Alzheimer’s disease (AD) mainly occurs in elderly individuals. Comorbidities and chronic pain are frequent in this population. Previous studies revealed that personality modulates both chronic pain (CP) andADoccurrence and evolution. Moreover, as pain treatments can induce side-effects, non-drugs treatments, such as art interventions, are interesting alternative therapies for decreasing CP in these patients.
Objective:
Our aim was to assess the potential role of personality traits on art intervention efficacy for reducing CP in a population of patients with mild AD.
Methods:
Design: multicenter randomized controlled trial. Fifty mild AD patients underwent a 12-week art intervention including singing and painting groups. Personality was assessed with the Big Five Inventory before the sessions. CP was measured with Numeric Rating Scale (NRS) [Usual pain (NRS-U) and most Intense pain (NRS-I)], Simple Visual Scale [Usual pain (SVS-U) and most Intense pain (SVS-I)] and Brief Pain Inventory (BPI) before and after the sessions. The influence of personality traits on CP evolution before and after art intervention was assessed with multiple linear regression models.
Results:
A positive association was observed between neuroticism and the evolution of three CP measures including NRS-U (B = 0.34, p = 0.01), SVS-U (B = 0.20, p = 0.04), and BPI-U (B = 0.46, p = 0.02) evolution. No significant relationship was observed between neuroticism and NRS-I, SVS-I and BPI-R evolution.
Conclusions:
Our findings suggest that neuroticism can decrease the efficacy of group art intervention on pain in patients with mild AD. Individual therapies could be more appropriate for these patients. These results emphasize the interest of taking into account patients’ personality before proposing them to participate to a group therapy.
GalimbertiD, ScarpiniE (2013) Progress in Alzheimer’s disease research in the last year. J Neurol260, 1936–1941.
2.
RamarosonH, HelmerC, Barberger-GateauP, LetenneurL, DartiguesJF (2003) Prevalence of dementia and Alzheimer’s disease among subjects aged 75 years or over: Updated results of the PAQUID cohort. Rev Neurol648, 405–411.
3.
PickeringG, JourdanD, EschalierA, DubrayC (2001) Impact of age on pain perception and analgesic pharmacology. Presse Med30, 754–758.
4.
NilssonU (2008) The anxiety- and pain-reducing effects of music interventions: A systematic review. AORN J87, 780–807.
5.
McCaffreyR, FreemanE (2003) Effect of music on chronic osteoarthritis pain in older people. J Adv Nurs44, 517–524.
6.
KroutRE (2001) The effects of single-session music therapy interventions on the observed and self-reported levels of pain control, physical comfort, and relaxation of hospice patients. Am J Hosp Palliat Care18, 383–390.
7.
SarkamoT, TervaniemiM, LaitinenS, NumminenA, KurkiM, JohnsonJK, RantanenP (2014) Cognitive, emotional, and social benefits of regular musical activities in early dementia: Randomized controlled study. Gerontologist54, 634–650.
8.
Van de WinckelA, FeysH, De WeerdtW, DomR (2004) Cognitive and behavioural effects of music-based exercises in patients with dementia. Clin Rehabil18, 253–260.
9.
BairdA, SamsonS (2009) Memory for music in Alzheimer’s disease: Unforgettable?Neuropsychol Rev19, 85–101.
10.
UedaT, SuzukamoY, SatoM, IzumiS (2013) Effects of music therapy on behavioral and psychological symptoms of dementia: A systematic review and meta-analysis. Ageing Res Rev12, 628–641.
11.
CookeM, MoyleW, ShumD, HarrisonS, MurfieldJ (2010) A randomized controlled trial exploring the effect of music on quality of life and depression in older people with dementia. J Health Psychol15, 765–776.
12.
PonganE, TillmannB, LevequeY, TrombertB, GetenetJC, AugusteN, DauphinotV, El HaouariH, NavezM, DoreyJM, Krolak-SalmonP, LaurentB, RouchI (2017) Can musical or painting interventions improve chronic pain, mood, quality of life, and cognition in patients with mild Alzheimer’s disease? Evidence from a randomized controlled trial. J Alzheimers Dis60, 663–677.
