturbance were modeled as latent variables with 2 to 3 indicators each. The model controlled for age, sex, disability status (Expanded Disability Status Scale), and social support. RESULTS: A model with indirect effects of pain on depression had adequate fit and accounted for nearly 80% of the variance in depression. The effects of chronic pain on depression were almost completely mediated by fatigue, anxiety, and sleep disturbance. Higher pain was associated with greater fatigue, anxiety, and sleep disturbance, which in turn were associated with higher levels of depression. The largest mediating effect was through fatigue. Additional analyses excluded items with common content and suggested that the meditational effects observed were not attributable to content overlap across scales. CONCLUSION: Individuals living with MS who report high levels of chronic pain and depressive symptoms may benefit from treatment approaches that can address sleep, fatigue, and anxiety.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">1</style></issue></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Kratz, Anna L</style></author><author><style face="normal" font="default" size="100%">Hirsh, Adam T</style></author><author><style face="normal" font="default" size="100%">Ehde, Dawn M</style></author><author><style face="normal" font="default" size="100%">Jensen, Mark P</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Acceptance of pain in neurological disorders: associations with functioning and psychosocial well-being.</style></title><secondary-title><style face="normal" font="default" size="100%">Rehabil Psychol</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Rehabil Psychol</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Activities of Daily Living</style></keyword><keyword><style  face="normal" font="default" size="100%">Adaptation, Psychological</style></keyword><keyword><style  face="normal" font="default" size="100%">Adult</style></keyword><keyword><style  face="normal" font="default" size="100%">Chronic Pain</style></keyword><keyword><style  face="normal" font="default" size="100%">Depressive Disorder</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Illness Behavior</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Multiple Sclerosis</style></keyword><keyword><style  face="normal" font="default" size="100%">Muscular Dystrophies</style></keyword><keyword><style  face="normal" font="default" size="100%">Pain Measurement</style></keyword><keyword><style  face="normal" font="default" size="100%">Postpoliomyelitis Syndrome</style></keyword><keyword><style  face="normal" font="default" size="100%">Quality of Life</style></keyword><keyword><style  face="normal" font="default" size="100%">Questionnaires</style></keyword><keyword><style  face="normal" font="default" size="100%">Social Adjustment</style></keyword><keyword><style  face="normal" font="default" size="100%">Socioeconomic Factors</style></keyword><keyword><style  face="normal" font="default" size="100%">Spinal Cord Injuries</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2013</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2013 Feb</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">58</style></volume><pages><style face="normal" font="default" size="100%">1-9</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">OBJECTIVE: Chronic pain acceptance has been shown to be related to positive adjustment to chronic pain in patients presenting with pain as a primary problem. However, the role of pain acceptance in adjustment to chronic pain secondary to a neurological disorder that is often associated with physical disability has not been determined. The purpose of this study was to examine whether two domains of chronic pain acceptance--activity engagement and pain willingness--predict adjustment to pain, controlling for pain intensity and key demographic and clinical variables in individuals with muscular dystrophy (MD), multiple sclerosis (MS), post-polio syndrome (PPS), or spinal cord injury (SCI).

METHOD: Participants were 508 community-dwelling adults with a diagnosis of MD, MS, PPS, or SCI who also endorsed a chronic pain problem. Participants completed self-report measures of pain acceptance, quality of life, pain interference, pain intensity, depression, and social role satisfaction.

RESULTS: Hierarchical linear regressions indicated that activity engagement predicted lower pain interference and depression, and greater quality of life and social role satisfaction. Pain willingness predicted less pain interference and depression. Together, the two pain acceptance subscales accounted for more variance in outcomes than did self-reported pain intensity.

CONCLUSIONS: Findings correspond with the broader pain acceptance literature, although activity engagement appears to be a more robust predictor of adjustment than does pain willingness. This research supports the need for future studies to determine the extent to which treatments that increase acceptance result in positive outcomes in persons with chronic pain secondary to neurological disorders.</style></abstract><issue><style face="normal" font="default" size="100%">1</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/23437995?dopt=Abstract</style></custom1></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Bombardier, Charles H</style></author><author><style face="normal" font="default" size="100%">Ehde, Dawn M</style></author><author><style face="normal" font="default" size="100%">Stoelb, Brenda</style></author><author><style face="normal" font="default" size="100%">Molton, Ivan R</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">The relationship of age-related factors to psychological functioning among people with disabilities.</style></title><secondary-title><style face="normal" font="default" size="100%">Physical medicine and rehabilitation clinics of North America</style></secondary-title><alt-title><style face="normal" font="default" size="100%">Phys Med Rehabil Clin N Am</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Activities of Daily Living</style></keyword><keyword><style  face="normal" font="default" size="100%">Adaptation, Psychological</style></keyword><keyword><style  face="normal" font="default" size="100%">Age Factors</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Depressive Disorder</style></keyword><keyword><style  face="normal" font="default" size="100%">Disability Evaluation</style></keyword><keyword><style  face="normal" font="default" size="100%">Disabled Persons</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Geriatric Assessment</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Interpersonal Relations</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Middle Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Multiple Sclerosis</style></keyword><keyword><style  face="normal" font="default" size="100%">Psychology</style></keyword><keyword><style  face="normal" font="default" size="100%">Quality of Life</style></keyword><keyword><style  face="normal" font="default" size="100%">Self Concept</style></keyword><keyword><style  face="normal" font="default" size="100%">Sickness Impact Profile</style></keyword><keyword><style  face="normal" font="default" size="100%">Social Support</style></keyword><keyword><style  face="normal" font="default" size="100%">Spinal Cord Injuries</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2010</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2010 May</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">21</style></volume><pages><style face="normal" font="default" size="100%">281-97</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;The potential influence of age and aging on the psychological functioning of people with disabilities is surprisingly complex. In people with spinal cord injury or multiple sclerosis, depression is highly prevalent. The limited research in this area indicates that older age and greater time span since disability onset may be associated with less self-reported depressive symptoms. Posttraumatic growth (PTG) and benefit finding (BF) are also common in people with disabilities. Older age tends to be associated with less BF and PTG. Studies that use longitudinal designs and examine multiple age-related factors simultaneously are needed. Potential mediators of age-related effects, such as historical trends, life-cycle events, maturity, and declining health, also need to be examined. There are many interesting theoretic and empiric concepts from aging research that can inform future research on the psychological aspects of aging with disability.&lt;/p&gt;
</style></abstract><issue><style face="normal" font="default" size="100%">2</style></issue><custom1><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/pubmed/20494277?dopt=Abstract</style></custom1></record></records></xml>