Matisyohu Weisenberg

The influence of film-induced mood on pain perception

&NA; It has been shown that a persons mood can influence pain tolerance. Films have been used as a means of inducing a desired mood. The effect on pain perception of film type and film length to induce mood was investigated. Previous research with brief humorous films had not indicated any unique advantage of humor over distraction approaches. Other recent research had indicated that after exposure to film stimulation there is a need to wait approximately 40 min before physiological changes can be obtained. Thus, the present study varied both film type and length and introduced a 30‐min waiting period following the mood induction via film prior to exposure to cold‐pressor pain. Two hundred subjects in nine different groups participated in the study. Three types of films were used: (1) humorous, (2) holocaust, (3) neutral. Three lengths of each type were also used: 15 min, 30 min, and 45 min. In addition, a tenth no‐film group served as a control for the effects of a film. Each subject was given a baseline trial of cold‐pressor pain, a trial immediately following the film and a trial 30 min later. Results indicated an advantage in increased pain tolerance for the humorous film and an increased pain tolerance for the longer film regardless of type only after the 30‐min waiting period. Results were discussed from a pain theoretical perspective with emphasis placed on returning to psychological manipulations of the sensory aspects of pain and not just the cognitive/emotional/motivational dimensions.

Coping of School-Age Children in the Sealed Room during Scud Missile Bombardment and Postwar Stress Reactions.

Childrens coping behaviors in the sealed room (a shelter against chemical and biological weapons) during scud missile attacks in the Persian Gulf war were examined in relation to postwar stress reactions. Three weeks after the war, 5th, 7th, and 10th graders (N = 492) completed questionnaires assessing coping behaviors and emotional responses in the sealed room, as well as current stress reactions and posttraumatic stress disorder (PTSD). Despite an underlying feeling of tension, the dominant emotional stance in the sealed room was one of detached optimism. Common forms of coping involved information seeking, checking, and wishful thinking. Emotion-focused coping such as avoidance and distraction strategies was associated with less postwar stress reactions than persistence at direct problem-focused actions once the minimal actions available had been undertaken. Fifth graders were found to use less emotion-focused and more problem-focused coping strategies than were the 7th and 10th graders.

Relevant and irrelevant anxiety in the reaction to pain

&NA; Despite its importance in pain perception, there is a paucity of research investigating the influence of anxiety. This study tested the proposition that anxiety can lead to the exacerbation of pain perception when the source of anxiety is related to the pain experience. When the source is related to something else, anxiety may even reduce the reaction to pain. Sources of anxiety were manipulated in the laboratory — anxiety related to pain and anxiety related to successful learning or the combination of anxiety related to both pain and learning. Verbal, physiological and behavioral differences were obtained showing that focus upon both the pain and the learning task yielded the strongest pain reactions, while focus upon the learning alone yielded the lowest pain reaction, but the largest learning errors. Focus upon pain was in‐between. The theoretical implications of these data were discussed.

Humor as a cognitive technique for increasing pain tolerance

&NA; Substantial research has demonstrated that cognitive psychological techniques including distraction can increase pain tolerance. In recent years, there also have been claims that humor and laughter possess unique characteristics for coping with pain and stress. Theoretically, explanations include the release of endorphins, the lowering of tension, as well as the distraction that results from humor. The question is whether humor is more effective than simple distraction. For this purpose humor was contrasted with a repulsive stimulus and a neutral stimulus controlled for interest level, that would also have distraction capabilities but not the unique aspects of humor. Pain tolerance was tested using cold pressor stimulation. Four groups (20 subjects in each) were tested. Three groups were shown a film: (1) a humorous film, (2) a repulsive film, (3) a neutral film. Group 4 was not shown any film. Results indicated that both the humor and repulsive groups showed a significant increase in pain tolerance as compared to the other groups. The repulsive group yielded the largest increase in pain tolerance although not different from the humor group. Except for sex differences, pain ratings did not show any group effects. Discussion focused on the type of distraction that would be meaningful for increasing pain tolerance and on the place of humor in pain control.

Subject versus experimenter control in the reaction to pain.

