Avoidance Behavior In Relation Research Articles

Exposure in Vivo as a Treatment Approach to Target Pain-Related Fear: Theory and New Insights From Research and Clinical Practice

For patients with chronic pain who have elevated pain-related fear (PRF), exposure is the treatment of choice. This Perspective highlights the inhibitory learning approach, summarizes mechanistic work from experimental psychology and neuroimaging regarding PRF in chronic pain, and describes possible clinical applications of EXP in chronic secondary pain as well as in primary care.

Development of the Avoidance Daily Activities Photo Scale for Patients With Shoulder Pain.

The purpose of this study was to develop the Avoidance of Daily Activities Photo Scale (ADAP Shoulder Scale) to measure shoulder pain-related avoidance behavior in patients with shoulder pain and evaluate and report the structural validity and internal consistency of the scale. Potential daily activities involving the shoulder were selected from the activities and participation domain of the International Classification of Functioning, Disability and Health. The selected activities were presented to an expert panel, health care professionals, and patients with shoulder pain with the question "How much do you think it is important to ask patients with shoulder pain about this activity?" Activities attaining a content validity index (CVI) ≥ 0.8 were represented using a digitally colored photograph. Activity photographs were evaluated by health care professionals and patients with shoulder pain. Photographs with a CVI ≥ 0.8 were included in the scale. To evaluate structural validity and internal consistency of the scale, exploratory factor analysis was performed to determine the presence of any scale domain. Cronbach alpha was calculated to indicate the internal consistency of each domain. Of the 107 preselected activities, 21 attained a CVI ≥ 0.8. Eighteen photographs (CVI ≥ 0.8) were included in the scale after being analyzed by 120 health care professionals and 50 patients with shoulder pain. Exploratory factor analysis (N = 156) showed that the ADAP Shoulder Scale consists of 3 domains: free movement, high effort, and self-care. The internal consistencies of the domains were 0.92, 0.89, and 0.92, respectively. The ADAP Shoulder Scale included 15 photographs distributed in 3 domains. All domains had a high internal consistency. The scale is easily applicable, well understood, and relevant for shoulder pain. The ADAP Shoulder Scale can be used to rate shoulder pain-related avoidance behaviors.

Effects of "Dirty" Information on Disgust Responding to an Unknown Animal in Children: The Moderating Role of Maternal Disgust Proneness

Although research has shown that disgust facilitates avoidance of small animals among adults, much less is known about disgust appraisals of small animals in children as well as the predictors of such appraisals. To address this gap, children (ages 5–13) were exposed to dirt-related and cleanliness-related information about unknown animals. The extent to which these types of information influenced children's feelings of fear, disgust, positivity, and avoidance behavior in relation to the animals was examined. The present study then examined the extent to which child and maternal disgust proneness predicted feelings of disgust to the ‘dirty’ animal. The findings show that providing dirt-related information resulted in a significant increase in disgust, but not fear, responding to the animal. Dirt-related information also resulted in a significant decrease in positive feelings toward the animal. Conversely, providing cleanliness-related information resulted in a significant decrease in disgust, but not fear, responding to the animal. In addition, providing cleanliness-related information resulted in a significant increase in positive feelings toward the animal. Children also engage in more avoidance of the animal described as dirty compared to the animal described as clean. In addition, subsequent analysis revealed an interaction between child and maternal disgust propensity in predicting learned disgust to the dirty animal such that the highest levels of feelings of disgust to the dirty animal were observed among children with high disgust proneness who also have mothers with high disgust proneness. The implications of these findings for conceptualizing the role of disgust in animal phobias among youth will be discussed.

