Distracting Responses Research Articles

Successive association of adaptive/maladaptive response styles to depressive mood and decentering: a preliminary study of Japanese university students

Response styles to depressive mood, which are ruminative or distractive responses, have both adaptive and maladaptive forms. The adaptiveness of ruminative/distractive responses is associated with decentering. However, whether decentering increases using adaptive response styles or adaptive (maladaptive) response styles heighten (lower) decentering levels remains unclear. This short-term longitudinal survey examined the sequential influence of decentering on response styles and the indirect effect of decentering on depression through response styles. One hundred twenty-six Japanese undergraduates completed questionnaires on response styles, decentering, and depressive symptoms at two points in time, four weeks apart. Cross-lagged panel analyses indicated that decentering predicted lower maladaptive ruminative and distractive responses and a higher adaptive ruminative response. Adaptive ruminative response predicted higher decentering. Furthermore, mediation analyses showed that decentering influenced depression through adaptive/maladaptive ruminative responses. Results suggest that an individual’s decentering level partly determines which response style is likely to be used when an initial depressive mood is experienced.

Comparing Ruminative and Distracting Responses and Emotion Regulation Difficulties in Early Community Adolescents With and Without Self-Harm.

This study aimed to compare the demographic characteristics, responses to negative emotions, and difficulties in emotion regulation between self-harming adolescents and control individuals aged 12-14 years from the community. Data were collected from adolescents in Chungcheong Province, South Korea, between September 2021 and November 2022. Demographic characteristics and responses to the Depressed Mood Questionnaire and Difficulties in Emotion Regulation Scale-16 (DERS-16) were compared between the self-harm and control groups. The self-harm group exhibited a higher prevalence of child abuse (odds ratio [OR]=4.787, 95% confidence interval [CI]=1.591-14.409, p=0.005) and school bullying victimization (OR=4.495, 95% CI=2.353-8.588, p<0.001) than those in the control group. The selfharm group displayed higher levels of rumination (t=7.88, p<0.001) and reduced distraction responses (reverse score t=2.25, p=0.025) than those of the control group. Additionally, the self-harm group scored higher on all subscales and the total DERS-16 score (t=7.61, p<0.001). Interventions for self-harming adolescents should address child abuse and bullying victimization. Prevention programs for self-harming adolescents should focus on reducing rumination responses, increasing distractive responses, and addressing difficulties in emotion regulation using dialectical behavior therapy-skill training.

When crying turns to hitting: Examining maternal responses to negative affect

Physical aggression in toddlerhood is empirically linked to anger and often conceptualized as a byproduct of frustration and related negative affect. Further, parenting is the major environmental construct implicated in the development of aggressive behaviors. Given parents’ role as “external regulators,” parents’ responses to their toddlers’ negative affect may serve to escalate or de-escalate their toddlers’ affective experience, thereby impacting the likelihood of subsequent aggression. In the present study, we examined whether parents’ negative affect, harsh, soothing, and distracting responses to their toddlers’ negative affect mediated the relation between toddlers’ negative affect and their aggressive behavior in brief conflict episodes. During a laboratory visit, a community sample of 69 mother-toddler dyads was observed in a structured interaction task. We found that child negative affect is associated with subsequent aggressive behavior by way of maternal harsh responses to negative affect. Negative emotional expression, soothing, and distraction neither facilitated or hindered children’s escalation from negative affect to aggression. Our findings support a dyadic intervention in which patterns of coercive parent-child interactions are targets for prevention and intervention of toddler aggression.

