Family etiology of psychogenic pain: The systems perspectives

A close examination of the causation of psychogenic pain as enuciated by the protagonists of strategic and structural family theories clearly reveal that linear rather than circular logic underlies their conceptualization of etiologic mechanisms and to date there is very little empirical evidence to support their claim of family etiology. It is argued that the strategic perspective on symtom formation is predicated on untestable assumptions. According to the structural family model learning theory is the basis for psychogenic pain in children. The strategic and structural family models are, however, powerful conceptual tools for an understanding of internal family forces that all too often result in the maintenance and perpetuation of pain symptom and pain behaviour.I am deeply grateful to Professor Walters for his help in clarifying my thoughts on this complex topic.     

Chronic pelvic pain: A meta-analytic review

Abstract

Chronic pelvic pain (CPP) in women of reproductive age is a common complaint; for many women no identifiable pathology can be found. Research has suggested that women who have chronic pelvic pain without obvious pathology differ on a range of psychological characteristics, such as anxiety and depression, compared with those with identified pathology. A meta-analysis of 22 studies was undertaken to clarify these issues. Results showed that there were no significant differences on a range of psychological variables between women who were identified, via laparoscopy and clinical judgement, as having organic disorders and those who were not so identified. When women with chronic pelvic pain were compared with pain-free groups a profile of elevated depression, anxiety, neuroticism and psychopathology was found which is consistent with findings from studies of other painful conditions.     

The concept of adaptation-level in psychological research

Vuorinen, R. The concept of adaptation-level in psychological research. Scand. J. Psychol., 1973, 14, 228–240.- Helson's adaptation-level theory (ALT) is appraised as a general theory of psychology. The reformulated Fechner law underlying ALT is shown to be untenable and the conceptual status of AL is shown to be self-contradictory. The ambiguous measures and the inconsistent theoretical definitions proposed for AL are found to limit the scope of ALT. Reasons for its flexibility and claimed heuristic value are analyzed and potential sources of confusion are suggested. Some defects of ALT are likely to be shared by other behaviouristic theories since they follow from a commitment to the strict S-R model.     

Salivary cortisol concentrations, stress and quality of life in women with endometriosis and chronic pelvic pain

The objective of this study was to evaluate the perceived stress index, quality of life, and hypothalamus-pituitary-adrenal axis activity in women with endometriosis and chronic pelvic pain. For the study, 93 women with endometriosis and 82 healthy women volunteered. The visual analogue scale (VAS) (0=no pain; 10=severe pain) was used to determine pain intensity; the perceived stress questionnaire (PSQ) defined stress index, and the health-related quality-of-life (HRQOL)-SF-36 questionnaire was used to evaluate quality of life. Salivary cortisol was measured at 0800, 1600, and 2000 h and the awakening cortisol response was assessed to evaluate the hypothalamus-pituitary-adrenal axis activity. The results show that women with endometriosis and chronic pelvic pain of moderate intensity (4.1+/-0.58, mean+/-SEM) have higher levels of perceived stress (0.55+/-0.01 versus 0.42+/-0.01, p<0.05), a poorer quality of life expressed as lower scores for all items of the inventory and hypocortisolism. Lower levels of salivary cortisol were observed in all three samples collected, as well as in the awakening cortisol response, for women with endometriosis (0.19+/-0.09 microg/dl) when compared with controls (0.78+/-0.08 microg/dl, p<0.05 l), and it was independent of pain intensity and Mental health (MH) scores in SF-36. We concluded that women with endometriosis and chronic pelvic pain show low concentrations of salivary cortisol and a high level of perceived stress, associated with a poor quality of life. Whether the hypocortisolism was an adaptive response to the aversive symptoms of the disorder or a feature related to the etiology of endometriosis remains to be elucidated.     

The disruptive nature of pain: An experimental investigation

Pain interrupts, distracts and takes effort to ignore. Focusing our research attention upon this central aspect of pain experience, an experimental paradigm is introduced to study the disruptive nature of pain. Healthy volunteers were exposed several times to an electrical pain stimulus and a control stimulus. Tone probes were presented immediately (100 ms) and later on (1500 ms) after pain/control onset, and after pain/control offset (1000 ms). Results clearly showed disruption during pain. This disruptive effect was most marked immediately after onset. No differential results between pain and control conditions were observed later on during the pain experience. These results are interpreted within current cognitive and psychophysiological theories of attention. Emphasis is placed upon the importance of the experimental investigation of the role of attention in pain processing.     

