scholarly journals Empirical Investigation of the Verbal Cues Involved in Delivering Experiential Metaphors

2021 ◽  
Vol 18 (20) ◽  
pp. 10630
Author(s):  
Eduar S. Ramírez ◽  
Francisco J. Ruiz ◽  
Andrés Peña-Vargas ◽  
Paola A. Bernal
Keyword(s):  
Cold Pressor ◽  
Pain Tolerance ◽  
Double Blind ◽  
Verbal Cues ◽  
Acceptance And Commitment ◽  
Model Probability ◽  
Elaboration Condition ◽  
Condition C ◽  
The Individual ◽  
Condition B

Delivering metaphors experientially has been emphasized in several psychotherapies, such as acceptance and commitment therapy. However, few research has analyzed the variables involved in the efficacy of metaphors. This experimental analog study aims to advance in this topic by analyzing the effect of two components involved in the experiential delivery of metaphors in psychotherapy. The first component is presenting the metaphor by asking the individual to imagine herself as the protagonist of the story versus presenting the metaphor in the third person (Self vs. Other). The second component is the inclusion of verbal cues prompting the relational elaboration of the rules derived from the metaphor content versus not including these prompts (Elaboration vs. No Elaboration). The effect of these components was tested in a double-blind, randomized, 2 × 2 factorial experiment that used the cold pressor task (CPT). Eighty-four participants were exposed to the CPT at the pretest. Afterward, participants were randomly assigned to four experimental protocols. The protocols were audiotaped and consisted of the same metaphor presented in four slightly different ways. Specifically, the protocol of Condition A involved a metaphor with Self and Elaboration, Condition B involved Self and No Elaboration, Condition C involved Other and Elaboration, and Condition D involved Other and No Elaboration. Then, participants were re-exposed to the CPT in the posttest. We hypothesized that Condition A (Self and Elaboration) would show a higher mean increase in pain tolerance than the remaining conditions, which would show similar results. The results were consistent with this hypothesis because Condition A showed a higher percentual increase in pain tolerance (Condition A: M = 268.21, SD = 167.47; Condition B: M = 180.86, SD = 73.01; Condition C: M = 204.81, SD = 100.19; Condition D: M = 175.41, SD = 76.00). A Bayesian informative hypothesis evaluation showed that this hypothesis obtained the highest posterior model probability. Thus, the results indicate that introducing metaphors by asking the individual to imagine herself as the protagonist of the story and providing prompts for relational elaboration might increase the therapeutic effect of the metaphor.

scholarly journals A Phase 1, Randomized, Double-blind, Placebo-controlled, Crossover Study to Evaluate the Pharmacodynamic Effects of VX-150, a highly selective NaV1.8 inhibitor, in Healthy Male Adults

Pain Medicine ◽  
2021 ◽  
Author(s):  
H J (Hemme) Hijma ◽  
P S (Pieter) Siebenga ◽  
M L (Marieke) de Kam ◽  
G J (Geert Jan) Groeneveld
Keyword(s):  
Crossover Study ◽  
Repeated Measures ◽  
Healthy Subjects ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Healthy Male ◽  
Post Dose ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Pain Tests

Abstract Objective To evaluate the analgesic potential, safety, tolerability and pharmacokinetics of VX-150, a pro-drug of a highly selective NaV1.8 inhibitor, in healthy subjects. Design This was a randomized, double-blind, placebo-controlled, crossover study in healthy subjects. Subjects Twenty healthy male subjects with an age of 18-55, inclusive, were enrolled. Eligibility was based on general fitness, absence of current or previous medical conditions that could compromise subject safety and a training assessment of pain tolerance across pain tests, to exclude highly tolerant individuals that could compromise the ability to detect analgesic responses. All dosed subjects completed the study. Methods Subjects were randomized 1:1 to 1 of 2 sequences receiving a single VX-150 dose and subsequently placebo, or vice versa, with at least 7 days between dosing. A battery of pain tests (pressure, electrical stair, (capsaicin-induced) heat and cold pressor) was administered pre-dose and repetitively up to 10 h post-dose, with blood sampling up to 24 h post-dose. Safety was monitored throughout the study. Data were analyzed with a repeated measures mixed-effects model. Results VX-150 induced analgesia in a variety of evoked pain tests, without affecting subject safety. Significant effects were reported for cold pressor and heat pain thresholds. Maximum median concentration for the active moiety was 4.30 ug/mL at 4 h post-dose. Conclusion Results of this proof-of-mechanism study are supportive of the potential of VX-150, a highly selective NaV1.8 channel inhibitor, to treat various pain indications.