Key mechanisms of cognitive behavioural therapy in irritable bowel syndrome: The importance of gastrointestinal related cognitions, behaviours and general anxiety

BackgroundIrritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterised by abdominal pain and altered bowel movements. Cognitive behavioural therapy (CBT) has been shown to be effective in reducing symptom severity in IBS and enhancing quality of life/functioning. The present study sought to identify how CBT achieves change in these outcomes. MethodSecondary analysis was conducted on 149 patients with irritable bowel syndrome who had been randomised to cognitive behavioural therapy plus an antispasmodic medication or antispasmodic alone. Single and sequential mediation was modelled using structural equation modelling. Gastrointestinal (GI) related avoidance behaviour, safety behaviour, cognitions and general anxiety were included as mediators. ResultsGI safety behaviours, cognitions and general anxiety mediated treatment effect on the outcomes of symptom severity and work and social adjustment. Avoidance behaviour was not a significant mediator for either outcome. Sequential mediation models indicated that unhelpful GI related cognitions reduced before anxiety did, and this sequential path (R➔GI related cognitions➔anxiety➔outcome) was significant for both symptom severity (b = −0.22, CI [−0.40 to −0.90], p = .005) and work and social adjustment (b = −0.26, CI [−0.44 to −0.11], p = .003) where ‘R' is randomisation. Reduction in GI safety behaviours also preceded reduction in anxiety. This sequence (R ➔GI safety behaviours➔anxiety➔outcome) was significant for both symptom severity (b = −0.11, CI [−0.24 to −0.01], p = .049) and work and social adjustment (b = −0.12, CI [−0.23 to −0.03], p = .03). ConclusionResults suggest that it is important for psychological treatments to target IBS specific factors for change.

Disgust, shame and the psychosocial impact of skin picking: Evidence from an online support forum.

This article examines the accounts of individuals who problematically pick their skin and explores their subjective experiences. In total, 100 problem disclosure statements were taken from posts made to a publicly accessible online skin picking support forum. These posts were systematically analysed using thematic analysis. Themes of disgust, shame and psychosocial avoidance dominated the analysis and appeared central to the experience of skin picking. Skin picking was shown to be a heterogeneous experience with a complex emotional profile. We argue that disgust, shame and related avoidance behaviour should be considered when conceptualising skin picking and considering treatment interventions.

Overactivity in daily life: a crucial step in understanding how to tailor treatments.

Overactivity in daily life: a crucial step in understanding how to tailor treatments.

MGlu2 receptor-mediated modulation of conditioned avoidance behavior in rats

Inhibition of conditioned avoidance behavior in rats is generally considered predictive for antipsychotic activity in man. The present study investigated the mGlu2-mediated modulation of conditioned avoidance and compared mGlu2 agonists with available antipsychotics for their relative effects on conditioned avoidance behavior and locomotion. The mGlu2/3 orthosteric agonist 4-amino-2-thiabicyclo[3.1.0]hexane-4,6-dicarboxylic acid 2,2-dioxide (LY-404039) and mGlu2 positive allosteric modulator (PAM) 3-(cyclopropylmethyl)-7-(4-phenylpiperidin-1-yl)-8-(trifluoromethyl)[1,2,4]triazolo[4,3-a]pyridine (JNJ-42153605) inhibited avoidance and blocked escape behavior. The mGlu2/3 negative allosteric modulators (NAMs) 7-(dimethylamino)-4-(3-pyridin-3-ylphenyl)-8-(trifluoromethyl)-1,3-dihydro-2 H-1,5-benzodiazepin-2-one (JNJ-42112265) and 4-[3-(2,6-dimethylpyridin-4-yl)phenyl]-7-methyl-8-(trifluoromethyl)-1,3-dihydro-2H-1,5-benzodiazepin-2-one (RO-4491533) reversed the LY-404039-induced impairment of avoidance and escape. JNJ-42112265 also reversed the impairment of avoidance and escape induced by the mGlu2-specific PAM JNJ-42153605, suggesting that the effects on conditioned avoidance are specifically mGlu2-mediated. The mGlu2/3 antagonist (2-(2-carboxycyclopropyl)-3-(9H-xanthen-9-yl)-d-alanine (LY-341495; s.c.) reversed the LY-404039-induced escape impairment but failed to restore avoidance, suggesting interfering side effects. Like the tested antipsychotics, mGlu2/3 orthosteric and allosteric agonists inhibited avoidance behavior and locomotion at similar doses. Hence no clear-cut differences between mGlu2 modulators and currently available antipsychotics in the way they interfere with avoidance behavior in relation to inhibition of locomotion could be established.

