@article{WernickedeWittHubertsWippert2017,
  author    = {Wernicke, Sarah and de Witt Huberts, Jessie and Wippert, Pia-Maria},
  title     = {The pain of being misunderstood},
  series = {Journal of Health Psychology},
  volume    = {22},
  journal   = {Journal of Health Psychology},
  publisher = {Sage Publ.},
  address   = {London},
  issn      = {1359-1053},
  doi       = {10.1177/1359105315596371},
  pages     = {135 -- 147},
  year      = {2017},
  abstract  = {A particular form of social pain is invalidation. Therefore, this study (a) investigates whether patients with chronic low back pain experience invalidation, (b) if it has an influence on their pain, and (c) explores whether various social sources (e.g. partner and work) influence physical pain differentially. A total of 92 patients completed questionnaires, and for analysis, Pearson's correlation coefficients and hierarchical linear regression analyses were conducted. They indicated a significant association between discounting and disability due to pain (respective β = .29, p > .05). Especially, discounting by partner was linked to higher disability (β = .28, p > .05).},
  language  = {en}
}
@misc{DeWittHubertsNiedererWippertetal.2017,
  author    = {De Witt Huberts, Jessie and Niederer, Daniel and Wippert, Pia-Maria and Mayer, Frank},
  title     = {The effects of a new practical and synergetic multimodal treatment for chronic back pain on pain-related cognitions and wellbeing},
  series = {Psychosomatic medicine},
  volume    = {79},
  journal   = {Psychosomatic medicine},
  number    = {4},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0033-3174},
  pages     = {A22 -- A23},
  year      = {2017},
  language  = {en}
}
@article{FliesserDeWittHubertsWippert2017,
  author    = {Fliesser, Michael and De Witt Huberts, Jessie and Wippert, Pia-Maria},
  title     = {The choice that matters: the relative influence of socioeconomic status indicators on chronic back pain- a longitudinal study},
  series = {BMC health services research},
  volume    = {17},
  journal   = {BMC health services research},
  publisher = {BioMed Central},
  address   = {London},
  issn      = {1472-6963},
  doi       = {10.1186/s12913-017-2735-9},
  pages     = {8},
  year      = {2017},
  abstract  = {Background: In health research, indicators of socioeconomic status (SES) are often used interchangeably and often lack theoretical foundation. This makes it difficult to compare results from different studies and to explore the relationship between SES and health outcomes. To aid researchers in choosing appropriate indicators of SES, this article proposes and tests a theory-based selection of SES indicators using chronic back pain as a health outcome. Results: Chronic back pain intensity was best predicted by the multidimensional index (beta = 0.31, p < 0.05), followed by job position (beta = 0.29, p < 0.05) and education (beta = -0.29, p < 0.05); whereas, income exerted no significant influence. Back pain disability was predicted strongest by education (beta = -0.30, p < 0.05) and job position (beta = 0. 29, p < 0.05). Here, multidimensional index and income had no significant influence. Conclusions: The choice of SES indicators influences predictive power on both back pain dimensions, suggesting SES predictors cannot be used interchangeably. Therefore, researchers should carefully consider prior to each study which SES indicator to use. The introduced framework can be valuable in supporting this decision because it allows for a stable prediction of SES indicator influence and their hierarchy on a specific health outcomes.},
  language  = {en}
}
@article{FliesserDeWittHubertsWippert2017,
  author    = {Fliesser, Michael and De Witt Huberts, Jessie and Wippert, Pia-Maria},
  title     = {The choice that matters: the relative influence of socioeconomic status indicators on chronic back pain},
  series = {BMC health services research},
  volume    = {17},
  journal   = {BMC health services research},
  publisher = {BioMed Central},
  address   = {London},
  issn      = {1472-6963},
  doi       = {10.1186/s12913-017-2735-9},
  year      = {2017},
