Animal Pain: What It is and Why It Matters

The basis of having a direct moral obligation to an entity is that what we do to that entity matters to it. The ability to experience pain is a sufficient condition for a being to be morally considerable. But the ability to feel pain is not a necessary condition for moral considerability. Organisms could have possibly evolved so as to be motivated to flee danger or injury or to eat or drink not by pain, but by “pangs of pleasure” that increase as one fills the relevant need or escapes the harm. In such a world, “mattering” would be positive, not negative, but would still be based in sentience and awareness. In our world, however, the “mattering” necessary to survival is negative—injuries and unfulfilled needs ramify in pain. But physical pain is by no means the only morally relevant mattering—fear, anxiety, loneliness, grief, certainly do not equate to varieties of physical pain, but are surely forms of “mattering.” An adequate morality towards animals would include a full range of possible matterings unique to each kind of animal, what I, following Aristotle, call “telos”. Sometimes not meeting other aspects of animal nature matter more to the animal than does physical pain. “Negative mattering” means all actions or events that harm animals—from frightening an animal to removing its young unnaturally early, to keeping it so it is unable to move or socialize. Physical pain is perhaps the paradigmatic case of “negative mattering”, but only constitutes a small part of what the concept covers. “Positive mattering” would of course encompass all states that are positive for the animal. An adequate ethic for animals takes cognizance of both kinds. The question arises as to how animals value death as compared with pain. Human cognition is such that it can value long-term future goals and endure short-run negative experiences for the sake of achieving them. In the case of animals, however, there is no evidence, either empirical or conceptual, that they have the capability to weigh future benefits or possibilities against current misery. We have no reason to believe that an animal can grasp the notion of extended life, let alone choose to trade current suffering for it. Pain may well be worse for animals than for humans, as they cannot rationalize its acceptance by appeal to future life without pain. How can we know that animals experience all or any of the negative or positive states we have enumerated above? The notion that we needed to be agnostic or downright atheistic about animal mentation, including pain, because we could not verify it through experience, became a mainstay of what I have called “scientific ideology”, the uncriticized dogma taught to young scientists through most of the 20th century despite its patent ignoring of Darwinian phylogenetic continuity. Together with the equally pernicious notion that science is “value-free”, and thus has no truck with ethics, this provided the complete justification for hurting animals in science without providing any pain control. This ideology could only be overthrown by federal law. Ordinary common sense throughout history, in contradistinction to scientific ideology, never denied that animals felt pain. Where, then, does the denial of pain and other forms of mattering come from if it is inimical to common sense? It came from the creation of philosophical systems hostile to common sense and salubrious to a scientific, non-commonsensical world view. Reasons for rejecting this philosophical position are detailed. In the end, then, there are no sound reasons for rejecting knowledge of animal pain and other forms of both negative and positive mattering in animals. Once that hurdle is cleared, science must work assiduously to classify, understand, and mitigate all instances of negative mattering occasioned in animals by human use, as well as to understand and maximize all modes of positive mattering.     

Application of Problem Solving Therapy for Late-Life Anxiety

Cognitive behavioral therapy for anxiety has demonstrated lower efficacy in older compared with younger adults. Yet, few other evidence-based options for late-life anxiety have been examined. This case series aimed to demonstrate the application of Problem Solving Therapy (PST) to older adults with anxiety disorders building on PST’s strong empirical support for treating late-life depression. PST was implemented to treat three older primary-care patients diagnosed with anxiety disorders. We present treatment outcomes and discuss the feasibility and acceptability of using PST to treat these patients. Implications and lessons learned from these patients are discussed to inform further development of PST to better meet the needs of older patients suffering from late-life anxiety.     

A Psychoeducational Approach to Hypochondriasis: Background,Content, and Practice Guidelines

Patients suffering from health anxiety are difficult to engage in a psychological treatment, although it has now been empirically established that cognitive behavioral treatments are beneficial for many of these patients. A first important step is to change their orientation from a biomedical to a biopsychosocial perspective. One way of promoting this change is to provide focused psychoeducation. A number of studies have shown that group psychoeducation for patients with health anxiety results in a reduction in anxious concerns, depression, and medical services utilization. The purpose of this paper is to describe the background, content, and implementation of a brief course entitled “Coping With Health Anxiety.” The empirical support as well as the potentially active ingredients of this approach are discussed.     

