Information processing and affective distress in osteoarthritis patients.

The relationship between affective distress and chronic illnesses is well recognized. Recent research has focused on depressive symptomatology among patients with chronic pain. The present study was conducted to (a) examine depressive information processing in osteoarthritis patients and (b) assess whether the presence of somatic items on a depression measure would affect the observed associations between information processing and affective distress in arthritis patients. A group of 40 osteoarthritis patients was assessed using the Beck Depression Inventory, and a non-self-report measure of depressive self-schemas. Results suggest that observed depressive cognitive structures appear to be better differentiated by a nonsomatic measure of affective distress and that individuals selectively process information to fit the parameters of their currently active self-schema. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Word completion in chronic pain: evidence for schematic representation of pain?

Schematic representation of pain information was investigated in chronic pain patients, health professionals, and nonpatient controls. Under the guise of an English-language experiment, Ss were presented with 12 word stems to be completed with the first 2 English words that came to mind. Four of the stems could be completed with sensory pain words, 4 with effective, and 4 with words associated with pain or illness. All could be completed with at least 3 other nonpain words of equal or greater frequency. Results indicate that chronic pain Ss produced significantly more pain-related completions than control Ss and that in all 3 groups the types of pain words produced were related to the extent of personal experience of pain. The theoretical implications of these findings are discussed in relation to the organization of schema, implicit memory, and the activation of mental representations of pain (schema).     

Self-schemas and risk for depression: A prospective study.

Two longitudinal experiments with 375 undergraduates investigated the role of depressive self-schemas in vulnerability to depression. Ss were divided into 5 groups hypothesized to be at differential risk for depression according to a schema model: depressed schematic, depressed nonschematic, nondepressed schematic, nondepressed nonschematic, and psychopathology control. In Exp I, Ss were followed regularly for 4 mo with self-report and clinical interview measures of depression (e.g., Beck Depression Inventory). There was no evidence of risk for depression associated with schema status apart from initial mood and no interaction of life stress events and schemas. In Exp II, links among self-schemas, information processing, and mood status were investigated. It was shown that depressive self-schemas did not exert an ongoing, active influence on everyday information processing; instead, current mood affected information processing. Remitted depressed Ss resembled nondepressed rather than depressed Ss. Findings support the distinction between concomitant and vulnerability schemas noted by N. Kuiper et al (in press) and help to clarify differences between cognitions that are symptoms of depression and those that may play a causal role under certain conditions. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specificity of Stroop interference in patients with pain and PTSD.

The authors investigated processing of threat words in motor vehicle accident survivors using a modified Stroop procedure. Three samples were included: 28 participants with comorbid posttraumatic stress disorder (PTSD) and pain, 26 participants with pain without PTSD, and 21 participants without pain or any psychiatric conditions. Four word categories were used: (a) accident words, (b) pain words, (c) positive words, and (d) neutral words. This study examined whether processing biases would occur to accident words only in participants with PTSD or if these biases would also be noted in the No PTSD/Pain sample. Additionally, this study examined whether processing biases would be noted to pain words in the 2 pain samples, irrespective of PTSD. Overall, color naming was significantly slower in the PTSD/Pain group in comparison with the other groups. As well, the PTSD/Pain sample showed significant response delays to both accident and pain-related words, whereas patients with No PTSD/Pain showed delays to pain stimuli only. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of "Social Cognition: The Ontario Symposium."

Reviews the book, Social Cognition: The Ontario Symposium edited by E. Tory Higgins, C. Peter Herman and Mark P. Zanna (1981). This volume presents the papers from the first Ontario Symposium on Personality and Social Psychology which was held at the University of Western Ontario in 1978. The first five chapters deal with cognitive organization. Chapter 3 provides a broad overview of schemas and their functions and liabilities which is particularly good for the reader who is fairly naive to cognitive psychology. Chapter 2 overlaps with it quite a bit, but is narrower in scope - focusing only on the issue of the relationship of information relevance and congruence to schema memory. Chapter I presents a review of the literature and a series of experiments on cognitive clustering. Chapters 4 and 5 are more conceptual in nature, dealing with respectively, the manner in which schemas govern the encoding and retention of social information and a storage bin model of category accesibility. The second part of the book, chapters 6-11, focuses on specific aspects of cognitive mechanisms, processes and biases. Some of the chapters, such as those on the use of confirmatory strategies in interpersonal hypothesis testing, self-centered biases, and nonverbal behaviour in impression management, are summaries of the authors' own line of research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medical crisis intervention with children and adolescents with chronic pain.

