Behavioral Distraction Research Articles

Auditory distraction by duration and location deviants: a behavioral and event-related potential study

Auditory distractibility was investigated using four noise stimuli that differed in their duration and/or sound source. In the duration-task/location-deviant condition, participants were asked to discriminate between equiprobable short and long stimuli. Mostly, stimuli were presented from one location (Standards), but, infrequently, a stimulus was presented from another location (Deviant). In the location-task/duration-deviant condition, participants had to discriminate between stimuli presented equiprobably from the speaker in front of them or to their left. Here, most stimuli were of equal duration (Standards), but, infrequently, a stimulus duration changed (Deviant). The rare deviations in location and duration were irrelevant for the actual task. Whether they affected processes related to the actual task was assessed with performance- and event-related potential (ERP) measures. In both conditions, responses to Deviants were slowed compared to responses to Standards. Deviants elicited ERP components mismatch negativity (MMN), P3a and reorienting negativity (RON). These results show that the processing of both a sound’s duration and a sound’s location can be distracted by rare, but irrelevant, changes in its location and duration, respectively. Behavioral distraction effects were markedly smaller with duration Deviants. It is suggested that duration Deviants interfere with task-related processing at later stages than location Deviants, as the processing of task-relevant information (i.e. stimulus location) commences before deviation in the location-task/duration-deviant condition occurs. Interestingly, distraction effects also prevail in the first Standard stimulus after a Deviant, as indicated by the prolonged response times and late negativity in the ERPs.

Auditory distraction with different presentation rates: an event-related potential and behavioral study.

The present study addresses the question of whether behavioral and electrophysiological effects obtained with the auditory distraction paradigm proposed by Schröger et al. [Clin Neurophysiol 2000;111:1450] depend on the timing of stimulus occurrence. Subjects had to discriminate the duration of tones. Occasionally, task-irrelevant frequency changes were used as distractors. In 3 experiments the stimulus onset asynchrony (SOA) was manipulated: In Experiment 1, SOAs of 1500, 2000 and 3000 ms were used in separate blocks; in Experiment 2, 5 different SOA of lengths between 1300 and 2500 ms were used within the blocks; in Experiment 3, a constant SOA of 1400 ms was compared with a SOA of random lengths between 1300 and 1500 ms. Performance data was analyzed for distraction effects. Event-related potentials (ERPs) were examined for deviance-related components, i.e. the mismatch negativity (MMN), the P3a and the re-orienting negativity (RON). Behavioral distraction effects were obtained in all experimental conditions. The electrophysiological data show MMN, P3a and RON for the deviating tones in all experimental conditions as well. The behavioral and electrophysiological deviance-related effects were not sensitive to the SOA manipulations. Therefore, the timing of the presentation can be adjusted to the proficiency level of the population to be tested without loosing the distraction effects.

An electrophysiological and behavioral investigation of involuntary attention towards auditory frequency, duration and intensity changes

We measured behavior and event-related brain potentials (ERPs) in 12 subjects performing on an audio-visual distraction paradigm to investigate the cerebral mechanisms of involuntary attention towards stimulus changes in the acoustic environment. Subjects classified odd/even numbers presented on a computer screen 300 ms after the occurrence of a task-irrelevant auditory stimulus, by pressing the corresponding response button. Auditory stimuli were standard tones (600 Hz, 200 ms, 85 dB; P=0.8) or deviant tones ( P=0.2), these differing from the standard either in frequency (700 Hz), duration (50 ms) or intensity (79 dB), in separate blocks. In comparison to performance to visual stimuli following the standard tones, reaction time increased by 24 ms ( F(1,11)=10.91, P<0.01) and hit rate decreased by 4.6% ( F(1,11)=35.47, P<0.001) to visual stimuli following the deviant tones, indicating behavioral distraction. ERPs revealed the mismatch negativity (MMN) elicited to deviant tones, which was larger for the duration deviant than for the frequency and intensity deviants ( F(2,22)=19.43, P<0.001, ε=0.83), and which had different scalp distribution for all three deviant conditions ( F(16,176)=2.40, P<0.05, ε=0.12). As the shorter duration and softer intensity deviant tones were unlikely to engage fresh neurons responding to their specific physical features, the present results indicate that a genuine change detection mechanism is involved in triggering attention switching towards sound changes, and suggest a largely distributed neural network of the auditory cortex underlying such involuntary attention switching.

