@article{PuschmannDriessleinBecketal.2020,
  author    = {Puschmann, Anne-Katrin and Drießlein, David and Beck, Heidrun and Arampatzis, Adamantios and Moreno Catal{\´a}, Maria and Schiltenwolf, Marcus and Mayer, Frank and Wippert, Pia-Maria},
  title     = {Stress and Self-Efficacy as Long-Term Predictors for Chronic Low Back Pain},
  series = {Journal of Pain Research},
  volume    = {13},
  journal   = {Journal of Pain Research},
  publisher = {Dove Medical Press},
  address   = {Albany, Auckland},
  issn      = {1178-7090},
  doi       = {10.2147/JPR.S223893},
  pages     = {613 -- 621},
  year      = {2020},
  abstract  = {Purpose: Psychosocial variables are known risk factors for the development and chronification of low back pain (LBP). Psychosocial stress is one of these risk factors. Therefore, this study aims to identify the most important types of stress predicting LBP. Self-efficacy was included as a potential protective factor related to both, stress and pain. Participants and Methods: This prospective observational study assessed n = 1071 subjects with low back pain over 2 years. Psychosocial stress was evaluated in a broad manner using instruments assessing perceived stress, stress experiences in work and social contexts, vital exhaustion and life-event stress. Further, self-efficacy and pain (characteristic pain intensity and disability) were assessed. Using least absolute shrinkage selection operator regression, important predictors of characteristic pain intensity and pain-related disability at 1-year and 2-years follow-up were analyzed. Results: The final sample for the statistic procedure consisted of 588 subjects (age: 39.2 (± 13.4) years; baseline pain intensity: 27.8 (± 18.4); disability: 14.3 (± 17.9)). In the 1-year follow-up, the stress types "tendency to worry", "social isolation", "work discontent" as well as vital exhaustion and negative life events were identified as risk factors for both pain intensity and pain-related disability. Within the 2-years follow-up, Lasso models identified the stress types "tendency to worry", "social isolation", "social conflicts", and "perceived long-term stress" as potential risk factors for both pain intensity and disability. Furthermore, "self-efficacy" ("internality", "self-concept") and "social externality" play a role in reducing pain-related disability. Conclusion: Stress experiences in social and work-related contexts were identified as important risk factors for LBP 1 or 2 years in the future, even in subjects with low initial pain levels. Self-efficacy turned out to be a protective factor for pain development, especially in the long-term follow-up. Results suggest a differentiation of stress types in addressing psychosocial factors in research, prevention and therapy approaches.},
  language  = {en}
}
@article{WippertNiedererDriessleinetal.2020,
  author    = {Wippert, Pia-Maria and Niederer, Daniel and Drießlein, David and Beck, Heidrun and Banzer, Winfried Eberhard and Schneider, Christian and Schiltenwolf, Marcus and Mayer, Frank},
  title     = {Psychosocial Moderators and Mediators of Sensorimotor Exercise in Low Back Pain: A Randomized Multicenter Controlled Trial},
  series = {Frontiers in Psychiatry},
  volume    = {12},
  journal   = {Frontiers in Psychiatry},
  publisher = {Frontiers Research Foundation},
  address   = {Lausanne, Schweiz},
  issn      = {1664-0640},
  doi       = {10.3389/fpsyt.2021.629474},
  pages     = {1 -- 16},
  year      = {2020},
  abstract  = {The effects of exercise interventions on unspecific chronic low back pain (CLBP) have been investigated in many studies, but the results are inconclusive regarding exercise types, efficiency, and sustainability. This may be because the influence of psychosocial factors on exercise induced adaptation regarding CLBP is neglected. Therefore, this study assessed psychosocial characteristics, which moderate and mediate the effects of sensorimotor exercise on LBP. A single-blind 3-arm multicenter randomized controlled trial was conducted for 12-weeks. Three exercise groups, sensorimotor exercise (SMT), sensorimotor and behavioral training (SMT-BT), and regular routines (CG) were randomly assigned to 662 volunteers. Primary outcomes (pain intensity and disability) and psychosocial characteristics were assessed at baseline (M1) and follow-up (3/6/12/24 weeks, M2-M5). Multiple regression models were used to analyze whether psychosocial characteristics are moderators of the relationship between exercise and pain, meaning that psychosocial factors and exercise interact. Causal mediation analysis were conducted to analyze, whether psychosocial characteristics mediate the exercise effect on pain. A total of 453 participants with intermittent pain (mean age = 39.5 ± 12.2 years, f = 62\%) completed the training. It was shown, that depressive symptomatology (at M4, M5), vital exhaustion (at M4), and perceived social support (at M5) are significant moderators of the relationship between exercise and the