Measuring Fear of Movement/(Re)injury in Chronic Low Back Pain Using Implicit Measures

Fear of movement/(re)injury is assumed to contribute to the development and maintenance of chronic low back pain (CLBP) in a subgroup of patients. Studying fear of movement/(re)injury with implicit attitude measures, without the awareness of the patient, might be a valuable addition to self‐report questionnaires. The aims of the current study were to investigate whether CLBP patients demonstrate more implicit fear of movement/(re)injury than healthy controls, and whether 2 implicit measures are related to each other, and to an explicit self‐report measure of fear of movement/(re)injury. A group of 66 CLBP patients and 30 healthy controls took part in this study. In addition to self‐report questionnaires, fear of movement/(re)injury was implicitly assessed by the Extrinsic Affective Simon Task (EAST) and the Go‐No‐Go‐Association Task (GNAT) that aimed to determine the association between back‐stressing movements and the evaluation “threatening”. On both implicit tasks it was found that neither CLBP patients nor healthy controls demonstrated implicit fear of movement/(re)injury, and that CLBP patients did not differ from healthy controls in their level of implicit fear of movement/(re)injury. In general, no associations were found between the EAST and the GNAT, or between implicitly measured and self‐reported fear of movement/(re)injury. One major caveat in drawing inferences from these findings is the poor reliability of these implicit measures. Research towards the psychometric properties of these measures should first be expanded before modifying, and applying, them to more complex domains such as fear of movement/(re)injury.     

Interoceptive Exposure Therapy Combined with Trauma‐related Exposure Therapy for Post‐traumatic Stress Disorder: a Case Report

Trauma‐related exposure therapy is a useful but not universally effective treatment for post‐traumatic stress disorder. Anxiety sensitivity may play an important role in this disorder, as it does in panic disorder. Studies have shown that interoceptive exposure therapy reduces anxiety sensitivity in panic disorder. The present case study was a preliminary investigation of the merits of including interoceptive exposure therapy in the treatment of post‐traumatic stress disorder, in order to improve treatment outcome for a patient who had no history of panic disorder or panic attacks. Interoceptive exposure therapy (4 sessions) was one component of treatment, combined with trauma‐related exposure therapy (4 sessions of imaginal exposure followed by 4 sessions of in vivo exposure). Treatment outcome was assessed with the Clinician‐Administered Post‐traumatic Stress Disorder Scale, a self‐report measure of post‐traumatic stress disorder symptoms, and measures of symptoms and cognitions commonly associated with post‐traumatic stress disorder. Scores on all outcome measures decreased over the course of treatment, with gains maintained at 1‐ and 3‐month follow‐up. Symptoms of anxiety sensitivity and post‐traumatic stress disorder decreased during interoceptive exposure therapy. The results indicate that interoceptive exposure therapy is a promising adjunctive intervention for post‐traumatic stress disorder. Further research is needed into the merits of combining interoceptive exposure therapy and trauma‐related exposure therapy as a means of boosting treatment efficacy.     

Examination of the Psychometric Properties of a Brief PTSD Measure on a French–Canadian Undergraduate Population

This study examines the psychometric properties of the French-Canadian Modified PTSD Symptom Scale (MPSS-FC) in a sample of French-Canadian undergraduates. Findings uncovered a 3-dimensional model for the Frequency and Severity scales, which shared factorial invariance. In addition, the MPSS-FC scales had adequate internal consistency and a satisfactory 5-week test-retest reliability. In view of its satisfactory psychometric properties, the MPSS-FC seems promising as a brief screening measure of PTSD. Indeed, the MPSS-FC as a stand-alone measure could be used with a population known to have been exposed to a traumatic event.     

En experimentell prövning av aktivt lyssnande som tröst för sm[acaron] barn som gr[acaron]ter

The procedural validity of the Composite International Diagnostic Interview - short form (CIDISF) administered via an Internet web-page was examined and compared with an in-person interview (Structured Clinical Interview for DSM-IV Axis I Disorders, research version; SCID) for 7 DSM-IV mental disorders: major depression, generalized anxiety, specific phobia, social phobia, agoraphobia, panic attack and obsessive-compulsive disorder. The 53 participants completed a computerized interview (CIDI-SF) via a web page 2 days before the scheduled in-person interview (SCID). The agreement between CIDI-SF and SCID was generally low (Cohens Kappa <0.40). However, if the panic disorder module from the long version of CIDI is used instead, the Kappa is fair (K = 0.48) with an agreement of 75%. Practical applications and future directions are discussed.     

