Behaviour research and therapy
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Randomized Controlled Trial Comparative Study Clinical Trial
Cognitive-behavioural therapy versus EMG biofeedback in the treatment of chronic low back pain.
Forty-four chronic, but relatively well functioning, low back pain patients were assigned to either Cognitive Behaviour Therapy (CBT). Electromyographic Biofeedback (EMGBF) or Wait List Control (WLC). Both treatments were conducted over eight sessions in groups of four subjects. ⋯ At 6 months follow-up, treatment gains were maintained in the areas of pain intensity, pain beliefs, and depression, for both treatment groups, with further improvements occurring in anxiety and use of active coping skills. No significant differences were found between CBT and EMGBF on any of the outcome measures at either post-treatment or at 6 months follow-up. Further research is required to determine the degree to which these results reflect the mild level of psychological impairment and disability status of patients in the present study.
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Although there is anecdotal evidence for the psychoanalgesic properties of distraction, research evidence is equivocal. Drawing on the clinical and experimental studies of attention-based coping strategies for pain control, and the theoretically driven 'cognitive' models of the human attention system, two experiments are reported. ⋯ Experiment Two tests the hypothesis that the low intensity pain patients in Experiment One are coping with the dual demand of processing the pain and processing the task by switching quickly between these attentional demands. The results of both experiments are discussed in terms of the evidence for the analgesic properties attention based coping strategies with clinical pain populations and re-addresses the literature on coping with pain in terms of cognitive theories of attention.
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This study investigated the physiological, subjective and behavioral responses to hyperventilation of four groups of Ss with: (1) clinical panic disorder (n = 13); (2) infrequent panic (n = 16); (3) no panic and high trait anxiety (n = 16); and (4) no panic and low trait anxiety. After completing a number of anxiety-related questionnaires, Ss participated in 2 min of hyperventilation during which heart rate and electrodermal activity were recorded continuously. ⋯ Analyses revealed no group differences in physiological responses to the hyperventilation, although group differences in subjective sensations and cognitions were found. Data are discussed with regards to the role of physiological processes vs subjective responses to anxiety-provoking stimuli in the psychopathology of clinical panic disorder.
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Comparative Study
The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories.
The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. ⋯ Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.
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Comparative Study
Detecting depression in chronic pain patients: adequacy of self-reports.
Depression, a complex psychobiological syndrome, has been found to be prevalent among individuals with chronic pain problems. It has been repeatedly recommended that chronic pain patients be routinely screened for depression. Many self-report questionnaires have been used to screen for depression although few have addressed potential limitations of using a self-report questionnaire to identify depressed chronic pain patients. ⋯ The results support the predictive validity of the CES-D and suggest that a cut-off score of 19 should be used for diagnosing depression in chronic pain patients rather than the standard cut-off point of 16. Interestingly, the removal of the somatic items did not enhance the effectiveness of the CES-D. The discriminatory ability of somatic items with the total assessment of depression is discussed.