Active and passive distraction using a head-mounted display helmet: Effects on cold pressor pain in children.

Objective: The current study tested the effectiveness of interactive versus passive distraction that was delivered via a virtual reality type head-mounted display helmet for children experiencing cold pressor pain. Design: Forty children, aged 5 to 13 years, underwent 1 or 2 baseline cold pressor trials followed by interactive distraction and passive distraction trials in counterbalanced order. Main Outcome Measures: Pain threshold and pain tolerance. Results: Children who experienced either passive or interactive distraction demonstrated significant improvements in both pain tolerance and pain threshold relative to their baseline scores. In contrast, children who underwent a second cold pressor trial without distraction showed no significant improvements in pain tolerance or threshold. Conclusion: Although both distraction conditions were effective, the interactive distraction condition was significantly more effective. Implications for the treatment of children's distress during painful medical procedures are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive impairment influences drinking outcome by altering therapeutic mechanisms of change.

Serious neuropsychological impairments are seen in a minority of addiction treatment clients, and, theoretically, these impairments should undermine behavioral changes targeted by treatment; however, little evidence supports a direct influence of impairment on treatment response. To address this paradox, the authors used structural equation modeling and Project MATCH data (N=1,726) to examine direct, mediated, and moderated paths between cognitive impairment, therapeutic processes, and treatment outcome. Mediated relations were found, wherein impairment led to less treatment compliance, lower self-efficacy, and greater Alcoholics Anonymous Involvement, which, in turn, more proximally predicted drinking. Impairment further moderated the effect of self-efficacy, making it a poor predictor of drinking outcomes in impaired clients, thereby suggesting that impaired and unimpaired clients traverse different pathways to addiction recovery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-processing bias in chronic pain: A review and integration.

Do patients with chronic pain selectively process pain- and illness-related stimuli? The evidence with regard to attention, interpretation, and recall biases is critically reviewed. A model is proposed to account for the findings in which it is suggested that biases in information processing in chronic pain are the result of overlap between 3 schemas: pain, illness, and self. With frequent repeated or continued experience of pain, the pain schema becomes enmeshed with illness and self-schemas. The extent of the enmeshment and the salient content of the schema determine the bias. A fundamental assumption is that all patients with pain selectively process sensory-intensity information. A clinical implication of the results is that processing biases that extend beyond this healthy and adaptive process to enmesh the self-schema with pain and illness schemas could maintain and exacerbate distress and illness behavior in patients with chronic pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypnosis and clinical pain.

Hypnosis has been demonstrated to reduce analogue pain, and studies on the mechanisms of laboratory pain reduction have provided useful applications to clinical populations. Studies showing central nervous system activity during hypnotic procedures offer preliminary information concerning possible physiological mechanisms of hypnotic analgesia. Randomized controlled studies with clinical populations indicate that hypnosis has a reliable and significant impact on acute procedural pain and chronic pain conditions, Methodological issues of this body of research are discussed, as are methods to better integrate hypnosis into comprehensive pain treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological resilience predicts decreases in pain catastrophizing through positive emotions.

The study used a daily process design to examine the role of psychological resilience and positive emotions in the day-to-day experience of pain catastrophizing. A sample of 95 men and women with chronic pain completed initial assessments of neuroticism, psychological resilience, and demographic data, and then completed short diaries regarding pain intensity, pain catastrophizing, and positive and negative emotions every day for 14 consecutive days. Multilevel modeling analyses indicated that independent of level of neuroticism, negative emotions, pain intensity, income, and age, high-resilient individuals reported greater positive emotions and exhibited lower day-to-day pain catastrophizing compared with low-resilient individuals. Mediation analyses revealed that psychologically resilient individuals rebound from daily pain catastrophizing through experiences of positive emotion. Implications for research on psychological resilience, pain catastrophizing, and positive emotions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of sex steroids on spatial performance: A review and an experimental clinical investigation.

Males typically surpass females in spatial performance, an outcome that may be linked to testosterone and estrogen. The authors (a) review physiological mechanisms, developmental periods, and past empirical work relevant to sex steroids' effects on human spatial performance and (b) report an experimental study of the role of actively circulating sex steroids in 55 adolescents being treated for delayed puberty (mean age 13.70 yrs). Sex steroids (stimulating early, middle, and late puberty) and placebos were given alternately over 21 months and spatial tests were given every 3 months. Spatial performance showed traditional sex differences but did not vary with levels of actively circulating sex steroids. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiple mechanisms in the perception of face gender: Effect of sex-irrelevant features.