A specific application of medical crisis counseling (Pollin 1994, 1995)—a time-limited, clinical intervention for individuals with a chronic illness—is presented for work with children and adolescents who are experiencing chronic pain. Particular emphasis is placed on the meaning patients make of their illness experience and the role of explanatory models of chronic pain in shaping the psychosocial experience of patients. An integrated biological and psychosocial approach to understanding and treating pain is emphasized. A conceptual framework and set of strategies for treating chronic pain and addressing the common fears and concerns that arise for patients are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of attentional strategies in moderating links between acute pain induction and subsequent psychological stress: Evidence for symptom-specific reactivity among patients with chronic pain versus healthy nonpatients.

Vulnerability to stressors after pain may depend on the degree to which the strategy used to process information about pain perpetuates thoughts of suffering and distress. Patients with chronic low back pain (CLBP) may show susceptibility to stress after pain through symptom-specific (lower paraspinal [LP]) muscle reactivity. Patients with CLBP (n = 100) and healthy nonpatients (n = 105) underwent a cold pressor, under sensory focus, distraction, suppression, or control conditions, and then performed mental arithmetic. Only patients under the suppression condition revealed increased LP tension during pain that was sustained during mental arithmetic and sustained systolic blood pressure after mental arithmetic. Patients with CLBP who suppress pain may detrimentally affect responses to the next noxious event, particularly through prolonged LP muscle tension, that may contribute to a cycle of pain-stress-pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The biopsychosocial approach to chronic pain: Scientific advances and future directions.

The prevalence and cost of chronic pain is a major physical and mental health care problem in the United States today. As a result, there has been a recent explosion of research on chronic pain, with significant advances in better understanding its etiology, assessment, and treatment. The purpose of the present article is to provide a review of the most noteworthy developments in the field. The biopsychosocial model is now widely accepted as the most heuristic approach to chronic pain. With this model in mind, a review of the basic neuroscience processes of pain (the bio part of biopsychosocial), as well as the psychosocial factors, is presented. This spans research on how psychological and social factors can interact with brain processes to influence health and illness as well as on the development of new technologies, such as brain imaging, that provide new insights into brain-pain mechanisms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adult age differences in memory in relation to availability and accessibility of knowledge-based schemas.

Three experiments investigated whether, over adulthood, the use of schemas to process and remember new information increases (developmental shift hypothesis), decreases (production deficiency hypothesis) or remains constant (age-invariance hypothesis). Effects of schema access were studied by having young, middle-aged, and old music experts and nonexperts recall information that was relevant or irrelevant to music (Experiment 1) and by comparing young and old participants' memory for prose passages when they knew or did not know the subject of the passage (Experiments 2 and 3). In each case, schema access facilitated memory equally across age levels, supporting the age-invariance hypothesis and implying that the basic structures and operations of memory do not necessarily change with age. Possible limits on the independence of age and schema utilization were considered in relation to the conditions under which each of the two alternative hypotheses might hold. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender schema theory: A cognitive account of sex typing.

Gender schema theory proposes that the phenomenon of sex typing derives, in part, from gender-based schematic processing— a generalized readiness to process information on the basis of the sex-linked associations that constitute the gender schema. In particular, the theory proposes that sex typing results from the fact that the self-concept itself is assimilated in the gender schema. Several studies are described, including 2 experiments with 96 male and 96 female undergraduates, that demonstrate that sex-typed individuals do, in fact, have a greater readiness to process information—including information about the self—in terms of the gender schema. It is speculated that such gender-based schematic processing derives, in part, from the society's ubiquitous insistence on the functional importance of the gender dichotomy. The political implications of gender schema theory and its relationship to the concept of androgyny are discussed. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is self-concealment associated with acute and chronic pain?

Objective: Self-concealment is the predisposition to hide negative personal information. The present research examined whether self-concealment was associated with acute and chronic pain. Methods: In Study 1, undergraduate students (N = 44) completed an online questionnaire packet and then completed a cold-pressor task in the laboratory. In Study 2, individuals with chronic pain (N = 85) completed an online survey. Results: Study 1: Trait self-concealment was negatively associated with pain tolerance. Study 2: Self-concealment of chronic pain (hiding aspects of one's chronic pain condition from others) was associated with higher levels of self-reported pain and lower psychological well-being, independent of disclosure of feelings regarding pain. Furthermore, this association was mediated by autonomy and competence needs. Conclusions: Self-concealment was found to be associated with higher levels of pain in both healthy and chronic pain samples. Moreover, the findings also suggest that intervention methods using the self-determination theory framework (i.e., autonomy and competence supportive) might be effective for individuals with chronic pain. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Common sense representations of common illnesses.

