A pilot study examining the effects of priming headache illness schema on attentional engagement towards pain relief medication,in those with high and low medication treatment beliefs

Few studies have assessed the underlying theoretical components of the Common Sense Model. Past studies have found, through implicit priming, that coping strategies are embedded within illness schema. Our aim was to evaluate the effect priming ‘headache’ illness schema upon attentional engagement to pain relief medication and to examine the interaction with illness treatment beliefs. Attentional engagement to the pain relief medication (‘Paracetamol’) was assessed using a 2 (primed vs. control) × 2 (strong belief in medication efficacy vs. weak belief in medication efficacy) design. During a grammatical decision task (identifying verbs/non-verbs), participants were randomised to receive a headache prime or a control. Response latency to the target word, ‘Paracetamol’ was the dependent variable. ‘Paracetamol’ treatment beliefs were determined using the brief illness perception questionnaire. Sixty-three participants completed the experiment. There was a significant interaction between illness-primed vs. control and high vs. low treatment efficacy of Paracetamol (p < .001), suggesting an attentional disengagement effect to the coping strategy in illness-primed participants whom held stronger treatment beliefs regarding the efficacy of Paracetamol. In summary, implicit illness schema activation may simultaneously activate embedded coping strategies, which appears to be moderated by specific illness beliefs.     

Humor, abstraction, and disbelief

We investigated humor as a context for learning about abstraction and disbelief. More specifically, we investigated how parents support humor understanding during book sharing with their toddlers. In Study 1, a corpus analysis revealed that in books aimed at 1-to 2-year-olds, humor is found more often than other forms of doing the wrong thing including mistakes, pretense, lying, false beliefs, and metaphors. In Study 2, 20 parents read a book containing humorous and non-humorous pages to their 19-to 26-month-olds. Parents used a significantly higher percentage of high abstraction extra-textual utterances (ETUs) when reading the humorous pages. In Study 3, 41 parents read either a humorous or non-humorous book to their 18-to 24-month-olds. Parents reading the humorous book made significantly more ETUs coded for a specific form of high abstraction: those encouraging disbelief of prior utterances. Sharing humorous books thus increases toddlers' exposure to high abstraction and belief-based language.     

The effects of laughter on discomfort thresholds: does expectation become reality?

Distraction and relaxation have been controlled in previous studies as possible mechanisms for the effectiveness of mirthful laughter in coping with pain and discomfort. The purpose of this study is to control expectation of benefit from laughter. Discomfort thresholds for a blood pressure cuff at the upper dominant arm were recorded immediately before and after exposure to either a humorous or a relaxation video. Instructional sets led participants to believe that the video would either increase or decrease their sensitivity to discomfort. A 5th group watched the humorous video without manipulation of expectation. All participants completed A. Ziv's (1979) Sense of Humor Questionnaire (SHQZ). Humor and relaxation videos raised discomfort thresholds, and the effect of both video types was enhanced by expectations. Humorous personality trait (SHQZ) did not moderate effects. The larger issue of whether mirthful laughter has any unique benefit for pain or discomfort control beyond the effects of relaxation, distraction, or expectation is discussed.     

Does humor facilitate coping with physical discomfort?

The mediation of superior coping with physical discomfort after humorous stimulation was explored through respondents' exposure to materials varying markedly in their capacity to evoke amusement and joviality. Both male and female respondents were exposed to (a) stand-up comedy, (b) situation comedy, (c) serious drama, (d) instructional material, or (e) tragedy. Discomfort threshold for cuff pressure at the upper arm was ascertained prior to and following exposure. Cognitive and affective responses to the materials were recorded after the postexposure threshold measurement. Compared against exposure to instructional material in the control condition, and compared against pre-exposure threshold measures, exposure to either type of comedy and, unexpectedly, to tragedy significantly elevated the threshold for physical discomfort in both male and female respondents. Serious drama had no such effect. Taken together, the exposure effects on the discomfort threshold could not be attributed to amusement reactions. Nor could they be considered mediated by responses of positive hedonic quality during and after exposure. There was some indication, however, that the capacity of stimuli to evoke humorous reactions (material being deemed funny) and the absorption potential of stimuli (material being deemed captivating) were positively involved in the mediation of postexposure tolerance of physical discomfort.The authors would like to thank Charles Aust, Rahul Biswas, Ted Jones, and John Owens for their assistance in the data collection and in the planning of this investigation.     