School-aged homeless sheltered children's stressors and coping behaviors

The purpose of this study was to examine the stressors and coping behaviors of school-aged homeless children staying in shelters. A secondary analysis of interview data from 30 children, between the ages of 8 to 12 years, was used to delineate the stressors and coping behaviors. Homeless, family, self, peer, school, and violent behavior were the stressor categories derived from content analysis. The children expressed more stresses in the homeless, family, and self categories than in the other 3 categories. The coping behaviors from the content analysis were categorized by using Ryan-Wenger's (1992) coping taxonomy. The majority of the children's coping responses were in the social support, cognitive avoidance, and behavioral distraction categories. Nurses should assess each child's stressors and coping behaviors when providing care to homeless children, and assist the child in alleviating some stressors by strengthening one's coping behaviors. Copyright © 2001 by W.B. Saunders Company

A Danish adaptation of the Pain Coping Questionnaire for children: preliminary data concerning reliability and validity

The aim of this study was to determine the reliability and validity of a Danish translation of the Pain Coping Questionnaire (PCQ) for children in Danish children. The PCQ was translated using a translation‐back‐translation method. The subjects were 352 healthy children and 40 children with juvenile arthritis (JA), aged 8–17 y. Sixteen of the JA children were divided into a high‐pain group (n= 7) and a low‐pain group (n= 9). The results were factor analysed using principal component analysis with varimax rotation. Clinical pain intensity was measured using visual analogue scales (VAS) from the Varni/Thompson Pediatric Pain Questionnaire. Experimental pain was induced using a cold pressor pain paradigm and outcome measures were pain intensity, pain discomfort and tolerance to cold pressor pain. A seven‐factor solution emerged as the most consistent factor structure. Four subscales, Seeking Social Support (SSS), Cognitive Distraction (CD), Externalizing (EXT) and Internalizing/Catastrophizing (INT), corresponded with the parallel subscales proposed by Reid et al. (Pain 1998; 76: 83–96). Two subscales, Positive Self‐Statements (PSS) and Behavioral Distraction (BD), were composed of four of the five items from the previously proposed subscales. One subscale, Information Seeking/Problem Solving (IP), consisted of items from two subscales proposed by Reid et al., i.e. Information Seeking and Problem Solving. Internal consistencies of the subscales were acceptable, with reliability coefficients ranging from 0.60 (BD) to 0.83 (IP) and with test‐retest reliabilities between 0.59 and 0.78. Low‐pain JA patients showed significantly higher levels of BD than High‐pain JA patients (p &lt; 0.05). Greater utilization of PSS and BD was associated with less patient‐reported present pain and less average everyday pain (p &lt; 0.05‐0.01), and greater utilization of INT was significantly associated with higher experimental pain intensity (p &lt; 0.01). These preliminary findings provide support for the reliability and validity of the Danish modification of the PCQ in a Danish population and for the hypothesis that paediatric pain‐coping strategies are associated with the intensity of clinical and experimental pain.