The Effectiveness of Emotion Focused Group Therapy (EFT) on Rumination and Emotional Expression in Patients with Multiple Sclerosis

Aim: Multiple sclerosis is a progressive neurological disease. This disease has many negative and positive effects on the physical and mental health of patients. The aim of this research was to investigate the effectiveness of emotion focused group therapy (EFT) on emotional expression and rumination in patients with multiple sclerosis in Shiraz. Method: The statistical population of this research includes all patients with M. S. In the city of Shiraz in 1401, their diagnosis was confirmed by a neurologist based on McDonald's 2017 criteria. After identifying patients with MS. 30 people who met the criteria for entering the research were selected purposefully and randomly and in equal numbers were placed in an experimental group and a control group. The experimental group underwent emotion focused group therapy sessions during 8 sessions of 90 minutes. During this period, the control group remained waiting without receiving any intervention. The main data of this research was obtained using Nolenhoeksma and Maro (1991) rumination questionnaires and King and Emmons (1962) emotional expressiveness questionnaires. Descriptive statistics and inferential statistics (variance analysis with repeated measurements) were used in data analysis. Findings: Data analysis showed that after the implementation of the intervention, there was a significant difference between the control and experimental groups in both variables of emotional expression and rumination (P&lt;0.05). A significant difference was observed in emotional expression components (positive emotion expression, sincerity expression and negative emotion expression) and rumination components (rumination responses and distracting responses) between patients with multiple sclerosis in the experimental and control groups (05 /0&gt;P). Conclusion: The use of emotion-oriented therapy is a suitable intervention to improve emotional expression and rumination in multiple sclerosis patients and can be used to improve psychological status and better cope with the disease.

Semantic associates create retroactive interference on an independent spatial memory task.

Semantic similarity between stimuli can lead to false memories and can also potentially cause retroactive interference (RI) for veridical memories. Here, participants first learned spatial locations for "critical" words that reliably produce false memories in the Deese-Roediger-McDermott paradigm. Next, participants centrally viewed words that were semantically associated with half of the critical words. Finally, participants retrieved the spatial locations for the critical words. We found that spatial memory was worse for critical words whose semantic associates were shown versus not shown, suggesting that semantic relatedness caused RI. This effect occurred in three experiments when the interfering information was presented shortly before the spatial test but not when there was a 1-hour delay before the test, nor when the order of the spatial learning and associate learning phases were reversed. These findings suggest that RI can occur solely via semantic associates when all relevant responses and no distracting responses were available at retrieval. We consider these findings to be an example of cue overload, whereby cues can be overloaded indirectly via semantic associates, and to support the importance of both semantic similarity and temporal context in RI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Coping strategies, illness perceptions, and relationship dynamics contribute to female sexual function and sexual distress in Sjögren's syndrome.

Sexual dysfunction and sexual distress are common complaints for women with the autoimmune rheumatic disease Sjögren's syndrome (SS); however, the role of psychosocial and interpersonal factors has not previously been explored in SS. This study investigated whether psychosocial variables, such as coping strategies, illness perceptions, and relationship dynamics, contributed to sexual function and sexual distress for women with SS. Participants with SS completed an online cross-sectional survey that included prevalidated questionnaires assessing sexual function, sexual distress, disease-related symptom experiences, cognitive coping strategies, illness perceptions, relationship satisfaction, and partners' behavioral responses. Multiple linear regression was used to identify factors significantly associated with sexual function (total Female Sexual Function Index [FSFI] score) and sexual distress (total Female Sexual Distress Scale score) for women with SS. Study outcome measures were the FSFI, Female Sexual Distress Scale, EULAR Sjӧgren's Syndrome Patient Reported Index, numeric rating scale for vaginal dryness (0-10), Profile of Fatigue and Discomfort, Cognitive Emotion Regulation Questionnaire (CERQ), Brief Illness Perceptions Questionnaire (B-IPQ), West Haven-Yale Multidimensional Pain Inventory (WHYMPI), and Maudsley Marital Questionnaire. A total of 98 cisgender women with SS participated in the study (meanage = 48.13 years, SD = 13.26). Vaginal dryness was reported by 92.9% of participants, and clinical levels of sexual dysfunction (total FSFI score <26.55) were observed in 85.2% (n = 69/81) of cases. More vaginal dryness, lower CERQ positive reappraisal, and higher CERQ catastrophizing were significantly associated with poorer self-rated sexual function (R2 = 0.420, F3,72 = 17.394, P < .001). Higher CERQ rumination, lower CERQ perspective, lower WHYMPI distracting responses, and higher B-IPQ identity were significantly associated with higher sexual distress (R2 = 0.631, F5,83 = 28.376, P < .001). This study suggests that interpersonal and psychosocial factors are important contributors to sexual function and distress in women with SS and that the development of psychosocial interventions for this population is warranted. This study is one of the first to explore the impacts of coping strategies, illness perceptions, and relationship dynamics on sexual function and sexual distress for women with SS. Limitations of our study include its cross-sectional nature and narrow sample demographic, which limit the generalizability of our results to other population groups. Women with SS who utilized adaptive coping strategies had better sexual function and lower levels of sexual distress than women who utilized maladaptive coping strategies.

