Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial

Although 14% to 42% of people with whiplash injuries end up with chronic debilitating pain, there is still a paucity of empirically supported treatments for this group of patients. In chronic pain management, there is increasing consensus regarding the importance of a behavioural medicine approach to symptoms and disability. Cognitive behaviour therapy has proven to be beneficial in the treatment of chronic pain. An approach that promotes acceptance of, or willingness to experience, pain and other associated negative private events (e.g. fear, anxiety, and fatigue) instead of reducing or controlling symptoms has received increasing attention. Although the empirical support for treatments emphasizing exposure and acceptance (such as acceptance and commitment therapy) is growing, there is clearly a need for more outcome studies, especially randomized controlled trials. In this study, participants (N = 21) with chronic pain and whiplash-associated disorders were recruited from a patient organization and randomized to either a treatment or a wait-list control condition. Both groups continued to receive treatment as usual. In the experimental condition, a learning theory framework was applied to the analysis and treatment. The intervention consisted of a 10-session protocol emphasizing values-based exposure and acceptance strategies to improve functioning and life satisfaction by increasing the participants' abilities to behave in accordance with values in the presence of interfering pain and distress (psychological flexibility). After treatment, significant differences in favor of the treatment group were seen in pain disability, life satisfaction, fear of movements, depression, and psychological inflexibility. No change for any of the groups was seen in pain intensity. Improvements in the treatment group were maintained at 7-month follow-up. The authors discuss implications of these findings and offer suggestions for further research in this area.     

Distance cognition in virtual environmental space: Further investigations to clarify the route-angularity effect

Two experiments with 72 participants in total investigated the route-angularity effect. This effect is shown when a greater number of turns along a route increase the estimated length of this route. In this study it was shown that the route-angularity effect is likely to be a memory-based effect depending on task difficulty. The important factor seems to be how heavily memory is loaded during learning. The route-angularity effect even appears in intentional learning, when memory is loaded heavily. Under this learning condition participants know beforehand that they have to estimate distances. All experiments were conducted in a controlled virtual environment, which allows a reliable investigation of distance estimations in environmental space.     

Achievement motives and emotional processes in children during problem-solving: Two experimental studies of their relation to performance in different achievement goal conditions

In two studies, the influence of key emotional and motivational factors on performance in different achievement goal-type situations is examined. In study 1, based on 314 sixth-graders, two types of goal situations were induced; performance and mastery. The goals were examined with respect to important antecedents (e.g., motive dispositions) and several consequences (e.g., performance, satisfaction, pleasant affect, worry, and emotionality). The results showed that the motive to achieve success (M _s) produced positive affects, satisfaction, and increased performance, whereas the motive to avoid failure (M _f) produced worries and performance reduction. In study 2, based on 331 sixth-graders, three types of goal situations were induced; performance–approach, performance–avoidance, and mastery goals. The findings revealed that the most important single factors positively related to performance were M _s and mastery–goal situation. In addition, high M _s pupils performed better under mastery condition than under performance condition. Finally, avoidance-goal situation accentuate the negative effects of high M _f on performance.     

The import of the cortisol rise in child care differs as a function of behavioral inhibition

Children of ages 3 to 4.5 years (N = 107; 45 boys, 62 girls) were studied twice, 6 months apart, to examine whether the cortisol rise in child care at Time 1 (T1) was associated with (a) changes in anxious, vigilant behavior from T1 to Time 2 (T2) and (b) higher internalizing symptoms at T2. Controlling for measures of home environment and child care quality at T1, as well as for cortisol activity at T2, we obtained results indicating that behavioral inhibition moderated the associations between the rise in cortisol at T1 and child outcomes at T2 (i.e., anxious, vigilant behavior and internalizing symptoms). For both outcomes, the rise in cortisol at T1 became more positively predictive at increasing levels of behavioral inhibition. Specifically, at higher levels of behavioral inhibition, children with larger T1 cortisol increases expressed more internalizing symptoms than did children at lower levels of behavioral inhibition; in contrast, for those with low cortisol activity at T1, children with higher levels of inhibition expressed fewer internalizing symptoms than did children at lower levels of inhibition. In addition, children with higher levels of behavioral inhibition and lower cortisol activity at T1 exhibited reductions in anxious, vigilant behavior from T1 to T2, whereas at lower levels of behavioral inhibition, variations in the T1 cortisol rise bore no relation to changes in this behavior. These results suggest that the rise in cortisol at child care may have differential predictive value as a function of behaviorally inhibited temperament.     

