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Acute and chronic pain affects more Americans than heart disease, diabetes, and cancer combined. Conservative estimates suggest the total economic cost of pain in the United States is $600 billion, and more than half of this cost is due to lost productivity, such as absenteeism, presenteeism, and turnover. In addition, an escalating opioid epidemic in the United States and abroad spurred by a lack of safe and effective pain management has magnified challenges to address pain in the workforce, particularly the military. Thus, it is imperative to investigate the organizational antecedents and consequences of pain and prescription opioid misuse (POM). This chapter provides a brief introduction to pain processing and the biopsychosocial model of pain, emphasizing the relationship between stress, emotional well-being, and pain in the military workforce. We review personal and organizational risk and protective factors for pain, such as post-traumatic stress disorder, optimism, perceived organizational support, and job strain. Further, we discuss the potential adverse impact of pain on organizational outcomes, the rise of POM in military personnel, and risk factors for POM in civilian and military populations. Lastly, we propose potential organizational interventions to mitigate pain and provide the future directions for work, stress, and pain research.

Chronic pain is a global community health and human rights issue. Proper health care is an important necessity for every human being and access for treatment is every human’s right. Likewise, it is significant that proper instruments should be administered to assess these clinical issues. It is equally necessary to reassess these tools accordingly to diverse cultures, especially subjective tools to check their validity and cultural specification. The purpose of this study is to adapt and examine the factorial structure of 20 items and three-factor structure, pain anxiety symptoms scale (McCracken and Dhingra, 2002). As literature evidence suggested of a three-factor structure (Cho, 2010).

Primarily, the scale was translated into Urdu language using the forward-backward method. Afterward, a reliability assessment and a confirmatory factor analysis (CFA) for construct validity, on an osteoporosis patients’ sample (N = 250) was performed. Subsequently, an Obliman method exploratory factor analysis (EFA) was conducted on an osteoporosis sample (N = 500) for factor structuring followed by validity and reliability analysis.

The initial findings demonstrated a high internal consistency of the translated version of the scale (α = 0.85) and an acceptable test-retest reliability (r = 0.69). CFA displayed a high inter-correlation between scale and its subscales. However, CFA suggested a three-factor model. Consequently, EFA proposed a three-factor, 19 item scale, namely, behavioral; cognitive; and physical subscale, which demonstrated high alpha reliability (α.= 0.86). Other results indicated the scale to have a significant predictive and convergent validity for depression and positive and negative affect.

The present study is novel in its approach as the present study not only tried to adapt the original Pain Anxiety Symptom Scale to Pakistani culture but has also checked the factorial structure of the original scale. The results achieved in the process suggested a three-factor structure scale with 19 items in opposition to the original four structured, 20 items scale.

It is well recognized that emotions support adaptation to environmental demands by guiding cognitions and behavior in line with one’s implicit and explicit goals. This is true in the work context, as in other areas of life. Traditionally, however, research into emotion regulation within the work context has been centered on the problematic aspects of feeling and displaying emotion at work. In order to meet organizational goals, felt emotions need to be subdued or modified, and inauthentic emotions displayed. In this way, conceptualizations of work-related emotion regulation have disconnected emotion from its most basic and adaptive signal function. This disconnection has led to a dilemma regarding the real- and the fake-self and been associated with a range of negative consequences for employee health and well-being. Understanding how emotions can be regulated to help employees meet personal goals for growth and development has also been overlooked. In this chapter, we challenge this existing paradigm, and instead argue that examining emotion regulation in terms of its adaptive functions will help to unify disparate findings from within the emotion regulation literature and progress research in the field of emotion and emotion regulation at work.

Examines the development of traditional quality practices in America since World War 2. Identifies areas of current Acceptable Quality level practice which require radical change by the implementation of TQM, citing case studies of four American companies′ quality programmes. Concludes that TQM depends on establishing goals of perfection, communicating them to the workforce, the use of process controls, and employing TQM in design, marketing and service areas; and that TQM is necessary for domestic and international success.

The purpose of this paper is to engage stakeholders in the development of a community based chronic pain-management service and identify their different agendas for service design and delivery.

Data were collected using the Nominal Group Technique (NGT), a ten-step process that generates qualitative and quantitative data. Seven NGT groups were conducted in the south-west region of the UK, three with General Practitioners and nurses, three with chronic pain patients, and one with Healthcare Commissioners.

The patient agenda for service development focused on process of care issues particularly the need for deep- empathy and emotional support from providers, while professionals prioritised cost-effectiveness. While there was some overlap between agendas they were largely discrete and often contradictory.

The findings imply service planners will need to make trade-offs between cost-containment and patient satisfaction. The methodology did not allow trade-offs to be put to participants in a structured form. However, such techniques are available, for example, Conjoint Analysis. There may also be value in bringing together patients and professionals in joint focus groups, to see if the gap between their different agendas can be bridged through discussion.

The findings provide a novel insight into the competing agendas of patients and professionals regarding service development and design which will be of value to service planners and managers as they strive to reconcile these differences.

The management of individuals with autism spectrum disorders (ASDs) requires a multimodal approach of behavioural, educational and pharmacological treatments. At present, there are no available drugs to treat the core symptoms of ASDs and therefore a wide range of psychotropic medications are used in the management of problems behaviours, co-occurring psychiatric disorders and other associated features. The purpose of this paper is to map the literature on pharmacological treatment in persons with ASD in order to identify those most commonly used, choice criteria, and safety.

