Meta-analysis of psychological interventions for chronic low back pain.

The purpose of this meta-analysis of randomized controlled trials was to evaluate the efficacy of psychological interventions for adults with noncancerous chronic low back pain (CLBP). The authors updated and expanded upon prior meta-analyses by using broad definitions of CLBP and psychological intervention, a broad data search strategy, and state-of-the-art data analysis techniques. All relevant controlled clinical trials meeting the inclusion criteria were identified primarily through a computer-aided literature search. Two independent reviewers screened abstracts and articles for inclusion criteria and extracted relevant data. Cohen's d effect sizes were calculated by using a random effects model. Outcomes included pain intensity, emotional functioning, physical functioning (pain interference or pain-specific disability, health-related quality of life), participant ratings of global improvement, health care utilization, health care provider visits, pain medications, and employment/disability compensation status. A total of 205 effect sizes from 22 studies were pooled in 34 analyses. Positive effects of psychological interventions, contrasted with various control groups, were noted for pain intensity, pain-related interference, health-related quality of life, and depression. Cognitive-behavioral and self-regulatory treatments were specifically found to be efficacious. Multidisciplinary approaches that included a psychological component, when compared with active control conditions, were also noted to have positive short-term effects on pain interference and positive long-term effects on return to work. The results demonstrated positive effects of psychological interventions for CLBP. The rigor of the methods used, as well as the results that reflect mild to moderate heterogeneity and minimal publication bias, suggest confidence in the conclusions of this review.     

Training Observers to Detect Deception Effects of Self-Monitoring and Rehearsal

It was predicted that trained observers would detect deception more accurately than untrained observers. More specifically, it was predicted that the highest deception detection accuracy would be found among trained observers judging the veracity of low self-monitors and unrehearsed liars, whereas the lowest detection accuracy would be found among untrained observers judging the veracity of high self-monitors and rehearsed deceivers. It also was hypothesized that the discrepancy between observers‘actual ability to detect deception and their certainty in the accuracy of their judgments would be smaller for trained observers than for untrained observers. Observers trained to detect deception used six behavioral cues based on research by deTurck and Miller (1985): (a) message duration, (b) response latency, (c) adaptors, (d) pauses, (e) nonfluencies, and (f) hand gestures. Results confirmed both hypotheses.