  abstract  = {Background In health research, indicators of socioeconomic status (SES) are often used interchangeably and often lack theoretical foundation. This makes it difficult to compare results from different studies and to explore the relationship between SES and health outcomes. To aid researchers in choosing appropriate indicators of SES, this article proposes and tests a theory-based selection of SES indicators using chronic back pain as a health outcome. Methods Strength of relationship predictions were made using Brunner \& Marmot's model of 'social determinants of health'. Subsequently, a longitudinal study was conducted with 66 patients receiving in-patient treatment for chronic back pain. Sociodemographic variables, four SES indicators (education, job position, income, multidimensional index) and back pain intensity and disability were obtained at baseline. Both pain dimensions were assessed again 6 months later. Using linear regression, the predictive strength of each SES indicator on pain intensity and disability was estimated and compared to the theory based prediction. Results Chronic back pain intensity was best predicted by the multidimensional index (beta = 0.31, p < 0.05), followed by job position (beta = 0.29, p < 0.05) and education (beta = -0.29, p < 0.05); whereas, income exerted no significant influence. Back pain disability was predicted strongest by education (beta = -0.30, p < 0.05) and job position (beta = 0.29, p < 0.05). Here, multidimensional index and income had no significant influence. Conclusions The choice of SES indicators influences predictive power on both back pain dimensions, suggesting SES predictors cannot be used interchangeably. Therefore, researchers should carefully consider prior to each study which SES indicator to use. The introduced framework can be valuable in supporting this decision because it allows for a stable prediction of SES indicator influence and their hierarchy on a specific health outcomes.},
  language  = {en}
}
@article{WippertRectorKuhnetal.2017,
  author    = {Wippert, Pia-Maria and Rector, Michael V. and Kuhn, Gisela and Wuertz-Kozak, Karin},
  title     = {Stress and Alterations in Bones},
  series = {Frontiers in endocrinology},
  volume    = {8},
  journal   = {Frontiers in endocrinology},
  publisher = {Frontiers Research Foundation},
  address   = {Lausanne},
  issn      = {1664-2392},
  doi       = {10.3389/fendo.2017.00096},
  pages     = {7},
  year      = {2017},
  abstract  = {Decades of research have demonstrated that physical stress (PS) stimulates bone remodeling and affects bone structure and function through complex mechanotransduction mechanisms. Recent research has laid ground to the hypothesis that mental stress (MS) also influences bone biology, eventually leading to osteoporosis and increased bone fracture risk. These effects are likely exerted by modulation of hypothalamic-pituitary-adrenal axis activity, resulting in an altered release of growth hormones, glucocorticoids and cytokines, as demonstrated in human and animal studies. Furthermore, molecular cross talk between mental and PS is thought to exist, with either synergistic or preventative effects on bone disease progression depending on the characteristics of the applied stressor. This mini review will explain the emerging concept of MS as an important player in bone adaptation and its potential cross talk with PS by summarizing the current state of knowledge, highlighting newly evolving notions (such as intergenerational transmission of stress and its epigenetic modifications affecting bone) and proposing new research directions.},
  language  = {en}
}
@article{WippertFliesserKrause2017,
  author    = {Wippert, Pia-Maria and Fliesser, Michael and Krause, Matthias},
  title     = {Risk and protective factors in the clinical rehabilitation of chronic back pain},
  series = {Journal of pain research},
  volume    = {10},
  journal   = {Journal of pain research},
  publisher = {Dove Medical Press},
  address   = {Albany, Auckland},
  issn      = {1178-7090},
  doi       = {10.2147/JPR.S134976},
  pages     = {1569 -- 1579},
  year      = {2017},