NaylorB, BoagS, GustinSM (2017) New evidence for a pain personality? A critical review of the last 120 years of pain and personality. Scand J Pain17, 58–67.
15.
KatoF, AbeT, KanbaraK, BanI, KibaT, KawashimaS, SakaY, MizunoY, FukunagaM (2017) Pain threshold2 reflects psychological traits in patients with chronic pain: A cross-sectional study. Biopsychosoc Med11, 13.
16.
WongWS, LamHM, ChenPP, ChowYF, WongS, LimHS, JensenMP, FieldingR (2015) The fear-avoidance model of chronic pain: Assessing the role of neuroticism and nega- 486tive affect in pain catastrophizing using structural equation 487modeling. Int J Behav Med22, 118–131.
17.
MagyarM, GondaX, PapD, EdesA, GalambosA, BaksaD, KocselN, SzaboE, BagdyG, ElliottR, KokonyeiG, JuhaszG (2017) Decreased openness to experience is associated with migraine-type headaches in subjects with lifetime depression. Front Neurol8, 270.
18.
ZampieriMA, TognolaWA, GalegoJC (2014) Patients with chronic headache tend to have more psychological symptoms than those with sporadic episodes of pain. Arq Neuropsiquiatr72, 598–602.
19.
ShivarathreDG, HowardN, KrishnaS, CowanC, PlattSR (2014) Psychological factors and personality traits associated with patients in chronic foot and ankle pain. Foot Ankle Int35, 1103–1107.
20.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, Washington, DC.
21.
NarmeP, BonnetAM, DuboisB, ChabyL (2011) Understanding facial emotion perception in Parkinson’s disease: The role of configural processing. Neuropsychologia49, 3295–3302.
22.
McKhannGM, KnopmanDS, ChertkowH, HymanBT, JackCRJr, KawasCH, KlunkWE, KoroshetzWJ, ManlyJJ, MayeuxR, MohsRC, MorrisJC, RossorMN, ScheltensP, CarrilloMC, ThiesB, WeintraubS, PhelpsCH (2011) The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement7, 263–269.
23.
FrancoisV, DarresV, MoussaH, SebbaneG, PerillatI, MaugourdMF (2004) Evaluation of a pressure stimulus by simple verbal numeric and analogical visual scales in elderly inpatients: The implications for the assessment of pain in geriatrics. La Rev Gériatr29, 95–101.
24.
JohnOP, DonahueEM, KentleRM (1991) The Big Five Inventory: Versions 4a and 54, Institute of Personality and Social Research, Berkeley.
25.
TurkDC, RudyTE, SorkinBA (1993) Neglected topics in chronic pain treatment outcome studies: Determination of success. Pain53, 3–16.
26.
CleelandCS, RyanKM (1994) Pain assessment: Global use of the Brief Pain Inventory. Ann Acad Med Singapore23, 129–138.
27.
KunzM, MyliusV, ScharmannS, SchepelmanK, LautenbacherS (2009) Influence of dementia on multiple components of pain. Eur J Pain13, 317–325.
28.
CostaPT, McCraeRR (2010) Bridging the gap with the five-factor model. Personal Disord1, 127–130.
29.
KotovR, GamezW, SchmidtF, WatsonD (2010) Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis. Psychol Bull136, 768–821.
30.
TrullTJ (2005) Dimensional models of personality disorder: Coverage and cutoffs. J Pers Disord19, 262–282.
31.
MulderRT (2002) Personality pathology and treatment outcome in major depression: A review. Am J Psychiatry159, 359–371.
32.
QuiltyLC, De FruytF, RollandJP, KennedySH, RouillonPF, BagbyRM (2008) Dimensional personality traits and treatment outcome in patients with major depressive disorder. J Affect Disord108, 241–250.
33.
Newton-HowesG, TyrerP, JohnsonT (2006) Personality disorder and the outcome of depression: Meta-analysis of published studies. Br J Psychiatry188, 13–20.
