Effects of pain acceptance and pain control strategies on physical impairment in individuals with chronic low back pain

Psychosocial treatments for chronic pain are effective. There is a need, however, to understand the processes involved in determining how these treatments contribute to behavior change. Control and acceptance strategies represent two potentially important processes involved in treatment, although they differ significantly in approach. Results from laboratory-based studies suggest that acceptance-oriented strategies significantly enhance pain tolerance and behavioral persistence, compared with control-oriented strategies. There is a need, however, to investigate processes of acceptance and control directly in clinical settings. The present study investigated the effects of three brief instructional sets (pain control, pain acceptance, continued practice) on demonstrated physical impairment in 74 individuals with chronic low back pain using an analogue experimental design. After controlling for baseline performance, the pain acceptance group demonstrated greater overall functioning on a set of 7 standardized physical tasks relative to the other two groups, which did not differ from one another. Further, the acceptance group exhibited a 16.3% improvement in impairment, whereas the pain control group worsened by 8.3% and the continued practice group improved by 2.5%. These results suggest that acceptance may be a key process involved in behavior change in individuals with chronic pain.     

Accuracy of Self-Reported Personal History of Cancer in an Outpatient Breast Center

The self-reporting of cancer history is becoming increasingly important, as it frequently guides medical decision-making. We studied the accuracy of personal cancer history using a self-administered questionnaire, comparing the results with the Tumor Registry at our institution. Among 39,662 records, we identified 3614 women with a single cancer in the Tumor Registry who reported none or one cancer on their questionnaire. The sensitivity in self-reporting cancers was 85.7%, ranging from 92.1% for breast cancer to 42.9% for leukemia. The accuracy for breast cancer and Hodgkin's Lymphoma was significantly better than other cancers (p=0.00027, CI: 1.4–3.88). Analysis of patient's characteristics showed that Caucasians reported breast cancer more accurately than Asian/Pacific Islanders (p=0.008), and those with Jewish ancestry more accurately than non-Jewish (p=0.0435). These results will help us to improve data collection and thus improve medical decision-making.     

Compound Nominals,Context, and Compositionality

There are good reasons to think natural languages are compositional. But compound nominals (CNs) are largely productive constructions that have proven highly recalcitrant to compositional semantic analysis. I evaluate existing proposals to treat CNs compositionally and argue that they are unsuccessful. I then articulate an alternative proposal according to which CNs contain covert indexicals. Features of the context allow a variety of relations to be expressed using CNs, but this variety is not expressed in the lexicon or the semantic rules of the language. This proposal accounts for the diversity of contents CNs can be used to express while preserving compositionality. Finally, I defend this proposal against some recent anti-contextualist arguments.     

Discrete quantity judgments in the great apes (Pan paniscus, Pan troglodytes, Gorilla gorilla, Pongo pygmaeus): the effect of presenting whole sets versus item-by-item

The authors examined quantity-based judgments for up to 10 items for simultaneous and sequential whole sets as well as for sequentially dropped items in chimpanzees (Pan troglodytes), gorillas (Gorilla gorilla), bonobos (Pan paniscus), and orangutans (Pongo pygmaeus). In Experiment 1, subjects had to choose the larger of 2 quantities presented in 2 separate dishes either simultaneously or 1 dish after the other. Representatives of all species were capable of selecting the larger of 2 quantities in both conditions, even when the quantities were large and the numerical distance between them was small. In Experiment 2, subjects had to select between the same food quantities sequentially dropped into 2 opaque cups so that none of the quantities were ever viewed as a whole. The authors found some evidence (albeit weaker) that subjects were able to select the larger quantity of items. Furthermore, the authors found no performance breakdown with the inclusion of certain quantities. Instead, the ratio between quantities was the best performance predictor. The authors conclude that quantity-based judgments rely on an analogical system, not a discrete object file model or perceptual estimation mechanism, such as subitizing.     

The problem of serial order in behavior: Lashley's legacy

In a prescient paper Karl Lashley (1951) rejected reflex chaining accounts of the sequencing of behavior and argued instead for a more cognitive account in which behavioral sequences are typically controlled with central plans. An important feature of such plans, according to Lashley, is that they are hierarchical. Lashley offered several sources of evidence for the hierarchical organization for behavioral plans, and others afterward provided more evidence for this hypothesis. We briefly review that evidence here and then shift from a focus on the structure of plans (Lashley's point of concentration) to the processes by which plans are formed in real time. Two principles emerge from the studies we review. One is that plans are not formed from scratch for each successive movement sequence but instead are formed by making whatever changes are needed to distinguish the movement sequence to be performed next from the movement sequence that has just been performed. This plan-modification view is supported by two phenomena discovered in our laboratory: the parameter remapping effect, and the handpath priming effect. The other principle we review is that even single movements appear to be controlled with hierarchically organized plans. At the top level are the starting and goal postures. At the lower level are the intermediate states comprising the transition from the starting posture to the goal posture. The latter principle is supported by another phenomenon discovered in our lab, the end-state comfort effect, and by a computational model of motor planning which accounts for a large number of motor phenomena. Interestingly, the computational model hearkens back to a classical method of generating cartoon animations that relies on the production of keyframes first and the production of interframes (intermediate frames) second.