Effects of sex-relevant and sex-irrelevant facial features on the evaluation of facial gender were investigated. Participants rated masculinity of 48 male facial photographs and femininity of 48 female facial photographs. Eighty feature points were measured on each of the facial photographs. Using a generalized Procrustes analysis, facial shapes were converted into multidimensional vectors, with the average face as a starting point. Each vector was decomposed into a sex-relevant subvector and a sex-irrelevant subvector which were, respectively, parallel and orthogonal to the main male–female axis. Principal components analysis (PCA) was performed on the sex-irrelevant subvectors. One principal component was negatively correlated with both perceived masculinity and femininity, and another was correlated only with femininity, though both components were orthogonal to the male–female dimension (and thus by definition sex-irrelevant). These results indicate that evaluation of facial gender depends on sex-irrelevant as well as sex-relevant facial features. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Social comparison as a predictor of body dissatisfaction: A meta-analytic review.

The relationship between social comparison and body dissatisfaction was examined using meta-analysis. Several demographic and methodological variables were examined as potential moderators. Data from 156 studies (189 effect sizes) showed that social comparison was related to higher levels of body dissatisfaction. The effect for social comparison and body dissatisfaction was stronger for women than men and inversely related to age. This effect was stronger when social comparison was directly measured rather than inferred. No differences emerged for the presence of eating psychopathology, study design, or object of comparison. Results confirm theory and research suggesting that comparing oneself unfavorably to another on the basis of appearance may lead to dissatisfaction with one’s own appearance. Moderator variables refine our understanding of the social comparison–body dissatisfaction relationship. These constructs and their relationship should be explored further in future studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in cooperation: A meta-analytic review of social dilemmas.

Although it is commonly believed that women are kinder and more cooperative than men, there is conflicting evidence for this assertion. Current theories of sex differences in social behavior suggest that it may be useful to examine in what situations men and women are likely to differ in cooperation. Here, we derive predictions from both sociocultural and evolutionary perspectives on context-specific sex differences in cooperation, and we conduct a unique meta-analytic study of 272 effect sizes—sampled across 50 years of research—on social dilemmas to examine several potential moderators. The overall average effect size is not statistically different from zero (d = –0.05), suggesting that men and women do not differ in their overall amounts of cooperation. However, the association between sex and cooperation is moderated by several key features of the social context: Male–male interactions are more cooperative than female–female interactions (d = 0.16), yet women cooperate more than men in mixed-sex interactions (d = –0.22). In repeated interactions, men are more cooperative than women. Women were more cooperative than men in larger groups and in more recent studies, but these differences disappeared after statistically controlling for several study characteristics. We discuss these results in the context of both sociocultural and evolutionary theories of sex differences, stress the need for an integrated biosocial approach, and outline directions for future research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Gender differences in willingness to pay to avoid pain and their correlation with risk.

This article presents experimental evidence on forced choices between inferior alternatives. In asking subjects to make trade offs between an experimentally induced cold-pressor pain of different durations and paying money to avoid the administration of pain, we try to shed some light on the questions: (a) are there any gender differences in elicited willingness to pay (WTP) values for pain; (b) when present, is differing WTP across genders better explained by measures of risk-aversion or measures of loss-aversion; and (c) we further investigate whether there are variations in hypothetically elicited WTP values (hypothetical pain and hypothetical money) and WTP values elicited when subjects face real consequences (both real pain and real money). Our results confirmed the hypothesis of significant gender differences in elicited WTP values in both the hypothetical and real groups. We also found some evidence of significant differences due to the treatment. Subjects who experienced the cold-pressor pain only once (hypothetical group) exhibited on average greater WTP compared with subjects who experienced the cold-pressor pain multiple times (real group). Females, however, stated lower WTP in the real treatment while for males the effect was in the opposite direction. Moreover, we found risk attitudes to be significantly associated with WTP while loss-aversion not. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Alone but feeling no pain: Effects of social exclusion on physical pain tolerance and pain threshold, affective forecasting, and interpersonal empathy.

