An examination of pain, disability, and the psychological correlates of Chiari Malformation pre- and post-surgical correction
Chiari malformation; Decompression surgery; Disability; Pain; Psychological symptoms
BACKGROUND: 50% of patients with Chiari Malformation (CM) report a history of depression; however, rates of other psychological symptoms are unknown. Further, it is unclear whether surgical correction impacts pain, disability, and psychological symptoms. OBJECTIVE: /Hypothesis: We examined rates of symptoms in a nationwide sample of CM patients who had (n = 639) and had not (n = 551) undergone surgical correction. We hypothesized lower symptom severity in the latter group. METHODS: Participants completed assessments and submitted pre-surgical MRI scans online (n = 286). Informed by the Fear-Avoidance Model of pain, we controlled for psychological symptoms when assessing pain/disability, and pain/disability when assessing psychological symptoms. RESULTS: Overall, high rates of depression (44% moderate-severe) and anxiety (60% moderate-severe) were reported. Groups (surgery vs. no-surgery) did not differ in the proportion of patients meeting cutoff scores for current disability; however, the no-surgery group was more likely to meet cutoffs for anxiety (χ2 = 11.26, p < .05), stress (χ2 = 14.63, p < .01) and health anxiety (χ2 = 4.63, p < .05). The surgery group reported lower levels of continuous affective pain F(1, 1065) = 10.28, p < .001), anxiety F(1,1026) = 4.96, p < .05) and stress F(1, 978) = 5.67, p < .05) although effect sizes were small (η2s ranging from 0.010 to 0.006, Cohen's D ranging from 0.17 to 0.25). CONCLUSION: CM patients experience high rates of psychological symptomatology regardless of surgical status, suggesting that all CM patients may benefit from evidence-based interventions to address anxiety and depression.
Garcia Monica A; Allen Philip A; Li Xuan; Houston James R; Loth Francis; Labuda Rick; Delahanty Douglas L
Disability and Health Journal
2019
2019-05
<a href="http://doi.org/10.1016/j.dhjo.2019.05.004" target="_blank" rel="noreferrer noopener">10.1016/j.dhjo.2019.05.004</a>
A Test of the Career Construction Theory Model of Adaptation in Adult Workers With Chiari Malformation
abilities scale; adaptability; Career Adapt-Abilities Scale-Short Form; career adaptability; career construction theory; Chiari malformation; job; life; mediation; need satisfaction; personality; psychometric properties; self-regulation; students
October 2019 Update
The present study examined the career construction theory (CCT) model of adaptation using a sample of working adults diagnosed with Chiari malformation. Specifically, we tested a mediation model in which adaptivity (i.e., proactivity, openness, and conscientiousness) fosters adaptability, which conditions adapting (i.e., competence need satisfaction at work), which leads to adaptation (i.e., work well-being and subjective well-being). Results of structural equation modeling supported all of the hypothesized direct and indirect relations between CCT constructs, thus providing strong support for the applicability of the model of adaptation among workers with Chiari malformation. Prior to testing the model of adaptation, we examined and found support for the hypothesized hierarchical structure of the Career Adapt-Abilities Scale-Short Form, a recently developed operationalization of career adaptability.
Tokar David M; Savickas Mark L; Kaut Kevin P
Journal of Career Assessment
2019
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1069072719867733" target="_blank" rel="noreferrer noopener">10.1177/1069072719867733</a>