reduction of pain intensity. Further depressive mood (at M4), social-satisfaction (at M4), and anxiety (at M5 SMT) significantly moderate the exercise effect on pain disability. The amount of moderation was of clinical relevance. In contrast, there were no psychosocial variables which mediated exercise effects on pain. In conclusion it was shown, that psychosocial variables can be moderators in the relationship between sensorimotor exercise induced adaptation on CLBP which may explain conflicting results in the past regarding the merit of exercise interventions in CLBP. Results suggest further an early identification of psychosocial risk factors by diagnostic tools, which may essential support the planning of personalized exercise therapy. Level of Evidence: Level I. Clinical Trial Registration: DRKS00004977, LOE: I, MiSpEx: grant-number: 080102A/11-14. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML\&TRIAL_ID=DRKS00004977.},
  language  = {en}
}
@misc{WuertzKozakRoszkowskiCambriaetal.2020,
  author    = {Wuertz-Kozak, Karin and Roszkowski, Martin and Cambria, Elena and Block, Andrea and Kuhn, Gisela A. and Abele, Thea and Hitzl, Wolfgang and Drießlein, David and M{\"u}ller, Ralph and Rapp, Michael A. and Mansuy, Isabelle M. and Peters, Eva M. J. and Wippert, Pia-Maria},
  title     = {Effects of Early Life Stress on Bone Homeostasis in Mice and Humans},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {670},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-48532},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-485324},
  pages     = {26},
  year      = {2020},
  abstract  = {Bone pathology is frequent in stressed individuals. A comprehensive examination of mechanisms linking life stress, depression and disturbed bone homeostasis is missing. In this translational study, mice exposed to early life stress (MSUS) were examined for bone microarchitecture (μCT), metabolism (qPCR/ELISA), and neuronal stress mediator expression (qPCR) and compared with a sample of depressive patients with or without early life stress by analyzing bone mineral density (BMD) (DXA) and metabolic changes in serum (osteocalcin, PINP, CTX-I). MSUS mice showed a significant decrease in NGF, NPYR1, VIPR1 and TACR1 expression, higher innervation density in bone, and increased serum levels of CTX-I, suggesting a milieu in favor of catabolic bone turnover. MSUS mice had a significantly lower body weight compared to control mice, and this caused minor effects on bone microarchitecture. Depressive patients with experiences of childhood neglect also showed a catabolic pattern. A significant reduction in BMD was observed in depressive patients with childhood abuse and stressful life events during childhood. Therefore, future studies on prevention and treatment strategies for both mental and bone disease should consider early life stress as a risk factor for bone pathologies.},
  language  = {en}
}
@article{WuertzKozakRoszkowskiCambriaetal.2020,
  author    = {Wuertz-Kozak, Karin and Roszkowski, Martin and Cambria, Elena and Block, Andrea and Kuhn, Gisela A. and Abele, Thea and Hitzl, Wolfgang and Drießlein, David and M{\"u}ller, Ralph and Rapp, Michael A. and Mansuy, Isabelle M. and Peters, Eva M. J. and Wippert, Pia-Maria},
  title     = {Effects of Early Life Stress on Bone Homeostasis in Mice and Humans},
  series = {International Journal of Molecular Sciences},
  volume    = {21},
  journal   = {International Journal of Molecular Sciences},
  number    = {18},
  publisher = {Molecular Diversity Preservation International},
  address   = {Basel},
  issn      = {1422-0067},
  doi       = {10.3390/ijms21186634},
  pages     = {24},
  year      = {2020},
  abstract  = {Bone pathology is frequent in stressed individuals. A comprehensive examination of mechanisms linking life stress, depression and disturbed bone homeostasis is missing. In this translational study, mice exposed to early life stress (MSUS) were examined for bone microarchitecture (μCT), metabolism (qPCR/ELISA), and neuronal stress mediator expression (qPCR) and compared with a sample of depressive patients with or without early life stress by analyzing bone mineral density (BMD) (DXA) and metabolic changes in serum (osteocalcin, PINP, CTX-I). MSUS mice showed a significant decrease in NGF, NPYR1, VIPR1 and TACR1 expression, higher innervation density in bone, and increased serum levels of CTX-I, suggesting a milieu in favor of catabolic bone turnover. MSUS mice had a significantly lower body weight compared to control mice, and this caused minor effects on bone microarchitecture. Depressive patients with experiences of childhood neglect also showed a catabolic pattern. A significant reduction in BMD was observed in depressive patients with childhood abuse and stressful life events during childhood. Therefore, future studies on prevention and treatment strategies for both mental and bone disease should consider early life stress as a risk factor for bone pathologies.},
  language  = {en}
}