Christina Liossi

Bio: Christina Liossi is an academic researcher from University of Southampton. The author has contributed to research in topics: Chronic pain & Attentional bias. The author has an hindex of 33, co-authored 125 publications receiving 3411 citations. Previous affiliations of Christina Liossi include National and Kapodistrian University of Athens & University of Sunderland.

Clinical hypnosis versus cognitive behavioral training for pain management with pediatric cancer patients undergoing bone marrow aspirations

Abstract: A randomized controlled trial was conducted to compare the efficacy of clinical hypnosis versus cognitive behavioral (CB) coping skills training in alleviating the pain and distress of 30 pediatric cancer patients (age 5 to 15 years) undergoing bone marrow aspirations. Patients were randomized to one of three groups: hypnosis, a package of CB coping skills, and no intervention. Patients who received either hypnosis or CB reported less pain and pain-related anxiety than did control patients and less pain and anxiety than at their own baseline. Hypnosis and CB were similarly effective in the relief of pain. Results also indicated that children reported more anxiety and exhibited more behavioral distress in the CB group than in the hypnosis group. It is concluded that hypnosis and CB coping skills are effective in preparing pediatric oncology patients for bone marrow aspiration.

Pediatric Chronic Pain: Biopsychosocial Assessment and Formulation

Abstract: Chronic pain in children is an increasingly recognized clinical problem with alarmingly high prevalence rates found in some populations. Although it is not understood why some children experience high levels of pain, the subjective experience of chronic pain (including its site, intensity, quality, unpleasantness, and associated suffering) has long been believed to result from interactions between multiple contributors, including nociceptive, affective, sociocultural, behavioral, and cognitive. Regardless of whether the antecedent of chronic pain is known or unknown, similar patterns of symptoms, behaviors, and disability are often seen. Historically, however, there has been an unhelpful tendency to dichotomize chronic pain as either physical or functional in origin. However, recent studies strongly support a biopsychosocial basis to all pain, revealing its sensory emotional nature by showing that large distributed neural networks are accessed during nociceptive processing. The development and maintenance of chronic pain involve long-term changes in multiple integrated peripheral, spinal, and brain regions interacting in a complex way to shape the individual’s experience. Hence, chronic pain from any cause cannot be viewed as a purely physical or psychological phenomenon, nor should it be expected that a unimodal approach to treatment will succeed. It follows that when assessing children and young people with chronic pain, information on a wide range of developmentally relevant dimensions, conveniently classified as biological, psychological, and sociocultural, should be gathered to formulate the potential causes, contributors, and effects of pain to devise an appropriate multimodal management plan.

Clinical Hypnosis in the Alleviation of Procedure-Related Pain in Pediatric Oncology Patients

Abstract: This prospective controlled trial investigated the efficacy of a manual-based clinical hypnosis intervention in alleviating pain in 80 pediatric cancer patients (6-16 years of age) undergoing regular lumbar punctures. Patients were randomly assigned to 1 of 4 groups: direct hypnosis with standard medical treatment, indirect hypnosis with standard medical treatment, attention control with standard medical treatment, and standard medical treatment alone. Patients in the hypnosis groups reported less pain and anxiety and were rated as demonstrating less behavioral distress than those in the control groups. Direct and indirect suggestions were equally effective, and the level of hypnotizability was significantly associated with treatment benefit in the hypnosis groups. Therapeutic benefit degraded when patients were switched to self-hypnosis. The study indicates that hypnosis is effective in preparing pediatric oncology patients for lumbar puncture, but the presence of the therapist may be critical.

Living with chronic low back pain: a metasynthesis of qualitative research

Abstract: OBJECTIVES The purpose of this qualitative metasynthesis is to articulate the knowledge gained from a review of qualitative studies of patients' experiences of chronic low back pain. METHODS Meta-ethnographic methodology guided the review of 33 articles representing 28 studies published in English in peer-reviewed journals between 2000 and 2012. A systematic comparison of the main themes from each study was conducted and 'synthesised' to create superordinate themes. RESULTS Three overarching interrelated themes were identified: the impact of chronic low back pain on self; relationships with significant others that incorporated two streams - health professionals and the organisation of care and relationships with family and friends; coping with chronic low back pain. Coping strategies were predominantly physical therapies, medication and avoidance behaviours with very few successful strategies reported. Professional and family support, self-efficacy, motivation, work conditions and exercise opportunities influenced pain experiences. Review authors' recommendations included psychological therapies, education, the facilitation of self-management strategies and support groups. DISCUSSION The review substantiates chronic low back pain as complex, dynamic and multidimensional, underpinned by experiences of persistent distressing pain, loss, and lowered self-worth, stigma, depression, premature aging, fear of the future. Future research should address the paucity of longitudinal studies, loss and issues of ethnicity, gender, ageing.

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