MMPI-2 Content Scale Validity Within a Sample of Chronic Pain Patients

The concurrent, criterion-related and discriminant validity of four of the MMPI-2 content scales were examined within a population of 309 patients being evaluated for the treatment of chronic pain. Utilizing both self-report and therapist-derived criteria, the MMPI-2 content scales designed to assess symptoms of anxiety (ANX), depression (DEP), low self-esteem (LSE), and anger (ANG) demonstrated the ability to provide valid information beyond that provided by the traditional MMPI-2 clinical and validity indices. Further, a multi-trait/multi-method analytic approach revealed; (1) strong discriminant validity for the ANG content scale and (2) substantial variance overlap among all the self-report measures of subjective distress, compromising our efforts to evaluate the discriminant validity of the ANX, DEP, and LSE content scales.     

Social discounting of pain

Impatience can be formalized as a delay discount rate, describing how the subjective value of reward decreases as it is delayed. By analogy, selfishness can be formalized as a social discount rate, representing how the subjective value of rewarding another person decreases with increasing social distance. Delay and social discount rates for reward are correlated across individuals. However no previous work has examined whether this relationship also holds for aversive outcomes. Neither has previous work described a functional form for social discounting of pain in humans. This is a pertinent question, since preferences over aversive outcomes formally diverge from those for reward. We addressed this issue in an experiment in which healthy adult participants (N = 67) chose the timing and intensity of hypothetical pain for themselves and others. In keeping with previous studies, participants showed a strong preference for immediate over delayed pain. Participants showed greater concern for pain in close others than for their own pain, though this hyperaltruism was steeply discounted with increasing social distance. Impatience for pain and social discounting of pain were weakly correlated across individuals. Our results extend a link between impatience and selfishness to the aversive domain.     

积极怀旧情绪对疼痛共情影响的ERP研究

采用ERP技术比较积极怀旧情绪诱发组被试和中性情绪组被试在判断疼痛/非疼痛图片刺激时的疼痛共情反应,探讨积极怀旧情绪对个体疼痛共情加工的影响及其电生理学机制。结果发现,在P2成分和晚期的P3成分上,积极怀旧情绪下的疼痛图片比中性情绪下的疼痛图片诱发了更大的波幅。疼痛图片比非疼痛图片诱发更大的P2、N2、P3及400～600 ms正成分的波幅。结果表明积极怀旧情绪的诱发促进个体对疼痛刺激的加工和共情。     

Shock-induced aggression and pain sensitivity in the rat: Catecholamine involvement in the corticomedial amygdala

The possible role of amygdaloid catecholamines in the control of shock-induced aggression and pain sensitivity in the rat was investigated. Bilateral microinjections of chlorpromazine into the corticomedial amygdala resulted in decreased fighting and decreased sensitivity to the shock stimulus. Further analysis of this effect, using specific adrenergic antagonists, revealed that neither a- nor Padrenergic systems appeared to be responsible for the behavioral effect of chlorpromazine. Injections of haloperidol into the same region, however, yielded a reduction similar to that produced by chlorpromazine, while dopamine injections resulted in significant elevations in both fighting and pain sensitivity. No effect on any of these behavioral measures was obtained following injection of any of the agents into the basolateral amygdala. These results suggest that the observed effect of catecholamine injections in the corticomedial amygdala is related to changes in pain sensitivity mediated by dopamine.     

Uprooted minds: displacement,trauma and dissociation

The author, English born and living in Sydney, Australia, presents an argument for the usefulness of the recognition of the implicit simultaneous links between the following:

• development of psychic skin and the establishment of the body schema
• development of a sense of identity
• relationship with place

such that the formulation psychic skin< > mind < > body < > self < > place < > world can be thought of as an organising gestalt or implicit continuum of ‘skin’ experience and process upon which the explicit always depends. This constitutes a taken‐for‐granted ground‐plan of the self‐in‐place . The author follows this with an exploration of the consequences for psychic health of a traumatic rupture of this gestalt for both individual and group. Material from two cases is presented: first, a young woman whose family fled the Balkan wars which splintered the former Yugoslavia; second, the transmission of displacement trauma into the third generation of a family who arrived in Australia after WW II from the former Yugoslavia. For the purposes of this paper I will not make a distinction between migrants/exiles/refugees and instead refer to either displacement or dislocation.     

