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Article ; Online: Effects of perioperative clinical hypnosis on heart rate variability in patients undergoing oncologic surgery: secondary outcomes of a randomized controlled trial.

Azam, Muhammad Abid / Weinrib, Aliza Z / Slepian, P Maxwell / Rosenbloom, Brittany N / Waisman, Anna / Clarke, Hance / Katz, Joel

Frontiers in pain research (Lausanne, Switzerland)

2024 Volume 5, Page(s) 1354015

Abstract: Introduction: Clinical hypnosis has been proposed for post-surgical pain management for its potential vagal-mediated anti-inflammatory properties. Evidence is needed to understand its effectiveness for post-surgical recovery. Iin this secondary outcome ... ...

Abstract	Introduction: Clinical hypnosis has been proposed for post-surgical pain management for its potential vagal-mediated anti-inflammatory properties. Evidence is needed to understand its effectiveness for post-surgical recovery. Iin this secondary outcome study, it was hypothesized that surgical oncology patients randomized to receive perioperative clinical hypnosis (CH) would demonstrate greater heart-rate variability (HRV) during rest and relaxation at a 1-month post-surgery assessment compared to a treatment-as-usual group (TAU). Methods: After REB approval, trial registration and informed consent, 92 participants were randomized to receive CH ( Results: One month after surgery, HRV was significantly higher in CH group ( Discussion: The results suggest that hypnosis prevents the deleterious effects of surgery on HRV by preserving pre-operative vagal activity. These findings underscore the potential of clinical hypnosis in mitigating the adverse effects of surgery on autonomic function and may have significant implications for enhancing post-surgical recovery and pain management strategies. Clinical trial registration: ClinicalTrials.gov, identifier (NCT03730350).
Language	English
Publishing date	2024-03-08
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-561X
ISSN (online)	2673-561X
DOI	10.3389/fpain.2024.1354015
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A Randomized Controlled Trial of Clinical Hypnosis as an Opioid-Sparing Adjunct Treatment for Pain Relief in Adults Undergoing Major Oncologic Surgery

Rosenbloom BN / Slepian PM / Azam MA / Aternali A / Birnie KA / Curtis K / Thaker S / Ladak S / Waisman A / Clarke H / Katz J / Weinrib AZ

Journal of Pain Research, Vol Volume 17, Pp 45-

2024 Volume 59

Abstract: Brittany N Rosenbloom,1– 3 P Maxwell Slepian,1,2,4 Muhammed Abid Azam,1,2 Andrea Aternali,1 Kathryn A Birnie,5,6 Kathryn Curtis,2 Sonal Thaker,2 Salima Ladak,2 Anna Waisman,1 Hance Clarke,2,4 Joel Katz,1,2,4 Aliza Z Weinrib1,2 1Department of Psychology, ... ...

Abstract	Brittany N Rosenbloom,1– 3 P Maxwell Slepian,1,2,4 Muhammed Abid Azam,1,2 Andrea Aternali,1 Kathryn A Birnie,5,6 Kathryn Curtis,2 Sonal Thaker,2 Salima Ladak,2 Anna Waisman,1 Hance Clarke,2,4 Joel Katz,1,2,4 Aliza Z Weinrib1,2 1Department of Psychology, York University, Toronto, ON, Canada; 2Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada; 3Toronto Academic Pain Medicine Institute, Women’s College Hospital, Toronto, ON, Canada; 4Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; 5Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, AB, Canada; 6Department of Community Health Sciences, University of Calgary, Calgary, AB, CanadaCorrespondence: Joel Katz; Aliza Z Weinrib, Department of Psychology, York University, BSB 232, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada, Email jkatz@yorku.ca; Aliza.Weinrib@gmail.comAbstract: Clinical hypnosis is an effective strategy for managing acute pain in the surgical setting. However, the opioid sparing effects of clinical hypnosis are not as well understood. This pre-registered (NCT03730350) randomized, controlled trial (RCT) examined the impact of clinical hypnosis, pre- and post-surgery, on opioid consumption during hospitalization as well as on measures of pain intensity, pain interference, depressed mood, anxiety, sleep, and pain catastrophizing. Participants (M = 57.6 years; SD = 10.9) awaiting oncologic surgery were randomized to treatment-as-usual (n = 47) or hypnosis (n = 45). Intent-to-treat analyses were conducted using linear mixed effects modeling. A significant Group × Time interaction, F(6, 323.34) = 3.32, p = 0.003, indicated an opioid sparing effect of clinical hypnosis during the acute postoperative period. Hypnosis also protected against increases in pain catastrophizing at one-week after surgery, F (1, 75.26) = 4.04, p = 0.048. A perioperative clinical hypnosis intervention had a sparing effect on opioid ...
Keywords	clinical hypnosis ; oncologic surgery ; postoperative opioid use ; postoperative pain ; pain catastrophizing ; Medicine (General) ; R5-920
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Predictive Validity and Patterns of Change Over Time of the Sensitivity to Pain Traumatization Scale

