Relationships among pain intensity,pain-related distress,and psychological distress in pre-surgical total knee arthroplasty patients: a secondary analysis

The current study aimed to examine the relationships between movement and resting pain intensity, pain-related distress, and psychological distress in participants scheduled for total knee arthroplasty (TKA). This study examined the impact of anxiety, depression, and pain catastrophizing on the relationship between pain intensity and pain-related distress. Data analyzed for the current study (N = 346) were collected at baseline as part of a larger Randomized Controlled Trial investigating the efficacy of TENS for TKA (TANK Study). Participants provided demographic information, pain intensity and pain-related distress, and completed validated measures of depression, anxiety, and pain catastrophizing. Only 58% of the sample reported resting pain >0 while 92% of the sample reported movement pain >0. Both movement and resting pain intensity correlated significantly with distress (r_s = .86, p < .01 and .79, p < .01, respectively). About three quarters to two thirds of the sample (78% for resting pain and 65% for movement pain) reported different pain intensity and pain-related distress. Both pain intensity and pain-related distress demonstrated significant relationships with anxiety, depression, and catastrophizing. Of participants reporting pain, those reporting higher anxiety reported higher levels of distress compared to pain intensity. These findings suggest that anxious patients may be particularly distressed by movement pain preceding TKA. Future research is needed to investigate the utility of brief psychological interventions for pre-surgical TKA patients.     

“There’s Beauty in Brokenness”: Teaching Empathy Through Dialogue with Art

Empathy, a core element of helping skills training, is vital to the development of the therapeutic alliance and positive counseling outcomes. This article presents a classroom exercise developed to increase students’ empathy. The exercise features imaginative dialogue by members of a counselor education beginning skills class with art works in an exhibit curated by a museum educator. Presented are the details of the teaching exercise, student and faculty reflections on the exercise, and suggestions for further research.     

The latent structure of social anxiety disorder and the performance only specifier: a taxometric analysis

Social anxiety disorder (SAD) is often treated as a discrete diagnostic entity that represents a naturally occurring class, though empirical evidence largely supports a dimensional conceptualization of social fears. Further, the inclusion of a “performance only” specifier in the DSM-5 implies that individuals who experience intense social anxiety exclusively in performance situations are distinct from those with broader social fears. The purpose of the present research was to examine the latent structure of SAD and the DSM-5 “performance only” specifier in a large nonclinical sample (n = 2019). Three taxometric procedures (MAXCOV, MAMBAC, and L-Mode) were applied to indicators derived from two commonly used measures of social anxiety. Results yielded convergent evidence indicating that social anxiety exhibits a dimensional latent structure. Further, social performance anxiety demonstrates continuous relationships with milder social fears, suggesting that the “performance only” specifier may not represent a discrete entity. The implications of these findings for the assessment, diagnosis, classification, and treatment of social anxiety are discussed.     

The Children’s Attention-Deficit Hyperactivity Disorder Telemental Health Treatment Study: Caregiver Outcomes

The Children’s Attention-deficit Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS) tested the hypotheses that children and caregivers who received guideline-based treatment delivered through a hybrid telehealth service delivery model would experience greater improvements in outcomes than children and caregivers receiving treatment via a comparison delivery model. Here, we present caregiver outcomes. 88 primary care providers (PCPs) in seven geographically underserved communities referred 223 children (ages 5.5 ? 12.9 years) to the randomized controlled trial. Over 22 weeks, children randomized to the CATTS service delivery model received six sessions of telepsychiatry and six sessions of caregiver behavior management training provided in person by community therapists who were trained and supervised remotely. Children randomized to the comparison Augmented Primary Care (APC) service model received management in primary care augmented by a single telepsychiatry consultation. Caregiver outcomes included changes in distress, as measured by the Patient Health Questionnaire (PHQ-9), Parenting Stress Index (PSI), Caregiver Strain Questionnaire (CSQ) and Family Empowerment Scale (FES). Caregivers completed five assessments. Multilevel mixed effects regression modeling tested for differences between the two service delivery models in caregiver outcomes from baseline to 25 weeks. Compared to caregivers of children in the APC model, caregivers of children in the CATTS service model showed statistically significantly greater improvements on the PHQ-9 (β?=?-1.41, 95 % CI?=?[?2.74, ?0.08], p?<?.05), PSI (β?=??4.59, 95 % CI?=?[?7.87, ? 1.31], p?<?.001), CSQ (β?=??5.41, 95 % CI?=?[? 8.58, ?2.24], p?<?.001) and FES (β?=?6.69, 95 % CI?=?[2.32, 11.06], p?<?.01). Improvement in child ADHD symptoms mediated improved caregiver scores on the PSI and CSQ. Improvement in child ODD behaviors mediated caregiver CSQ scores. The CATTS trial supports the effectiveness of a hybrid telehealth service delivery model for reducing distress in caregivers of children with ADHD and suggests a mechanism through which the service model affected caregiver distress.     

