Threat of pain influences social context effects on verbal pain report and facial expression

Current theoretical models of pain catastrophizing have diverging predictions regarding the role of social context and perceived threat on pain expression. The communal coping model of catastrophizing predicts that high pain catastrophizers display more pain expression in the presence of another, regardless of the threat value of the pain, while a cognitive appraisal model predicts high pain catastrophizers to express more pain when pain has increased threat value, regardless of social context. A 2 × 2 factorial design was used to test the validity of both predictions. Healthy participants with varying levels of pain catastrophizing were exposed to a cold pressor task, consisting of a 60 s immersion and 60 s recovery period. Interestingly, the immersion results revealed that beyond and independent from the effects of pain catastrophizing, the effect of threat on verbal pain report and facial expression was dependent on social context and vice versa. In a threatening context, perceived threat of pain mediated the inhibitory effect of social presence on pain expression, suggesting that the observer acted as a safety signal. In the recovery period, social presence enhanced facial expression, but only when no threat was induced. The results are discussed in terms of the dynamic interaction between social context and threat appraisals.     

PTSD and Emotional Distress Symptoms Measured After a Motor Vehicle Accident: Relationships with Pain Coping Profiles

This study explored differences among pain patients classified as Dysfunctional, Interpersonally Distressed, and Adaptive Copers on the Multidimensional Pain Inventory with respect to PTSD symptomatology, anxiety, and depression. Eighty-five patients with pain complaints who had experienced a serious motor vehicle accident were classified into these three pain coping categories and assessed using clinician and self-report measures. Results indicated that patients classified as Adaptive Copers (n = 24) showed less PTSD symptomatology, anxiety, and depressed mood, relative to individuals classified as Dysfunctional (n = 36) and as Interpersonally Distressed (n = 25), who did not differ on these dimensions. Emotional responses during the accident (fear, helplessness, danger, perceived control, and certainty that one would die) did not differentiate the groups. Pain profiles contributed to the prediction of self-reported PTSD symptoms, controlling for state anxiety. These data suggest that pain patients with both Dysfunctional and Interpersonally Distressed coping profiles are at elevated risk for a range of posttrauma problems following a serious motor vehicle accident.     

Epistemic Justice and a Role for Virtue in the Politics of Knowing

The dual aim of this article is to reveal and explain a certain phenomenon of epistemic injustice as manifested in testimonial practice, and to arrive at a characterisation of the anti–prejudicial intellectual virtue that is such as to counteract it. This sort of injustice occurs when prejudice on the part of the hearer leads to the speaker receiving less credibility than he or she deserves. It is suggested that where this phenomenon is systematic it constitutes an important form of oppression.     

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.     

ORGANISATIONAL AND EDUCATIONAL INTERNAL IMPEDIMENTS OF PSYCHOANALYSIS: CONTEMPORARY CHALLENGES

Our psychoanalytic discipline originated, has evolved and is still located within a congregational network that blends and binds together, in an inextricable and contradictory way, the missionary mandates and commendations of a 'movement' and a 'cause' with the inherent prerogatives and functions of academic professions and sciences. In this paper the author explores the consequential past and present impedimenta of this organisational and educational syncretism, for six fundamental dimensions of action for psychoanalysis. Subsequently, the nature of a proposition is delineated, suggesting a reorganisation, local and international, to address what the author visualises as five of our most pressing contemporary challenges: a) an autonomous university educational model, freed from regressive societal-political inertias, enabling us to abandon our seclusive monasticism; b) the consolidation of an epistemological frame of reference, idiographic and nomothetically substantiated against our cumulative inductivism, which is the seedbed of our sectarianism, cross-sterilisation and pseudo-ecumenism; c) local and external educational and professional systems of accreditation and certification, independent from affiliation and membership privileges of our supraordinate ecclesia; d) social relevance and community presence, moving away from our meaningless organisational and educational cloistering; and e) a local and international functional and interdependent reorganisation, in the context of sovereignty and integrity, in contrast to our prevalently crusading and indoctrinating homogamous pathological co-dependency. The author concludes that only a harmonisation of objectives and administrative structure might loosen the talons of faith that keep us retrogressively tied to our past.     