Pain‐induced aggression and changes in social behavior in mice

The effects of neuropathic, formalin, and acetic acid‐induced visceral pain were investigated on the social and aggressive behaviors in the Swiss male mice. Neuropathic pain was induced by tibial nerve transection (TNT). Also, somatic and visceral pain was conducted by intraplantar injection of diluted formalin (1%, 20 μl) and intraperitoneal administration of acetic acid (0.6%, 200 μl), respectively. Fourteen and twenty one days after the TNT surgery, and also, 1 and 7 days following formalin and acetic acid administration, the three‐chambered test was used to determine sociability and preference for social novelty and resident/intruder test was used for the evaluation of the aggressive behaviors. In the sociability phase of the three‐chambered test, all the three models of pain did not change the animal's sociability. However, in the social novelty preference phase, the animals in pain showed deficits in social novelty preference by a significant increase in the time spent with the familiar mice compared to the control groups. Also, animals in pain significantly showed more aggressive behaviors like biting and clinching and have much less attack latency in comparison to the control groups. Pain‐induced changes in the social novelty preference and aggressive behaviors continued in the neuropathic group until the end of the experiment. However, 7 days following the induction of both formalin and visceral pain, animals' social memory, and aggression almost returned to the standard value. These results suggest that long‐lasting pain could lead to social memory impairment and increase aggressive behaviors in mice.     

Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review

Background/Objective: To assess the differential efficacy between mindfulness-based interventions and cognitive-behavioral Therapy (CBT) on chronic pain across medical conditions involving pain. Method: ProQuest, Science Direct, Google Scholar, Pubmed, and Embase databases were searched to identify randomized clinical trials. Measurements of mindfulness, pain, mood, and further miscellaneous measurements were included. Results: 18 studies met the inclusion criteria (fibromyalgia, n = 5; low back pain, n = 5; headache/migraine, n = 4; non-specific chronic pain, n = 4). In fibromyalgia, mindfulness based stress reduction (MBSR) was superior to the usual care and Fibroqol, in impact and symptoms. In low back pain, MBSR was superior to the usual care, but not to CBT, in physical functionality and pain intensity. There were no studies on differential efficacy between mindfulness and CBT for headache and non-specific chronic pain, but Mindfulness interventions were superior to the usual care in these syndromes. Conclusions: Mindfulness interventions are superior to usual cares in all diagnoses, but it is not possible to conclude their superiority over CBT. Comparisons between mindfulness interventions are scarce, with MBSR being the most studied. In central sensitization syndromes, variables associated with pain tend to improve with treatment. More research is needed to differentiate diagnosis and intervention.     

Acute pain disrupts prospective memory cue detection processes

Prospective memory refers to the planning, retention, retrieval, and execution of intentions for future behaviours and it is integral to the enterprise of daily living. Although prospective memory relies upon retrospective memory and executive processes often disrupted by pain, limited research has explored the influence of acute or chronic pain on the ability to complete prospective memory tasks. In the present study we investigated the influence of acute pain on prospective memory tasks that varied in their demands on executive processes (i.e., non-focal versus focal prospective memory cues). Complex-span working memory tasks were also administered to examine whether individual differences in working memory capacity moderated any negative impact of pain on prospective memory. Acute pain significantly impaired prospective memory performance in conditions that encouraged non-focal strategic processing of prospective memory cues, but not in conditions that encouraged more spontaneous focal processing. Individual differences in working memory capacity did not moderate the effect of acute pain on non-focal prospective memory. These findings provide new insights into prospective memory dysfunction created by painful experiences.     

THE “AS‐YET SITUATION” IN WINNICOTT'S “FRAGMENT OF AN ANALYSIS”: YOUR FATHER “NEVER DID YOU THE HONOR OF”… YET

The author proposes a new hypothesis in relation to Winnicott's “Fragment of an Analysis”: that as early as 1955, in the case described in this text, Winnicott is creating the paternal function in his patient's psychic functioning by implicitly linking his interpretations regarding the father to the Freudian concept of Nachträglichkeit. The author introduces an original clinical concept, the as‐yet situation, which she has observed in her own clinical work, as well as in Winnicott's analysis of the patient described in “Fragment of an Analysis” (1955).