A Lifespan Model of Interference Resolution and Inhibitory Control: Risk for Depression and Changes with Illness Progression

Neuropsychology Review - The cognitive processes involved in inhibitory control accuracy (IC) and interference resolution speed (IR) or broadly – inhibition – are discussed in this...     

Assessing a retrieval account of the generation and perceptual-interference effects

A number of memory phenomena are modulated by experimental design, with the effect (e.g., of bizarreness, generation, or perceptual interference) occurring in recall for mixed-list, but not pure-list designs. These effects have other similarities and have been treated in common theoretical frameworks, some focusing on encoding and others on retrieval. The typical paradigm for examining design effects confounds encoding and retrieval contexts, making it difficult to compare these accounts. Using a new paradigm, McDaniel, Dornburg, and Guynn (2005) concluded that retrieval processes contribute to the bizarreness effect. We applied this paradigm to the related perceptual-interference and generation effects. Participants were presented with two pure study lists and later recalled the lists separately (inducing pure retrieval sets) or together (inducing a combined or mixed retrieval set) in a single test. In four experiments, the combined recall condition consistently failed to enhance the size of the generation or perceptual-interference effect. Two additional experiments verified that perceptual interference and generation enhanced recognition memory, as predicted by the standard encoding accounts. The results provide no support for the retrieval account of these two variables but generally are consistent with an encoding locus.     

The mnemonic advantage of processing fitness-relevant information

Nairne, Thompson, and Pandeirada (2007) proposed that our memory systems serve an adaptive function and that they have evolved to help us remember fitness-relevant information. In a series of experiments, they demonstrated that processing words according to their survival relevance resulted in better retention than did rating them for pleasantness, personal relevance, or relevance to moving to a new house. The aim of the present study was to examine whether the advantage of survival processing could be replicated, using a control condition that was designed to match the survival processing task in arousal, novelty, and media exposure--the relevance to planning a bank heist. We found that survival processing nonetheless yielded better retention on both a recall (Experiment 1) and a recognition (Experiment 2) test. This mnemonic advantage of survival processing was also obtained when words were rated for their relevance to a character depicted in a video clip (Experiment 3). Our findings provide additional evidence that the mnemonic benefit of survival processing is a robust phenomenon, and they also support the utility of adopting a functional perspective in investigating memory.     

The development of the Children's Empathic Attitudes Questionnaire using classical and Rasch analyses

Empathic responding is implicated in antisocial behaviors such as bullying, sexual offending, and violent crime. Identifying children and adolescents at risk for antisocial behavior and evaluating interventions designed to address problem behaviors require valid and reliable measures. Definitional controversies and limited measurement models have hindered measurement. This study describes the development and analysis of the Children's Empathic Attitudes Questionnaire (CEAQ) using both classical and modern techniques. Rasch analyses provided probabilistic results over large item and person groups, enabling meaningful inferences from patterns of responses at the construct level. Analyses of fifth through seventh graders' responses to the final version of the CEAQ provide support for its reliability, validity, and functionality. Four meaningful item clusters were identified, each reflecting more cognitively advanced empathic attitudes. These analyses suggest that the CEAQ provides a theoretically sound, hierarchically meaningful measure of empathic attitudes that will be useful in identification and intervention with children and adolescents at risk for antisocial behavior.     

Two ways to be complex and why they matter: implications for attitude strength and lying

Integrative complexity broadly measures the structural complexity of statements. This breadth, although beneficial in multiple ways, can potentially hamper the development of specific theories. In response, the authors developed a model of complex thinking, focusing on 2 different ways that people can be complex within the integrative complexity system and subsequently developed measurements of each of these 2 routes: Dialectical complexity focuses on a dialectical tension between 2 or more competing perspectives, whereas elaborative complexity focuses on complexly elaborating on 1 singular perspective. The authors posit that many variables have different effects on these 2 forms of complexity and subsequently test this idea in 2 different theoretical domains. In Studies 1a, 1b, and 2, the authors demonstrate that variables related to attitude strength (e.g., domain importance, extremism, domain accessibility) decrease dialectical complexity but increase elaborative complexity. In Study 3, the authors show that counterattitudinal lying decreases dialectical complexity but increases elaborative complexity, implicating a strategic (as opposed to a cognitive strain) view of the lying-complexity relationship. The authors argue that this dual demonstration across 2 different theoretical domains helps establish the utility of the new model and measurements as well as offer the potential to reconcile apparent conflicts in the area of cognitive complexity.