When does power trigger approach motivation? Threats and the role of perceived control in the power domain

It is widely believed that power activates the behavioral approach system (Guinote, 2017 ; Keltner, Gruenfeld, & Anderson, 2003 ); however, findings are inconsistent. Here we discuss evidence suggesting that perceived threats to control in the power domain are key determinants of the association between power and approach motivation. We propose that objective or subjective threats to the exercise of power trigger behavioral inhibition, conflicts between approach and behavioral inhibition, and reactive, negatively valenced approach motivation. Furthermore, threatened power holders reassert power—in particular by using coercion—as defense against threat. We discuss literature in support of these hypotheses involving external threats (e.g., instability, illegitimacy, and uncertainty) and subjective states (anxiety, motivation to maintain power, perceived incompetence, submissiveness, and perceptions of low power) that trigger the perception of lack of control in the power domain and undermine the positive tone of power holders' approach motivation.     

Keeping the “cognitive” in cognitive neuroscience, the “affective” in affective neuroscience, and the “behavioral” in behavioral neuroscience: The CABN mission for the next five years

The fields of cognitive, affective, and behavioral neuroscience have been with us for many years now, and have served to spawn an ever growing body of research that has helped to clarify the mechanisms by which the brain gives rise to the diverse processes that govern our thoughts, emotions, and behaviors. These fields of research have grown exponentially as more and more tools have become available for invasive and noninvasive measures of brain function in both humans and animals, and as information about the human and animal genomes has increased. These advances in neurosciencebased tools have clearly advanced our knowledge and understanding of brain—behavior relationships. However, there is also a danger that lurks in the shadows of these methodological and empirical advances. This danger is that the enticement of understanding neural processes sometimes leads us to forget about the exact phenomena that we ultimately wish to understand and explain—namely, cognitive, affective, and behavioral processes. What do I mean by danger? I mean the concern that we often seem to prioritize the sophistication of our neural and genetic tools and theorizing over our psychological tools and theorizing, and that we may overlook the absence of linkage between neural (e.g., imaging results at a range of levels) or genetic findings and well—grounded psychological theories about specific cognitive, affective, or behavioral mechanisms. In other words, we can be seduced by the “call of the brain mechanism,” without a reminder of the phenomena we wish to explain.     

Pain catastrophizing mediates the relationship between worry and pain suffering in patients with irritable bowel syndrome

Although separate lines of behaviorally oriented pain research have drawn attention to the importance of pain catastrophizing and trait worry, little is known about how they work together to influence aspects of chronic pain. Integrating pain research with the broader anxiety, cognitive science, and learning literature, we hypothesized that the process (vs. content) of worry influences pain through catastrophizing. One hundred and eighty-six consecutive patients diagnosed (Rome II) with irritable bowel syndrome completed measures of three dimensions of pain (sensory pain, affective pain, long-term suffering), pain intensity, trait anxiety, worry, catastrophizing, and somatization during baseline assessment of an NIH-funded clinical trial of two psychological treatments. Worry was most strongly associated with the emotionally unpleasant aspects of pain, particularly suffering. Multivariate mediational analyses showed that catastrophizing mediated the link between worry and suffering. Worry, catastrophizing and control variables accounted for 46% of the variance in suffering. Chronic pain patients who worry excessively engage in more catastrophic thinking and through this cognitive process experience more intensely the suffering component of pain. Data are consistent with the notion that worry functions as an "experiential avoidance" strategy for aversive features of pain. Findings are discussed with respect to their relevance to behavioral models for understanding and treating anxiety-related chronic pain disorders.     

The 2004 Indian Ocean Tsunami Catastrophe,its Survivors,Job and the Universal Features of Suffering: A Theoretical Study

The purpose of this theoretical article is to discuss the existential and universal feature of suffering—as illustrated by Job’s suffering in the Book of Job in the Bible and by the survivors of the 2004 Asian tsunami catastrophe—and to highlight its significance for health care. Further, the study is aiming at contributing to health professionals’ understanding of patients’ suffering. The sources are narratives, comprising Job’s book, TV interviews 1 year after the tsunami catastrophe and the survivors’ autobiographies. The methodological approach is a philosophical analysis. The existential, universal, ontological and epistemological aspects of suffering are carefully scrutinized to unveil the universal and existential versus culture-specific features of suffering. Based on the results, the authors’ recommendations are (1) a holistic concept of the patient and health care has to seriously consider suffering in all its complexity because when a person is in pain, it is not his/her body but the whole person as a unity of body, psyche and spirit that suffers and (2) suffering should be seen as the most central concept of health care, which should provide treatment for physical pain and all dimensions of suffering: physical, social, mental and spiritual aspects.     

