The fear-avoidance model of exaggerated pain perception—II: Preliminary studies of coping strategies for pain

The personal history of pain and personal coping strategies for pain are two of the contributory factors in the Fear-Avoidance Model of exaggerated pain perception proposed by Lethem, Slade, Troup and Bentley (1983, this issue, pp. 401–408). In order to test this aspect of the hypothesis, a questionnaire was designed and has been completed by 165 students (93 female, 72 male) at the University of Liverpool.They were asked about the severity of externally-produced pain (e.g. fracture), of internally-produced pain (e.g. headache) and of back pain; about the strategies they adopted for coping with internallyproduced pain (e.g. did they ignore the pain and carry on—an active strategy—or did they go and rest—a passive strategy); and about the effects of back pain on each of 10 activities or postures (from ‘no effect’ to ‘had to stop completely’) in order to obtain an index of back-pain avoidance.Out of 165, 91 reported previous back pain (Back Pain group) and their average rating for the severity of externally-produced pain was significantly higher than for the No Back Pain group; but there were no differences between these two groups for their coping strategies for internally-produced pain. However, of the Back Pain group with two or more previous attacks, 35 gave a history indicating decreasingly severe attacks and 28, increasingly severe: the coping strategies of the latter group for internally-produced pain were significantly more passive. The ratings for severity of back pain correlated significantly with the indices for back-pain avoidance and with the ratings for severity of internally-produced pain.These findings are in line with the prediction that personal pain history and personal coping strategies are relevant to the Fear-Avoidance Model of exaggerated pain perception and may therefore influence the adoption of an avoidance or a confrontation response by the patient with chronic back pain.     

Blocking of inhibitory conditioning within a serial conditioned stimulus-conditioned inhibitor compound: Maintenance of acquired behavior without an unconditioned stimulus

Well-trained classically conditioned stimuli, presented unreinforced, were protected from extinction when they were followed by a signal of the omission of the reinforcer (conditioned inhibitor Konorskian type) in eight cats. An aversive classical conditioning paradigm with shock as the reinforcer was used. Of several behavioral (leg flexion, vocalization) and organismic arousal (heart rate, respiration rate, respiration amplitude) measures of conditioned responses, the respiration amplitude changes were found to be most informative for the continuous assessment of elicited arousal of low and medium intensity. In all subjects conditioned stimuli presented during extinction in serial compound with the conditioned inhibitor elicited larger responses than did conditioned stimuli presented alone during extinction. The mechanism of protection from extinction in a paradigm in which the elicitor of learned behavior occurs prior to the conditioned inhibitor provides the organism with the mechanism for the maintenance of learned behavior in the absence of a reinforcer.     

Spatial memory in rats under restricted viewing conditions

In a procedure devised by J. A. Walker and D. S. Olton (Learning and Motivation, 1979, 10, 73–84), rats were placed on two arms of a four-arm radial maze and then were placed in the center of the maze to test how accurately they could choose the alleys on which they had not been placed. In three experiments, the conditions under which animals viewed the environment from the arms were varied. In Experiment 1, both the extent of spatial view and the exposure time were varied factorially in a within-subjects design; animals viewed the environment down a tunnel or had a 180° or 360° view, and subjects were allowed to view the environment for either 2 or 20 sec. In Experiment 2, a between-subjects design was used, in which different groups of subjects were tested repeatedly under either the tunnel, 180°, or 360° conditions. Both experiments showed that animals could avoid the arms previously visited at no better than a chance level of accuracy in the tunnel viewing condition but could perform with progressively better accuracy at the 180 and 360° viewing conditions. Animals also were more accurate in Experiment 1 after viewing for 20 sec than after viewing for 2 sec. Experiment 3 involved a procedure in which restricted viewing conditions were used both during arm placements and testing. Animals tested under tunnel viewing eventually achieved above-chance performance with this procedure, but did not exceed chance as rapidly as groups tested with 45 and 90° views of the environment. These results suggest that animals can learn about their position in a spatial environment through observation and that an animal's ability to locate its position is directly related to the extent of the surrounding environment it can see and the length of time it is allowed to look. The implications of these findings for list and map hypotheses of spatial memory representation are discussed.     