scholarly journals Sound can enhance the analgesic effect of virtual reality

2016 ◽  
Vol 3 (3) ◽  
pp. 150567 ◽  
Author(s):  
Sarah Johnson ◽  
Matthew Coxon
Keyword(s):  
Virtual Reality ◽  
Pain Management ◽  
Cold Water ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Auditory Information ◽  
Head Mounted Display ◽  
Concurrent Use ◽  
Adult Participants ◽  
The Individual

Virtual reality (VR) technology may serve as an effective non-pharmacological analgesic to aid pain management. During VR distraction, the individual is immersed in a game presented through a head-mounted display (HMD). The technological level of the HMD can vary, as can the use of different input devices and the inclusion of sound. While more technologically advanced designs may lead to more effective pain management the specific roles of individual components within such systems are not yet fully understood. Here, the role of supplementary auditory information was explored owing to its particular ecological relevance. Healthy adult participants took part in a series of cold-pressor trials submerging their hand in cold water for as long as possible. Individual pain tolerances were measured according to the time (in seconds) before the participant withdrew their hand. The concurrent use of a VR game and the inclusion of sound was varied systematically within participants. In keeping with previous literature, the use of a VR game increased pain tolerance across conditions. Highest pain tolerance was recorded when participants were simultaneously exposed to both the VR game and supplementary sound. The simultaneous inclusion of sound may therefore play an important role when designing VR to manage pain.

scholarly journals Experimental sleep disruption attenuates morphine analgesia: findings from a randomized trial and implications for the opioid abuse epidemic

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Michael T. Smith ◽  
Chung Jung Mun ◽  
Bethany Remeniuk ◽  
Patrick H. Finan ◽  
Claudia M. Campbell ◽  
...  
Keyword(s):  
Drug Effects ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Reward Processing ◽  
Sleep Disruption ◽  
Morphine Analgesia ◽  
Opioid Use ◽  
Double Blind ◽  
Before And After ◽  
Sleep Condition

AbstractPreclinical studies demonstrate that sleep disruption diminishes morphine analgesia and modulates reward processing. We sought to translate these preclinical findings to humans by examining whether sleep disruption alters morphine’s analgesic and hedonic properties. We randomized 100 healthy adults to receive morphine versus placebo after two nights of undisturbed sleep (US) and two nights of forced awakening (FA) sleep disruption. Sleep conditions were counterbalanced, separated by a two-week washout. The morning after both sleep conditions, we tested cold pressor pain tolerance before and 40-min after double-blind injection of .08 mg/kg morphine or placebo. The primary outcome was the analgesia index, calculated as the change in cold pressor hand withdrawal latency (HWL) before and after drug injection. Secondary outcomes were ratings of feeling “high,” drug “liking,” and negative drug effects. We found a significant sleep condition by drug interaction on the analgesia index (95% CI − 0.57, − 0.001). After US, subjects receiving morphine demonstrated significantly longer HWL compared to placebo (95% CI 0.23, 0.65), but not after FA (95% CI − 0.05, 0.38). Morphine analgesia was diminished threefold under FA, relative to US. After FA, females (95% CI − 0.88, − 0.05), but not males (95% CI − 0.23, 0.72), reported decreased subjective “high” effects compared to US. After FA, females (95% CI 0.05, 0.27), but not males (95% CI − 0.10, 0.11), administered morphine reported increased negative drug effects compared to US. These data demonstrate that sleep disruption attenuates morphine analgesia in humans and suggest that sleep disturbed males may be at greatest risk for problematic opioid use.