Application of a behavioral theory of motivation to the concepts of anxiety and impulsivity

Gray's model has been employed in attempts to formulate theories concerning the processes underlying various types of psychopathology. In the most direct application of his model, the dominant mood is assumed to reflect the strength of the underlying motivational system—i.e., strong anxiety with a strong behavioral inhibition system (BIS), strong positive affect with a strong behavioral activation system (BAS). This approach would predict strong anxiety to be associated with a dominance of passive avoidance and extinction and, similarly, strong positive affect with a dominance of impulsivity and other approach behaviors.The present paper has argued that these expectations are based on an implicit assumption that equally stressful environments are encountered—an assumption that would be undermined by individual differences in the very motivational systems under consideration. Examination of the approach-avoidance conflict paradigm supported the argument that, at least in the case of anxiety, one should not expect a strong association between behavior and motivational states. In particular, a weak behavioral inhibition system or strong behavioral activation system is likely to facilitate anxiety-producing impulsive behavior, whereas a strong behavioral inhibition system or weak behavioral activation system may facilitate anxiety-reducing cautious behavior. Other factors were also thought to promote independence of affective states and behavioral traits across individuals.On this argument, trait anxiety conceptualized as resulting from a strong BIS may not be highly correlated with frequent anxiety. Stating this another way, the behavioral correlates of a dominant BIS may be relatively independent of a trait involving a dominance of anxious mood. Using Tellegen's (1985) discussion of self-report measures of mood and personality traits, it was proposed that the trait factor of Constraint may be more strongly associated with behavioral consequences of the BAS and BIS, whereas the Negative Emotionality dimension is largely unrelated to the behavioral effects of the BIS. Since Negative Emotionality corresponds to the traditional anxiety/neuroticism factor, this proposal differs from the customary assumptions about the alignment of Gray's motivational systems and personality traits. The personality trait of Positive Emotionality (cf. extraversion) may be associated with individual differences in the strength of the BAS, with both affective and behavioral components. Thus, the hypothesis of motivational-behavioral uncoupling offers an alternative to the usual intepretations of the three major dimensions seen in most personality inventories. Unfortunately, it remains unclear as to how well the three major personality traits (Positive Emotionality, Negative Emotionality, and Constraint) are aligned with the hypothesized underlying motivational dimensions, and any hypotheses must be seen as extremely tentative.Finally, the question of the validity of self-report measures was discussed briefly. Of greatest interest is the possibility that a subset of subjects are unable to accurately report their emotional states, and that methods are available for identifying these individuals. If so, the validity of these self-report measures may be significantly improved, facilitating research on anxiety and impulsivity.     

Human Dignity and the Ethics and Aesthetics of Pain and Suffering

Inasmuch as unmitigated pain and suffering areoften thought to rob human beings of theirdignity, physicians and other care providersincur a special duty to relieve pain andsuffering when they encounter it. When pain andsuffering cannot be controlled it is sometimesthought that human dignity is compromised.Death, it is sometimes argued, would bepreferred to a life without dignity.Reasoning such as this trades on certainpreconceptions of the nature of pain andsuffering, and of their relationships todignity. The purpose of this paper is to laybare these preconceptions. The duties torelieve pain and suffering are clearly mattersof moral obligation, as is the duty to respondappropriately to the dignity of other persons.However, it is argued that our understanding ofthe phenomena of pain and suffering and theirrelationships to human dignity will be expandedwhen we explore the aesthetic dimensions ofthese various concepts. On the view presentedhere the life worth living is both morally goodand aesthetically beautiful. Appropriate``suffering with' another can help to maintainand restore the dignity of the relationshipsinvolved, even as it preserves and enhances thedignity of patient and caregiver alike.     

Putting the client in control: The perception of control in the behavioral treatment of anxiety

Traditional explanations of anxiety reduction through behavioral interventions such as extinction, habituation, reciprocal inhibition, and counterconditioning do not adequately account for all instances and aspects of anxiety reduction and clinical methods employed in contemporary behavior therapy. This article examines the role of an additional process — the alterations of perceptions of control — believed to be operative in anxiety reduction. We discuss three targets for establishing control in behavioral treatments of anxiety: (1) control over one's physiological responding while in an anxiety-producing situation, (2) control over the anxiety-producing stimulus or situation itself, and (3) control over the conduct of exposure. These three types of control perceptions are differentially important for different types of anxiety disorders. Implications for the conduct of behavioral treatments and possibilities for increasing client perceptions of control in anxiety treatment programs are outlined. We also recommend that client perceptions of control should be systematically assessed in order to relate them to treatment successes and failures.     

Conceptualizing suffering and pain

Background

This article aims to contribute to a better conceptualization of pain and suffering by providing non-essential and non-naturalistic definitions of both phenomena. Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them (the mind-body dichotomy, Cassel’s idea of persons as “intact beings”) are critically discussed with such purpose.

