Behaviour research and therapy
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Gross (Behaviour Research and Therapy, 30, 7-13, 1992a) showed that the fear of pain (pain sensitivity) could be distinguished from dental fears and health concerns. Furthermore, the Pain Sensitivity Index (PSI) correlated significantly with pain expectations, and pain expectations correlated significantly with dental avoidance behaviour. However, Gross noted that the psychometric properties of the PSI had not been fully determined. ⋯ Subsequently, it was hypothesized that pain sensitivity correlates positively with fears relating to police tasks which are characterized by pain expectancies, such as the fear of being assaulted during operational police work. In support of the hypothesis, pain sensitivity correlated highest with situations involving pain. The pain sensitivity construct may help to explain individual differences in fear reactions to situations where pain could be experienced, such as operational police duties or dental attendances.
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Randomized Controlled Trial Comparative Study Clinical Trial
Operant-behavioural and cognitive-behavioural treatment for chronic low back pain.
Fifty-eight outpatients with chronic low back pain were randomly allocated to one of six experimental conditions. Four conditions were designated as treatment conditions and two as control conditions. The four treatment groups consisted of: cognitive treatment (either with or without relaxation training) and behavioural treatment (either with or without relaxation training). ⋯ However, these differences were only weakly maintained at 6- and 12-month follow-ups. The behavioural conditions improved significantly more than the cognitive conditions from pre to posttreatment on the self-rated measure of functional impairment, but this difference was not maintained at 6- and 12-month follow-ups. Progressive relaxation training was found to make little contribution to either cognitive or behavioural treatments.
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Previous experimental research on the effects of incorrect intensity expectations of aversive events can be criticized because intensity expectations were not manipulated independently from changes in objective intensity. The present study aims at investigating the effects of incorrect intensity expectations on the immediate and later responses to a painful stimulus, and on the acquisition of anticipatory responses, with proper experimental control. Subjects (n = 62) received 20 painful stimuli of varying intensity. ⋯ Overpredicted painful experiences were related to a faster decrease in subjective fear compared to the control group, but did not influence other variables. The findings support the notion that underpredictions contribute to the acquisition of fear and disrupt habituation processes. The asymmetrical processing of the two kinds of incorrectly predicted experiences is discussed.
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This study examined the role family support plays in insulating chronic pain patients from maladaptive behaviors associated with their pain. Two hundred and thirty-three patients who described their family as always being supportive and never having any conflicts were compared with 275 chronic pain patients who endorsed having family disharmony and limited support. One year after completing an out-patient pain program a random sample of 181 of these patients were followed to determine the extent to which family support influenced treatment outcome. ⋯ On follow-up, patients who described their families as being supportive reported significantly less pain intensity, less reliance on medication and greater activity levels. They tended to be working and not to have gone elsewhere for treatment of their pain compared with patients who described their family as non-supportive. The results of this study demonstrate that perceived support is an important factor in the rehabilitation of chronic pain patients.
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This study explored possible mechanisms involved with the maintenance of generalized anxiety. While several general anxiety-related variables were investigated, the relationship between worry and intrusive thoughts was of primary interest. We postulated that anxious persons continue to worry in order to avoid recollections of distressing life events. ⋯ Results of a factor analysis indicated that worry and intrusive thought items loaded on separate factors, which supports the hypothesis that worry can be distinguished from intrusive thoughts. The study also examined whether different patterns of worry and intrusive thoughts distinguish between high-anxious, panic, and low-anxious persons and how anxiety sensitivity and self-consciousness are related to generalized anxiety and panic. Finally, we discussed the implications of our results for understanding the psychopathology base of Generalized Anxiety Disorder.