Prior findings of emotional numbness (rather than distress) among socially excluded persons led the authors to investigate whether exclusion causes a far-reaching insensitivity to both physical and emotional pain. Experiments 1-4 showed that receiving an ostensibly diagnostic forecast of a lonesome future life reduced sensitivity to physical pain, as indicated by both (higher) thresholds and tolerance. Exclusion also caused emotional insensitivity, as indicated by reductions in affective forecasting of joy or woe over a future football outcome (Experiment 3), as well as lesser empathizing with another person's suffering from either romantic breakup (Experiment 4) or a broken leg (Experiment 5). The insensitivities to pain and emotion were highly intercorrelated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An investigation of the effects of music and art on pain perception.

The authors examined the effects of preferred music, visual distraction, and silence on pain perception. Visual distraction was provided by participants' choice of painting from a selection of 15 popular artworks. Eighty participants (43 females) underwent 3 trials of cold pressor pain induction with measurement of tolerance, pain intensity, perceived control, and anxiety, and a music listening patterns questionnaire. Preferred music was found to significantly increase tolerance and perceived control over the painful stimulus and to decrease anxiety compared with both the visual distraction and silence conditions. Pain intensity rating was decreased by music listening when compared with silence. During the music condition, frequent listening to the chosen piece in everyday life was found to negatively correlate with anxiety level, and extent of knowledge of the lyrics further positively correlated with tolerance of the stimulus and perceived control. That general importance of music in everyday life also correlated with perceived control reiterates the importance of relationship and familiarity with favorite music as key to its therapeutic effect. There was no relationship between structural features of the selected music and any of the significant effects. It is suggested that preference may render music with different structural aspects functionally equivalent. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic influences on the dynamics of pain and affect in fibromyalgia.

[Correction Notice: An erratum for this article was reported in Vol 29(3) of Health Psychology (see record 2010-09923-002). In the article, grant information was omitted from the author note. The authors wish to acknowledge grant support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR046034: Alex J. Zautra, PI).] Objective: The purpose of the present investigation was to determine if variation in the catechol- O-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genes is associated with pain-related positive affective regulation in fibromyalgia (FM). Design: Forty-six female patients with FM completed an electronic diary that included daily assessments of positive affect and pain. Between- and within-person analyses were conducted with multilevel modeling. Main Outcome Measure: Daily positive affect was the primary outcome measure. Results: Analyses revealed a significant gene × experience interaction for COMT, such that individuals with met/met genotype experienced a greater decline in positive affect on days when pain was elevated than did either val/met or val/val individuals. This finding supports a role for catecholamines in positive affective reactivity to FM pain. A gene × experience interaction for OPRM1 also emerged, indicating that individuals with at least one asp?? allele maintained greater positive affect despite elevations in daily pain than those homozygous for the asn?? allele. This finding may be explained by the asp?? allele’s role in reward processing. Conclusions: Together, the findings offer researchers ample reason to further investigate the contribution of the catecholamine and opioid systems, and their associated genomic variants, to the still poorly understood experience of FM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic pain alters drug self-administration: Implications for addiction and pain mechanisms.

This review article focuses on the impact that the presence of pain has on drug self-administration in rodents, and the potential for using self-administration to study both addiction and pain, as well as their interaction. The literature on the effects of noxious input to the brain on both spinal and supraspinal neuronal activity is reviewed as well as the evidence that human and rodent neurobiology is affected similarly by noxious stimulation. The convergence of peripheral input to somatosensory systems with limbic forebrain structures is briefly discussed in the context of how the activity of one system may influence activity within the other system. Finally, the literature on how pain influences drug-seeking behaviors in rodents is reviewed, with a final discussion of how these techniques might be able to contribute to the development of novel analgesic treatments that minimize addiction and tolerance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pain perception and nonsuicidal self-injury: A laboratory investigation.

People who engage in self-injurious behaviors such as cutting and burning may have altered pain perception. Using a community sample, we examined group differences in pain threshold and pain endurance between participants who self-injured and control participants who were exposed to pressure pain applied to the finger. Participants who self-injured had higher pain thresholds (time to report pain) and endured pain for longer than control participants. Among participants who self-injured, those with longer histories of self-injury had higher pain thresholds. Duration of self-injury was unrelated to pain endurance. Instead, greater pain endurance was predicted by higher levels of introversion and neuroticism and by more negative beliefs about one's self-worth. A highly self-critical cognitive style was the strongest predictor of prolonged pain endurance. People who self-injure may regard suffering and pain as something that they deserve. Our findings also have implications for understanding factors that might be involved in the development and maintenance of self-injury. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the featured section: Pain—from mechanisms to management.