The Variation of Hand Steadiness with Physical Stress

The performance of 12 subjects in a hand steadiness task was compared at different work loads. Hand steadiness expressed in the form of values of hand shakiness was found not to increase linearly with work intensity. On the contrary, the relation between hand shakiness and activation level, induced by physical work, was found to be positively accelerated by an exponent of 1.6. Subjective effort measured by a ratio estimation method grew, likewise, according to a positively accelerating function with an exponent of about 1.6, while subjective effort according to the “RPE” category scale, like heart rate, grew linearly with work load.     

Social support and emotional adjustment during and after a severe life event: A study of wives of myocardial infarction patients

Abstract

This paper examines the relationship between quantitative and qualitative indicators of social support and anxiety. depression and use of health services in a sample of 37 wives of myocardial infarction (MI) patients. In a prospective design, the wives were interviewed during the acute phase of the illness, three months and 10 years post index-MI. Congruent with previous research, the quantitative aspect of social support, defined as number of persons giving help, was unrelated to adjustment, whereas qualitative aspect of social support, defined as the wives' dissatisfaction with social support, was associated with depression and use of health services. The observed association indicated, however, an effect in the opposite direction of the social support model. The findings were unexpected and may be due to a small sample. An alternative explanation is that long-term relationship between depression and social support is more complex, and more long-term studies are needed in this field.     

Work environment and health in different types of temporary jobs

The aim of the study was to compare and analyse differences in work conditions and health between workers in permanent and temporary employment. The study group consisted of a representative, stratified sample of the Swedish working population (n = 2767). The data support the main hypothesis of the study, i.e., that temporary employed differ from permanent employed in control over their working life. With some exceptions, there were clear differences between these two categories with respect to a number of variables that can be regarded as central to both the individual's success at work and protection against job loss and exclusion from working life. Health differences were in favour of the permanent employed. There were also considerable differences between different sub-groups of temporary employees of such amplitude and consistency that they formed a distinct centre-periphery structure.     

Moving European research on work and ageing forward: Overview and agenda

This longitudinal retrospective study shows that when the results of an organizational development intervention are fed back properly and action plans are made, factors associated with leadership and commitments to organization are enhanced. The study compared the effects of survey feedback, including the making of action plans and survey feedback without action plans, to the effects of no feedback at all on several psychosocial factors and sick leave over a 3-year period. The data were derived from 1236 individuals for whom baseline data were available and who completed a 3-year follow-up. Applied statistics revealed that the feedback action plan group reported greater improvements regarding leadership factors and commitment to the organization. The results reveal no differences between the feedback groups in regard to sick leave. There is a need for further studies, preferably with a randomized control design, on how to enhance both the psychosocial work environment and employee health and also how to reduce sick leave in the workplace.     

Spatial knowledge of children with spina bifida in a virtual large-scale space

The spatial knowledge of 18 children with spina bifida and 18 healthy control children (matched according to sex, age, and verbal IQ) was investigated in a computer-simulated environment. All children had to learn a route through a virtual floor system containing 18 landmarks. Controlling for cognitive abilities, the results revealed that children with spina bifida showed impaired route knowledge but not an impaired landmark knowledge. Thus the results suggest that children with spina bifida are not impaired in all large-scale abilities similarly. The impairments of the children with spina bifida are more accentuated in more behaviour based measurements, which indicates a relation to the reduced mobility of the children with spina bifida.     

The effect of specific hypnotic suggestions on blood pressure in normotensive subjects

Twenty normotensive subjects participated on a voluntary basis in an experiment designed to study the effects of specific suggestions on blood pressure (BP). After an induction procedure, the experimental group received suggestions presumed to be relatively nonactivating, although capable of lowering or raising BP. A control group was used to record the BP changes over time. All subjects met for one session. Eight subjects from the experimental group met for a second session. Both adaptation and induction resulted in significant BP decreases. A specific suggestion to increase BP gave a significant result when compared to the induction point. There was no significant change from induction to the BP decrease suggestion. Both systolic and diastolic BP behaved in the same way. A second experimental session resulted in no significant change compared with the first session. Also, no significant difference was found in suggestibility scores from the first to the second session. The results are in line with previously published studies.