The early history of the behavior modification of stuttering: From laboratory to clinic

The knowledge of and attitudes toward stuttering of 152 Alabama vocational rehabilitation counselors were studied using the Alabama Rehabilitation Counselors' Attitudes Toward Stuttering (ARCATS) Inventory consisting of 25 true- false statements designed to assess knowledge of stuttering and 15 statements designed to assess attitudes toward stuttering. Counselors were found to perceive stuttering as being significantly vocationally handicapping and amenable to therapy and to perceive stutterers as almost always benefiting from therapy and as being good candidates for vocational rehabilitation. It was concluded that the vocational rehabilitation counselors studied hold attitudes facilitative to the rehabilitation of stutterers.     

Reading ability and disfluency in stuttering and nonstuttering elementary school children

This study was aimed at comparing the reading abilities of elementary school children who stutter with their nonstuttering peers. Forty-four stuttering children from four grade levels were matched with a group of normally fluent controls on the basis of age, sex, and grade level. Reading ability was assessed by means of three Dutch standardized tests yielding a total of six scores. Disfluency scores during oral reading were also obtained for each subject. Results indicated significant differences between the two groups on reading rate and reading errors, but not on reading comprehension. Analysis of reading errors did not show qualitative differences among subjects: stuttering and nonstuttering children made the same kinds of reading errors. Similarly, the two groups did not differ with respect to performances at different grade levels. Among both groups of subjects performances became better with increasing grade on four of the six measures. Correlational analyses indicated that the measures of reading ability used in this study were significantly associated with frequency of disfluency for the nonstuttering children. In contrast, no significant relationship was found between reading ability and disfluency in the stuttering group, except for reading rate. Results are discussed with respect to the possible interaction between verbal performance and linguistic competence in reading ability measures, particularly for the stuttering child.     

The mean fundamental frequency in stutterers and nonstutterers during reading and spontaneous speech

Corresponding to the higher tension of muscles involved in speech production, a higher mean fundamental frequency should be expected in stutterers as compared to nonstutterers. It could be shown by the change scores of the mean fundamental frequency from reading to free conversation that stutterers tend to have a higher fundamental frequency during spontaneous speech.     

Apractic agraphia in a patient with normal praxis

Most right-handed crossed aphasics are not apractic. They usually have agraphia characterized by misspellings but retain the ability to write well-formed graphemes. We describe a right-handed patient with a right parietal lesion who was aphasic and not apractic. He was unable to write any formed graphemes despite a relatively preserved ability to spell aloud. We postulate that praxis and writing are dissociated in this patient because the motor engrams for praxis were located in his left hemisphere and the engrams for writing were in his right hemisphere. In addition, he comprehended commands for limb motor activities (praxis) far better than he comprehended other speech. This suggests that in this patient the areas used to comprehend limb motor commands may be anatomically distinct from areas important in comprehending other aspects of speech.     

The relationship between treatment exposure times and changes in stuttering frequency during contingent stimulation

Four adult stutterers were exposed to 60 consecutive minutes of verbal contigent stimulation. In each session subjects spoke until a stuttering frequency stability criterion was met (baserate) followed by 60 min of exposure to the word wrong presented contingently upon each instance of stuttering. The data were analyzed according to changes in stuttering which occured following 20, 40, and 60 min of treatment exposure. The results revealed that stuttering frequency was reduced for all subjects during all three 20-min segments of the treatment condition. The only significant reductions in stuttering frequency, however, occured within the first 20 min of treatment.     

A perceptual comparison: Stuttering and nonstuttering children''s nonstuttered speech

Recently, perceptual evaluation of the nonstuttered speech of stutterers has received renewed research interest. To summarize, the majority of research on this subject reported the nonstuttered speech of adult stutterers was perceptually identifiable from that produced by normal speaking individuals. A continuation of this line of research would be to determine if the nonstuttered speech of children would be equally recognizable. The results of this investigation would indicate this is not the case. The implications of the sophisticated judge's inability to identify stuttering children based on nonstuttered speech are discussed.