Coping with pediatric ambulatory surgery: Effectiveness of parent-implemented behavioral distraction strategies

This study evaluated two behavioral distraction interventions for parents of pediatric ambulatory surgery patients. One hundred and one children, 4 to 8 years of age, and their parents were randomly assigned to one of three groups, written behavioral distraction guidelines (n = 34), didactic session plus written behavioral guidelines (n = 33), and standard procedure control (n = 34). Baseline assessment of child and parent anxiety took place immediately prior to surgery. Intervention effects were measured on child outcomes including distress, cooperation, and postoperative pain, and on parent outcomes including their perceptions of intervention helpfulness and satisfaction with the surgical experience. Control parents received standard care. Intervention parents received, in addition, written behavioral guidelines describing the use of distraction to reduce children's preoperative distress as well as age-appropriate toys to use during the preoperative period. One group of parents also participated in a brief didactic session on the use of distraction techniques. While no differences were found between the control and the distraction with didactic instruction groups, the group that received written instructions alone showed significantly more distress behaviors prior to surgery compared to the control and didactic instruction groups. Although parents responded positively to the didactic session, it appeared that a structured parent-implemented behavioral distraction program as described in this study was not more effective than standard care.

Behavioral and electrophysiological effects of task-irrelevant sound change: a new distraction paradigm

A distraction paradigm was utilized that is suited to yield reliable auditory distraction on an individual level even with rather small frequency deviances (7%). Distraction to these tiny deviants was achieved by embedding task-relevant aspects and task-irrelevant, distracting aspects of stimulation into the same perceptual object. Event-related potential (ERP) and behavioral effects of this newly developed paradigm were determined. Subjects received tones that could be of short or long duration equiprobably. They were instructed to press a response button to long-duration tones (targets). In oddball blocks, tones could be of standard frequency or of low-probability ( p=0.1), deviant frequency. The task-irrelevant frequency deviants elicited MMN, N2b, and P3a components, and caused impoverished behavioral performance to targets. The usage of tiny distractors permits an interpretation of auditory distraction in terms of attention switching due to a particular memory-related change-detection process. On the basis of the results from an additional condition in which tones were of 10 different frequencies (involving those frequencies which served as standard and deviant in oddball blocks), it is argued that one important prerequisite for linking the neural mechanisms reflected in change-related brain waves to behavioral distraction effects may be regarded as fulfilled. The robustness of the distraction effects to tiny deviations was confirmed in two control experiments.

The Pain Coping Questionnaire: preliminary validation

A new measure of coping, the Pain Coping Questionnaire (PCQ), is presented and validated in two studies of children and adolescents. Factor analyses of data from healthy children and adolescents supported eight hypothesized subscales (information seeking, problem solving, seeking social support, positive self-statements, behavioral distraction, cognitive distraction, externalizing, internalizing/catastrophizing) and three higher-order scales (approach, problem-focused avoidance, emotion-focused avoidance). The subscales and higher-order scales were internally consistent. The pain coping scales were correlated in the expected directions with children's appraisals of pain controllability, self-rated coping effectiveness, emotional distress when in pain, and among high school students, pain thresholds and functional disability. The structure and internal consistency of the PCQ were replicated in a sample of children and adolescents experiencing recurrent pain (headache, arthritis), and their parents. Relations between child- and parent-ratings of children's coping were moderate (median r=0.34). Higher levels of emotion-focused avoidance were related to more emotional distress (both samples), less coping effectiveness (headache sample), and higher levels of pain (arthritis sample). Higher levels of approach coping were related to less disability (headache sample). Other relations between approach and distraction coping and the outcome variables were generally not significant. The PCQ is a promising instrument for assessing children's pain coping strategies. The items are simple and relatively few, making it useful for assessing coping across a wide age range. It can be administered to children as young as 8 years of age in approximately 15 min.

Mind-Body Methods of Pain Management

Mind-body pain management methods begin with the mind and provide pain relief through an attentional focus. Such management includes hypnosis, biofeedback relaxation, and the bubbleblowing method of behavioral distraction. These active treatments also mobilize a child's coping and recovery skills while controlling anxiety and reliance on medication. Mind-body methods have wide applicability in pediatric practice, do not require a lot of time, and work synergistically with pharmacologic and physical treatments. They fit naturally with the pain experience, and therefore, potentially have a central role in the treatment of pain in children.