&NA; Although perceived control has been used as a means of reducing the reaction to pain, conceptually, much is still unclear. The purpose of this study was to clarify the effects of control as a mediating variable in the reaction to pain as a function of the predispositional variables of perceived self‐efficacy and trait anxiety. Self‐efficacy refers to the subjects premeasured, perceived ability to control his pain. The type of control provided either to the subject or the experimenter was varied over 5 independent groups. Predictability of occurrence of the pain stimulation was varied on a within‐subject basis. Results mirrored the complexity of the problem. Overall, when subjects were given decisional control alone the largest reactions to pain were obtained. Subjects given decisional plus behavioral control yielded the lowest reactions to pain. Both self‐efficacy and trait anxiety significantly were pedictive of outcomes. Unexpectedly, experimenter control reduced the reaction to pain among those with high self‐efficacy, but increased the reaction among those with low self‐efficacy. Results of trait anxiety appear to indicate the need to keep anxiety within bounds. Adding responsibility such as control to an individual who is already anxious may increase the reaction to pain. In general, it appears that control that is perceived as inadequate may be worse than not having any control. The theoretical and methodological implications of these results were discussed.

Cultural and educational influences on pain of childbirth

This study investigated the effects of sociocultural family of origin and educational level on the verbal ratings of pain and pain behavior during childbirth for 83 women. Coping style and extroversion were also measured. It was found that all women rated the pain of childbirth as high. Overall, women from a Middle-Eastern compared with a Western background gave higher ratings of pain and showed more pain behavior. This was found especially for Middle-Eastern women of a low educational background. Overall, low compared with high educational level resulted in higher ratings of pain and more pain behavior. No differences were obtained as a function of extroversion. Middle-Eastern and Western women did not differ in coping style. However, women who had higher monitoring scores rated the pain as less even through no differences were obtained for pain behavior. Sociocultural group of origin as well as other relevant reference groups, such as educational level, are important in determining pain perception and behavior. Combining this information with coping style could lead to an instructional intervention for preparing women for childbirth.

Psychological intervention for the control of pain

Abstract The psychology of pain control has grown greatly in the past 25 years. Many psychololgical techniques have been applied successfully to the regulation of both acute and chronic pain. Many of these techniques rely upon anxiety reduction and/or the installation of perceived control. The connection between pain perception and anxiety and perceived control is, however, not yet fully understood. The two major approaches to the treatment of chronic pain are the behavioral and cognitive-behavioral. Each approach has been shown to be effective in the treatment of chronic pain. However, which are the critical ingredients and what are the psychological limits of pain control via these and other approaches are still to be determined. What is lacking more than anything else is a comprehensive psychological theory of pain perception and control.

Supportive versus cognitive-behavioral intervention programs in achieving adjustment to home peritoneal kidney dialysis.

Two psychological interventions given for 8 weeks, supportive and cognitive-behavioral, were compared in achieving psychosocial adjustment to home peritoneal kidney dialysis. Participants were divided into 3 groups of patients and their spouses: a supportive group (18 couples), a cognitive-behavioral group (18 couples), and a no-intervention control group (24 couples). A group of 97 healthy participants served as a baseline control group. Self-report measurements were made before treatment (T1), halfway through (T2), and after treatment (T3). Results indicated that, without treatment, the no-intervention control group demonstrated a deterioration of psychosocial adjustment going from T1 to T3. Both interventions were effective in aiding patients and spouses in maintaining psychosocial adjustment in comparison with the no-intervention control group, with few differences between treatments. Most improvement was obtained in the emotional, cognitive, and interpersonal areas, with smaller gains made in the behavioral area.

Stress reactions of school-age children to the bombardment by scud missiles: a 1-year follow-up

Follow-up long-term stress effects to bombardment by scud missiles were restudied 1 year following the Persian Gulf war in a group of 326 6th, 8th, and 11th grade children from areas hit and not hit by the missiles. Postwar stress reactions were assessed by a continuous global symptom score (Frederick and Pynoos, 1988) and by a dichotomous PTSD index. Overall, a large drop in stress reactions was obtained with lapse of time. Residual long-term stress reactions were found to be associated with higher immediate (4-week) stress reactions, a greater degree of exposure, and younger age. Results were discussed in relation to residual and evaporation of stress reaction effects as well as in terms of childhood resilience.

Judgment of control and depression: The role of self-esteem threat and self-focused attention

This study assessed the effects of threat to self-esteem and self-focused attention (i.e., presence of a mirror) on judgment of control among students scoring high or low on depression. Subjects completed the Beck Depression Inventory and were asked to judge control for controllable and uncontrollable problems. Subjects were further divided according to (a) messages varying in the extent to which lack of control threatened self-esteem, and (b) the presence/absence of a mirror. Findings showed that nondepressives estimated more control over uncontrollable events than depressives. In addition, high-threat subjects estimated more control over uncontrollable events than low-threat subjects only under no-mirror conditions. The presence of a mirror eliminated the overestimation of control. Finally, results showed that the presence of mirror led depressives to underestimate control over controllable events. Results were discussed in terms of the motivational hypothesis of illusion of control and the role played by self-focused attention in depression.