A longitudinal study of pain sensitivity and blood pressure in adolescent boys: results from a 5-year follow-up.

A growing literature has observed a significant reduction in pain sensitivity among hypertensive animals and humans. It is uncertain whether a reduced sensitivity to pain can be observed in nonnotensive individuals who go on to develop high blood pressure. Blood pressure (BP) was reassessed in one hundred fifteen 19-year-old boys initially tested at age 14, when they were also presented with a pain stimulus (mechanical finger pressure). Hierarchical regression analyses indicated that information regarding pain tolerance improved prediction of changes in systolic and diastolic blood pressure beyond that afforded by differences in BP at age 14, parental history of hypertension, and body mass index. These analyses suggest that pain sensitivity may be associated with physiological processes involved in the development of sustained high blood pressure.     

Therapeutic Contract Program: preliminary report on a behavioral alternative to the token economy

The token economy has been the primary model for the behavioral management of inpatient populations. However, this basically operant approach seldom emphasizes the development of cognitive-coping skills to help patients more effectively manage stressors that result in hospitalization. The Therapeutic Contract Program (TCP) is described as an inpatient-treatment strategy that is designed to help foster such cognitive-coping and self-control skills. While external structure is provided by components of this program, subprograms of the TCP have as their goal the development of internally-attributed coping skills and self-perceptions of competence. This preliminary report describes the structure of the TCP, as well as planned and in-progress measures of program participation and treatment outcome.