S.03.04 - Magnetoencephalography (MEG) in the study of human brain functions

A distraction paradigm was utilized that is suited to yield reliable auditory distraction on an individual level even with rather small frequency deviances (7%). Distraction to these tiny deviants was achieved by embedding task-relevant aspects and task-irrelevant, distracting aspects of stimulation into the same perceptual object. Event-related potential (ERP) and behavioral effects of this newly developed paradigm were determined. Subjects received tones that could be of short or long duration equiprobably. They were instructed to press a response button to long-duration tones (targets). In oddball blocks, tones could be of standard frequency or of low-probability (p=0.1), deviant frequency. The task-irrelevant frequency deviants elicited MMN, N2b, and P3a components, and caused impoverished behavioral performance to targets. The usage of tiny distractors permits an interpretation of auditory distraction in terms of attention switching due to a particular memory-related change-detection process. On the basis of the results from an additional condition in which tones were of 10 different frequencies (involving those frequencies which served as standard and deviant in oddball blocks), it is argued that one important prerequisite for linking the neural mechanisms reflected in change-related brain waves to behavioral distraction effects may be regarded as fulfilled. The robustness of the distraction effects to tiny deviations was confirmed in two control experiments.

Psychosocial problems of children and adolescents with a chronic disease: coping strategies.

The purpose of this pilot study was to identify the coping strategies used by children, adolescents and youths with insulin dependent diabetes mellitus (IDDM) attending a camp for IDDM patients near Ryosen town, Fukushima Prefecture, Japan. Forty-three IDDM patients (24 females and 19 males) were studied, divided into two age groups. The first group included children (seven males and 10 females). The second group included adolescents and youths (12 males and 14 females). For the child group a projective drawing method was used for study and for the older group, an open questionnaire was used. Ryan-Wenger's taxonomy of children's coping strategies and Band's coding systems and classification were used for the content analysis. 'Instrumental action', 'Emotional expression' and 'Catastrophizing thinking' were the coping strategies, represented in the child group. Gender differences in coping strategies were found in the group of adolescents and youths. The most often represented and most important coping category for the male subgroup was 'Behavioral avoidance'. Next in frequency of representation for the male subgroup were 'Cognitive distraction' and 'Behavioral distraction'. The coping categories 'Seeking social support' and 'Behavioral distraction' were represented with equal frequency in the female subgroup and the next was 'Aggressive activities'. The most important coping strategy for the female group was 'Talking to peers' from the seeking social support category. The study also helped to identify several children and adolescents who might need special psychological support.

Children's knowledge and use of coping strategies during hospitalization for elective surgery

The questions addressed in this study were: (a) how age relates to differences in children's coping knowledge and coping behaviors while they are hospitalized for elective surgey, (b) how individual differences and development in problem-solving relate to children's coping capacities, and how these factors affect relations between age and coping, and (c) the degree to which coping knowledge and coping behaviors are related. The results indicated that age, in combination with problem-solving skills and gender, predicted children's knowledge of specific coping strategies— behavioral distraction, cognitive distraction, adaptive approach, and escape. Specific coping knowledge, in turn, related to aspects of children's coping behaviors while they were hospitalized for elective surgery. Studies of children's responses to hospitalization and medical treatment provide a valuable opportunity to learn more about children's responses to streesful, uncontrollable situations in which awareness and manipulation of cognitive states are likely to be important.

