A Unified,Transdiagnostic Treatment for Adolescents With Chronic Pain and Comorbid Anxiety and Depression

Chronic pain disorders represent a significant public health concern, particularly for children and adolescents. High rates of comorbid anxiety and unipolar mood disorders often complicate psychological interventions for chronic pain. Unified treatment approaches, based on emotion regulation skills, are applicable to a broad range of emotional disorders and suggest the possibility of extending these interventions to chronic pain and pain-related dysfunction. This case report describes the use of a unified protocol for treatment of an adolescent boy with chronic daily headache and social anxiety and an adolescent girl with whole body pain and depression. Following weekly, 50-minute individual treatment sessions, the boy demonstrated notable improvement in emotional symptoms, emotion regulation skills, somatization, and functional disability. The girl showed some improvement on measures of anxiety and depression, although there appeared to be a worsening of pain symptoms and somatization. However, both patients demonstrated improvement over follow-up. This case study illustrates the potential utility of a unified treatment approach targeting pain and emotional symptoms from an emotion regulation perspective in an adolescent population.     

First‐hand sensory experience plays a limited role in children's early understanding of seeing and hearing as sources of knowledge: Evidence from typically hearing and deaf children

One early‐developing component of theory of mind is an understanding of the link between sensory perception and knowledge formation. We know little about the extent to which children's first‐hand sensory experiences drive the development of this understanding, as most tasks capturing this early understanding target vision, with less attention paid to the other senses. In this study, 64 typically hearing children (M_age = 4.0 years) and 21 orally educated deaf children (M_age = 5.44 years) were asked to identify which of two informants knew the identity of a toy animal when each had differing perceptual access to the animal. In the ‘seeing’ condition, one informant saw the animal and the other did not; in the ‘hearing’ condition, one informant heard the animal and the other did not. For both hearing and deaf children, there was no difference between performance on hearing and seeing trials, but deaf children were delayed in both conditions. Further, within both the hearing and deaf groups, older children outperformed younger children on these tasks, indicating that there is a developmental progression. Taken together, the pattern of results suggests that experiences other than first‐hand sensory experiences drive children's developing understanding that sensory perception is associated with knowledge.     

Gesture Helps,Only If You Need It: Inhibiting Gesture Reduces Tip-of-the-Tongue Resolution for Those With Weak Short-Term Memory

People frequently gesture when a word is on the tip of their tongue (TOT), yet research is mixed as to whether and why gesture aids lexical retrieval. We tested three accounts: the lexical retrieval hypothesis, which predicts that semantically related gestures facilitate successful lexical retrieval; the cognitive load account, which predicts that matching gestures facilitate lexical retrieval only when retrieval is hard, as in the case of a TOT; and the motor movement account, which predicts that any motor movements should support lexical retrieval. In Experiment 1 (a between-subjects study; N = 90), gesture inhibition, but not neck inhibition, affected TOT resolution but not overall lexical retrieval; participants in the gesture-inhibited condition resolved fewer TOTs than participants who were allowed to gesture. When participants could gesture, they produced more representational gestures during resolved than unresolved TOTs, a pattern not observed for meaningless motor movements (e.g., beats). However, the effect of gesture inhibition on TOT resolution was not uniform; some participants resolved many TOTs, while others struggled. In Experiment 2 (a within-subjects study; N = 34), the effect of gesture inhibition was traced to individual differences in verbal, not spatial short-term memory (STM) span; those with weaker verbal STM resolved fewer TOTs when unable to gesture. This relationship between verbal STM and TOT resolution was not observed when participants were allowed to gesture. Taken together, these results fit the cognitive load account; when lexical retrieval is hard, gesture effectively reduces the cognitive load of TOT resolution for those who find the task especially taxing.