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.     

Waving the Flag: National Symbolism,Social Identity,and Political Engagement*

This research examined the psychological underpinnings of concern for national symbols and ritualistic‐ceremonial activities or “symbolic involvement.” We propose and test a distinction between symbolic and “instrumental” involvement or concern for the functionality of national institutions and their capability to provide instrumental benefits to citizens. Items comprising the two constructs were found to be empirically distinct, evidenced by statistically reliable and orthogonal dimensions in exploratory factor analysis. Moreover, evidence based on divergent patterns of relations with various forms of national membership indicates that symbolic and instrumental involvement are rooted in distinct motivational concerns related to identity expression and object appraisal, respectively. These findings suggest that national symbolism evokes a psychological attachment to the nation as an abstracted social entity, but not as a concrete functional system.