Pain Catastrophizing Thoughts Explain the Link Between Perceived Caregiver Responses and Pain Behaviors of Patients With Chronic Musculoskeletal Pain.

PurposeCaregivers’ responses to pain behaviors of patients with chronic pain have an essential role in how patients perceive their pain condition. The current study investigated the mediating role of pain catastrophizing on the link between perceived caregiver responses and patient pain behaviors.Materials and MethodsThe sample of this cross-sectional study consisted of 200 patients with chronic pain (mean of age = 44.6; 71.5% were female). Participants responded to measures assessing their perception of their caregiver responses to their pain, their pain catastrophizing thoughts, and their pain behaviors.ResultsThe mediation analyses showed that perceived distracting responses were negatively related to pain catastrophizing level in patients, which in turn was positively associated with expressing pain behaviors. Besides, perceived caregiver negative responses were positively associated with catastrophizing thoughts, which in turn was positively related to expressing pain behaviors.ConclusionPatients’ perceptions regarding how their caregiver responds to their pain condition can be related to their thoughts about their pain and how they react to their pain situation. Investigating the external sources that might have an impact on patients’ reactions to their pain, especially when those external sources are caregivers who, in most situations, are with the patients for a prolonged duration, is essential.

“Speed Up to Hit the Worker”: Impact of hacked road signs on work zone safety

This study sheds light on the travel behavior of drivers when they encounter fabricated messages in work zones. Using the response of 4302 participants to a stated preference survey, we develop a multivariate ordered response model and a structural equation model to study speed change and distraction response behavior. The results of our models for fabricated announcements signify that drivers normally follow the announcement and are affected likewise. The selected socioeconomic and attitudinal variables are shown to have mixed impacts in our speed and distraction models. Some variables are statistically significant for each model, while other variables are only statistically significant for one of the models. For instance, drivers that have seen a fabricated announcement before are less likely to speed up when encountering the message, while drivers who rely on technology for their daily travels are more likely to be distracted. Higher income is shown in our models to signify undesirable behaviors: speeding up and being distracted. Contrastingly, female drivers are less likely to do nothing or be distracted by the announcement. The findings, taken together, have implications for researchers and practitioners. First, they illustrate how cyberattacks can destabilize traffic in work zone and put the life of work zone crew members in jeopardy. Second, they explain the degree of compliance with compromised dynamic message signs.

Cognitieve gedragstherapie voor depressieve klachten bij jongeren in residentiële zorg met een LVB in vergelijking met normaal begaafde jongeren