Quality of Life,Personality and Use of Pain Medication in Patients with Chronic Back Pain

The aim of the study was to assess whether the functional disability and the quality of life in patients with chronic back pain was associated with some personality traits and whether the use of pain medication in patients with chronic back pain can be predisposed with some personality traits. The study sample comprised 262 older patients with chronic back pain of non-inflammatory origin. The level of disability related to chronic back pain was assessed by Roland-Morris Questionnaire, health-related quality of life was assessed by Short Form 36 and personality traits by Eysenck Personality Questionnaire. Among analyzed personality traits (psychoticism, extraversion, neuroticism, lie tendencies), only neuroticism significantly predicted self-reported disability caused by back pain. Patients on pain medication had significantly worse quality of life and disability caused by back pain, but they did not differ significantly in personality traits compared to patients without pain medication. There were no differences in disability due to back pain and in level of neuroticism between patients who had jobs with higher or lower physical demand. People with higher scores on neuroticism inclined more to report a lower functional disability and the quality of life caused by chronic back pain. Patients on pain medication reported more inferior physical than psychological concept of quality of life. Use of pain medication was not associated with personality traits assessed by Eysenck Personality Questionnaire. In our elderly patients with chronic back pain, lower quality of life was associated with elevated neuroticism score and more frequent use of pain medication.     

Does religion affect humour creation? An experimental study

Humour has been hypothesized to be negatively affected by religion. In a recent study (Saroglou, 2000), religiosity and religious fundamentalism (contrary to 'quest' religiosity) were found to be negatively associated with humour creation. The present experiment investigated whether this association reflects causality. Eighty-five students were tested for their propensity to spontaneously produce humour as a response to hypothetical daily hassles after exposure to a religious video or to a humorous one vs. a non-stimulation condition. Significant effects of condition, gender and interaction were observed, and this in the predicted direction: religious stimulation inhibited humour, while humorous stimulation promoted it. Participants' religious fundamentalism and orthodoxy predicted low humour creation in the religious condition but not in the humorous one. The possible impact of conscientiousness is also discussed.     

Choice‐making,Expectations, and Treatment Positivity: How and When Choosing Shapes Aversive Experiences

Every day we use products and treatments with unknown but expected effects, such as using medication to manage pain. In many cases, we have a choice over which products or treatments to use; however, in other cases, people choose for us or choices are unavailable. Does choosing (versus not choosing) have implications for how a product or treatment is experienced? The current experiments examined the role of choice‐making in facilitating so‐called expectation assimilation effects—or situations in which a person's experiences (e.g., discomfort and pain) are evaluated in a manner consistent with their expectations. In Experiment 1, participants were initially exposed to a baseline set of aversive stimuli (i.e., sounds). Next, some participants were given expectations for two “treatments” (i.e., changes in screen display) that could ostensibly reduce discomfort. Critically, participants were either given a choice or not about which of the two treatments they preferred. Participants in a control condition were not provided with treatment expectations. Results revealed that discomfort experiences assimilated to expectations only when participants were provided with choice. Experiment 2 replicated this finding and provided evidence against the idea that demand characteristics and choice‐making unrelated to the core task (i.e., choices without associated expectations) could account for the results. Further, Experiment 2 showed that choosing reduced discomfort because of increased positivity about the treatment. Results are discussed in the context of extant research on choice‐making and expectation effects. Copyright © 2013 John Wiley & Sons, Ltd.     

The effect of mortality salience on the evaluation of humorous material

The motivational aspects of humor are considered from the perspective of terror management theory, testing the hypothesis that exposure to the mortality salience manipulation will result in an alteration in participants' appreciation of humorous material. Participants rated several comic strips, indicating how funny they found the jokes. The differential relevance of various forms of jokes to the process of terror management was also examined by having participants rate their appreciation of jokes that address issues of varying applicability to existential concerns. Results indicate that mortality salience results in an exacerbation of the evaluation of humorous material, and that jokes' relative centrality to terror management processes produces differing evaluative responses. Theoretical and practical implications are examined.     