  abstract  = {Objectives: Chronic back pain (CBP) can lead to disability and burden. In addition to its medical causes, its development is influenced by psychosocial risk factors, the so-called flag factors, which are categorized and integrated into many treatment guidelines. Currently, most studies investigate single flag factors, which limit the estimation of individual factor significance in the development of chronic pain. Furthermore, factors concerning patients' lifestyle, biography and treatment history are often neglected. Therefore, the objectives of the present study are to identify commonly neglected factors of CBP and integrate them into an analysis model comparing their significance with established flag factors. Methods: A total of 24 patients and therapists were cross-sectionally interviewed to identify commonly neglected factors of CBP. Subsequently, the impact of these factors was surveyed in a longitudinal study. In two rehabilitation clinics, CBP patients (n = 145) were examined before and 6 months after a 3-week inpatient rehabilitation. Outcome variables, chronification factor pain experience (CF-PE) and chronification factor disability (CF-D), were ascertained with confirmatory factor analysis (CFA) of standardized questionnaires. Predictors were evaluated using stepwise calculations of simple and multiple regression models. Results: Through interviews, medical history, iatrogenic factors, poor compliance, critical life events (LEs), social support (SS) type and effort-reward were identified as commonly neglected factors. However, only the final three held significance in comparison to established factors such as depression and pain-related cognitions. Longitudinally, lifestyle factors found to influence future pain were initial pain, physically demanding work, nicotine consumption, gender and rehabilitation clinic. LEs were unexpectedly found to be a strong predictor of future pain, as were the protective factors, reward at work and perceived SS. Discussion: These findings shed insight regarding often overlooked factors in the development of CBP, suggesting that more detailed operationalization and superordinate frameworks would be beneficial to further research. Conclusion: In particular, LEs should be taken into account in future research. Protective factors should be integrated in therapeutic settings.},
  language  = {en}
}
@article{LindenBernertFunkeetal.2017,
  author    = {Linden, Michael and Bernert, Sebastian and Funke, Ariane and Dreinh{\"o}fer, Karsten E. and J{\"o}bges, Michael and von Kardorff, Ernst and Riedel-Heller, Steffi G. and Spyra, Karla and V{\"o}ller, Heinz and Warschburger, Petra and Wippert, Pia-Maria},
  title     = {Medizinische Rehabilitation unter einer Lifespan-Perspektive},
  series = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz},
  volume    = {60},
  journal   = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz},
  publisher = {Springer},
  address   = {New York},
  issn      = {1436-9990},
  doi       = {10.1007/s00103-017-2520-2},
  pages     = {445 -- 452},
  year      = {2017},
  abstract  = {Die Lifespan-Forschung untersucht die Entwicklung von Individuen {\"u}ber den gesamten Lebenslauf. Die medizinische Rehabilitation hat nach geltendem Sozialrecht die Aufgabe, chronische Krankheiten abzuwenden, zu beseitigen, zu mindern, auszugleichen, eine Verschlimmerung zu verh{\"u}ten und Negativfolgen f{\"u}r die Lebensf{\"u}hrung zu reduzieren. Dies erfordert in wissenschaftlicher wie in praxisbezogener Hinsicht die Entwicklung einer Lebensspannenperspektive als Voraussetzung f{\"u}r die Klassifikation und Diagnostik chronischer Erkrankungen, die Beschreibung von verlaufsbeeinflussenden Faktoren, kritischen Lebensphasen und Critical Incidents (kritische Verlaufszeitpunkte), die Durchf{\"u}hrung von prophylaktischen Maßnahmen, die Entwicklung von Assessmentverfahren zur Erfassung und Bewertung von Verl{\"a}ufen oder Vorbehandlungen, die Auswahl und Priorisierung von Interventionen, eine Behandlungs- und Behandlerkoordination auf der Zeitachse, die Pr{\"a}zisierung der Aufgabenstellung f{\"u}r spezialisierte Rehabilitationsmaßnahmen, wie beispielsweise Rehabilitationskliniken, und als Grundlage f{\"u}r die Sozialmedizin. Aufgrund der Vielfalt der individuellen Risikokonstellationen, Krankheitsverl{\"a}ufe und Behandlungssituationen {\"u}ber die Lebensspanne hinweg, bedarf es in der medizinischen Rehabilitation in besonderer Weise einer personalisierten Medizin, die zugleich rehabilitationsf{\"o}rderliche und -behindernde Umweltfaktoren im Rehabilitationsverlauf ber{\"u}cksichtigt.},