Fashler SR / Pagé MG / Svendrovski A / Flora DB / Slepian PM / Weinrib AZ / Huang A / Fiorellino J / Clarke H / Katz J

Journal of Pain Research, Vol Volume 15, Pp 2587-

A Trajectory Analysis of Patients Seen by the Transitional Pain Service Up to Two Years After Surgery

2022 Volume 2605

Abstract: Samantha R Fashler,1 M Gabrielle Pagé,2 Anton Svendrovski,3 David B Flora,1 P Maxwell Slepian,1,4,5 Aliza Z Weinrib,1,4 Alexander Huang,4,5 Joseph Fiorellino,4,5 Hance Clarke,4,5 Joel Katz1,4,5 1Department of Psychology, York University, Toronto, ON, ... ...

Abstract	Samantha R Fashler,1 M Gabrielle Pagé,2 Anton Svendrovski,3 David B Flora,1 P Maxwell Slepian,1,4,5 Aliza Z Weinrib,1,4 Alexander Huang,4,5 Joseph Fiorellino,4,5 Hance Clarke,4,5 Joel Katz1,4,5 1Department of Psychology, York University, Toronto, ON, Canada; 2Department of Anesthesiology & Pain Medicine and Department of Psychology, Université de Montréal; Research Center of the Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada; 3UZIK Consulting Inc, Toronto, ON, Canada; 4Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada; 5Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, CanadaCorrespondence: Samantha R Fashler; Joel Katz, Department of Psychology, York University, 4700 Keele St., BSB 232, Toronto, ON, M3J 1P3, Canada, Email samantha.fashler@vch.ca; jkatz@yorku.caPurpose: The Sensitivity to Pain Traumatization Scale (SPTS-12) was developed to assess the propensity to develop a traumatic stress response to pain. The SPTS-12 is a reliable and valid scale with a one-factor structure. The aim of the present study is to further examine the psychometric properties of the SPTS-12 by evaluating its criterion validity and how scores change over time in a sample of postsurgical patients at the Toronto General Hospital Transitional Pain Service.Participants and Methods: 361 adults (55% male; Mage = 50.6 years, SDage = 14.3) completed questionnaires assessing symptoms of pain, anxiety, depression, and trauma at multiple visits to the Transitional Pain Service after surgery. Latent-class growth mixture modeling defined prototypical longitudinal patterns (latent trajectories) of SPTS-12 scores up to two years after surgery. One-way ANOVAs examined how trajectory classes differed over time on measures of daily opioid use (mg morphine equivalents (MME)), average pain intensity, pain interference, and depressive symptoms.Results: The final model consisted of five SPTS-12 trajectory groups; two characterized by a flat and ...
Keywords	chronic pain ; chronic postsurgical pain ; trauma ; psychology ; scale validation ; psychosocial factors ; trajectory ; Medicine (General) ; R5-920
Subject code	150
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: A Randomized Controlled Trial of Clinical Hypnosis as an Opioid-Sparing Adjunct Treatment for Pain Relief in Adults Undergoing Major Oncologic Surgery.

Rosenbloom, Brittany N / Slepian, P Maxwell / Azam, Muhammed Abid / Aternali, Andrea / Birnie, Kathryn A / Curtis, Kathryn / Thaker, Sonal / Ladak, Salima / Waisman, Anna / Clarke, Hance / Katz, Joel / Weinrib, Aliza Z

Journal of pain research

2024 Volume 17, Page(s) 45–59

Abstract: Clinical hypnosis is an effective strategy for managing acute pain in the surgical setting. However, the opioid sparing effects of clinical hypnosis are not as well understood. This pre-registered (NCT03730350) randomized, controlled trial (RCT) examined ...

