The Role of Cardioprotective Avoidance Beliefs in Noncardiac Chest Pain and Associated Emergency Department Utilization

This study examined cardioprotective avoidance beliefs and general panic/agoraphobia variables among 45 Emergency Department patients with a primary complaint of noncardiac chest pain (NCCP) in the absence of coronary artery disease or other medical explanation. Cardioprotective beliefs about the dangerousness of work and physical activity were assessed with the Fear-Avoidance Beliefs Questionnaire (FABQ). Additional measures assessed complaints of cardiac distress and panic, anxiety sensitivity, panic-related beliefs, agoraphobic avoidance, and depressive symptoms. Hierarchical regression analysis indicated that cardiac distress symptoms are a function of panic symptoms and cardioprotective beliefs concerning both physical activity and work, with 62% of the total variance explained. The predictors also explained 57% of the variance in Emergency Department utilization, which was significantly related to cardiac distress symptoms, number of illnesses, and work-avoidance beliefs. Neither outcome was related to demographics, depression symptoms, general anxiety sensitivity, general panic cognitions, or agoraphobic avoidance. Results suggest that current behavioral understandings of NCCP might be advanced by further examination of cardiac-specific avoidance beliefs and behavior and the potential role these factors play in both symptom experience and medical utilization.     

Biology and a Theology of Evolution

The challenge and stimulus to theology that is constituted by the scientific version of Genesis which will prevail for the foreseeable future is expounded in relation to the significance of the succeeding stages of the life process and to the general features of biological evolution. A responsive theology of evolution is discerned as involving a renewal of insights associated with the themes of immanence, panentheism, the Wisdom and Word of God, and a sacramental universe. Such a revitalized theology allows one to conceive of humanity and Jesus the Christ in a fully evolutionary perspective without loss of an emphasis on the particularity of the Incarnation.     

The Family Environment in Chronic Pain Patients: Comparison to Controls and Relationship to Patient Functioning

Operant and cognitive-behavioral models of chronic pain have called attention to the importance of examining the marital and family environments of chronic pain patients. In this study, 50 chronic pain patients and their spouses and 33 control participants and their spouses completed measures of the family environment, marital satisfaction, and patient physical and psychological functioning. Patients' overt pain behaviors were coded from videotapes of patient–spouse interactions. Compared to controls, pain patients and their spouses rated their family environments as lower in cohesion and higher in control, and there was a trend for spouses to report more marital dissatisfaction. Chronic pain patient depression was associated negatively with patient-rated family cohesion and expressiveness and spouse-rated family organization and positively with patient-rated family conflict. Overt patient pain behaviors and spouse-rated patient disability were related negatively to spouse-rated family cohesion. Spouse marital satisfaction was associated negatively with patient depression and with spouse ratings of patient disability and pain behaviors.     

Multidimensional Assessment of Chronic Low Back Pain: Predicting Treatment Outcomes

This study explored responses of chronic low back pain patients to treatment for different types of patients (dysfunctional, interpersonally distressed, and minimizer/adaptive coper), as classified using the Multidimensional Pain Inventory (MPI). In addition, changes in MPI scores during treatment were examined separately for each patient type. Finally, this study explored the relationships between changes in MPI scores and physical improvement. Between-group differences in improvement were significant, with dysfunctional patients showing the most improvement on several scales. MPI scales that best predicted physical improvement differed according to patient type. Implications for treatment of low back pain patients are suggested, based upon differential reactions to treatment and different predictors of physical improvement for each patient group.     

焦虑水平与体育高考生竞技状态关系及其对策

通过对体育高考学生焦虑状况的调查与评定 ,探讨焦虑水平与体育高考生竞技状态的关系。采用Spielberger状态 -特质焦虑量表对 2 5 9名考生进行调查 ,其中男 2 0 5人 ,女 5 4人。结果表明 ,在体育高考的情境压力下 ,学生的焦虑水平普遍提高 ,女生明显高于男生 (p <0 .0 1) ,其状态焦虑得分既非常显著地高于常模 (p <0 .0 1) ,也高于相关研究报告中普通高考学生的平均得分。体育高考学生适宜的状态焦虑水平为男 38～ 5 0分 ,女 4 1～ 5 2分。作者对结果进行了讨论分析 ,认为这反映了体育高考情境的特殊性 ,也反映了个体间最佳焦虑水平的差异性。其结果为我们重视对体育高考学生这一特殊的应试群体进行心理技能训练提供了依据。     

Is pain-related fear a predictor of somatosensory hypervigilance in chronic low back pain patients?