Basal ganglia, dopamine and temporal processing: performance on three timing tasks on and off medication in Parkinson's disease

A pervasive hypothesis in the timing literature is that temporal processing in the milliseconds and seconds range engages the basal ganglia and is modulated by dopamine. This hypothesis was investigated by testing 12 patients with Parkinson's disease (PD), both 'on' and 'off' dopaminergic medication, and 20 healthy controls on three timing tasks. In a seconds range (30-120 s) time production task, patients tested 'on' medication showed a significantly different accuracy profile compared to controls and when tested 'off' medication. However, no group or on vs off medication differences in accuracy were found on a time reproduction task and a warned reaction time task requiring temporal processing within the 250-2000 ms range. Variability was measured using the coefficient of variation, with the performance of the patient group on the time reproduction task violating the scalar property, suggesting atypical temporal processing mechanisms. The data suggest that the integrity of the basal ganglia is necessary for 'typical' time production in the seconds range as well as for time reproduction at shorter intervals. Exploratory factor analysis suggested that the time production task uses neural mechanisms distinct from those used in the other two timing tasks. The dissociation of the effects of dopaminergic medication and nature of task on performance in PD raises interesting questions about the pharmacological mediation and task-specificity of deficits in temporal processing.     

When do trauma experts choose exposure therapy for PTSD patients? A controlled study of therapist and patient factors

To investigate when and why therapists opt for or rule out imaginal exposure (IE) for patients with posttraumatic stress disorder (PTSD), 255 trauma experts were randomized to two conditions in which they were presented with four cases in which the patients' comorbidity and treatment preferences were manipulated. The results confirmed IE to be an underutilized approach, with the majority of professionals being undertrained in the technique. As predicted, the patient factors influenced the expert's choice of therapy: in case of a comorbid depression, IE was significantly less preferred than medication. Also, IE was significantly more likely to be offered when patients expressed a preference for trauma-focused treatment. The therapist factors were also found to be importantly related to treatment preferences, with high credibility in the technique being positively related to the therapists' preference for IE. Perceived barriers to IE, such as a fear of symptom exacerbation and dropout, were negatively related to the perceived suitability of the treatment when patients had suffered multiple traumas in childhood. The results are discussed in the light of clinical implications and the need of exposure training for trauma professionals.     

The influence of gender on the frequency of pain and sedative medication administered to postoperative patients

This study examines whether the frequency of pain and sedative medication administered to postoperative coronary artery bypass graft (CABG) patients differs according to patient gender. It was hypothesized that nurses medicate patients with pain medication more frequently if they are men than if they are women. It was also hypothesized that nurses medicate female patients with sedative medication more frequently than male patients. The hypotheses in this study were based on a review of the literature indicating that health care professionals hold stereotypic views of women as emotionally labile and more apt to exaggerate complaints of pain than men. The medication records of 30 male and 30 female patients between 44–71 years of age, who had undergone recent CABG surgery, were evaluated in this study. Male and female patients were matched on the basis of age, number of grafts completed in surgery, and location of graft donor sites. All data were obtained through the use of medical records to allow for control of patients' current and past medical history. The frequency of pain and sedative medication administered to these patients from 12 hours postop to 72 hours postop was compared. The results revealed that male patients were administered pain medication significantly more frequently than female patients, and that female patients were administered sedative medication significantly more frequently than male patients. Also, patients 61 years or younger received pain medication significantly more frequently than those patients 62 years and over.     