Methods

A philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of what are found as better definitions of suffering and pain.

Results

Pain can be described in neurological terms but cognitive awareness, interpretation, behavioral dispositions, as well as cultural and educational factors have a decisive influence on pain perception. Suffering is proposed to be defined as an unpleasant or even anguishing experience, severely affecting a person at a psychophysical and existential level. Pain and suffering are considered unpleasant. However, the provided definitions neither include the idea that pain and suffering can attack and even destroy the self nor the idea that they can constructively expand the self; both perspectives can b e equally useful for managing pain and suffering, but they are not defining features of the same. Including the existential dimension in the definition of suffering highlights the relevance of suffering in life and its effect on one’s own attachment to the world (including personal management, or the cultural and social influences which shape it). An understanding of pain and suffering life experiences is proposed, meaning that they are considered aspects of a person’s life, and the self is the ever-changing sum of these (and other) experiences.

Conclusions

The provided definitions will be useful to the identification of pain and suffering, to the discussion of how to relieve them, and to a better understanding of how they are expressed and experienced. They lay the groundwork for further research in all these areas, with the twofold aim of a) avoiding epistemological mistakes and moral injustices, and b) highlighting the limitations of medicine in the treatment of suffering and pain.

     

Core,animal reminder,and contamination disgust: Three kinds of disgust with distinct personality,behavioral, physiological,and clinical correlates

We examined the relationships between sensitivity to three kinds of disgust (core, animal-reminder, and contamination) and personality traits, behavioral avoidance, physiological responding, and anxiety disorder symptoms. Study 1 revealed that these disgusts are particularly associated with neuroticism and behavioral inhibition. Moreover, the three disgusts showed a theoretically consistent pattern of relations on four disgust-relevant behavioral avoidance tasks in Study 2. Similar results were found in Study 3 such that core disgust was significantly related to increased physiological responding during exposure to vomit, while animal-reminder disgust was specifically related to physiological responding during exposure to blood. Lastly, Study 4 revealed that each of the three disgusts showed a different pattern of relations with fear of contamination, fear of animals, and fear of blood–injury relevant stimuli. These findings provide support for the convergent and divergent validity of core, animal-reminder, and contamination disgust. These findings also highlight the possibility that the three kinds of disgust may manifest as a function of different psychological mechanisms (i.e., oral incorporation, mortality defense, disease avoidance) that may give rise to different clinical conditions. However, empirical examination of the mechanisms that underlie the three disgusts will require further refinement of the psychometric properties of the disgust scale.     

A time of change: Behavioral and neural correlates of adolescent sensitivity to appetitive and aversive environmental cues

Adolescence is a developmental period that entails substantial changes in affective and incentive-seeking behavior relative to both childhood and adulthood, including a heightened propensity to engage in risky behaviors and experience persistent negative and labile mood states. This review discusses the emotional and incentive-driven behavioral changes in adolescents and their associated neural mechanisms, focusing on the dynamic interactions between the amygdala, ventral striatum, and prefrontal cortex. Common behavioral changes during adolescence may be associated with a heightened responsiveness to incentives and emotional cues while the capacity to effectively engage in cognitive and emotion regulation is still relatively immature. We highlight empirical work in humans and animals that addresses the interactions between these neural systems in adolescents relative to children and adults, and propose a neurobiological model that may account for the nonlinear changes in adolescent behavior. Finally, we discuss other influences that may contribute to exaggerated reward and emotion processing associated with adolescence, including hormonal fluctuations and the role of the social environment.     

Learned helplessness as a schedule-shift effect

The essentials of learned helplessness theory are described and supporting evidence surveyed. It is shown that two main empirical phenomena are associated with learned helplessness: a low rate of responding in laboratory animals following numerous discrete trials with continuous free relief and in human subjects following continuous nonrelief/reward or traditional extinction. The explanation Seligman and Maier give for these findings is critically analyzed and found to be unsupported at several critical points. The “patchwork” nature of the theory and observations is considered and it is contended that what is new in learned helplessness research is a schedule-shift effect like that observed when extinction follows partial reinforcement. A schedule-shift discrimination theory of “learned helplessness” effects is offered which is closely parallel to a widely accepted explanation of other schedule-shift effects, notably the partial reinforcement extinction effect. Although the behavioral effects of some schedule shifts resemble clinical depression, the latter is a more complex behavioral phenomena than the former which in turn has broader relevance to human behavior than just depression.     