Zicht op Evenwicht. Evaluatie van een landelijk geïmplementeerde cursus gericht op het verminderen van bezorgdheid om te vallen bij zelfstandig wonende ouderen

A cognitive behavioral program reduced concerns about falling and related avoidance behavior among older community-dwelling adults in a randomized controlled trial. In the current study we examined the effects and acceptability of the program after nation-wide implementation into home care organizations in The Netherlands. In a one-group pretest-posttest study with data collection before the start of the program and at 2 and 4 months, the effects and acceptability of the program were assessed in 125 community-dwelling older people. The outcomes of the effect evaluation included concerns about falls, related avoidance behavior, falls, fall-related medical attention, feelings of anxiety, symptoms of depression, and loneliness. Pretest-posttest analyses with the Wilcoxon signed-rank test and the paired t-test showed significant improvements at 4 months for concerns about falls, activity avoidance, number of falls in the past 2 months, feelings of anxiety, and symptoms of depression. No significant differences were shown for the other outcomes. After implementation in home care organizations, the outcomes indicate positive program effects on concerns about falls, avoidance behavior, and falls in community-dwelling older people. Given the similarity in results, i.e. between those of the previously performed randomized controlled trial and those of the current pretest-posttest study, we conclude that the program can be successfully implemented in practice. This article is an adjusted, Dutch version of Zijlstra GA, van Haastregt JC, Du Moulin MF, de Jonge MC, van der Poel A, Kempen GI. Effects of the implementation of an evidenc-based program to manage concerns about falls in older adults. The Gerontologist 2013;53(5):839-849; doi: 10.1093/geront/gns142.

Effects of the Implementation of an Evidence-Based Program to Manage Concerns About Falls in Older Adults

Concerns about falls and related activity avoidance are common in older people. A multicomponent program reduced these concerns and increased daily activity among older people in a randomized controlled trial. This study explored whether the effects and acceptability of the program maintain after its implementation into home care organizations. In a pretest-post-test study, the effects and acceptability of the 8-week cognitive behavioral program was evaluated in 125 community-living older adults. Data on concerns about falls, related avoidance behavior, falls, fall-related medical attention, feelings of loneliness and anxiety, and symptoms of depression were collected prior to the start of the program and at 2 and 4 months. Pretest-post-test analyses showed significant improvements at 4 months for concerns about falls, activity avoidance, number of falls in the past 2 months, feelings of anxiety, and symptoms of depression. No significant differences were shown for daily activity, feelings of loneliness, and fall-related medical attention. After implementation in home care organizations, the program reduced concerns about falls, avoidance behavior, and falls in community-living older adults. These findings are highly consistent with the outcomes of a previously performed randomized controlled trial, indicating that the program can be successfully implemented in practice. Further dissemination of the program is recommended to reduce concerns about falls and related activity avoidance in community-living older people.

‘Zicht op Evenwicht’: een effectieve interventie om bezorgdheid om te vallen en gerelateerd vermijdingsgedrag bij ouderen te verminderen

Concerns about falls and related avoidance behavior are common among older people and may lead to decreased quality of life, decreased physical and psychosocial functioning, and premature admission to a nursing home. In a randomized controlled trial among 540 community-dwelling older people we studied the feasibility and effects of a cognitive behavioral program on concerns about falls, related avoidance of activity, and falls. Data of the process evaluation obtained from participants in the intervention group (n = 280) and the trainers (n = 6) showed that the program was considered as feasible by the trainers, and positively judged by participants and trainers. Furthermore, participants experienced benefits from attending the program (61% still reported benefits one year after the program). Prior to the start of the program 26% of the participants of the intervention dropped out, yet, among the participants who started the program completion was high (84%). The effect evaluation showed positive outcomes for concerns about falls, related avoidance of activity, and daily activity at 2 months (after the program) when comparing the intervention group with the control group (n = 260). Long-term effects were also shown for, amongst others, concerns about falls and recurrent falls. Following these positive results the cognitive behavioral group program is currently made available to geriatric care settings nationwide in the Netherlands.

Detecting Atlantic herring by parametric sonar

The difference-frequency band of the Kongsberg TOPAS PS18 parametric sub-bottom profiling sonar, nominally 1-6 kHz, is being used to observe Atlantic herring. Representative TOPAS echograms of herring layers and schools observed in situ in December 2008 and November 2009 are presented. These agree well with echograms of volume backscattering strength derived simultaneously with the narrowband Simrad EK60/18- and 38-kHz scientific echo sounder, also giving insight into herring avoidance behavior in relation to survey vessel passage. Progress in rendering the TOPAS echograms quantitative is described.