医学生疼痛共情的认知过程特征：来自ERP的证据

以往研究发现临床医生的疼痛共情显著低于常人,表现为前者感知他人疼痛时会出现早期情绪分享和晚期情绪调节的相对抑制。而处于职前培养期的医学生是否存在相似问题,其疼痛共情又是否会受到重复暴露的影响,目前并不清楚。为此,本研究采用ERP技术比较了医学与非医学专业大学生疼痛共情的认知过程,并通过前后测设计检验了重复暴露对二者疼痛共情的影响。行为结果发现两组被试的主观疼痛判断都出现了疼痛共情效应,但未出现组别差异,也未发现重复暴露的影响。但ERP结果显示,医学生的疼痛共情过程显著区别于非医学生。他们虽表现出早期情绪分享成分N1的抑制效应,但LPP反映的晚期认知加工却显著增强,且上述两阶段加工均未受到重复暴露的显著影响。研究表明：（1）医学学习能够抑制疼痛共情的早期情绪分享,但医学生仍可通过更多晚期认知资源投入来维持其疼痛共情水平。（2）医学生的疼痛共情较少受到重复暴露的影响,呈现情绪适应特点。     

Perceived self-efficacy and pain control: opioid and nonopioid mechanisms

In this experiment, we tested for opioid and nonopioid mechanisms of pain control through cognitive means and the relation of opioid involvement to perceived coping efficacy. Subjects were taught cognitive methods of pain control, were administered a placebo, or received no intervention. Their pain tolerance was then measured at periodic intervals after they were administered either a saline solution or naloxone, an opiate antagonist that blocks the effects of endogenous opiates. Training in cognitive control strengthened perceived self-efficacy both to withstand and to reduce pain; placebo medication enhanced perceived efficacy to withstand pain but not reductive efficacy; and neither form of perceived self-efficacy changed without any intervention. Regardless of condition, the stronger the perceived self-efficacy to withstand pain, the longer subjects endured mounting pain stimulation. The findings provide evidence that attenuation of the impact of pain stimulation through cognitive control is mediated by both opioid and nonopioid mechanisms. Cognitive copers administered naloxone were less able to tolerate pain stimulation than were their saline counterparts. The stronger the perceived self-efficacy to reduce pain, the greater was the opioid activation. Cognitive copers were also able to achieve some increase in pain tolerance even when opioid mechanisms were blocked by naloxone, which is in keeping with a nonopioid component in cognitive pain control. We found suggestive evidence that placebo medication may also activate some opioid involvement. Because placebos do not impart pain reduction skills, it was perceived self-efficacy to endure pain that predicted degree of opioid activation.     

“It’s not funny if they’re laughing”: Self-categorization, social influence, and responses to canned laughter

Pre-recorded, or “canned” laughter is often used to encourage audience laughter. Previous research suggests that hearing others laugh can influence an audience, although several variables moderate its effects. We examined an unexplored moderator, hypothesizing that canned laughter would influence listeners only if they believed the laughter came from fellow in-group members. We manipulated the presence or absence of canned laughter in a potentially humorous recording and participants’ beliefs about the in-group or out-group composition of the laughing audience. The results confirmed our hypothesis: participants laughed and smiled more, laughed longer, and rated humorous material more favorably when they heard in-group laughter rather than out-group laughter or no laughter at all.     

Adherence to pharmacological treatment of non-malignant chronic pain: The role of illness perceptions and medication beliefs

The objective was to identify the degree to which illness perceptions and medication beliefs explain variations in reported adherence to medication prescribed for the treatment of non-malignant chronic pain and to test the applicability of an extended version of the self-regulatory model to the chronic pain population. A cross-sectional design included 217 clinic patients completing validated questionnaires assessing their illness perceptions, medication beliefs and reported adherence to medication. Perceptions of illness (pain) as chronic, uncontrollable and unremitting were associated with greater adherence, fewer medication concerns and a belief that treatment was necessary. Structural equation modelling supports an extended SRM for chronic pain. It suggests that patients holding perceptions of serious consequences of pain and high emotion levels have more concerns about medication and are less adherent. Perceptions of serious illness consequences are also associated with stronger beliefs about the necessity of medicines and greater adherence. Beliefs about illness and medication are associated with adherence to treatment in chronic pain and this can be explained by an extended SRM. Results are preliminary and require replication. Further studies should explore the role that emotion has on coping strategies in chronic pain. Interventions should focus on altering unhelpful beliefs that reduce adherence.     