A systematic mapping of the recent literature was undertaken on the basis of the following questions: What are the most frequently used psychoactive compounds in ASD? What are the criteria guiding the choice of a specific compound? How effective and safe is every psychoactive drug used in ASD? The literature search was conducted through search engines available on Medline, Medmatrix, NHS Evidence, Web of Science and the Cochrane Library.

Many psychotropic medications have been studied in ASDs, but few have strong evidence to support their use. Most commonly prescribed medications, in order of frequency, are antipsychotics, antidepressants, anticonvulsants and stimulants, many of them without definitive studies guiding their usage. Recent animal studies can be useful models for understanding the common pathogenic pathways leading to ASDs, and have the potential to offer new biologically focused treatment options.

This is a practice review paper applying recent evidence from the literature.

The purpose of this paper is to understand service users’ experience of a new acceptance and commitment therapy (ACT)-based substance misuse programme. The programme is designed for people in secure mental health services, presenting with complex mental health difficulties and co-occurring substance misuse problems.

A qualitative approach informed an exploratory pilot of this novel intervention. Service users completing a 16-week ACT programme were invited to participate in the current study. Out of the nine individuals enroled on the programme, six opted to take part in the exploratory pilot and completed semi-structured interviews following part 1 of the programme (eight weeks). Four of these participants proceeded into part 2 of the programme (eight weeks) and completed a further semi-structured interview.

The thematic analysis identified five main themes: “Increased awareness of personal values and the impact of substance use on values”, “Taking committed action towards values”, “Coping skills and the application of skills to manage difficult thoughts and feelings”, “Personal development” and “Use of metaphors/analogies”.

A quantitative evaluation of clinical outcomes is recommended to gauge further programme effectiveness.

The findings provide preliminary support for the use of an ACT-based substance misuse programme in a secure mental health setting.

This study evaluates the use of a novel ACT-based substance misuse intervention with people in secure mental health care with co-occurring mental health and substance misuse difficulties. This paper provides an in-depth understanding of service users’ experience of participating in this new treatment programme.

The purpose of this paper is to explore the concepts of social isolation and loneliness in relation to people with chronic musculoskeletal pain. Through these concepts, biological, psychological and social factors will be examined to consider how we can identify people at risk of social isolation and loneliness who have chronic musculoskeletal pain and then how health professionals may intervene to reduce their effects.

Conceptual paper.

Social isolation and loneliness are often evident in the situation of people with chronic musculoskeletal diseases. This may be bi-directional where pains may lead to social isolation and loneliness, but equally, social isolation and loneliness may exacerbate pain. Interventions to improve the symptoms of chronic musculoskeletal pain, and also approaches around social participation and engagement should be adopted in combination to ameliorate this potentially disabling scenario.

There remains limited evidence around the prevalence and management of social isolation and loneliness for people with chronic musculoskeletal pain. By raising awareness of social isolation and loneliness in this population, people with chronic musculoskeletal pain may be better supported to reduce the negative impact that social isolation and loneliness can have on their health and well-being.

Data gathered from routine clinical settings is complementary to evidence garnered from controlled efficacy trials. The purpose of this paper is to present individual-level analysis of changes in a group of patients discharged from psychological therapy within an outpatient pain service. The service had recently shifted from a traditional cognitive-behavioural approach to one underpinned by Acceptance and Commitment Therapy.

Reliable and clinically significant change methodology was applied to CORE-10 outcomes for 27 patients discharged during 2013-2014. Outcomes were compared to 2012-2013. A patient satisfaction questionnaire was administered and functional outcomes were collated.

Outcomes were not adversely affected by the shift in service focus as clients demonstrating reliable improvement increased from 2012-2013; 81 per cent reliably improved, 44 per cent made a clinically significant improvement. Increases in returning to work/unpaid activities at post-treatment were noted. The service met a number of NICE quality standards concerning the “relational” aspects of care.

Clinical effectiveness is evaluated through one outcome measure thereby limiting conclusions. The longer term effectiveness of the service remains unclear. Narrow demographic information limits an assessment of any systematic biases in findings. Little is known about treatment drop-outs.

A number of recommendations concerning data collection and future service evaluations are made.

Returning to paid or unpaid activities has a high public health impact.

This paper contributes towards the evidence base for using psychological therapies with clients experiencing chronic pain and related distress. Importantly, the paper complements evidence for general efficacy (from large-scale controlled studies) through an evaluation of real-world effectiveness (i.e. practice-based evidence).

Because our emotions are crucial determinants of how well we function in our personal and professional lives, researchers from different perspectives have sought to understand how emotions can be best managed for optimal functioning. In this chapter, we focus on two research traditions that have examined this issue, the emotion regulation (ER) tradition and the emotional labor (EL) tradition. This effort is predicated on the belief that a more fundamental research tradition such as ER can inform and complement a more applied research tradition such as EL, first by extending our understanding of the various processes by which employees deal with their emotions, and second, by permitting a more accurate prediction of the consequences of these emotions. A case is presented that discriminating more finely between the various emotion management strategies may help to resolve some of the paradoxical findings observed in the EL literature.