The Syracuse strains,selectively bred for differences in active avoidance learning,may be models of genetic differences in trait and state anxiety

The derivation of the Syracuse high- and low-avoidance strains is described. The behavioral characterization of the high- and low-avoidance phenotypes is summarized and it is concluded that the SLA/Bru strain is best described as having higher state and trait anxiety than their SHA/Bru counterparts. Although the behavioral covariates of the high- and low avoidance phenotypes are consistent, the covariation of the endocrine system normally thought to be involved in stress, is anomalous. The SLA/Bru rats, which are behaviorally more anxious than the SHA/Bru animals, show hypertrophy of the adrenal glands but reduced synthesis and release of the stress-related corticosterone than the SHA/Bru animals. This dissociation of the behavioral and endocrine measures of anxiety appears to be genetic, since a selective genetic analysis, involving F2 and high and low backcross segregating generations, indicates that both the behavioral and endocrine covariates cosegregate with the avoidance phenotypes. These data suggest that the expected association of behavioral and endocrine measures of anxiety is correlational, not causal.     

On euthanasia: blindspots in the argument from mercy

In the euthanasia debate, the argument from mercy holds that if someone is in unbearable pain and is hopelessly ill or injured, then mercy dictates that inflicting death may be morally justified. One common way of setting the stage for the argument from mercy is to draw parallels between human and animal suffering, and to suggest that insofar as we are prepared to relieve an animal's suffering by putting it out of its misery we should likewise be prepared to offer the same relief to human beings.
In this paper, I will argue that the use of parallels between human and animal suffering in the argument from mercy relies upon truncated views of how the concept of a human being enters our moral thought and responsiveness. In particular, the focus on the nature and extent of the empirical similarities between human beings and animals obscures the significance for our moral lives of the kind of human fellowship which is not reducible to the shared possession of empirical capacities.
I will suggest that although a critical examination of the blindspots in these arguments does not license the conclusion that euthanasia for mercy's sake is never morally permissible, it does limit the power of arguments such as those provided by Rachels and Singer to justify it. I will further suggest that examination of these blindspots helps to deepen our understanding of what is at stake in the question of euthanasia in ways that tend otherwise to remain obscured.     

Dissociation,Physical Pain,and Suicide: A Hypothesis

The hypothesis of this paper states that at least some suicidal individuals are characterized by a disposition toward dissociation manifested in relative insensitivity to physical pain and indifference to their bodies. Three main topics are discussed: dissociation and suicide, psychological aspects of pain, and pain and suicide. Various theoretical and experimental studies suggest that certain stress conditions lead to the development of dissociative tendencies, and that once these tendencies are established, they become an integral part of suicidal behavior. Psychological variables that affect pain tolerance are presented and they include perception, motivation, emotions, and behavioral and cognitive strategies of pain control. These can increase tolerance of pain in suicidal individuals, making the suicidal act possible. The specific relationships of pain and suicide are then introduced through an examination of pain analgesia in the phenomenon of self-harm. The integration of the material suggests that early and continuous stress lead to the simultaneous development of dissociative tendencies (including indifference to the body and pain) and heightened vulnerability to stress. These dispositions may facilitate suicidal behavior in the face of mounting intolerable stress, helplessness, and hopelessness. Preliminary empirical support for the present hypothesis is cited. This hypothesis shifts the focus of attention from the question of what causes suicide to what facilitates suicide, and in so doing suggests new directions for research and therapy.     

The Role of Emotional Distress Tolerance on Fear Responding in a Heights-Fearful Sample: Perceived Versus Actual Behavior

Emotional distress tolerance (EDT)—or the ability to withstand negative emotional states—is considered a transdiagnostic risk factor for psychopathology. Although EDT is theorized to play a role in anxiety development and maintenance, research aiming to delineate the relationship between anxiety and EDT is lacking. The current study tested whether self-reported EDT predicted self-reported and actual avoidance in the presence of feared stimuli using a heights-fearful sample. Moreover, the study tested whether EDT predicted other in-the-moment fear responses, such as peak anxiety, anxious cognitions, and bodily sensations. Participants (N = 128) completed questionnaires assessing fear of heights, negative affect, anxious cognitions, and bodily sensations, as well as two heights behavioral avoidance tasks (BATs). Results demonstrated that EDT did not predict actual avoidance or other in-the-moment fear responses, except for peak anxiety in one BAT. However, EDT predicted self-reported avoidance of heights beyond fear of heights and negative affect. Taken together, results suggest that perception of ability to tolerate emotional distress predicts perception of avoidance of heights, but not actual avoidance of heights or reactions to heights (with the exception of peak anxiety in one BAT). Given these findings, self-reported EDT may not adequately predict how individuals react in anxiety-provoking situations.