  language  = {de}
}
@misc{PuschmannBeckSchiltenwolfetal.2017,
  author    = {Puschmann, Anne-Kathrin and Beck, Heidrun and Schiltenwolf, Marcus and Wippert, Pia-Maria and Mayer, Frank},
  title     = {Distress in a longitudinal study of a population with nonspecific low back pain},
  series = {Psychosomatic medicine},
  volume    = {79},
  journal   = {Psychosomatic medicine},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0033-3174},
  pages     = {A20 -- A21},
  year      = {2017},
  language  = {en}
}
@article{WippertPuschmannArampatzisetal.2017,
  author    = {Wippert, Pia-Maria and Puschmann, Anne-Katrin and Arampatzis, Adamantios and Schiltenwolf, Marcus and Mayer, Frank},
  title     = {Diagnosis of psychosocial risk factors in prevention of low back pain in athletes (MiSpEx)},
  series = {BMJ Open Sport \& Exercise Medicine},
  volume    = {3},
  journal   = {BMJ Open Sport \& Exercise Medicine},
  number    = {1},
  issn      = {2055-7647},
  doi       = {10.1136/bmjsem-2017-000295},
  year      = {2017},
  abstract  = {Background Low back pain (LBP) is a common pain syndrome in athletes, responsible for 28\% of missed training days/year. Psychosocial factors contribute to chronic pain development. This study aims to investigate the transferability of psychosocial screening tools developed in the general population to athletes and to define athlete-specific thresholds. Methods Data from a prospective multicentre study on LBP were collected at baseline and 1-year follow-up (n=52 athletes, n=289 recreational athletes and n=246 non-athletes). Pain was assessed using the Chronic Pain Grade questionnaire. The psychosocial Risk Stratification Index (RSI) was used to obtain prognostic information regarding the risk of chronic LBP (CLBP). Individual psychosocial risk profile was gained with the Risk Prevention Index - Social (RPI-S). Differences between groups were calculated using general linear models and planned contrasts. Discrimination thresholds for athletes were defined with receiver operating characteristics (ROC) curves. Results Athletes and recreational athletes showed significantly lower psychosocial risk profiles and prognostic risk for CLBP than non-athletes. ROC curves suggested discrimination thresholds for athletes were different compared with non-athletes. Both screenings demonstrated very good sensitivity (RSI=100\%; RPI-S: 75\%-100\%) and specificity (RSI: 76\%-93\%; RPI-S: 71\%-93\%). RSI revealed two risk classes for pain intensity (area under the curve (AUC) 0.92(95\% CI 0.85 to 1.0)) and pain disability (AUC 0.88(95\% CI 0.71 to 1.0)). Conclusions Both screening tools can be used for athletes. Athlete-specific thresholds will improve physicians' decision making and allow stratified treatment and prevention.},
  language  = {en}
}
@article{WippertPuschmannDriessleinetal.2017,
  author    = {Wippert, Pia-Maria and Puschmann, Anne-Katrin and Drießlein, David and Arampatzis, Adamantios and Banzer, Winfried and Beck, Heidrun and Schiltenwolf, Marcus and Schmidt, Hendrik and Schneider, Christian and Mayer, Frank},
  title     = {Development of a risk stratification and prevention index for stratified care in chronic low back pain. Focus: yellow flags (MiSpEx network)},
  series = {Pain reports},
  volume    = {9},
  journal   = {Pain reports},
  publisher = {Wolters Kluwer Health},
  address   = {Riverwoods, IL},
  doi       = {10.1097/PR9.0000000000000623},
  pages     = {1 -- 11},
  year      = {2017},
  abstract  = {Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges. Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S). Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined. Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95\% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly. Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments.},
  language  = {en}
}