Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis

Pain-related avoidance factors and social resources, as assessed by pain coping and social support, are supposed to have lasting effects on functional disability and pain in chronic pain disorders. As a follow-up to a prospective study demonstrating short-term effects after one year (Behaviour Research and Therapy, 36, 179-193, 1998), the role of pain coping and social support at the time of diagnosis was investigated in relationship to the long-term course of functional disability and pain after three and five years in 78 patients with rheumatoid arthritis (RA), taking into account personality characteristics of neuroticism and extraversion, clinical status and use of medication. In line with findings at the one-year follow-up, results showed that more passive pain coping predicted functional disability at the three-year, but not the five-year follow-up. In addition, low levels of social support at the time of diagnosis consistently predicted both functional disability and pain at the three and five-year follow-ups. Results indicate that pain coping and social support, assessed very early in the disease process, can affect long-term functional disability and pain in RA, and suggest that early interventions focusing on pain-related avoidance factors and social resources for patients at risk may beneficially influence long-term outcomes in RA.     

Pain anxiety among chronic pain patients: specific phobia or manifestation of anxiety sensitivity?

Rather than viewing anxiety among chronic pain patients as simply a component of negative affectivity, investigators have developed a model of "pain anxiety" in which patients develop fear and avoidance of activity linked to pain. We examined whether pain anxiety can be conceptualized as a specific phobia, or whether evidence supported the notion that pain anxiety is better understood as a manifestation of anxiety sensitivity in the context of chronic pain. Chronic musculoskeletal pain patients (N=70) underwent cold pressor and mental arithmetic tasks while cardiovascular, self-report, and behavior indexes were recorded. They completed measures of pain anxiety, anxiety sensitivity, fear of negative evaluation, depression and trait anxiety. Correlation analyses showed pain anxiety was related to pain-relevant responses during cold pressor, but it was also related to evaluation-relevant responses during cold pressor, and to pain- and evaluation-relevant responses (including subtraction accuracy) during mental arithmetic. Regression analyses showed that almost all effects of pain anxiety on task responses were accounted for by anxiety sensitivity. Fear of negative evaluation, in contrast, correlated only with evaluation-relevant responses, and mostly during mental arithmetic. These effects remained significant when depression, trait anxiety, or anxiety sensitivity were statistically controlled. Pain anxiety may be an expression of anxiety sensitivity rather than a circumscribed phobia; a distinction that could profitably guide treatment strategies.     

The use of prosodic cues in language discrimination tasks by rats

Recent research with cotton-top tamarin monkeys has revealed language discrimination abilities similar to those found in human infants, demonstrating that these perceptual abilities are not unique to humans but are also present in non-human primates. Specifically, tamarins could discriminate forward but not backward sentences of Dutch from Japanese, using both natural and synthesized utterances. The present study was designed as a conceptual replication of the work on tamarins. Results show that rats trained in a discrimination learning task readily discriminate forward, but not backward sentences of Dutch from Japanese; the results are particularly robust for synthetic utterances, a pattern that shows greater parallels with newborns than with tamarins. Our results extend the claims made in the research with tamarins that the capacity to discriminate languages from different rhythmic classes depends on general perceptual abilities that evolved at least as far back as the rodents. Electronic Publication     

Pain and Pain-Related Impairment in Adults with Cystic Fibrosis

The Multidimensional Pain Inventory (MPI) was utilized in a sample of adult outpatients with cystic fibrosis (CF) to assess their perception of pain and its psychosocial consequences. Subsequently, the data were compared to the ratings of pain and pain-related impairment in these patients as perceived by two nurses from the CF treatment team, as well as to a quantitative measure of illness severity. The results of these comparisons demonstrate that the majority of adult outpatients with CF reported experiencing lower levels of pain and pain-related impairment than expected, although the male patients tend to report experiencing significantly less impact in these domains than do the female patients. Additionally, the nurses do not underestimate the degree to which patients, especially males, experience pain and pain-related interference from chronic illness. Finally, there was no significant relationship between patients' self-report of pain severity or pain-related interference and an objective measure of disease severity.     

Societal Risk Perception Among Children, Adolescents, Adults, and Elderly People

This study reported on mean risk magnitude judgments expressed by French participants aged 8 to 75 years, on a set of 91 hazardous activities, substances, and technologies. It then systematically analyzed the effects of the age factor on the judgments. Between elderly people and young and mature adults, few notable differences were detected. The most important result was that a considerable proportion of the children were able to estimate the risk associated with most items of the present study, and that the linear association between children's ratings and adults' ratings was very high. This finding supports the view that the learning of the risk associated with various technologies, common in society, is a fast process, depending probably much more on exposure to media information and family discussions (socialization) than on exposure to everyday reality.     

Eternity in an hour: experiences of time related to psychotherapy sessions

In this paper I consider the individual nature of the way a person develops senses of time. I suggest that something of a patient's early, unvoiced, experience is revealed through the temporal rhythms of interaction with the therapist. I refer to development, cycles of experience, metabolism, transgenerational emotions, experiences of beginnings and endings, early interactions with (m)other, together with narrative and its relation to unconscious processes. Experiences of time within the session indicate the nature of the feelings that are being lived, or refused life. I consider the paradox of living in the present and its relation to chronology. Lastly I give an example of the difficulty of timing comments when there is no flow of feeling, which is, itself, a communication.     

