Meta-analysis of psychological interventions for chronic low back pain.

The purpose of this meta-analysis of randomized controlled trials was to evaluate the efficacy of psychological interventions for adults with noncancerous chronic low back pain (CLBP). The authors updated and expanded upon prior meta-analyses by using broad definitions of CLBP and psychological intervention, a broad data search strategy, and state-of-the-art data analysis techniques. All relevant controlled clinical trials meeting the inclusion criteria were identified primarily through a computer-aided literature search. Two independent reviewers screened abstracts and articles for inclusion criteria and extracted relevant data. Cohen's d effect sizes were calculated by using a random effects model. Outcomes included pain intensity, emotional functioning, physical functioning (pain interference or pain-specific disability, health-related quality of life), participant ratings of global improvement, health care utilization, health care provider visits, pain medications, and employment/disability compensation status. A total of 205 effect sizes from 22 studies were pooled in 34 analyses. Positive effects of psychological interventions, contrasted with various control groups, were noted for pain intensity, pain-related interference, health-related quality of life, and depression. Cognitive-behavioral and self-regulatory treatments were specifically found to be efficacious. Multidisciplinary approaches that included a psychological component, when compared with active control conditions, were also noted to have positive short-term effects on pain interference and positive long-term effects on return to work. The results demonstrated positive effects of psychological interventions for CLBP. The rigor of the methods used, as well as the results that reflect mild to moderate heterogeneity and minimal publication bias, suggest confidence in the conclusions of this review.     

Multiattribute Decision Making in Context: A Dynamic Neural Network Methodology

A theoretical structure for multiattribute decision making is presented, based on a dynamical system for interactions in a neural network incorporating affective and rational variables. This enables modeling of problems that elude two prevailing economic decision theories: subjective expected utility theory and prospect theory. The network is unlike some that fit economic data by choosing optimal weights or coefficients within a predetermined mathematical framework. Rather, the framework itself is based on principles used elsewhere to model many other cognitive and behavioral data, in a manner approximating how humans perform behavioral functions. Different, interconnected modules within the network encode (a) attributes of objects among which choices are made, (b) object categories, (c) and goals of the decision maker. An example is utilized to simulate the actual consumer choice between old and new versions of Coca-Cola. Potential applications are also discussed to market decisions involving negotiations between participants, such as international petroleum traders.     

Resolving Compensation Disputes with Three-party Job Evaluation

Des conflits naissent dans les organisations a propos du montant de la retribution versee aux titulaires de certains postes. Aux Etats-Unis par exem-ple, le probleme de la contribution-retribution a provoque recemment plusieurs conflits autour des postes traditionnellement reserves aux femmes. Mediation et arbitrage sont les procedures habituellement retenues, mais une evaluation du travail regroupant trois partenaires est une solution originate dont les retombees favorables sur l'organisation depassent la resolution d'un conflit particulier.
Un groupe tripartite a exploite pour 1'evaluation du travail des dimensions pourvues d'echelles precises. Des equipes de deux personnes representant les parties adverses ont evalue des postes "convenablement retribues" a partir des dimensions sus-mentionnees. Les donnees ont été statistiquement synthetisees. Des equipes de deux personnes ont ensuite evalue tous les postes defendus par le syndicat implique dans le conflit. Cet eventail de postes incluait ceux qui etaient en litige.
Une tierce partie neutre devait conseiller les adversaires dans l'application d'une methode d'evaluation du travail qui resolvait le conflit, depistait les postes susceptibles de poser probleme a l'avenir et fournissait un moyen pour retribuer equitablement les nouveaux postes.     

Cardiovascular reactivity to psychological stress in aerobically trained versus untrained mild hypertensives and normotensives

Cardiovascular reactivity to video game and mental arithmetic stressors was compared among three groups of men: aerobically trained mild hypertensives, untrained mild hypertensives, and a comparison group of untrained normotensives. Relative to the untrained hypertensives, the trained hypertensives reacted to the video game with marginally smaller systolic blood pressure and diastolic blood pressure, but there were no significant differences between these groups in reactivity during the mental arithmetic task. Comparisons between each hypertensive group and the normotensive group showed that blood pressure (BP) reactivity of normotensives during the video game was generally similar to that of trained hypertensives but smaller than that of untrained hypertensives. These results indicate that aerobic training, which has been found to reduce resting BP in mild hypertensives, may also exert a favorable impact in reducing cardiovascular reactivity of hypertensives during some stressful situations.     

The Dynamic Nature of Goals and Message Production as Revealed in a Sequential Analysis of Conflict Interactions

Although message‐production theories often assume that goals behave dynamically to direct communication behavior, few studies consider the interconnectedness of goals and behavior throughout interactions. Here, the interrelationship of communication goals and tactics was examined through a sequential analysis of 47 conflict interactions between close friends or dating partners. It was posited that for both the initiators and resistors in a conflict, the importance of relational or other‐identity goals would be associated with the use of integrative tactics and the importance of instrumental or self‐identity goals would be related to the use of distributive tactics. We examined these predictions within and across partners. Analyses indicated that for both conflict initiators and resistors, the importance of a combination self/instrumental goal predicted the use of distributive tactics and the importance of an other‐identity goal lead to partner‐oriented tactics. For resistors, the importance of an instrumental goal was associated with the use of distributive tactics and the importance of a combination identity/relational goal was aligned with issue‐oriented tactics as well. Across partners, several significant patterns between one partner’s use of distributive or integrative tactics and the other partner’s goals were observed. Implications of the results for understanding conflict and message production are discussed.     

Characteristics of adolescents at risk for compulsive overeating on a brief screening test

As part of a large survey of addictive behavior in high school students, 43% of a sample of 278 (26% of the males, 57% of the females) scored above the cutoff point set by Overeaters Anonymous on their scale for assessing compulsive overeating. While this at-risk group did not report poorer general adjustment, health, or school achievement than did the students not at risk, they did significantly more often perceive their life quality and relationship with the person closest to them as less positive. The at-risk subsample indicated the defensive effectiveness of overeating in their significantly more frequent report of dissociative experiences while eating, and less severe ratings of insecurity, worrying, and daydreaming. One of the most salient findings was the at-risk students' more frequent report of addictive problems in their parents (overeating, alcohol and drug use, and gambling).     

Somatic response to stress, physical symptoms and health service use: The role of current stress

The study examined physical symptoms and health service utilization of subjects high or low on a measure of the tendency to experience stress somatically and high or low on a measure of current stress. High somatic responders reported greater numbers of symptoms than low somatic responders regardless of stress level. However, high somatic responders who were experiencing high levels of current stress reported significantly more symptoms than high somatic responders who were experiencing low levels of stress. These findings indicate that somatic response to stress reflects both a general tendency to focus on physical symptoms, and a specific tendency to focus more on physical symptoms when under stress. Analysis of health service records indicated that high somatic responders had more visits prompted by symptoms than low somatic responders, but did not differ in frequency of health service visits designed to maintain health. The findings further clarify the relationship between somatic response to stress, physical symptoms and health service use.