Sherecce Fields

The relation between pain-related fear and disability: A meta-analysis

UNLABELLED Within a biopsychosocial framework, psychological factors are thought to play an important role in the onset and progression of chronic pain. The cognitive-behavioral fear-avoidance model of chronic pain suggests that pain-related fear contributes to the development and maintenance of pain-related disability. However, investigations of the relation between pain-related fear and disability have demonstrated considerable between-study variation. The main goal of the current meta-analysis was to synthesize findings of studies investigating cross-sectional associations between pain-related fear and disability in order to estimate the magnitude of this relation. We also tested potential moderators, including type of measure used, demographic characteristics, and relevant pain characteristics. Searches in PubMed and PsycINFO yielded a total of 46 independent samples (N = 9,579) that reported correlations between pain-related fear and disability among persons experiencing acute or chronic pain. Effect size estimates were generated using a random-effects model and artifact distribution method. The positive relation between pain-related fear and disability was observed to be moderate to large in magnitude, and stable across demographic and pain characteristics. Although some variability was observed across pain-related fear measures, results were largely consistent with the fear-avoidance model of chronic pain. PERSPECTIVE Results of this meta-analysis indicate a robust, positive association between pain-related fear and disability, which can be classified as moderate to large in magnitude. Consistent with the fear-avoidance model of chronic pain, these findings suggest that pain-related fear may be an important target for treatments intended to reduce pain-related disability.

Delay Discounting by Adolescents Experimenting with Cigarette Smoking

AIMS To evaluate delay discounting and self-reported impulsive behavior in a sample of adolescents experimenting with cigarette smoking compared with adolescents who had never smoked or were daily smokers. DESIGN A cross-sectional design was used to compare smoking-status groups. SETTING Columbus, Ohio, a city of approximately 780,000 people. PARTICIPANTS A sample of 141 male and female adolescents with a mean age of 15.37 (standard deviation = 1.09) years. MEASUREMENTS Primary measures included a computerized assessment of delay discounting, a self-report assessment of impulsivity [Barratt Impulsiveness Scale-adolescent (BIS-11-A)] and verifications of cigarette smoking status (breath carbon monoxide and urinary cotinine level). FINDINGS Smokers discounted more by delay and had higher impulsivity scores than non-smokers. Experimenters had scores intermediate to those of smokers and non-smokers on both measures. In some analyses the difference between experimenters and non-smokers was significant, with experimenters showing greater delay discounting, but in no case did experimenters differ significantly from the smokers. CONCLUSIONS Young people who experiment with cigarettes appear to be similar to those who smoke regularly in terms of tendency to discount future gains and report impulsive tendencies, and generally higher in these traits than non-smokers.

The relationship between stress and delay discounting: a meta-analytic review.

The objective of the present meta-analytic review was two-fold: (a) to address the mixed findings of previous research by determining the relationship between stress and impulsivity; and (b) to examine age differences in this relationship. A total of 16 articles fulfilled the inclusion criteria for the present meta-analysis for a total sample size of 2189 participants (k=22) ranging in age from 36 months to 71 years. Using the statistical software, Comprehensive Meta-Analysis, Version 2.0 – Hedges’s g was computed to estimate the effect size. Results showed that impulsivity was related to stress with a moderate–large effect size (g=0.590). Significant moderating effects were found for the type of stress measure (g=0.592) and the type of discounting measure (g=0.696) used. The current study emphasizes the need for further research on the relationship between stress and discounting as additional findings may aid in improving future prevention and intervention programs for health-risk behaviors.

The relationship between weight and smoking in a national sample of adolescents: Role of gender.

This study sought to investigate the role of weight status and body mass index percentile in risky smoking behaviors in male and female adolescents. Analyses of the data obtained in the 2011 Youth Risk Behavior Surveillance System were conducted. The national sample size included 15,425 adolescents. Questions addressing weight status and smoking behaviors were used in analyses. Significant effects of perceived weight status, weight change status, and body mass index percentile on smoking behaviors were found for both genders. The current findings indicate the importance of accounting for both gender and weight status when developing prevention and cessation programs targeting smoking behaviors.

Heavy drinking, impulsivity and attentional narrowing following alcohol cue exposure

RationaleResearch shows that alcohol-related stimuli have the propensity to capture attention among individuals motivated to consume alcohol. Research has further demonstrated that impulsive individuals are especially prone to this type of attentional bias. Recently, it is suggested that alcohol cue exposure can also produce a general narrowing of attention consistent with the activation of approach motivational states.ObjectiveBased on previous models of addiction and recent research on the activation of approach motivational states, we predicted that impulsive individuals would demonstrate a constriction of attentional focus in response to alcohol cue exposure.MethodsParticipants (n = 392) completed a task assessing attentional breadth in response to alcohol and non-alcohol cues, followed by measures of alcohol use and impulsivity.ResultsThe findings revealed that impulsivity scores predicted narrowing of attentional scope following the presentation of alcohol cues for heavier drinkers but not for light drinkers.ConclusionThese results suggest that impulsive individuals who drink more heavily demonstrate a narrowing of attention in the presence of alcohol-related incentive cues. Implications for how these findings might account for the link between impulsivity and alcohol use and misuse are discussed.

