A prospective analysis of acceptance of pain and values-based action in patients with chronic pain.

OBJECTIVE: Acceptance of pain and values-based action appear important in the emotional, physical, and social functioning of individuals with chronic pain. The purpose of the current study was to prospectively investigate these combined processes. METHOD: 115 patients attending an assessment and treatment course for chronic pain in the U.K. completed a standard set of measures on two occasions separated by an average of 18.5 weeks. RESULTS: Correlation analyses showed that acceptance of pain and values-based action measured at Time 1 were significantly correlated with pain, pain-related distress, pain-related anxiety and avoidance, depression, depression-related interference with functioning, and physical and psychosocial disability measured at Time 2. Multiple regression analyses, in which pain and relevant patient background variables were controlled, showed that the combined acceptance and values measures accounted for between 6.5% and 27.0% of variance in six key measures of patient functioning later in time. CONCLUSION: These results support the importance of acceptance and values-related processes in relation to chronic pain. These results also encourage continued applications of a functional contextual model of psychopathology, the model underlying Acceptance and Commitment Therapy and related approaches such as Contextual Cognitive-Behavioral Therapy.     

Defeasibility And The Normative Grasp Of Context

In this article, we present an analysis of defeasible generalizations – generalizations which are essentially exception-laden, yet genuinely explanatory – in terms of various notions of privileged conditions. We argue that any plausible epistemology must make essential use of defeasible generalizations so understood. We also consider the epistemic significance of the sort of understanding of context that is required for understanding of explanatory defeasible generalizations on any topic.     

A pilot study examining the effects of priming headache illness schema on attentional engagement towards pain relief medication,in those with high and low medication treatment beliefs

Few studies have assessed the underlying theoretical components of the Common Sense Model. Past studies have found, through implicit priming, that coping strategies are embedded within illness schema. Our aim was to evaluate the effect priming ‘headache’ illness schema upon attentional engagement to pain relief medication and to examine the interaction with illness treatment beliefs. Attentional engagement to the pain relief medication (‘Paracetamol’) was assessed using a 2 (primed vs. control) × 2 (strong belief in medication efficacy vs. weak belief in medication efficacy) design. During a grammatical decision task (identifying verbs/non-verbs), participants were randomised to receive a headache prime or a control. Response latency to the target word, ‘Paracetamol’ was the dependent variable. ‘Paracetamol’ treatment beliefs were determined using the brief illness perception questionnaire. Sixty-three participants completed the experiment. There was a significant interaction between illness-primed vs. control and high vs. low treatment efficacy of Paracetamol (p < .001), suggesting an attentional disengagement effect to the coping strategy in illness-primed participants whom held stronger treatment beliefs regarding the efficacy of Paracetamol. In summary, implicit illness schema activation may simultaneously activate embedded coping strategies, which appears to be moderated by specific illness beliefs.     

Development of a metabolic equation for the NuStep recumbent stepper in older adults

The purpose of this study was to develop an accurate metabolic equation for estimating steady-state oxygen consumption (VO2) during submaximal NuStep exercise. Adults (N = 40; M age = 64.0 yr., SD = 6.5; M height = 170.1 cm, SD = 9.1; M weight = 85.7 kg, SD = 19.9) performed two randomized testing sessions. Each session consisted of six stages with combinations of four workloads (1, 3, 5, and 7) at 3 cadences (60, 80, and 100 steps/min.). Multiple regression analysis to predict steady-state VO2 from NuStep workload (W), NuStep steps/min., and subject body mass resulted in the following model (R2 = .73): Steady-state VO2 = 3.5 + 0.016 (W* steps/min.) + 0.092 (steps/min.) - 0.053 (weight). The standard error of the estimate and total error for the prediction of steady-state VO2 under all NuStep workload conditions were 2.3 mL/kg/min. and 2.4 mL/kg/ min., respectively. The standard error of the estimate and total error values are similar to those previously reported in the literature regarding the accuracy of metabolic equations for other exercise modalities. These findings support the use of the equation developed to predict steady-state VO2 for NuStep exercise in older adult clientele.     

Reviewers for Special Issue

Objective: An enhanced stress and coping model was used to explain depression among HIV‐positive women in healthcare and community settings where highly active anti‐retroviral treatment (HAART) was commonplace. Method: HIV‐infected women in four cities (N=978) were assessed, cross‐sectionally, for mental and physical health, stress, social support, and other background factors. Results: Self‐reported level of depressive symptomatology was high. Number of physical symptoms, illness intrusiveness, and perceived stress were positively associated with depressed mood, while coping self‐efficacy and social support were negatively associated. Stress mediated the effect of health status on depression and coping self‐efficacy mediated the effect of psychosocial resources on depression. Our enhanced stress and coping model accounted for 52% of variance in depressive symtpomatology. Conclusions: Interventions focused on improving coping self‐efficacy, bolstering social supports, and decreasing stress in the lives of HIV‐positive women may help to reduce the negative effects of HIV disease on mood.     