Abstract	Clinical hypnosis is an effective strategy for managing acute pain in the surgical setting. However, the opioid sparing effects of clinical hypnosis are not as well understood. This pre-registered (NCT03730350) randomized, controlled trial (RCT) examined the impact of clinical hypnosis, pre- and post-surgery, on opioid consumption during hospitalization as well as on measures of pain intensity, pain interference, depressed mood, anxiety, sleep, and pain catastrophizing. Participants (M = 57.6 years; SD = 10.9) awaiting oncologic surgery were randomized to treatment-as-usual (n = 47) or hypnosis (n = 45). Intent-to-treat analyses were conducted using linear mixed effects modeling. A significant Group × Time interaction,
Language	English
Publishing date	2024-01-04
Publishing country	New Zealand
Document type	Case Reports ; Clinical Trial
ZDB-ID	2495284-9
ISSN	1178-7090
ISSN	1178-7090
DOI	10.2147/JPR.S424639
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Chronic postsurgical pain: From risk factor identification to multidisciplinary management at the Toronto General Hospital Transitional Pain Service.

Katz, Joel / Weinrib, Aliza Z / Clarke, Hance

Canadian journal of pain = Revue canadienne de la douleur

2019 Volume 3, Issue 2, Page(s) 49–58

Abstract: ... ...

Abstract	Background
Language	English
Publishing date	2019-07-30
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2474-0527
ISSN (online)	2474-0527
DOI	10.1080/24740527.2019.1574537
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Use of Acceptance and Commitment Therapy in Oncology Settings: A Narrative Review.

Fashler, Samantha R / Weinrib, Aliza Z / Azam, Muhammad Abid / Katz, Joel

Psychological reports

2017 Volume 121, Issue 2, Page(s) 229–252

Abstract: Various psychotherapeutic approaches have been developed to address the psychosocial stressors and distress associated with cancer diagnosis and treatment. One such approach, Acceptance and Commitment Therapy (ACT), may be particularly well suited to ... ...

Abstract	Various psychotherapeutic approaches have been developed to address the psychosocial stressors and distress associated with cancer diagnosis and treatment. One such approach, Acceptance and Commitment Therapy (ACT), may be particularly well suited to people with cancer as it offers a model of healthy adaptation to difficult circumstances. This paper provides a description and theoretical rationale for using ACT in psychosocial oncology care that emphasizes emotional distress and cancer-related pain and provides a narrative review of the current state of evidence for this setting. Six studies met eligibility criteria for inclusion in the review. The research designs included one case study, three pre-post cohort studies, and two randomized controlled trials. Cancer diagnoses of patients included breast cancer, ovarian cancer, colorectal cancer, and mixed cancer populations at various stages of disease progression or recovery. ACT interventions demonstrated significant improvements in symptoms including quality of life and psychological flexibility as well as reductions in symptoms including distress, emotional disturbances, physical pain, and traumatic responses. Overall, although there is limited published research currently available, there is some evidence to support ACT as an effective psychotherapeutic approach for cancer patients. Further research is needed for different cancer populations across the illness trajectory. Barriers to implementation are discussed.
MeSH term(s)	Acceptance and Commitment Therapy/methods ; Affective Symptoms/therapy ; Cancer Pain/therapy ; Humans ; Neoplasms/psychology ; Psychological Trauma/therapy ; Stress, Psychological/therapy
Language	English
Publishing date	2017-08-24
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	205658-6
ISSN	1558-691X ; 0033-2941
ISSN (online)	1558-691X
ISSN	0033-2941
DOI	10.1177/0033294117726061
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Predictive Validity and Patterns of Change Over Time of the Sensitivity to Pain Traumatization Scale: A Trajectory Analysis of Patients Seen by the Transitional Pain Service Up to Two Years After Surgery.

Fashler, Samantha R / Pagé, M Gabrielle / Svendrovski, Anton / Flora, David B / Slepian, P Maxwell / Weinrib, Aliza Z / Huang, Alexander / Fiorellino, Joseph / Clarke, Hance / Katz, Joel

Journal of pain research

2022 Volume 15, Page(s) 2587–2605

Abstract: Purpose: The Sensitivity to Pain Traumatization Scale (SPTS-12) was developed to assess the propensity to develop a traumatic stress response to pain. The SPTS-12 is a reliable and valid scale with a one-factor structure. The aim of the present study is ...