scholarly journals The peer effect on pain tolerance

2018 ◽  
Vol 18 (3) ◽  
pp. 467-477 ◽  
Author(s):  
Solveig Engebretsen ◽  
Arnoldo Frigessi ◽  
Kenth Engø-Monsen ◽  
Anne-Sofie Furberg ◽  
Audun Stubhaug ◽  
...  
Keyword(s):  
Social Network ◽  
Social Environment ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Potential Candidate ◽  
Peer Effect ◽  
Influence Effect ◽  
The Social ◽  
Average Pain

Abstract Background and aims Twin studies have found that approximately half of the variance in pain tolerance can be explained by genetic factors, while shared family environment has a negligible effect. Hence, a large proportion of the variance in pain tolerance is explained by the (non-shared) unique environment. The social environment beyond the family is a potential candidate for explaining some of the variance in pain tolerance. Numerous individual traits have previously shown to be associated with friendship ties. In this study, we investigate whether pain tolerance is associated with friendship ties. Methods We study the friendship effect on pain tolerance by considering data from the Tromsø Study: Fit Futures I, which contains pain tolerance measurements and social network information for adolescents attending first year of upper secondary school in the Tromsø area in Northern Norway. Pain tolerance was measured with the cold-pressor test (primary outcome), contact heat and pressure algometry. We analyse the data by using statistical methods from social network analysis. Specifically, we compute pairwise correlations in pain tolerance among friends. We also fit network autocorrelation models to the data, where the pain tolerance of an individual is explained by (among other factors) the average pain tolerance of the individual’s friends. Results We find a significant and positive relationship between the pain tolerance of an individual and the pain tolerance of their friends. The estimated effect is that for every 1 s increase in friends’ average cold-pressor tolerance time, the expected cold-pressor pain tolerance of the individual increases by 0.21 s (p-value: 0.0049, sample size n=997). This estimated effect is controlled for sex. The friendship effect remains significant when controlling for potential confounders such as lifestyle factors and test sequence among the students. Further investigating the role of sex on this friendship effect, we only find a significant peer effect of male friends on males, while there is no significant effect of friends’ average pain tolerance on females in stratified analyses. Similar, but somewhat lower estimates were obtained for the other pain modalities. Conclusions We find a positive and significant peer effect in pain tolerance. Hence, there is a significant tendency for students to be friends with others with similar pain tolerance. Sex-stratified analyses show that the only significant effect is the effect of male friends on males. Implications Two different processes can explain the friendship effect in pain tolerance, selection and social transmission. Individuals might select friends directly due to similarity in pain tolerance, or indirectly through similarity in other confounding variables that affect pain tolerance. Alternatively, there is an influence effect among friends either directly in pain tolerance, or indirectly through other variables that affect pain tolerance. If there is indeed a social influence effect in pain tolerance, then the social environment can account for some of the unique environmental variance in pain tolerance. If so, it is possible to therapeutically affect pain tolerance through alteration of the social environment.

scholarly journals Responsiveness of the Scripps Neurologic Rating Scale During a Multiple Sclerosis Clinical Trial

1999 ◽  
Vol 26 (4) ◽  
pp. 283-289 ◽  
Author(s):  
James A. Koziol ◽  
Adriana Lucero ◽  
Jack C. Sipe ◽  
John S. Romine ◽  
Ernest Beutler
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trial ◽  
Rating Scale ◽  
Effect Sizes ◽  
Active Therapy ◽  
Double Blind ◽  
Treatment Groups ◽  
Negative Effect ◽  
The Individual ◽  
Positive Effect

Objective:The Scripps neurologic rating scale (SNRS) is a summary measure of individual components comprising a neurological examination, designed for use in multiple sclerosis (MS). Our objective is to evaluate the responsiveness of the SNRS, within the context of a 2-year, randomized, double-blind crossover study of the efficacy of cladribine for treatment of secondary progressive MS.Methods:Effect sizes were determined for the SNRS and its components, separately for each treatment group (initial placebo, and initial cladribine) over both years of the clinical trial, using a standard random effects model.Results:Individual components tended to show positive effect sizes (improvement) during periods of active therapy in both treatment groups, and negative effect sizes (deterioration) during periods of no active therapy. Summation indices derived from the individual components of the SNRS seemed somewhat more stable than the individual components. The two components mentation and mood, and bladder, bowel, or sexual dysfunction, were rather unresponsive in our clinical trial.Conclusion:Changes in the components of the SNRS over the course of our clinical trial were consistent between the two treatment groups. Most components were moderately responsive; and, the summary SNRS score appropriately summarized the moderate magnitudes of change evinced in the individual components.