Pain-related fear has been found to be associated with increased disability and increased pain perception in patients with chronic low back pain. A possible mechanism by which pain-related fear could lead to increased pain perception is heightened attention to somatosensory sensations. In the present study, chronic pain patients reporting either a high or low level of pain related fear and control participants performed an auditory reaction time task, while occasionally non-painful electrical stimuli--accompanied by threatening instructions--were given to the arm or back. In the primary task condition, participants had to perform the auditory task while ignoring the electrical stimuli. Next, the task was presented under dual task conditions in which participants had to respond both to tones as well as to detection of electrical stimuli. It was hypothesized that for the primary task, high fearful patients would show greater disruption of performance on the auditory task than low fearful patients and controls when stimuli were presented to the back. For the dual task, slower reaction times for the auditory task, in combination with faster detection of electrical stimuli was expected. The hypotheses were not confirmed but patients scoring high on pain-related fear did show an overall increase in reaction time for all conditions of the primary task, with or without simultaneous stimulation. Regression analyses demonstrated that high pain-related fear was associated with increased reaction time to tones both in patients and healthy controls, and that within patients pain-related fear was a better predictor of reaction time to tones than present pain intensity. The findings may be interpreted as showing that patients with elevated levels of pain-related fear habitually attend to somatic sensations, giving less priority to other attention-demanding tasks.     

Anchors aweigh: a demonstration of cross-modality anchoring and magnitude priming

Research has shown that judgments tend to assimilate to irrelevant "anchors." We extend anchoring effects to show that anchors can even operate across modalities by, apparently, priming a general sense of magnitude that is not moored to any unit or scale. An initial study showed that participants drawing long "anchor" lines made higher numerical estimates of target lengths than did those drawing shorter lines. We then replicated this finding, showing that a similar pattern was obtained even when the target estimates were not in the dimension of length. A third study showed that an anchor's length relative to its context, and not its absolute length, is the key to predicting the anchor's impact on judgments. A final study demonstrated that magnitude priming (priming a sense of largeness or smallness) is a plausible mechanism underlying the reported effects. We conclude that the boundary conditions of anchoring effects may be much looser than previously thought, with anchors operating across modalities and dimensions to bias judgment.     

疼痛表达与中国人表达的躯体化

西方研究者认为中国人习惯用躯体化方式表达心理不适,不能区分身体疼痛和心理痛苦。通过回顾中文文本,认为在传统中国的语境中,身心互应的哲学观念使个体能够以一种隐性但自明的方式来表达自身情感。但在社会变迁的环境中,原有的社会关联多数都已崩解,个体开始使用躯体化以及疼痛作为索引,从而提供自我的某种参照。     

A service learning based intervention to change attitudes toward obese individuals in kinesiology pre-professionals

The purpose of this study was to conduct an intervention to change attitudes toward obese individuals. Ninety-five Kinesiology undergraduates conducted a FITNESSGRAM service-learning project with school-aged children. They completed anti-fat attitude test (AFAT) and explicit attitude assessments before and after the intervention. The results indicated participants had anti-fat bias toward obese individuals on the lazy/motivated scale, but not on the other four scales on pre measurements. Their anti-fat attitudes concerning whether people are responsible for their weight were significantly reduced through the intervention. Five themes emerged from the undergraduates’ reflective papers that support the efficacy of the intervention: Healthy lifestyle—an individual choice, barriers to physical activity, multi-factorial nature of obesity, and promotion of physical activity through information and encouragement. The findings partially support experiential learning as a potential mechanism to reduce individuals’ anti-fat attitudes.