Treating body dysmorphic disorder with medication: evidence, misconceptions, and a suggested approach

Body dysmorphic disorder (BDD) is a relatively common and often disabling disorder with high morbidity and mortality. Both psychotropic medication and cognitive behavioral therapy (CBT) are considered first-line treatments for BDD, and medication treatment is often essential for more severely ill and suicidal patients. In this practical overview of the pharmacotherapy of BDD, we briefly describe BDD's clinical features, associated morbidity, and how to recognize and diagnose BDD. We describe the importance of forming a therapeutic alliance with the patient, the need for psychoeducation, and other essential groundwork for successful treatment of BDD. We review available pharmacotherapy research, with a focus on serotonin-reuptake inhibitors (SSRIs, or SRIs), which are currently considered the medication of choice for BDD. Many patients have substantial improvement in core BDD symptoms, psychosocial functioning, quality of life, suicidality, and other aspects of BDD when treated with appropriate pharmacotherapy that targets BDD symptoms. We also discuss practical issues such as dosing, length of treatment, and potential side effects associated with the use of SRIs. In addition, we discuss pharmacotherapy approaches that can be tried if SRI treatment alone is not adequately helpful. Finally, some misconceptions about pharmacotherapy, gaps in knowledge about BDD's treatment, and the need for additional research are discussed.     

Effects of morphine and naloxone upon the reactions of rats to a heat stressor

Five experiments used rats to examine the conditioned hypoalgesia induced by exposure to a heated floor. Experiments 1 and 2 demonstrated that this hypoalgesia is mediated by non-opioid mechanisms of pain control, as evidenced by insensitivity to the opioid antagonist naloxone and by the absence of cross-tolerance with the opioid agonist morphine. Although non-opioid in nature, the acquisition of conditioned hypoalgesia was facilitated by naloxone and impaired by morphine (Experiments 3 and 4). These effects did not appear to be due to an opioid regulation of pain. (1) Pairing morphine with the heated floor attenuated acquisition in drug-tolerant rats. (2) This attenuation by morphine was removed when naloxone was given after exposure to the heated floor. (3) Conditioning was facilitated when naloxone was given after exposure to the heated floor (Experiment 5). The results were discussed in terms of an opioid regulation of (a) surprise, (b) arousal of an aversive motivational system, and (c) the affective component of pain.     

Fifteen-Month-Old Infants Match Vocal Cues to Intentional Actions

Fifteen-month-old infants detected a violation when an actor performed an action that did not match her preceding vocal cue: The infants looked reliably longer when the actor expressed a humorous vocal cue followed by a sweet action or expressed a sweet vocal cue followed by a humorous action, than when the vocal cue was followed by a matching action. The infants failed to detect the mismatch when one person expressed the vocal cue and another performed the action. The results suggest that by 15 months of age, infants are capable of distinguishing between two types of vocal cues and actions along the positive emotional spectrum: humor and sweetness. Furthermore, they match humorous vocal cues to humorous actions and sweet vocal cues to sweet actions only when the cues and actions are made by the same person.     

Fear,excitement, and financial risk-taking

Can fear trigger risk-taking? In this paper, we assess whether fear can be reinterpreted as a state of excitement as a result of contextual cues and promote, rather than discourage, risk-taking. In a laboratory experiment, the participants' emotional states were induced (fear vs. control), followed by a purportedly unrelated financial task. The task was framed as either a stock market investment or an exciting casino game. Our results showed that incidental fear (vs. control) induced risk-averse behaviour when the task was framed as a stock investment decision. However, fear encouraged risk-taking when the very same task was framed as an exciting casino game. The impact of fear on risk-taking was partially mediated by the excitement felt during the financial task.     

Self-monitoring and humor production1

According to reviews by Goodchilds (1972) and Lieberman (1977) of research on humor, the least studied component of the humorous event is the humorous person. Results of two studies investigating the relation between individual differences in self-monitoring and humor production are reported. In the first study, subjects completed a self-report measure of humorousness, captioned as many cartoons as possible within five minutes, and performed a three-minute monologue. The second study involved a group-discussion task. As predicted, high self-monitors compared to low self-monitors rated themselves as more humorous, generated more humorous cartoon captions, produced more humorous monologues, and were nominated by group participants as having made more witty remarks. The humorousness of the high self-monitors was discussed in terms of control of affective display and mastery of interpersonal skills required to initiate and maintain social interaction.