Examining the Psychometric Properties of the Barratt Impulsiveness Scale-Brief Form in Justice-Involved Samples

Impulsivity is an important component of many forms of psychopathology. Though widely used as an index of this construct, the 30-item Barratt Impulsiveness Scale-11 (BIS-11) has demonstrated questionable psychometric properties in several research reports. An 8-item shortened version has recently been proposed, the Barratt Impulsiveness Scale-Brief (BIS-Brief) form, which was designed to overcome some of the limitations of the longer scale. In this report, we examine the internal structure and theoretically relevant external correlates of this new short form in large archival samples of individuals involved in the criminal justice system (prison inmates, substance abusers in mandatory treatment, and forensic inpatients). Confirmatory factor analysis of the BIS-Brief indicates adequate fit following a relatively minor modification. Correlations between the BIS-Brief and an array of criterion measures-other self-report scales, interview-based measures, and behavioral outcomes-are consistent with predictions and show relatively little or no decrement in predictive validity when compared with the 30-item BIS-11. Our results suggest that the BIS-Brief is a promising brief measure of impulsivity that evinces good psychometric properties across a range of offender samples.

An examination of sexual risk behaviors in adolescent substance users

ABSTRACT. Objectives: This study examined the risk for engaging in high-risk sexual behavior associated with substance use in a sample of U.S. adolescents. Methods: The sample (N = 15,425) was obtained via the Youth Risk Behavior Surveillance System, a survey of public high school students. Results: Substance use was associated with sexual risk behaviors, with odds ratios being greatest for adolescents who used cigarettes and illicit substances, as well as those who engaged in injection drug use. Conclusions: Results highlight the need for prevention and intervention programs targeting sexual risk behaviors in substance-using adolescents as a means to decrease the spread of sexually transmitted infections.

The Role of Counterfactual Thinking on Attitudes Toward ADHD Medication Use

ABSTRACT Objective: Despite serious health risks, attitudes toward Attention-Deficit Hyperactivity Disorder (ADHD) medication use in college students remain favorable. Given the robust link between attitudes and behavior (e.g., the Theory of Planned Behavior), it is important to understand how these attitudes are developed and maintained. The current study examined the role of counterfactual, or “what if’” thinking as a mechanism for the development of attitudes toward ADHD medications. Method: All participants (n = 190) were asked to read either a positive or negative scenario regarding ADHD medication misuse and rate their attitudes toward the behavior; half of the participants were also asked to generate counterfactuals prior to rating their attitudes. Results: Results suggest that scenario valence influenced the direction of counterfactual statements. Further, through the generation of upward counterfactuals, the negative scenario elicited more positive attitudes toward ADHD medication misuse. Conclusions: Based on limited prior research, it is suggested that upward counterfactuals may allow individuals to explain away the misuse of ADHD medication and avoid negative emotions such as guilt and shame related to current or prior ADHD medication misuse. In sum, additional research is needed to confirm preliminary findings that suggest counterfactual thinking could be a precursor to ADHD medication misuse.

Examining weight concern and delay discounting in adolescent females.

OBJECTIVE Pediatric obesity is a growing public health concern that contributes to high rates of negative long-term physical and mental health outcomes. Research focused on identifying risk for pediatric obesity has linked delay discounting, or an inclination for immediate rewards, as well as weight concern to individuals with greater Body Mass Index (BMI). The current study seeks to fill a void in the literature by examining how these two variables interact to promote higher BMI in female adolescents. METHOD Adolescent (n=60) females between the ages of 13-19years (mage=17.45, SD=1.74) of age completed the Eating Disorder Examination Questionnaire (EDE-Q) and the Delay Discounting Questionnaire. RESULTS A mediation model examined whether delay discounting accounted for the relationship between weight concern and BMI. Results indicate that in the current study weight concern was negatively related to delay discounting and delay discounting was negatively related to BMI. The overall model revealed that a partial mediation occurred [b=1.28, t(60)=4.92, p<0.01]. DISCUSSION These results suggest that while impulsivity is an important factor to consider, other constructs may also be influential in how weight concerns contribute to greater BMI. Nevertheless, the results indicate that prevention and interventions should identify females with high levels of both weight concern and impulsivity as an increased risk for experiencing pediatric obesity and long-term negative health outcomes.

Delay discounting, but not disinhibition or inattention, partially mediates the effects of neuroticism on disordered eating in adolescents

Adolescence represents an integral developmental period for the prevention and intervention of disordered eating. Individuals with high levels of neuroticism have been shown to respond with greater impulsivity and use of disordered eating as a coping mechanism. However, the exact mechanism through which neuroticism and impulsivity affect disordered eating remains unknown. To understand the effects of personality and impulsivity on disordered eating in adolescence, the present study aimed to investigate whether impulsivity mediated the relationship between neuroticism and disordered eating. Adolescents (N=40) between the ages of 13 and 19 (Mage=18.25years; S.D.=1.30) were queried on eating attitudes and personality, as well as completed behavioral tasks assessing impulsivity (delay discounting, disinhibition and inattention). Mediation analyses revealed that neuroticism was significantly associated with patterns of disordered eating, but delay discounting, and not disinhibition and inattention, appeared to mediate the relationship between neuroticism and disordered eating. These results should guide prospective research exploring the relations between neurotic and impulsive behavior, particularly delay discounting on disordered eating, which will assist in future treatment efforts targeting the development of maladaptive eating behaviors.