Abstract Cognitive behavioural therapy and depressive symptoms among youth with and without Mild Intellectual Disability in residential care: an exploratory study investigating ‘Op Volle Kracht’ Depression is at least as prevalent in youth with a mild intellectual disability (MID) as it is in youth without disabilities. Little is known however about the etiology and treatment of depression in this group. This paper aims to investigate the possiblities for cognitive behavioural therapy in youth with MID by (1) testing the validity of Beck’s cognitive theory and Nolen-Hoeksema’s response style theory in youth with and without a MID in residential youth care; and (2) to examine the effects of Op Volle Kracht (OVK), a CBT-based depression prevention program among youth with and without a MID in a residential treatment setting. In study 1 the relationship between negative cognitive errors (Beck), response styles (Nolen- Hoeksema) and depressive symptoms was examined in 135 adolescents (age 9-17 years) using linear regression. Study 2 was an initial cluster randomized controlled trial in which twenty residential treatment groups (including in total N=92 adolescents aged 9-17 years), half of which targeted adolescents with a MID, were randomly assigned to either treatment as usual (TAU), or a combination of TAU and the group-CBT-program Op Volle Kracht (OVK+TAU). Depressive symptoms, cognitive errors and response styles were assessed at pre-test, post-test and 3 months follow-up. The data were analyzed by mixed effects linear regression analyses with age and gender as covariates. Results Study 1 showed that only the cognitive error ‘underestimation of the ability to cope’, and a ruminative and distractive response style predicted depressive symptoms in both youth with- and without MID. The negative cognitive error ‘underestimation of the ability to cope’ was more prevalent among youth with MID than among youth without MID. Study 2 showed that the group CBT-program OVK was effective in reducing rumination, but not in reducing depressive symptoms or cognitive errors. This effect was the same for youth with and without a MID. The main premises of Beck’s cognitive theory and Nolen-Hoeksema’s response style theory of depression are applicable to both youth with and without a MID. The cognitive error ‘underestimation of the ability to cope’ poses a specific risk factor for developing a depression for youth with a MID and may require special attention in treatment and prevention of depression. The specifically adapted program OVK did not show effectiveness in reducing symptoms of depression in youth in residential care.

Relationship between the perceived social support and catastrophization in individuals with chronic knee pain

BACKGROUND AND OBJECTIVES: Catastrophization and social support influence health outcomes in people with chronic pain. However, there is still no consensus regarding the relationship between these factors, and the information available in what relates to chronic pain in the knee joint is even scarcer. The objective of this study was to describe and understand the relationship between the perceived social support and pain catastrophization in adults with chronic knee pain. METHODS: Sociodemographic data were collected, and the West Haven-Yale Multidimensional Pain Inventory and Pain Catastrophizing Scale were completed by the participants. The sample included 28 participants attending daycare institutions in Aveiro, Braga and Leiria districts (Portugal). RESULTS: Seventy-five percent of the participants presented clinically significant catastrophization, and 64.3% reported high perceived social support. There is a direct relationship between high catastrophization and frequent solicitations and distraction responses. Conversely, an inverse association between high catastrophization levels and infrequent negative responses was observed in the collected sample. CONCLUSION: Useful social support contributes to a maladaptive response to pain by increasing catastrophization levels, and the catastrophic response may be a way to ask for support. There is a direct association between the perceived social support and the catastrophization of chronic knee pain in the participants. However, the association between these variables was poor/low evidencing the need to consider other factors in the catastrophization study.

Expression of Pain Behaviors and Perceived Partner Responses in Individuals With Chronic Pain: The Mediating Role of Partner Burden and Relationship Quality.

Expressions of pain by individuals with chronic pain may encourage solicitous and distracting responses from some partners and punishing responses from others. Partners' responses can impact the well-being of individuals with chronic pain. Yet information about factors that can explain the link between expression of pain behaviors and different partners' responses is scarce. The objective of this study was to investigate the role of perceived partner burden and relationship quality in the link between expressions of pain behaviors and perceived partner responses (ie, solicitous, distracting, and punishing responses). Participants were 158 individuals with chronic pain (ie, experiencing pain on most days for at least 6 months before participating in the study) who completed questionnaires about pain behaviors, as well as perceptions of partner burden, relationship quality, and partners' solicitous, distracting, and punishing responses. The link between expressing pain and each type of partner response was investigated by serial mediation analysis. Partner burden and relationship quality were entered into all analyses as the first and the second mediator, respectively. Expressing more pain was related to higher levels of perceived partner burden, which in turn, was associated with poorer relationship quality. Poorer relationship quality was associated with reporting fewer solicitous and distracting partner responses and more punishing responses. Enhanced partner burden and reduced relationship quality may be one pathway through which pain behaviors relate to partner responses.