Abstract	Purpose: The Sensitivity to Pain Traumatization Scale (SPTS-12) was developed to assess the propensity to develop a traumatic stress response to pain. The SPTS-12 is a reliable and valid scale with a one-factor structure. The aim of the present study is to further examine the psychometric properties of the SPTS-12 by evaluating its criterion validity and how scores change over time in a sample of postsurgical patients at the Toronto General Hospital Transitional Pain Service. Participants and methods: 361 adults (55% male; Results: The final model consisted of five SPTS-12 trajectory groups; two characterized by a flat and unchanging pattern and three showing a small but statistically significant decrease over time. Analysis of pain-related outcomes predicted by SPTS-12 trajectories provided evidence of criterion validity of the SPTS-12. SPTS-12 trajectories did not significantly differ on daily MME at any time. Average pain, pain interference, and depression scores significantly differed across SPTS-12 trajectory groups at two or more postsurgical visits (all p < 0.05). Conclusion: The SPTS-12 shows fairly stable patterns and predicts important pain-related and psychosocial outcomes over time. Two SPTS-12 trajectories (#2 and #5) with high scores, comprising ~28% of the total sample, are associated with problematic outcomes on several pain and psychosocial measures. Targeting patients with high SPTS-12 scores for presurgical psychological treatment may prove beneficial in reducing the impact of CPSP.
Language	English
Publishing date	2022-08-31
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2495284-9
ISSN	1178-7090
ISSN	1178-7090
DOI	10.2147/JPR.S370497
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Psychological treatments for the management of postsurgical pain

Nicholls JL / Azam MA / Burns LC / Englesakis M / Sutherland AM / Weinrib AZ / Katz J / Clarke H

Patient Related Outcome Measures, Vol Volume 9, Pp 49-

a systematic review of randomized controlled trials

2018 Volume 64

Abstract: Judith L Nicholls,1 Muhammad A Azam,1,2 Lindsay C Burns,1,2 Marina Englesakis,3 Ainsley M Sutherland,1 Aliza Z Weinrib,1,2 Joel Katz,1,2,4 Hance Clarke1,4 1Pain Research Unit, Department of Anesthesia and Pain Medicine, Toronto General Hospital, ... ...

Abstract	Judith L Nicholls,1 Muhammad A Azam,1,2 Lindsay C Burns,1,2 Marina Englesakis,3 Ainsley M Sutherland,1 Aliza Z Weinrib,1,2 Joel Katz,1,2,4 Hance Clarke1,4 1Pain Research Unit, Department of Anesthesia and Pain Medicine, Toronto General Hospital, 2Department of Psychology, York University, 3Library and Information Services, University Health Network, 4Department of Anesthesia, University of Toronto, Toronto, ON, Canada Background: Inadequately managed pain is a risk factor for chronic postsurgical pain (CPSP), a growing public health challenge. Multidisciplinary pain-management programs with psychological approaches, including cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based psychotherapy, have shown efficacy as treatments for chronic pain, and show promise as timely interventions in the pre/perioperative periods for the management of PSP. We reviewed the literature to identify randomized controlled trials evaluating the efficacy of these psychotherapy approaches on pain-related surgical outcomes. Materials and methods: We searched Medline, Medline-In-Process, Embase and Embase Classic, and PsycInfo to identify studies meeting our search criteria. After title and abstract review, selected articles were rated for risk of bias. Results: Six papers based on five trials (four back surgery, one cardiac surgery) met our inclusion criteria. Four papers employed CBT and two CBT-physiotherapy variant; no ACT or mindfulness-based studies were identified. Considerable heterogeneity was observed in the timing and delivery of psychological interventions and length of follow-up (1 week to 2–3 years). Whereas pain-intensity reporting varied widely, pain disability was reported using consistent methods across papers. The majority of papers (four of six) reported reduced pain intensity, and all relevant papers (five of five) found improvements in pain disability. General limitations included lack of large-scale data and difficulties with blinding. Conclusion: This systematic ...
Keywords	Post surgical pain ; CBT ; acute pain ; chronic pain ; chronic post-surgical pain ; multidisciplinary pain management ; Medicine (General) ; R5-920
Subject code	306
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The psychology of chronic post-surgical pain: new frontiers in risk factor identification, prevention and management.

