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.     

Cardiovascular reactivity to psychological stress in aerobically trained versus untrained mild hypertensives and normotensives

Cardiovascular reactivity to video game and mental arithmetic stressors was compared among three groups of men: aerobically trained mild hypertensives, untrained mild hypertensives, and a comparison group of untrained normotensives. Relative to the untrained hypertensives, the trained hypertensives reacted to the video game with marginally smaller systolic blood pressure and diastolic blood pressure, but there were no significant differences between these groups in reactivity during the mental arithmetic task. Comparisons between each hypertensive group and the normotensive group showed that blood pressure (BP) reactivity of normotensives during the video game was generally similar to that of trained hypertensives but smaller than that of untrained hypertensives. These results indicate that aerobic training, which has been found to reduce resting BP in mild hypertensives, may also exert a favorable impact in reducing cardiovascular reactivity of hypertensives during some stressful situations.     

The Dynamic Nature of Goals and Message Production as Revealed in a Sequential Analysis of Conflict Interactions

Although message‐production theories often assume that goals behave dynamically to direct communication behavior, few studies consider the interconnectedness of goals and behavior throughout interactions. Here, the interrelationship of communication goals and tactics was examined through a sequential analysis of 47 conflict interactions between close friends or dating partners. It was posited that for both the initiators and resistors in a conflict, the importance of relational or other‐identity goals would be associated with the use of integrative tactics and the importance of instrumental or self‐identity goals would be related to the use of distributive tactics. We examined these predictions within and across partners. Analyses indicated that for both conflict initiators and resistors, the importance of a combination self/instrumental goal predicted the use of distributive tactics and the importance of an other‐identity goal lead to partner‐oriented tactics. For resistors, the importance of an instrumental goal was associated with the use of distributive tactics and the importance of a combination identity/relational goal was aligned with issue‐oriented tactics as well. Across partners, several significant patterns between one partner’s use of distributive or integrative tactics and the other partner’s goals were observed. Implications of the results for understanding conflict and message production are discussed.     

Characteristics of adolescents at risk for compulsive overeating on a brief screening test

As part of a large survey of addictive behavior in high school students, 43% of a sample of 278 (26% of the males, 57% of the females) scored above the cutoff point set by Overeaters Anonymous on their scale for assessing compulsive overeating. While this at-risk group did not report poorer general adjustment, health, or school achievement than did the students not at risk, they did significantly more often perceive their life quality and relationship with the person closest to them as less positive. The at-risk subsample indicated the defensive effectiveness of overeating in their significantly more frequent report of dissociative experiences while eating, and less severe ratings of insecurity, worrying, and daydreaming. One of the most salient findings was the at-risk students' more frequent report of addictive problems in their parents (overeating, alcohol and drug use, and gambling).     

Autonomic arousal feedback and emotional experience: evidence from the spinal cord injured

We interviewed spinal-cord-injured, other handicapped, and nonhandicapped subjects to investigate the relation between the perception of autonomic arousal and experienced emotion. The three groups differed significantly on only one measure of affect intensity, with the spinal-cord-injured subjects more often reporting stronger fear in their lives now compared with the past. In addition, spinal-cord-injured subjects often described intense emotional experiences. Spinal-cord-injured subjects who differed in their level of autonomic feedback differed in intensity on several measures. Subjects with greater autonomic feedback tended to report more intense levels of negative emotions. The findings indicate that the perception of autonomic arousal may not be necessary for emotional experience. There were weak trends in our data, however, suggesting that the perception of arousal may enhance the experience of emotional intensity. The subjective well-being reports of the handicapped groups were comparable to those of nonhandicapped subjects, indicating successful coping with their disability.