Depressogenic Attributional Style and Depressive Symptoms in Chinese University Students: The Role of Rumination and Distraction

The objective of the current study was to test the hypothesis that rumination and distraction mediate the relationship between depressogenic attributional style and depressive symptoms. 1017 university students recruited from two universities (90.0% Han and 10.0% ethnic minority) in China, completed questionnaires that measured depressogenic attributional style (Cognitive Style Questionnaire), depressive symptoms (Center for Epidemiologic Studies Depression Scale) and rumination and distraction (Response Styles Questionnaire). Direct effects and the mediation model were evaluated via both linear regression analyses and Sobel tests. The rumination subscale of the RSQ was significantly positively correlated with the CESD and subscales of CSQ. However, the distraction subscale of the RSQ was significantly negatively correlated with the CESD and all subscales of the CSQ, except for the subscale of self. Higher levels of depressogenic attributional styles were associated with higher levels of rumination response style. In contrast, lower levels of CSQ-cause, CSQ-consequences, and CSQ-total were associated with higher levels of distraction response style. Higher levels of rumination response style were associated with higher levels of depressive symptoms. However, higher levels of distraction response style were associated with lower levels of depressive symptoms. The obtained results of Sobel tests confirmed that rumination partly mediated the relationship between depressogenic attributional style and depressive symptoms. The present results suggest that rumination but not distraction may mediate the relationship between depressogenic attributional style and depressive symptoms; additionally, rumination contributes to the negative outcomes of depressive symptoms.

Evolutionary significance of antiparasite, antipredator and learning phenotypes of avian nest defence

Avian nest defence, which is expected to serve both antiparasite and antipredator functions, may benefit or be detrimental to birds, although selective forces that potentially operate on nest defence have not been quantified as a whole. Together with fitness values, we analysed two traits of nest defence, intensity and plasticity, in two distantly related passerine species, yellow warbler (Setophaga petechia) in North America and reed warbler (Acrocephalus scirpaceus) in Europe, both favourite host species for brood parasites. Breeders that escaped parasitism were the most vocal among reed warblers, whereas there was no specific defence phenotype that predicted prevention of parasitism in yellow warblers. Breeders that escaped nest predation were, in both species, those with the most distractive response at the first exposure to a nest-threatening event, such as the experimental predation or parasitism simulated at the nest. However, increasing defence intensity benefited yellow warblers but was detrimental to reed warblers, because intense defence responses attracted predators. Adaptiveness of nest defence was revealed by nest defence phenotypes when examined in concert with the seasonal fitness (i.e. measures of reproductive success). Results revealed selective forces favoured yellow warblers with strong defence phenotypes. Opposite forces were instead revealed among reed warblers whose favoured phenotypes were strong, yet less flexible, defenders.

Partners' Overestimation of Patients' Pain Severity: Relationships with Partners' Interpersonal Responses.

The present study examined whether concordance between patients' and their partners' reports of patient pain severity relates to partners' social support and behavioral responses in couples coping with chronic pain. Fifty-two couples completed questionnaires about the patient's pain severity. Both dyad members also rated the partner's social support and negative, solicitous, and distracting responses toward the patient when in pain. Bivariate correlations showed moderate correspondence between patient and partner ratings of pain severity (r = 0.55) and negative (r = 0.46), solicitous (r = 0.47), and distracting responses (r = 0.53), but lower correspondence for social support (r = 0.28). Twenty-eight couples (54%) were concordant in their perceptions of patient pain; partners overestimated pain in 14 couples (27%), and partners underestimated pain in 10 couples (19%). Couple concordance in pain perceptions was not related to patients' reports; however, it significantly predicted partners' reports: Partners who overestimated pain reported giving more social support (β = 0.383, P = 0.016), fewer negative responses (β = -0.332, P = 0.029), and more solicitous responses (β = 0.438, P = 0.016) than partners who were in agreement or who underestimated pain. Partner overestimation of pain severity is associated with partner-reported but not with patient-reported support-related responses. This finding has important clinical implications for couple interventions in chronic pain.