Data from 320 undergraduates provide evidence that common sense representations of common illnesses involve 5 components: (1) a label, (2) consequences, (3) a time line, (4) a cause, and (5) a cure. The content of schemas for a person's most recent illness is shown to have small but significant effects on changes in health locus of control beliefs but not on preventive health behaviors. It is suggested that if people consistently employ the same schemas for every disease they experience, then cumulatively schematic processing could have large effects on health beliefs and health behaviors. It is also suggested that if the same illness schemas are employed when major diseases are encountered, then schemas based on the experience of minor illnesses could have dramatic and more immediate effects on morbidity and mortality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shifts in attention biases in response to acute pain induction: Examination of a model of "conversion" among repressors.

Unlike most people, those who are characterized by a repressive coping style report high levels of physical (sensory) pain but low levels of emotional distress (affective pain), which is a discrepancy that may suggest a “conversion” process. In two studies, we tested an attention allocation model, proposing that repressors direct attention away from threatening negative affective information and toward nonthreatening physical pain information during emotionally arousing (painful) situations. In Study 1, 84 participants underwent a cold pressor and then recovered. Repressors reported greater pain during recovery than low- and high-anxious participants, but they reported lower distress than high-anxious participants. Repressors reported significant and large discrepancies between high pain and low distress, whereas these differences were less pronounced for other groups. In Study 2, 77 participants underwent an ischemic pain task while performing a modified dot-probe task with sensory and negative affective pain words as stimuli. Repressors showed increasing biases away from affective pain words and toward sensory pain words as the pain task continued, whereas low- and high-anxious participants did not show these shifts in attention. The results support the notion that conversion among repressors may involve a process by which attention is directed away from emotional distress during noxious stimulation and is focused instead on sensory information from pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of anger suppression on pain severity and pain behaviors among chronic pain patients: Evaluation of an ironic process model.

Objective: Evidence for links between anger inhibition or suppression and chronic pain severity is based mostly on studies with correlation designs. Following from ironic process theory, we proposed that attempts to suppress angry thoughts during provocation would increase subsequent pain intensity among chronic low back pain (CLBP) patients, and do so through paradoxically enhanced accessibility of anger. Design: CLBP patients (N = 58) were assigned to suppression and nonsuppression conditions while performing a computer maze task with a harassing confederate. A structured pain behavior task (SPBT) followed. Main outcome measures: Self-reported anger, anxiety, and sadness following maze task. Self-reported pain severity and number of observed pain behaviors during SPBT. Results: Patients told to suppress during provocation: (a) reported greater anger following the maze task, reported greater pain intensity during the SPBT, and exhibited more pain behaviors than patients not suppressing; (b) postmaze anger levels significantly mediated group differences on pain behaviors. Conclusion: Attempts by CLBP patients to suppress anger may aggravate pain related to their clinical condition through ironically increased feelings of anger. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Older spouses' perceptions of partners' chronic arthritis pain: Implications for spousal responses, support provision, and caregiving experiences.

This study of older patients with osteoarthritis and their spouses examined concordance between patients' and spouses' reports of patients' pain severity and the association of concordance with support and caregiving outcomes. Patients and spouses independently viewed videotapes of the patient performing simulated household tasks and provided ratings of patients' pain. Spousal overestimation of patients' pain was the most common type of nonconcordance. Spouses who were accurate in their perceptions of their partner's level of pain during a log-carrying task responded less negatively and provided emotional support that was more satisfying to patients. In addition, spouses who were accurate in their perceptions of their partner's pain during the log-carrying task reported less stress from providing support and assistance. Future research that uses such observational methods may be highly useful for understanding the effects of chronic illness on older couples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of subjectivity and intersubjectivity in the reconstruction of dissociated schemas; converging perspectives from psychoanalysis, cognitive science and affective neuroscience.

Therapeutic change involves integration of emotion schemas that have been dissociated. Two types of avoidant dissociation are distinguished: primary dissociation dominated by fragmentary emotional memories; and secondary dissociation involving initial encoding of more organized memories whose meaning is avoided. Reconstruction of dissociated emotion schemas occurs through the referential process which includes three basic components: arousal of the subsymbolic affective core of a dissociated schema in the treatment relationship; connections of subsymbolic processes to symbolic representations in narratives and interactions in the session; and reflection leading to reorganization of the schema. The role of enactive perception and embodied communication as underlying intersubjectivity in the referential process is reviewed. Variations in states of awareness associated with each phase of the process, in both analyst and patient, and their effects on therapeutic change are examined. Current work in cognitive science and affective neuroscience supporting this process model is reviewed. This formulation is largely compatible with Freud's early theory of recollection and “associative working-over” with new emphasis on subjective state and the relational context. Studies of the referential process provide a potential interface between investigations of psychotherapy process and basic cognitive science and neuroscience research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)