The Effectiveness of Group Acceptance and Commitment Therapy and Cognitive Therapy on Alexithymia and Marital Boredom, Case study: Women Affected by Marital Infidelity in Mashhad, Iran

2022 ◽  
Author(s):  
Maryam Sadeghi ◽  
Naeimeh Moheb ◽  
Marziyeh Alivandi Vafa
Keyword(s):  
Cognitive Therapy ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Double Blind Study ◽  
University Counseling Center ◽  
Double Blind ◽  
University Counseling ◽  
Acceptance And Commitment ◽  
Marital Infidelity ◽  
The Mean

Introduction: The aim of current paper was to compare the effectiveness of acceptance and commitment group therapy (ACT) and group cognitive therapy (GCT) on Alexithymia and marital boredom (MB) among women affected by marital infidelity in Mashhad. Method: This clinical trial was a double- blind study with a pretest-posttest design in which two intervention groups and one control group were investigated. The study performed on women who realized their spouse infidelity and referred to Azad University Counseling Center in Mashhad in 2018. The sample consisted of 30 women who were selected by purposive sampling and were randomly assigned to two intervention groups and a control group (n=10 per group). The intervention groups were put under ACT training (twelve 90-minute sessions) and GCT training (twelve 90-minute sessions), but the control group did not receive any intervention. Data was obtained by the Toronto Alexithymia Scale-20 and Pines Marital Boredom Scale and was analyzed by multivariate analysis of covariance with SPSS (version 22) software. Results: The results showed a significant reduction in the mean score of MB in the ACT group, also there was a significant reduction in the mean score of Alexithymia in the GCT group (P <0.05). So comparing both therapies, ACT was more influential on reducing marital boredom whereas GCT was more effective on reducing alexithymia. Conclusion: Although both intervention methods were effective on Alexithymia and Marital Boredom in women affected by marital infidelity, it was demonstrated that ACT and GCT have more effect on Marital Boredom and Alexithymia, respectively.

scholarly journals Laboratory Personnel Gender and Cold Pressor Apparatus Affect Subjective Pain Reports

2014 ◽  
Vol 19 (1) ◽  
pp. e13-e18 ◽  
Author(s):  
Jacob M Vigil ◽  
Lauren N Rowell ◽  
Joe Alcock ◽  
Randy Maestes
Keyword(s):  
Pain Sensitivity ◽  
Experimental Pain ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Cold Pain ◽  
Laboratory Personnel ◽  
Subjective Pain ◽  
Lower Pain ◽  
Pain Reporting ◽  
Pain Reports

BACKGROUND: There is no standardized method for cold pressor pain tasks across experiments. Temperature, apparatus and aspects of experimenters vary widely among studies. It is well known that experimental pain tolerance is influenced by setting as well as the sex of the experimenter. It is not known whether other contextual factors influence experimental pain reporting.OBJECTIVES: The present two-part experiment examines whether minimizing and standardizing interactions with laboratory personnel (eg, limiting interaction with participants to consenting and questions and not during the actual pain task) eliminates the influence of examiner characteristics on subjective pain reports and whether using different cold pain apparatus (cooler versus machine) influences reports.METHODS:The present experiment manipulated the gender of the experimenter (male, female and transgender) and the type of cold pressor task (CPT) apparatus (ice cooler versus refrigerated bath circulator). Participants conducted the CPT at one of two pain levels (5°C or 16°C) without an experimenter present.RESULTS:Men and women showed lower pain sensitivity when they were processed by biological male personnel than by biological female personnel before the CPT. Women who interacted with a transgendered researcher likewise reported higher pain sensitivity than women processed by biological male or female researchers. The type of CPT apparatus, despite operating at equivalent temperatures, also influenced subjective pain reports.DISCUSSION: The findings show that even minimal interactions with laboratory personnel who differ in gender, and differences in laboratory materials impact the reliable measurement of pain.CONCLUSION: More standardized protocols for measuring pain across varying research and clinical settings should be developed.