Longitudinal outcomes associated with significant other responses to chronic fatigue and pain.

This study investigated significant others' behavior associated with fatigue, pain, and mental health outcomes among 68 individuals with chronic fatigue (43% also had fibromyalgia) over 18 months. More negative significant others' responses were associated with more pain, poorer physical and mental health, and more fatigue-related symptoms over time. More fibromyalgia tender points covaried with more solicitous significant others' responses over time. Better mental health covaried with more distracting significant others' responses over time. The results are discussed in terms of theoretical models of the role of perceived significant others' responses on patient outcomes and recommendations for future research.

The Relationship Between Decentering and Adaptiveness of Response Styles in Reducing Depression

Recent studies have suggested that ruminative and distractive response styles to negative moods could have adaptive and maladaptive consequences, respectively. However, whether there is a common component in the adaptive aspects of ruminative or distractive response styles has not been examined sufficiently. Adaptiveness of ruminative or distractive response styles is considered to be associated with decentering; thus, we investigated the indirect effects of four types of the response style (adaptive/maladaptive aspects of each response style) on depression through decentering. In this study, 241 Japanese undergraduate students (75 men and 166 women) were assessed using the Response Style Scale, the Japanese Version of Experience Questionnaire, and the Japanese Version of the Center for Epidemiologic Studies Depression Scale (CES-D). Mediation analyses revealed that decentering fully mediated the effects of adaptive aspects of ruminative and distractive response styles on depression whereas it partially mediated the effects of maladaptive aspects of response styles. These results indicate that the adaptiveness of response styles is influenced by decentering, and it particularly works in the adaptive aspects of ruminative/distractive response styles as a common element. Thus, a possibility is suggested that cultivating decentered perspective is effective in reducing maladaptive aspects of both response styles to negative moods or objects.

Beck’s cognitive theory and the response style theory of depression in adolescents with and without mild to borderline intellectual disability

AimThis study tests the validity of Beck’s cognitive theory and Nolen-Hoeksema’s response style theory of depression in adolescents with and without MBID. MethodsThe relationship between negative cognitive errors (Beck), response styles (Nolen-Hoeksema) and depressive symptoms was examined in 135 adolescents using linear regression. ResultsThe cognitive error ‘underestimation of the ability to cope’ was more prevalent among adolescents with MBID than among adolescents with average intelligence. This was the only negative cognitive error that predicted depressive symptoms. There were no differences between groups in the prevalence of the three response styles. In line with the theory, ruminating was positively and problem-solving was negatively related to depressive symptoms. Distractive response styles were not related to depressive symptoms. The relationship between response styles, cognitive errors and depressive symptoms were similar for both groups. ConclusionThe main premises of both theories of depression are equally applicable to adolescents with and without MBID. The cognitive error ‘Underestimation of the ability to cope’ poses a specific risk factor for developing a depression for adolescents with MBID and requires special attention in treatment and prevention of depression. What this paper adds?Despite the high prevalence of depression among adolescents with MBID, little is known about the etiology and cognitive processes that play a role in the development of depression in this group. The current paper fills this gap in research by examining the core tenets of two important theories on the etiology of depression (Beck’s cognitive theory and Nolen-Hoeksema’s response style theory) in a clinical sample of adolescents with and without MBID. This paper demonstrated that the theories are equally applicable to adolescents with MBID, as to adolescents with average intellectual ability. However, the cognitive bias ‘underestimation of the ability to cope’ was the only cognitive error related to depressive symptoms, and was much more prevalent among adolescents with MBID than among adolescents with average intellectual ability. This suggests that underestimating one’s coping skills may be a unique risk factor for depression among adolescents with MBID. This knowledge is important in understanding the causes and perpetuating mechanisms of depression in adolescents with MBID, and for the development of prevention- and treatment programs for adolescents with MBID.