Longitudinal Assessment of Pain, Coping, and Daily Functioning in Children with Sickle Cell Disease Receiving Pain Management Skills Training

Objective. To conduct intensive pain management skills training (IST) in children with sickle cell disease (SCD) and their parents and to comprehensively evaluate pain, coping, and daily functioning in children pre, immediately post, and 3 months following treatment. Methods. Three children who received IST in nonpharmacological and pharmacological pain management strategies completed a Coping Strategies Questionnaire (CSQ) at pre, post, and follow-up assessments, and daily pain and activity diaries for 18 weeks, spanning from 1 week pretreatment to 11 weeks posttreatment. Results. From pre- to posttreatment, 1 child receiving IST indicated increased report of active coping attempts and all 3 children indicated decreased report of negative thinking on the CSQ. Participants in IST used coping skills on 90% of days with pain and reported the skills to be moderately helpful on the daily diaries. For daily activities such as eating dinner, playing with friends, and hours slept, children participated similarly on days with pain and days without pain during the posttreatment period. Given the small number of participants in this study, individual cases are discussed to highlight similarities and differences in how participants responded to the treatment and during the 3-month follow-up period. Conclusions. In this pilot study, each participant showed improvement in coping and daily functioning after completing the IST program. Individual differences in response to treatment indicate the need for more targeted intervention programs that incorporate pharmacological and nonpharmacological components. The results of this study highlight both the promise and the complications of conducting comprehensive pain intervention and functional outcome studies in children with SCD.     

The impact of social desirability bias on the EPQ-R item scores: An item response theory analysis

This study assessed the potential influence of social desirability (SD) response bias on the E, N, and P EPQ-R scores at the level of individual items. The study was based on a bidimensional IRT model which was fitted in a large sample. This allowed a detailed analysis of both the internal validities of the items and the content of the items which were most affected by SD. The E items were least affected by SD, but the direction of the impact depended on the type of item. As expected, in the N and P cases the relations obtained were consistently negative, but the strength of the SD impact also depended considerably on the type of item. The P scale was the most problematic in terms of convergent and discriminant validity.     

Determinants of fraud examination performance: An empirical study of internal investigation reports

Fraud examiners from global auditing firms and local law firms are in the business of private policing by conducting internal investigations in private and public organisations when there is suspicion of financial crime. The business is often characterised by secrecy, and reports of investigations are often difficult or impossible to disclose. Since 2012, we have successfully retrieved 63 fraud examination reports in Scandinavia. Based on these reports, this article presents a statistical analysis of fraud examination performance. Performance was measured in terms of the extent of successful reconstruction of past events and the extent of justification of conclusions from the examinations. We identified three statistically significant determinants of fraud examination performance: the seriousness of the consequences, the relative seriousness of the consequences and the conclusions, and the seriousness of the conclusions.     

Similarity to imagined interlocutor and integration of viewpoints in internal dialogues

Numerous positive functions are ascribed to integrative internal dialogues (IDs). Additionally, IDs simulating social relationships are thought to serve as “prototypes” for interpersonal communication. Therefore, it would be useful to know how to increase the frequency of integrative IDs. Previous studies exploring the relationship between similarity to an imagined interlocutor and the integration in ID have produced inconsistent results. The aim of the present study was to examine the moderating and mediating factors in this relationship. Data from 119 people (mostly students) were analysed. Before the participants conducted IDs, they had written down 3 characteristics common to them and to their interlocutor. Finally, the Integration–Confrontation questionnaire was completed. Plausibility of ID was a moderator of the relationship between similarity to imagined interlocutor and integration in IDs; this relationship was significantly positive at lower plausibility, but non‐significant at high plausibility. Perceived similarity in ID exerted an indirect effect on ID's integration in 2 ways. The first pathway was through identifying with the interlocutor and the author's integrative attitude, suggesting a mechanism in line with social identity theory. The second potential mechanism, which seems to be consistent with similarity–attraction theory, was connected with the wishfulness of IDs and the interlocutor's integrative attitude.