The factor structure of the Coping Strategies Questionnaire

The Coping Strategies Questionnaire (CSQ) (Rosenstiel and Keefe 1983) is the most widely used measure of pain coping strategies. To date, with one exception (Tuttle et al. 1991), studies examining the factor structure of the CSQ have used the composite scores of its 8 a-priori theoretically derived scales rather than the 48 individual items. An examination of the match between the 8 theoretically derived scales and scales empirically extracted from an item analysis is lacking. Accordingly, the CSQ was administered to 126 chronic pain (whiplash) patients. Factor analyses of the individual items revealed an 8-factor structure to be uninterpretabie. Of the 2-9-factor solutions tested, the 5-factor structure was the most interpretable: Factor 1, Distraction; Factor 2, Ignoring Pain Sensations; Factor 3, Reinterpreting Pain Sensations; Factor 4, Catastrophizing; Factor 5, Praying and Hoping. Eighteen Ph.D. or M.D. level clinicians classified items into their corresponding category with a high degree of accuracy (on average, 90.2%), attesting to the face and construct validity of the subscales. Four subscales, Catastrophizing, Reinterpreting Pain Sensations, Praying and Hoping and (to a lesser degree) Ignoring Pain Sensations, correspond with parallel subscales proposed by Rosensteil and Keefe (1983). The fifth subscale, Distraction, is comprised of items from their Diverting Attention and Increasing Activity Level subscales, suggesting that cognitive and behavioural distraction comprise 1 rather than 2 coping strategies. That CSQ items on the original Coping Self-Statements and the Increasing Pain Behaviour subscales failed to load consistently on any factor suggests that they do not reliably measure distinct coping strategies. The 5-factor solution we obtained is very similar to that obtained by Tuttle et al. (1991), suggesting that this 5-factor structure is replicable cross-sample and cross-methods.

Children's strategies for coping with stress: Blunting and monitoring

The present study examined children's suggestions for coping with uncontrollable stress, from the perspective of the monitoring/blunting distinction proposed by Miller (1987). Children in the first through sixth grades heard stories depicting four stressful situations that afforded little opportunity for control. Children's coping suggestions were classified as blunting (including reappraisal, cognitive distraction, and behavioral distraction), monitoring, or seeking support. Overall, blunting strategies were mentioned most often, followed by monitoring, and seeking support. A grade-level increase in blunting suggestions was found, and this developmental pattern was identical for reappraisal, cognitive distraction, and behavioral distraction. No grade-level differences were observed for monitoring or support. Situational differences in coping suggestions were explored, and there was mixed evidence of cross-situational consistency in coping style.

Developmental changes in children's awareness of strategies for coping with uncontrollable stress.

Children at 3 age levels (5-6 1/2, 7 1/2-9, and 10-12 years) were interviewed to determine their spontaneous suggestions of coping strategies designed to manage frustration caused by waiting for a desired object (positive valence) and fear caused by waiting for an unpleasant event (negative valence) in uncontrollable situations. Subjects' responses were grouped into categories based on coping techniques discussed in the adult coping literature on a continuum from approach to avoidance techniques. The avoidance tactics, the main focus of interest, were further divided into 4 distinct forms. In contrast to investigations of children's coping in more controllable situations, approach strategies were very infrequently mentioned. An age increase was found in the proportion of cognitive distraction strategies suggested, but behavioral distraction strategies were most frequently suggested by children at all age levels and did not differ significantly across age. The developmental differences were particularly evident for the negative valence scenarios and, within the negative valence scenarios, for the story likely to be the most stressful to young children--getting a shot. The results are discussed in terms of possible reasons for age differences in cognitive but not behavioral distraction and their implications for children's ability to cope with uncontrollable stress.

Psychological Treatment of Distress, Pain, and Anxiety for Young Children with Cancer

The study compared the efficacy of hypnotic "imaginative involvement," behavioral distraction and standard medical practice for the reduction of pain, distress and anxiety in children with leukemia, during bone marrow aspirations. Two age groups of children, 3 to 6, and 7 to 10 years, were randomized to the three treatment groups. Two intervention sessions were given. At first intervention, observational ratings of distress indicated significant reductions for the younger group in the hypnotic treatment, whereas the older group achieved significant reductions in both treatment conditions for observer-rated pain and anxiety. At second intervention, all groups showed reductions and the control group appeared to be contaminated. The hypnotic method with its internal focus had an all-or-none effect, whereas distraction appeared to require that coping skills be learned over one session or more.