34.
WidigerTA, OltmannsJR (2017) Neuroticism is a fundamental domain of personality with enormous public health implications. World Psychiatry16, 144–145.
35.
ChangWH, ChengSH, SunZJ, LeeIH, LeeCT, ChenKC, TsaiCH, YangYK, YangYC (2015) The psychosocial indicators related to neuroticism in both sexes: A study of incoming university students. Kaohsiung J Med Sci31, 208–214.
36.
WongWS, LamHM, ChenPP, ChowYF, WongS, LimHS, JensenMP, FieldingR, The fear-avoidancemodel of chronic pain: Assessing the role of neuroticism and negative affect in pain catastrophizing using structural equation modeling. Int J Behav Med 22, 118–131.
37.
Ramirez-MaestreC, EsteveR (2013) Disposition and adjustment to chronic pain. Curr Pain Headache Rep17, 312.
38.
KempkeS, LuytenP, Van WambekeP, CoppensE, MorlionB (2014) Self-critical perfectionism predicts outcome in multidisciplinary treatment for chronic pain. Pain Pract14, 309–314.
39.
TorresX, BaillesE, ValdesM, GutierrezF, PeriJM, AriasA, GomezE, ColladoA (2013) Personality does not distinguish people with fibromyalgia but identifies subgroups of patients. Gen Hosp Psychiatry35, 640–648.
40.
LowLF, HarrisonF, LackersteenSM (2013) Does personality affect risk for dementia? A systematic review and meta-analysis. Am J Geriatr Psychiatry21, 713–728.
41.
ZuffereyV, DonatiA, PoppJ, MeuliR, RossierJ, FrackowiakR, DraganskiB, von GuntenA, KherifF (2017) Neuroticism, depression, and anxiety traits exacerbate the state of cognitive impairment and hippocampal vulnerability to Alzheimer’s disease. Alzheimers Dement (Amst)7, 107–114.
42.
OsborneH, SimpsonJ, StokesG (2010) The relationship between pre-morbid personality and challenging behaviour in people with dementia: A systematic review. Aging Ment Health14, 503–515.
43.
LuchettiM, TerraccianoA, StephanY, SutinAR (2016) Personality and cognitive decline in older adults: Data from a longitudinal sample and meta-analysis. J Gerontol B Psychol Sci Soc Sci71, 591–601.
44.
OlazaranJ, ReisbergB, ClareL, CruzI, Pena-CasanovaJ, Del SerT, WoodsB, BeckC, AuerS, LaiC, SpectorA, FazioS, BondJ, KivipeltoM, BrodatyH, RojoJM, CollinsH, TeriL, MittelmanM, OrrellM, FeldmanHH, MunizR (2010) Nonpharmacological therapies in Alzheimer’s disease: A systematic review of efficacy. Dement Geriatr Cogn Disord30, 161–178.
45.
KolanowskiAM, GarrM (1999) The relation of premorbid factors to aggressive physical behavior in dementia. J Neurosci Nurs31, 278–284.
46.
KeefeFJ, RumbleME, ScipioCD, GiordanoLA, PerriLM (2004) Psychological aspects of persistent pain: Current state of the science. J Pain5, 195–211.
47.
TseCS, BalotaDA, YapMJ, DuchekJM, McCabeDP (2010) Effects of healthy aging and early stage dementia of the Alzheimer’s type on components of response time distributions in three attention tasks. Neuropsychology24, 300–315.
48.
KolanowskiAM, HillNL (2013) Community-based non-pharmacological interventions delivered by family caregivers reduce behavioural and psychological symptoms of dementia. Evid Based Nurs16, 67–68.
49.
YamaguchiH, MakiY, YamagamiT (2010) Overview of non-pharmacological intervention for dementia and principles of brain-activating rehabilitation. Psychogeriatrics10, 206–213.
50.
KolanowskiA, MulhallP, YevchakA, HillN, FickD (2013) The triple challenge of recruiting older adults with dementia and high medical acuity in skilled nursing facilities. J Nurs Scholarsh45, 397–404.