Extension and Replication of an Internet-Based Treatment Program for Panic Disorder

This study describes an internet-based intervention for people with panic disorder that consisted of a 5-module program. Participants accessed the program for 5-8 weeks and were then re-assessed 3 months later. Use of the program was associated with reductions in severity of panic disorder and in catastrophic misinterpretation of ambiguous panic body sensations in 9 people with this anxiety disorder. There were also non-significant trends for body vigilance to decrease over the course of the study. Further investigations of the efficacy of this medium for the treatment of panic disorder and the associated mechanisms of change are warranted.     

Last issue of SJBT

Abstract

A system providing prompts (verbal encouragement) at prearranged time intervals was used with a woman with total blindness and profound intellectual disability who had discontinuous performance. The woman was to transport objects from one end of a corridor to the other (a space in which orientation was not a problem) and then assemble them. Data indicated that there was a clear increase in the number of objects transported and assembled in the sessions with the prompting system. Implications of the findings are discussed.     

Post-Traumatic Stress Disorder Symptoms in United Nations Peacekeepers: An Examination of Factor Structure in Peacekeepers with and without Chronic Pain

Recent factor analytic investigations of post-traumatic stress disorder in military veterans suggest that symptoms are best described by either a hierarchical 2-factor model or a 4-factor inter-correlated model. Other recent evidence suggests that post-traumatic stress disorder and chronic pain are intricately related; however, the nature of this relationship is not well understood. Factor analysis provides one method for clarifying this relationship. In study 1, we compared competing models of post-traumatic stress disorder symptom structure in a sample of 400 male United Nations peacekeepers using confirmatory factor analysis. Results indicated that both the hierarchical 2-factor and the 4-factor inter-correlated models provided good fit to the data. In study 2, the reliability of these models was assessed in 427 male United Nations peacekeepers with chronic back pain and 341 without. Group comparisons of the confirmatory factor analysis results revealed that the structure of the hierarchical 2-factor and 4-factor inter-correlated models both provided good fit to the data in both the chronic back pain and the group without. However, the structure of the models for the group with chronic back pain group differed in significant ways from that of the group without chronic back pain. Post-traumatic stress disorder symptoms in military veterans can be adequately conceptualized using either a hierarchical 2-factor or 4-factor inter-correlated model. Chronic pain has a minimal influence on overall factor structure. The hierarchical 2-factor model, while parsimonious, does not provide the degree of symptom detail provided by the 4-factor inter-correlated model. Implications for conceptualization of post-traumatic stress disorder symptoms for patients with chronic back pain and significant post-traumatic stress disorder symptomatology are discussed.     

Telephone-Administered Cognitive Behavior Therapy for Obsessive-Compulsive Disorder

Exposure with response prevention and cognitive behavior therapy are widely recognized as effective treatments for obsessive-compulsive disorder. Unfortunately, many people with obsessive-compulsive disorder - particularly those living in rural areas - do not have access to therapists providing these treatments. Accordingly, we investigated the efficacy of telephone-administered cognitive behavior therapy for obsessive-compulsive disorder. Two open trials are reported, for a total of 33 people with obsessive-compulsive disorder (without major depression). The first trial consisted of 12 weeks on a waiting list followed by 12 weeks of treatment (delayed treatment). The second trial consisted of 12 weeks of immediate treatment. Obsessive-compulsive symptoms did not change during the waiting period. Symptoms declined from pre- to post-treatment, with gains maintained at 12-week follow-up. For the pooled sample our pre-to-post-treatment effect size was as large or larger than those obtained in other studies of reduced contact treatment, and similar to those of face-to-face exposure with response prevention. Our proportion of treatment dropouts tended to be lower than those of other reduced contact interventions. The results suggest that telephone-administered cognitive behavior therapy is effective and well-tolerated, at least for people with obsessive-compulsive disorder without major depression. It remains to be seen whether this treatment is safe and effective when comorbid major depression is present.     

Dietary Control of Rumination: Two Case Studies

Chronic rumination of 2 institutionalized men with profound mental retardation was treated using a dietary approach. In the first case, a peanut butter or honey supplement was given, whereby 2 spoonfuls of either food was added to every meal, with drinks moved to a later time. In the second case, food satiation together with a honey supplement was applied. In the first case, an ABABACA design was used. In the second case, the non-experimental AB design was applied. In both cases, rapid decrease in rumination was achieved. Anecdotal follow-up confirmed the permanency of the results.     

Le rôle modérateur des orientations vers les objectifs dans la relation entre l’envergure de poste et l’engagement organisationnel

This paper examines the moderating role of goal orientations (learning, performance and avoidance orientation) in the relationship between job scope (i.e., a composite measure capturing task variety, autonomy, feedback and significance) and organizational commitment. Based on a sample of 314 participants, the analyses indicate that job scope is positively related to commitment and that performance orientation and avoidance orientation act as negative moderators of job scope. Specifically, job scope was more strongly related to commitment at low levels of these traits. We discuss the importance of considering the role of employee personality in the study of the effect of work context on commitment.