Behaviour research and therapy
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Randomized Controlled Trial
Acceptance versus distraction: brief instructions, metaphors and exercises in increasing tolerance for self-delivered electric shocks.
The current study compared the effects of an acceptance versus distraction rationale on coping with experimentally induced pain. Eighty participants were randomly assigned to one of five conditions: Full-Acceptance, Full-Distraction, Instruction-only-Acceptance, Instruction-only-Distraction and No-Instructions. ⋯ In addition, the participants in both of the acceptance conditions showed lower levels of believability in that they were more likely to continue with the task even when reporting more pain. The results support the prediction that acceptance-based interventions work by undermining the behavioural-control functions of pain-related thoughts and feelings, and call for a systematic analysis of how metaphors and exercises work in analogue research.
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Randomized Controlled Trial
Effects of preparatory information and distraction on children's cold-pressor pain outcomes: a randomized controlled trial.
This experimental study investigated whether preparatory sensory information was more effective in managing children's pain when coupled with a distraction technique. Seventy-eight children aged 7-12 years were randomly allocated to 1 of 4 experimental conditions. They were given either a detailed sensory description of an imminent painful event (cold-pressor arm immersion in 10 degrees C water) or control instructions lacking sensory information. ⋯ Children given sensory preparation reported less intense pain when this was coupled with distraction than when it was not. Children with a distraction-based coping style showed greater tolerance when assigned to a condition congruent with their coping style. These findings suggest ways to better prepare children for painful medical procedures.
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Randomized Controlled Trial
Interoceptive fear conditioning as a learning model of panic disorder: an experimental evaluation using 20% CO(2)-enriched air in a non-clinical sample.
Despite the role afforded interoceptive fear conditioning in etiologic accounts of panic disorder, there are no good experimental demonstrations of such learning in humans. The aim of the present study was to evaluate the interoceptive conditioning account using 20% carbon dioxide (CO(2))-enriched air as an interoceptive conditioned stimulus (CS) (i.e., physiologically inert 5-s exposures) and unconditioned stimulus (US) (i.e., physiologically prepotent 15-s exposures). Healthy participants (N=42) were randomly assigned to one of three conditions: a CS-only, contingent CS-US pairings, or unpaired/non-contingent CS and US presentations. ⋯ The explicitly unpaired condition showed even greater electrodermal and evaluative responding during acquisition, and marked resistance to extinction. The latter results are consistent with the possibility that the unpaired procedure constituted a partial reinforcement procedure in which CO(2) onset was paired with more extended CO(2) exposure on 50% of the trials. Overall, the findings are consistent with contemporary learning theory accounts of panic.
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Randomized Controlled Trial
Contextual control of human fear associations in a renewal paradigm.
The original model of behavior change suggests that extinction is context dependent whereas fear acquisition is context independent [Bouton, M. E. & Ricker, S. T. (1994). ⋯ Overall, results for expectancy ratings were more convincing than for electrodermal responses. In line with the extinction model, the present findings support the context dependency of extinction in humans. In contrast to the model, the findings suggest that in humans not only extinction learning, but also fear acquisition is controlled by its current context.
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Randomized Controlled Trial
Effects of suppression, acceptance and spontaneous coping on pain tolerance, pain intensity and distress.
Wegner's Theory of Ironic Processes has been applied to study the effects of cognitive strategies to control pain. Research suggests that suppression contributes to a more distressing pain experience. Recently, the acceptance-based approach has been proposed as an alternative to cognitive control. ⋯ In the second recovery period, although the acceptance group showed pain and distress ratings that were significantly lower than in the other two groups, the suppression and the spontaneous coping groups did not differ. The presence of a 'rebound' of physical discomfort and the effects of suppression on behavioural avoidance are discussed. These results support the acceptance approach in the management of pain.