Weinrib, Aliza Z / Azam, Muhammad A / Birnie, Kathryn A / Burns, Lindsay C / Clarke, Hance / Katz, Joel

British journal of pain

2017 Volume 11, Issue 4, Page(s) 169–177

Abstract: In an era of considerable advances in anaesthesiology and pain medicine, chronic pain after major surgery continues to be problematic. This article briefly reviews the known psychological risk and protective factors associated with the development of ... ...

Abstract	In an era of considerable advances in anaesthesiology and pain medicine, chronic pain after major surgery continues to be problematic. This article briefly reviews the known psychological risk and protective factors associated with the development of chronic postsurgical pain (CPSP). We begin with a definition of CPSP and then explain what we mean by a risk/protective factor. Next, we summarize known psychological risk and protective factors for CPSP. Psychological interventions that target risk factors and may impact postsurgical pain are reviewed, including the acceptance and commitment therapy (ACT)-based approach to CPSP prevention and management we use in the Transitional Pain Service (TPS) at the Toronto General Hospital. Finally, we conclude with recommendations for research in risk factor identification and psychological interventions to prevent CPSP. Several pre-surgical psychological risk factors for CPSP have been consistently identified in recent years. These include negative affective constructs, such as anxiety symptoms, depressive symptoms, pain catastrophizing and general psychological distress. In contrast, relatively few studies have examined psychological protective factors for CPSP. Psychological interventions that target known psychological risk factors while enhancing protective psychological factors may reduce new incidence of CPSP. The primary goal of our ACT intervention is to teach patients a mindful way of responding to their postsurgical pain that empowers them to interrupt the negative cycle of pain, distress, behavioural avoidance and escalating opioid use that can limit functioning and quality of life while paradoxically amplifying pain over time. Early clinical outcome data suggest that patients who receive care from TPS physicians reduce their pain and opioid use, yet patients who also receive our ACT intervention have a larger decrease in daily opioid dose while reporting less pain interference and lower depression scores.
Language	English
Publishing date	2017-07-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2670872-3
ISSN	2049-4645 ; 2049-4637
ISSN (online)	2049-4645
ISSN	2049-4637
DOI	10.1177/2049463717720636
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Psychological treatments for the management of postsurgical pain: a systematic review of randomized controlled trials.

Nicholls, Judith L / Azam, Muhammad A / Burns, Lindsay C / Englesakis, Marina / Sutherland, Ainsley M / Weinrib, Aliza Z / Katz, Joel / Clarke, Hance

Patient related outcome measures

2018 Volume 9, Page(s) 49–64

Abstract: Background: Inadequately managed pain is a risk factor for chronic postsurgical pain (CPSP), a growing public health challenge. Multidisciplinary pain-management programs with psychological approaches, including cognitive behavioral therapy (CBT), ... ...

Abstract	Background: Inadequately managed pain is a risk factor for chronic postsurgical pain (CPSP), a growing public health challenge. Multidisciplinary pain-management programs with psychological approaches, including cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based psychotherapy, have shown efficacy as treatments for chronic pain, and show promise as timely interventions in the pre/perioperative periods for the management of PSP. We reviewed the literature to identify randomized controlled trials evaluating the efficacy of these psychotherapy approaches on pain-related surgical outcomes. Materials and methods: We searched Medline, Medline-In-Process, Embase and Embase Classic, and PsycInfo to identify studies meeting our search criteria. After title and abstract review, selected articles were rated for risk of bias. Results: Six papers based on five trials (four back surgery, one cardiac surgery) met our inclusion criteria. Four papers employed CBT and two CBT-physiotherapy variant; no ACT or mindfulness-based studies were identified. Considerable heterogeneity was observed in the timing and delivery of psychological interventions and length of follow-up (1 week to 2-3 years). Whereas pain-intensity reporting varied widely, pain disability was reported using consistent methods across papers. The majority of papers (four of six) reported reduced pain intensity, and all relevant papers (five of five) found improvements in pain disability. General limitations included lack of large-scale data and difficulties with blinding. Conclusion: This systematic review provides preliminary evidence that CBT-based psychological interventions reduce PSP intensity and disability. Future research should further clarify the efficacy and optimal delivery of CBT and newer psychological approaches to PSP.
Language	English
Publishing date	2018-01-19
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2586660-6
ISSN	1179-271X
ISSN	1179-271X
DOI	10.2147/PROM.S121251
Database	MEDical Literature Analysis and Retrieval System OnLINE

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