Concepts of objects and substances in language

People distinguish objects from the substances that constitute them. Many languages also distinguish count nouns and mass nouns. What is the relation between these two distinctions? The connection between them is complicated by the facts that (a) some mass nouns (e.g., toast) seem to name countable objects; (b) some count and mass nouns (e.g., pots and pottery) seem to name the same objects; (c) nouns for seemingly the same things can be count in one language (English: dishes) but mass in another (French: la vaisselle); (d) count nouns can be used to name substances (There is carrot in the soup) and mass nouns to name portions (She drank three whiskeys); and (e) some languages (e.g., Mandarin) appear to have no count nouns, whereas others (e.g., Yudja) appear to have no mass nouns. All these cases counter a simple object-to-count-noun and substance-to-mass-noun relation, but they provide opportunities to see whether the grammatical distinction affects the referential one. We examine evidence from such cases and find continuity through development: Infants appear to have the conceptual OBJECT/SUBSTANCE distinction very early on. Although this distinction may change with development, the acquisition of count/mass syntax does not appear to be an effective factor for change.

     

What Drives OCD Symptom Change During CBT Treatment? Temporal Relationships Among Obsessions and Compulsions

Cognitive behavior therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD). However, less is known about how obsessions and compulsions change during treatment, either in tandem, sequentially, or independently. The current study used latent difference score analysis to show path-analytic dynamic modeling of OCD symptom change during CBT. Four competing models of the temporal relationship between obsessions and compulsions were examined: no coupling (obsessions and compulsions are not dynamically related), goal directed (obsessions lead to subsequent changes in compulsions), habit driven (compulsions lead to subsequent changes in obsessions), and reciprocal. Treatment seeking participants (N = 84) with a principal diagnosis of OCD completed 12 weeks of CBT group therapy and completed measures assessing obsession and compulsion severity at pretreatment, Sessions 4 and 8, and end of treatment. Bivariate results supported the goal directed traditional CBT model, where obsession scores are temporally associated with subsequent changes in compulsion scores. These results have implications for theoretical and treatment modelling of obsessions and compulsions in OCD treatment.     

Circular reasoning

Good informal arguments offer justification for their conclusions. They go wrong if the justifications double back, rendering the arguments circular. Circularity, however, is not necessarily a single property of an argument, but may depend on (a) whether the argument repeats an earlier claim, (b) whether the repetition occurs within the same line of justification, and (c) whether the claim is properly grounded in agreed‐upon information. The experiments reported here examine whether people take these factors into account in their judgments of whether arguments are circular and whether they are reasonable. The results suggest that direct judgments of circularity depend heavily on repetition and structural role of claims, but only minimally on grounding. Judgments of reasonableness take repetition and grounding into account, but are relatively insensitive to structural role.     

Friends as Reporters of Children's and Adolescents' Depressive Symptoms

Obtaining information from multiple informants is important when assessing youth depression. Past studies have utilized adults' reports of youths' emotional functioning and aggregate reports from classmates but have not considered close friends as reporters of depressive symptoms. This is surprising given the important roles of friends as companions and confidants. This study investigated relations between friend-reported depressive symptoms and youths' self-reports. From a larger sample of fifth-, seventh-, and ninth-grade participants, self-reports and friend reports of depressive symptoms and friend reports of friendship quality were available for a subset of 367 participants. Significant positive relations emerged between friend reports and self-reports of affective depressive symptoms for girls and youth in high-quality friendships. Relations between friend reports and self-reports were stronger for conduct-related than affective depressive symptoms and reached significance for boys as well as for girls and for youth in low-quality friendships as well as for youth in high-quality friendships. Implications for identifying at-risk youth are discussed.     

Revised estimates of dimension and exercise variance components in assessment center postexercise dimension ratings

The authors reanalyzed assessment center (AC) multitrait-multimethod (MTMM) matrices containing correlations among postexercise dimension ratings (PEDRs) reported by F. Lievens and J. M. Conway (2001). Unlike F. Lievens and J. M. Conway, who used a correlated dimension-correlated uniqueness model, we used a different set of confirmatory-factor-analysis-based models (1-dimension-correlated Exercise and 1-dimension-correlated uniqueness models) to estimate dimension and exercise variance components in AC PEDRs. Results of reanalyses suggest that, consistent with previous narrative reviews, exercise variance components dominate over dimension variance components after all. Implications for AC construct validity and possible redirections of research on the validity of ACs are discussed.