scholarly journals Swearing as a response to pain: Assessing hypoalgesic effects of novel “swear” words

2019 ◽  
Author(s):  
Richard Stephens ◽  
Olly May Robertson
Keyword(s):  
Heart Rate ◽  
Repeated Measures ◽  
Neutral Word ◽  
Pain Threshold ◽  
Pain Perception ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Mediation Effects ◽  
Independent Variable ◽  
Cold Pressor Pain

Background: This pre-registered study extends previous findings that swearing alleviates pain tolerance by assessing the effects of a conventional swear word (“fuck”) and two new “swear” words, “fouch” and “twizpipe”.Method: A mixed sex group of participants (N = 92) completed a repeated measures experimental design augmented by mediation analysis. The independent variable was Word with the levels, “fuck” v. “fouch” v. “twizpipe” v. a neutral word. The dependent variables were emotion rating, humour rating, distraction rating, cold pressor pain threshold, cold pressor pain tolerance, pain perception score and change from resting heart rate. Possible mediation effects were assessed for emotion, humour and distraction ratings. Results: For conventional swearing (“fuck”), confirmatory analyses found a 32% increase in pain threshold and a 33% increase in pain tolerance, accompanied by increased ratings for emotion, humour and distraction, relative to the neutral word condition. The new “swear” words, “fouch” and “twizpipe” were rated higher than the neutral word for emotion and humour although these words did not affect pain threshold or tolerance. Changes in heart rate, pain perception and were absent, as were mediation effects.Conclusions: Our data replicate previous findings that repeating a swear word at a steady pace and volume benefits pain tolerance, extending this finding to pain threshold. Our data cannot explain how such effects are manifest, although distraction appears to be of little importance, and emotion is worthy of future study. The new “swear” words did not alleviate pain even though participants rated them as emotion evoking and humorous.

scholarly journals The Confounding Effect of Assessor Ethnicity on Subjective Pain Reporting in Women

2017 ◽  
Vol 11 (1) ◽  
pp. 1-11
Author(s):  
Jacob Miguel Vigil ◽  
Patrick Coulombe ◽  
Lauren Nikki Rowell ◽  
Chance Strenth ◽  
Eric Kruger ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Severe Pain ◽  
Pain Sensitivity ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Random Effects Models ◽  
Subjective Pain ◽  
Lower Pain ◽  
Pain Reporting ◽  
Hispanic White

The current study examines how subjective pain reporting is influenced by the concordant and discordant nature of the ethnic identities of pain expressers (participants) and pain assessors (experimenters). Three discomfort conditions that varied in stimuli intensity (Study 1: mild pain; Study 2: severe pain), and distraction components (Study 3) were used to assess whether pain intensity and tolerance reporting differ with the ethnic identification of the participant and the experimenter. Specifically, 87 Hispanic and 74 Non-Hispanic White (NHW) women (18–51 yrs., Mage = 20.0, SD = 4.3) underwent a cold pressor pain task (CPT) after engaging in minimal procedural interactions with one of the 22 research experimenters (47% Hispanic, 42% females). The procedural interactions with the experimenters included only consenting and instructions, with no interaction between experimenter and participant during the actual CPT. Random-effects models showed that between the 0% and 18% of the variance in pain sensitivity (intensity and tolerance scores) was attributable to characteristics of the experimenters. Controlling for self-esteem, baseline pain levels, and the gender of the experimenter, Hispanic subjects showed higher pain sensitivity (as marked by lower pain tolerance and higher pain intensity scores) following interactions with an NHW rather than a Hispanic experimenter in response to the most severe pain intensity stimuli. These results question the validity of common findings of ethnic differences in pain sensitivity from studies that have not accounted for the ethnic identity of the pain assessor (and the general communicative nature of pain reporting).

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