Over the past 30 years, health psychologists have been at the forefront of pain research. Behavioral and psychological research has not only led to new insights into the nature of the pain experience, it has also led to the development of new behavioral and psychological pain management protocols. Although many individuals who have chronic pain respond well to behavioral or cognitive-behavioral treatment protocols, there are individuals who show little or no response to these treatment regimens. Tailoring treatment plans for refractory pain sufferers requires that we go beyond simple, minor adjustments to our standard treatment protocols. Rather, we need to more carefully assess the fundamental mechanisms that underpin the pain experience of treatment-resistant patients and develop new treatment approaches that effectively address these mechanisms. What mechanisms are responsible for flares in pain or pain episodes? Are there specific underlying mechanisms that can explain the persistence of pain? Finally, are there mechanisms that can explain why some people who use specific coping strategies report reduced pain, while others do not? The three articles that are included in this featured section are important because they provide some indications of how we might begin to address some of these questions. All three studies address pain mechanisms, although each does so from a different perspective. For health psychologists working in the pain research area, the challenge for the future is to translate an enlightened understanding of pain mechanisms into new and more effective treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of Chronic Pain in Rehabilitation: Outcomes Measures in Clinical Trials and Clinical Practice.

Objective: Chronic pain, or pain that lasts for months or even years, is prevalent among patients in rehabilitation settings, and treatment is costly. People with chronic pain often suffer physical limitations and emotional distress. As new treatments become available and clinical trials are initiated, it is important to measure outcomes in an effort to determine the efficacy of treatment interventions. This article provides a review of the core domains of outcomes assessment among people with chronic pain, including recommendations for outcome measures to be used in clinical trials and clinical practice settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cross-national patterns of gender differences in mathematics: A meta-analysis.

[Correction Notice: An erratum for this article was reported in Vol 136(2) of Psychological Bulletin (see record 2010-03383-012). On page 118 of the article “Cross-National Patterns of Gender Differences in Mathematics: A Meta-Analysis,” by Nicole M. Else-Quest, Janet Shibley Hyde, and Marcia C. Linn (Psychological Bulletin, 2010, Vol. 136, No. 1, pp. 103–127), the images on Figures 1 and 2 are incorrectly reversed. The legends for Figures 1 and 2 are in the correct order.] A gender gap in mathematics achievement persists in some nations but not in others. In light of the underrepresentation of women in careers in science, technology, mathematics, and engineering, increasing research attention is being devoted to understanding gender differences in mathematics achievement, attitudes, and affect. The gender stratification hypothesis maintains that such gender differences are closely related to cultural variations in opportunity structures for girls and women. We meta-analyzed 2 major international data sets, the 2003 Trends in International Mathematics and Science Study and the Programme for International Student Assessment, representing 493,495 students 14–16 years of age, to estimate the magnitude of gender differences in mathematics achievement, attitudes, and affect across 69 nations throughout the world. Consistent with the gender similarities hypothesis, all of the mean effect sizes in mathematics achievement were very small (d     

The lack of generality in defense mechanisms as indicated in auditory perception.

"Recent studies of perceptual behavior have demonstrated that there is a change in recognition threshold as a function of the 'emotionality' attached to a stimulus. It has been proposed that the change in threshold is a function of the type of mechanisms used to cope with anxiety generally. Since there is reason to doubt the generality of this assertion, this study was undertaken to test the hypothesis that those patients who use intellectualization as the preferred type of mechanisms to handle anxiety will perceive emotional words at lower thresholds than those patients who use predominantly repressive mechanisms." Results indicate no difference in perceptual recognition thresholds for the two groups of patients. Combined patient groups, however, had lower thresholds than normals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thirty-month follow-up of drinking moderation training for women: A randomized clinical trial.

This study examined the durability of a group-based drinking moderation training for heavily drinking women reporting low physical dependence on alcohol. A 30-month follow-up of participants was conducted based on a previous study of 144 women randomly assigned to treatment conditions (G. J. Connors & K. S. Walitzer, 2001). Thirty-month follow-up results indicated that women who at baseline were relatively heavier drinkers had significantly greater benefit from the drinking moderation training when exposed to intervention enhancements entailing life skills training and booster sessions. Further, the initial improvements in drinking, relative to baseline levels, did not statistically deteriorate over the 30-month follow-up. The findings support the application of treatment enhancements among women in this population who at baseline are relatively heavier drinkers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)