Do pain expectancies cause pain in chronic low back patients? A clinical investigation

The present study investigated whether pain expectancies cause pain in chronic low back patients. Back patients (N = 29) were requested to perform four exercise bouts (two with each leg), each consisting of flexing and extending the knee three times at maximal force (Cybex 350 System). During each exercise bout the baseline pain, the expected pain and experienced pain were recorded. Patients also reported their experienced fear of further injury to the back. Furthermore, the peak force of both knee flexors and extensors was assessed. Although patients did expect a back pain increase during the first exercise bout with each leg, no evidence was found for the thesis that pain expectancies generate increases in subjective pain experiences. Instead, the reported pain expectancy was readily corrected during the next exercise bout, whereas the experienced pain remained unchanged. Furthermore, a high pain expectancy co-occurred with (1) a marginally significant fear of (re)injury, and (2) a significant lower peak torque of the knee flexors. These results are consistent with conditioning models which state that pain expectations are associated with a fear response and an urge to avoid the pain.     

Exposure to physical movements in low back pain patients: restricted effects of generalization.

Whether the effects of exposure to 1 movement generalize to another dissimilar movement was investigated in 37 patients with low back pain (15 men, 22 women). Two movements were executed twice: bending forward while standing and lifting 1 leg while lying down. During each trial, baseline pain, expected pain, and experienced pain were recorded. Similar ratings for perceived harm were obtained. Analyses revealed an initial over prediction of pain, but after exposure the overprediction was readily corrected. This exposure effect did not generalize toward another dissimilar movement. These results were only characteristic for patients with catastrophic thinking about pain. Low pain catastrophizers did not overpredict pain. There were no effects of exposure on perceived harm. Exposure may profitably be conceived of as the learning of exceptions to a general rule.     

Exposure to physical movement in chronic back pain patients: no evidence for generalization across different movements

This study investigated whether the effects of exposure to one movement generalize towards another dissimilar movement in patients with low back pain. Thirty-nine patients (11 male, 28 female; mean age=43.49 yrs) were requested to perform two movements twice, i.e. bending forward and straight leg raising. During each of the four trials, baseline pain, expected pain and experienced pain were recorded. Analyses revealed that patients initially overpredicted pain, but after exposure the overprediction was readily corrected. This exposure effect did not generalize towards another dissimilar movement. The above pattern of results was only characteristic for patients reporting a high frequency of catastrophic thinking about pain. Low pain catastrophizers did not overpredict pain. The results are discussed in terms of the view that exposure may be better conceived of as the learning of exceptions to a general rule.     

Effects of varied-stimulus exposure on overpredictions of pain and behavioural performance in low back pain patients

The main objective of the present study was to investigate the benefits of exposure to a variety of movements versus exposure to the same movements on overprediction of pain and behavioural performance on a final behavioural test in a sample of chronic low back pain (CLBP) patients. Eighty-four CLBP patients were requested to perform four behavioural tests. Patients were assigned to two experimental conditions. The final behavioural test was the same for all patients. The first three behavioural tests consisted of three different movements in condition 1 and of three times the same movement in condition 2. During each behavioural test, baseline pain, expected pain and experienced pain were recorded. Furthermore, the peak torque and the variability of the produced muscle strength during the final behavioural test were assessed. Replicating and extending previous research, we found that patients overpredicted pain during a threatening behavioural test. Furthermore, pain-related fear and pain catastrophizing showed to be unique predictors of the peak torque of the final behavioural test. No support was found for our hypothesis that varied exposure facilitates generalization of exposure effects. Possible reasons for the failure to find an advantageous effect of varied-stimulus exposure and ideas for future research are discussed.     

Analysis of variance for repeated measures designs with word materials as a nested random or fixed factor

This article is about analysis of data obtained in repeated measures designs in psycholinguistics and related disciplines with items (words) nested within treatment (= type of words). Statistics tested in a series of computer simulations are: F1, F2, F1 & F2, F', min F', plus two decision procedures, the one suggested by Forster and Dickinson (1976) and one suggested by the authors of this article. The most common test statistic, F1 & F2, turns out to be wrong, but all alternative statistics suggested in the literature have problems too. The two decision procedures perform much better, especially the new one, because it systematically takes into account the subject by treatment interaction and the degree of word variability.     

God changes people: modes of authentication in Evangelical conversion narratives

One of the distinguishing characteristics of Evangelicalism is the conversion story. In this article we focus on the conversion stories of interviewees within the setting of several related Evangelical television programs broadcast in the Netherlands since the 1980s. We argue that the conversion story is construed through a particular view on and practice of authenticity. Thus we see that, in the televised conversion story, modes of authentication are at work in what we analytically distinguish as frames, narratives, and strategies of authentication. We argue that the idea of an authentic transformation has changed from a more fundamentalist mode of authentication, emphasizing the subjection of the self to a particular religious narrative, to a more expressive mode of authentication that emphasizes the exploration of the inner, unique self of the interviewee.     

National Identity and Attitude Toward Foreigners in a Multinational State: A Replication

An analysis of the 1995 Belgian General Election Survey indicates that the bipolar national identity variable, which contrasts citizens who identify exclusively with the Belgian nation with those who identify exclusively with the Flemish or Walloon subnation, measures not only the direction but also the intensity of national feelings. Respondents who are located at the middle of the scale tend to have a weak identification with both the nation and the subnation. On the basis of a structural equations modeling approach involving a test of the construct equivalence in the two regions and a control for agreeing-response bias, it is shown that the bipolar national identity variable and attitude toward foreigners are inversely related in Flanders and Wallonia. In Flanders, citizens with a strong subnational identification tend to have a negative attitude toward foreigners; those with a strong Belgian identification are more positive. This relationship became more pronounced after controlling for the respondents' level of education. In Wallonia, a reverse but less pronounced relationship was found. These findings support the hypothesis that the relationship between the variables of national identity and attitude toward foreigners is not intrinsic, but is at least partly determined by the social representation of the nation.