Sensory and affective components of pain: separation and synthesis.

It has become increasingly accepted that pain is not simply a sensation generated by nociceptors, but a perceptual phenomenon with particular emotional qualities. The purpose of this article is to bring together vastly different streams of research on the divisibility of pain into sensory and affective components. Empirical evidence for this divisibility is drawn from recent studies using multivariate statistics, signal detection theory, and unidimensional scaling. An important conclusion is that separable though pain components may be, they are not necessarily independent. In critiquing previous research, new criteria are derived for partitioning pain into sensory and affective components. Finally, speculations are offered as to how these same components might be synthesized on the basis of theories of perceptual organization.     

STIMULUS (INSTRUCTIONAL) FADING DURING EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR

Three individuals with developmental disabilities were exposed to a series of assessment conditions to identify the source of reinforcement for their self-injurious behavior. In each case, self-injury occurred most often in instructional (demand) situations containing a brief time-out from the task contingent on self-injury, indicating that the behavior was an escape response (i.e., maintained by negative reinforcement). Treatment was implemented in a multiple baseline across subjects design and consisted of extinction (prevention of escape) plus instructional fading (initial elimination of instructions followed by their gradual reintroduction). Results showed that the combined treatment produced immediate and large reductions in self-injury that were maintained as the frequency of instructions was increased across sessions to match the original baseline rate of presentation. Results of a component analysis conducted with 1 subject suggested that stimulus fading accelerated the behavior-reducing effects of extinction.     

On the putative uniqueness of cancer pain: do psychological principles apply?

A large volume of evidence has supported the important role of psychological principles and variables related to the perception of, and response to, nociceptive stimulation. On the basis of this research, a number of psychological interventions have been developed and used successfully with pain patients. Despite the evidence, there has been a tendency for practitioners to neglect the contributing role of cognitive, affective, and behavioral factors in reports of pain by cancer patients. Cancer seems to hold a unique status in medicine and society at large. In this paper, the cancer pain literature is briefly reviewed and evidence is presented for various psychological determinants of the pain report and response that may be extended to pain associated with cancer. The implications of these data for understanding and treatment of cancer patients are described.     

Comparison of the factors influencing interviewer hiring decisions for applicants with and those without disabilities

Two studies present an examination of the factors that influence hiring decisions for applicants with, and those without, disabilities in the employment interview. In Study 1, an integrative conceptual model of interviewer hiring decisions was proposed and tested in a field sample of applicants with disabilities. Interviewers provided ratings for 70 unstructured interviews with disabled applicants. Study 2 examined the fit of the model in an independent field sample of interviews with fully-able applicants (n=165). Results supported the model among both groups of applicants. Implications and recommendations for future research are discussed.This paper has been improved greatly through the suggestions of John Binning, Michael Campion, Robert L. Dipboye, Miles Patterson, and Mark Tubbs, and Lisa Brady and Jennifer Malatesta. Study 1 was partially funded by a grant from the U.S. Office of Special Education and Rehabilitative Services to the Wright State University Office of Disability Services (Theodore L. Hayes, co-Principal Investigator).     

Infants' sensitivity to arbitrary object-odor pairings

The ability of 4-month-old infants to learn the arbitrary relationship between an object and a distinctive odor was assessed. Infants were familiarized with two objects while one of them was paired with a cherry odor. Results indicated that only female subjects showed evidence of matching. They increased their looking to the target object in the presence of the odor but not in the absence of the odor, relative to baseline levels.     

Effects of models and demonstrations of personal narratives on the use of lexical ties by writers with mental retardation

A single subject reversal design was used to investigate the effects of two methods for teaching writing to eight adolescents with mild or moderate mental retardation during a weekly process writing workshop. During each workshop, each student wrote a personal narrative while the teacher circulated among the group and provided positive verbal feedback and spelled words on request. Students' texts were later typed with corrected spelling and punctuation and returned to them with verbal praise before the next writing workshop. During the first experimental condition, the subjects listened to an exemplar text selected by the teacher. In the second phase, the teacher read a narrative she had written as the exemplar text. During the third experimental condition, the teacher orally self-instructed herself through steps in writing a narrative. The subjects' texts were analyzed for number of words written and number and type of lexical ties used to produce cohesion between sentences in a text. The model narrative produced the best gains in the number of words written by the poorer readers, while the demonstration improved the cohesiveness of their texts. The better readers and writers wrote more cohesively during the model narrative and produced longer text during the demonstration condition.     

Students' self-estimated and actual knowledge of gender traditional and nontraditional occupations

This study investigated the degree and congruence of students' estimated and actual information about gender traditional and nontraditional occupations. Twenty-nine female and 29 male college students completed an instrument on which they rated how much they thought they knew about 18 male-dominant and 18 female-dominant occupations. They also completed an instrument measuring their actual knowledge of these and an additional wide variety of occupations. Results showed that subjects of each sex perceived themselves as less informed about nontraditional occupations. This result was much more pronounced for women than men. Each sex also tended to underestimate their actual knowledge of nontraditional occupations. Men and women did not differ in their actual knowledge, which was fairly limited for both sexes.     

To Be or Not: A Brief History of the Health Humanities Consortium

The Health Humanities Consortium (HHC) was established in 2015 to “promote health humanities scholarship, education, and practice through transdisciplinary methods and theories that focus on the intersection of the arts and humanities, health, illness, and healthcare.” As the founding co-chairs of the HHC, we provide a history of the founding of this organization in this article, describing the journey of its creation, the choices and challenges it faced as a new organization, and our hopes for a rich future.

     

From the Editor

Journal of Medical Humanities -     

Regression II. Development through regression

As shown in our previous paper (‘Regression I. Experimental approaches to regression’, JAP, 65, 2, 345-65), the common mechanism of regression can be described as reversible dedifferentiation, which is understood as a relative increase of the proportion of low-differentiated (older) systems in actualized experience. Experimental data show that regression following disease (chronic tension headache) is followed by adaptation and an increase in system differentiation in that experience domain which contains systems responsible for that adaptation. The results of mathematical modelling support the idea that reversible dedifferentiation can be one of the mechanisms for increasing the effectiveness of adaptation through learning. Reversible dedifferentiation, which is phenomenologically described as regression, is a general mechanism for restructuring the organism-environment interactions in situations where behaviours that were effective in the past become ineffective. Reversible dedifferentiation has evolved as a component of adaptation when new behaviours are formed and large-scale modifications in the existing behaviours are required in the face of changes in the external and/or internal environment. Thus, the authors believe that this article provides evidence for Jung’s view that regression is not only a ‘return’ to past forms of thinking, affects and behaviour, but that regressive processes provide a significant impetus for psychological growth and development.