The evolution of the boundaryless career concept: Examining physical and psychological mobility

Although there has been increased interest in the boundaryless career since the publication of Arthur and Rousseau’s book (1996), there is still some misunderstanding about what the concept means. This article examines the boundaryless career and presents a model that attempts to visually capture Arthur and Rousseau’s suggestion that the concept involves six underlying meanings. Rather than considering whether or not an individual has a boundaryless career, the model focuses on the degree of mobility reflected in a career along two continua: one psychological, one physical. Based on the model, we suggest five propositions and a series of directions for future research.     

Aesthetic package design: A behavioral,neural, and psychological investigation

In four experiments, this research sheds light on aesthetic experiences by rigorously investigating behavioral, neural, and psychological properties of package design. We find that aesthetic packages significantly increase the reaction time of consumers' choice responses; that they are chosen over products with well-known brands in standardized packages, despite higher prices; and that they result in increased activation in the nucleus accumbens and the ventromedial prefrontal cortex, according to functional magnetic resonance imaging (fMRI). The results suggest that reward value plays an important role in aesthetic product experiences. Further, a closer look at psychometric and neuroimaging data finds that a paper-and-pencil measure of affective product involvement correlates with aesthetic product experiences in the brain. Implications for future aesthetics research, package designers, and product managers are discussed.     

Romantic involvement,self-discrepancy,and psychological well-being: A preliminary investigation

In this study, we explored the relation between romantic involvement status, actual/Ideal self-discrepancy, and psychological well-being. We hypothesized that romantically involved individuals would report being closer to their ideal selves than would romantically uninvolved individuals. We also hypothesized that the reduced self-discrepancy reported by romantically involved individuals would be related to their experiencing higher levels of psychological well-being in comparison to romantically uninvolved individuals. Romantically involved and romantically uninvolved subjects rated their actual selves, closeness to their ideal selves, and psychological well-being. Results were consistent with both hypotheses. Although romantically involved and romantically uninvolved subjects did not differ in ratings of their actual selves, romantically involved subjects reported being significantly closer to their ideal selves. Furthermore, romantically involved subjects tended to report higher psychological well-being.     

The role of additional information in the compliance,satisfaction, psychological,and emotion responses of non-surgical patients with low back pain: An exploratory investigation

Abstract

Noncompliance and the psychological and emotional states of patients with low back pain are major concerns for health professionals. The current study evaluated whether amount of information available to patients enhanced compliance to a medical regimen and whether it reduced negative emotions in patients with low back pain. Forty-five orthopaedic non-surgical patients with low back pain were randomly assigned to one of three information presentation conditions: 1) Standard, 2) Pre-examination, and 3) Post-examination. Patients were also separated by compensation and noncompensation within each information group. Patients completed questionnaires at their initial visit and at their follow-up which evaluated their: levels of compliance to a prescribed treatment program, psychological, and emotional states. Results indicated that some patients benefitted from receiving additional information as the Pre-examination and Post-examination groups demonstrated superior comprehension and recall as well as higher levels of compliance to a physical therapy program. In addition, compensation patients complained of more negative psychological and emotional behaviors in comparison to noncompensation patients. Implications of the research and future research considerations were discussed.     

Preliminary report: psychological assessment of Greek women with diabetes during pregnancy

23 Greek pregnant women with type 1 diabetes had a higher mean score on the Maudsley Obsessive-Compulsive Inventory in the second and third trimesters of pregnancy than 13 women with gestational diabetes. Long-term changes in the lifestyle of the former may apparently lead to this higher mean. For those with gestational diabetes, higher scores of alexithymia were correlated with slightly worse glycemic control.     

Acute back pain: a psychological analysis.

A cross-sectional evaluation of 117 people who sustained acute back injuries was undertaken within 15 days of the first report of the pain. The subjects showed no discal or neural signs and had not experienced previous episodes of back or neck pain. All subjects were given a structured interview and filled in a series of psychological evaluation instruments. Results show acute pain reactions to be comparable to those seen in chronic pain groups. The predominant emotion is one of frustration rather than anxiety or depression and considerable behavioural disruption is evident from this early point. The extent to which these data undermine the model of gradual evolution of chronic back pain problems is discussed.     

Ageism and psychological testing with elderly immigrant women

The focus on aging and ageism are fairly recent in psychology. Nevertheless, it is clear that these processes are of particular interest to many psychologists involved in psychological assessment, since both of these affect the content and the process of the assessment. In the present paper some key issues are raised regarding ageism and stereotypes of the aging held by mental health professionals and psychologists in particular. On the assumption that psychological testing with the aging is required to achieve accurate diagnoses and therapeutic interventions, some concerns about how psychological testing with the aging should proceed is presented.