Infants’ coding of location in continuous space

The ability to code location in continuous space is fundamental to spatial behavior. Existing evidence indicates a robust ability for such coding by 12 months, but systematic evidence on earlier origins is lacking. A series of studies investigated 5-month-olds’ ability to code the location of an object hidden in a sandbox, using a looking-time paradigm. In Experiment 1, after familiarization with a hiding-and-finding sequence at one location, infants looked longer at an object being disclosed from a location 12 inches (30 cm) away than at an object emerging from the hiding location, showing they were able to code location in continuous space. In Experiment 2, infants reacted with greater looking when objects emerged from locations 8 inches (20 cm) away from the hiding location, showing that location coding was more finely grained than could be inferred based on the first study. In Experiment 3, infants were familiarized with an object shown in hiding-and-finding sequences at two different locations. Infants looked longer at objects emerging 12 inches (30 cm) away from the most recent hiding location than to emergence from the other location, showing that infants could code location even when events had previously occurred at each location. In Experiment 4, after familiarization with two objects with different shapes, colors, and sounding characteristics, shown in hiding-and-finding sequences in two locations, infants reacted to location violations as they had in Experiment 3. However, they did not react to object violations, that is, events in which the wrong object emerged from a hiding location. Experiment 5 also found no effect of object violation, even when the infants initially saw the two objects side by side. Spatiotemporal characteristics may play a more central role in early object individuation than they do later, although further study is required.     

The role of pain behaviour and family caregiver responses in the link between pain catastrophising and pain intensity: A moderated mediation model

Objectives: This study investigated the mediating role of pain behaviours in the association between pain catastrophising and pain intensity and explored the moderating role of family caregivers’ responses to pain in the link between pain behaviours and pain intensity.

Methods: The sample consisted of 154 chronic pain patients and their family caregivers. Patients completed questionnaires regarding pain intensity, pain catastrophising, pain behaviours and their caregivers’ responses to their pain. Family caregivers reported their responses to the patients’ pain.

Results: Pain catastrophising was associated with pain intensity (r = 0.37) and pain behaviours partly mediated this association. The positive association between pain behaviours and pain intensity was significant only if patients reported that their family caregivers showed high levels of solicitous (effect = .49) and distracting responses (effect = .58), and if caregivers reported to show high levels of solicitous responses (effect = .51). No support was found for negative responses as a moderator neither based on patients’ perception of negative responses nor based on caregivers’ perception of negative responses.

Conclusions: The findings are in line with the idea that family caregivers’ solicitous and distracting responses convey to patients that their condition is serious, which may reinforce patients’ pain and pain behaviours, especially in those who catastrophise.     

The role of ecological validity in hazard perception assessment

Hazard perception is one of the few quantifiable components of driving competency that can explain the high crash risk of novice drivers (see Horswill & McKenna, 2004). Some studies focused on investigating the stimulus part of hazard perception items by comparing several design features of the displayed traffic scenarios (e.g. Malone et al., 2012; Scialfa et al., 2013). Other empirical studies have been conducted to address the reaction part of hazard perception items (e.g. Vlakveld, 2014). Among others, existing hazard perception tests differ with respect to the ecological validity – the similarity to real-world demands – of the task that has to be completed by the participants (simple reaction, hazard localization, simulated driving, etc.). Based on the findings of general expertise research (see Glaser & Chi, 1988), the hypothesis of the present experiment was that an increased ecological validity of a hazard perception task has a positive effect on the magnitude of performance differences between more and less experienced drivers. 104 learner drivers and 51 experienced drivers were randomly assigned either to a less ecological valid version (multiple choice task) or a higher ecological valid version (reaction task) of a hazard perception test. In both conditions, the same 20 animated hazardous or non-hazardous traffic scenarios were presented. Overall, the experienced drivers outperformed the learner drivers. Principally, both of the applied versions of the test provided a criterion valid measure of driving expertise. However, increasing the ecological validity of the test by using a reaction task was especially beneficial for certain types of scenarios, leading to higher expertise-related differences. In addition, the reaction task provides response time measure as a further valid performance indicator. This allows the identification of those participants who are indeed able to detect a hazard in a certain scenario, but still have deficits in response time, compared to more experienced drivers. According to the present study, it is recommended to choose the reaction task over the multiple choice task to test hazard perception. Whether a further increase in ecological validity of the task would be useful, should be tested empirically in future research.     

Infant responses to adult happy and sad vocal and facial expressions during face-to-face interactions

We examined 5-month-olds’ responses to adult facial versus vocal displays of happy and sad expressions during face-to-face social interactions in three experiments. Infants interacted with adults in either happy-sad-happy or happy-happy-happy sequences. Across experiments, either facial expressions were present while presence/absence of vocal expressions was manipulated or visual access to facial expressions was blocked but vocal expressions were present throughout. Both visual attention and infant affect were recorded. Although infants looked more when vocal expressions were present, they smiled significantly more to happy than to sad facial expressions regardless of presence or absence of the voice. In contrast, infants showed no evidence of differential responding to voices when faces were obscured; their smiling and visual attention simply declined over time. These results extend findings from non-social contexts to social interactions and also indicate that infants may require facial expressions to be present to discriminate among adult vocal expressions of affect.