The role of pain behaviour and family caregiver responses in the link between pain catastrophising and pain intensity: A moderated mediation model

Objectives: This study investigated the mediating role of pain behaviours in the association between pain catastrophising and pain intensity and explored the moderating role of family caregivers’ responses to pain in the link between pain behaviours and pain intensity.Methods: The sample consisted of 154 chronic pain patients and their family caregivers. Patients completed questionnaires regarding pain intensity, pain catastrophising, pain behaviours and their caregivers’ responses to their pain. Family caregivers reported their responses to the patients’ pain.Results: Pain catastrophising was associated with pain intensity (r = 0.37) and pain behaviours partly mediated this association. The positive association between pain behaviours and pain intensity was significant only if patients reported that their family caregivers showed high levels of solicitous (effect = .49) and distracting responses (effect = .58), and if caregivers reported to show high levels of solicitous responses (effect = .51). No support was found for negative responses as a moderator neither based on patients’ perception of negative responses nor based on caregivers’ perception of negative responses.Conclusions: The findings are in line with the idea that family caregivers’ solicitous and distracting responses convey to patients that their condition is serious, which may reinforce patients’ pain and pain behaviours, especially in those who catastrophise.

Use of Smartphones to Prospectively Evaluate Predictors and Outcomes of Caregiver Responses to Pain in Youth with Chronic Disease.

This study examined outcomes and predictors of different types of responses to child pain used by caregivers of youth with chronic disease. Sixty-six children and adolescents (ages 7-18) with juvenile idiopathic arthritis answered questions about pain, pain interference in activities, and mood on a smartphone three times per day for one month, while a caregiver contemporaneously answered questions about their own mood and use of protecting, monitoring, minimizing, or distracting responses to their child's pain. Multilevel models were used to evaluate (a) how a child's pain and pain interference changes after a caregiver uses different types of pain responses; (b) the extent to which caregiver responses to pain vary across days; and (c) whether variability in caregiver responses to pain is predicted by changes in child pain characteristics, child mood, and/or caregiver mood. Results showed that children's pain intensity and pain interference increased following moments when caregivers used more protective responses, whereas children's pain interference decreased following times when caregivers responded with minimizing responses. Caregiver pain responses varied considerably across days, with caregivers responding with more protecting and monitoring responses and fewer minimizing responses at moments when their child reported high levels of pain unpleasantness and pain interference. Caregivers also were found to respond with fewer protective responses at moments when they themselves were in a more positive mood. Implications for clinical recommendations and future studies are discussed.

The Relation between the Fear-Avoidance Model and Constructs from the Social Cognitive Theory in Acute WAD.

In the fear-avoidance (FA) model social cognitive constructs could add to explaining the disabling process in whiplash associated disorder (WAD). The aim was to exemplify the possible input from Social Cognitive Theory on the FA model. Specifically the role of functional self-efficacy and perceived responses from a spouse/intimate partner was studied. A cross-sectional and correlational design was used. Data from 64 patients with acute WAD were used. Measures were pain intensity measured with a numerical rating scale, the Pain Disability Index, support, punishing responses, solicitous responses, and distracting responses subscales from the Multidimensional Pain Inventory, the Catastrophizing subscale from the Coping Strategies Questionnaire, the Tampa Scale of Kinesiophobia, and the Self-Efficacy Scale. Bivariate correlational, simple linear regression, and multiple regression analyses were used. In the statistical prediction models high pain intensity indicated high punishing responses, which indicated high catastrophizing. High catastrophizing indicated high fear of movement, which indicated low self-efficacy. Low self-efficacy indicated high disability, which indicated high pain intensity. All independent variables together explained 66.4% of the variance in pain disability, p < 0.001. Results suggest a possible link between one aspect of the social environment, perceived punishing responses from a spouse/intimate partner, pain intensity, and catastrophizing. Further, results support a mediating role of self-efficacy between fear of movement and disability in WAD.