The Effects of Verbal Disgust- and Threat-Related Information About Novel Animals on Disgust and Fear Beliefs and Avoidance in Children

Disgust is a basic emotion that is thought to play a role in the etiology of certain types of specific phobias, like animal phobias. Two experiments were conducted in which 9- to 14-year-old children were exposed to disgust-related, cleanliness-related, and threat-related information about unknown animals. It was investigated to what extent these types of information influenced children's fear beliefs, feelings of disgust, and avoidance behavior in relation to the animals. Most important, results suggested a bidirectional relationship between disgust and fear. That is, disgust-related information was found to promote fear beliefs, and conversely threat-related information enhanced feelings of disgust. Repercussions of these findings for the role of disgust in the development and maintenance of anxiety pathology are discussed.

Sadness, Depression, and Avoidance Behavior

Research into genetic, psychosocial, and cognitive explanations for depression (biopsychosocial models) provides support for the role of these variables in the etiology of depression. Regularly identified as basic to depression is loss, and the experience of loss has been found to be more influential than genetic factors in the causation of depression. A distinction is drawn between sadness and depression. Sadness is conceptualized as a normal, time-limited response to loss, whereas depression is a disorder because it is recurring and disruptive. Missing from current biopsychosocial explanations for depression is the importance of avoidance behavior in relation to loss. The thesis of this article is that sadness is transformed into depression as a result of avoidance behavior, which blocks access to lost positive reinforcers. Successful treatment requires replacing avoidance behavior with approach behaviors to overcome the consequences of the loss. An equation is presented specifying the factors involved in depression and how they are related. Implications following from the equation fit well with research results. Treatment issues associated with the theory are discussed.

Unpleasant auditory illusions and related avoidance behaviour in a child

Auditory aura is a rare symptom in focal epilepsy. It has been described in autosomal dominant partial epilepsy with auditory features, but is, in general, poorly documented. We report on a 7-year-old, right-handed boy, who suffered seizures characterized by positive auditory illusions with verbal and gestural automatisms and noticeable attempts at covering his ears. Clinical evaluation and video-recording of the seizures, confirmed that most of the ictal behavior was deliberately directed at trying to prevent the unpleasant sensations reaching his ears. [Published with video sequences].

Integration of pharmaco and nonpharmaco therapies of psychosomatic disorders

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterised by abdominal pain and altered bowel movements. Cognitive behavioural therapy (CBT) has been shown to be effective in reducing symptom severity in IBS and enhancing quality of life/functioning. The present study sought to identify how CBT achieves change in these outcomes.Secondary analysis was conducted on 149 patients with irritable bowel syndrome who had been randomised to cognitive behavioural therapy plus an antispasmodic medication or antispasmodic alone. Single and sequential mediation was modelled using structural equation modelling. Gastrointestinal (GI) related avoidance behaviour, safety behaviour, cognitions and general anxiety were included as mediators.GI safety behaviours, cognitions and general anxiety mediated treatment effect on the outcomes of symptom severity and work and social adjustment. Avoidance behaviour was not a significant mediator for either outcome. Sequential mediation models indicated that unhelpful GI related cognitions reduced before anxiety did, and this sequential path (R➔GI related cognitions➔anxiety➔outcome) was significant for both symptom severity (b = −0.22, CI [−0.40 to −0.90], p = .005) and work and social adjustment (b = −0.26, CI [−0.44 to −0.11], p = .003) where ‘R' is randomisation. Reduction in GI safety behaviours also preceded reduction in anxiety. This sequence (R ➔GI safety behaviours➔anxiety➔outcome) was significant for both symptom severity (b = −0.11, CI [−0.24 to −0.01], p = .049) and work and social adjustment (b = −0.12, CI [−0.23 to −0.03], p = .03).Results suggest that it is important for psychological treatments to target IBS specific factors for change.

What causes stuttering?

Stuttering, with its characteristic disruption in verbal fluency, has been known for centuries; earliest descriptions probably date back to the Biblical Moses' “slowness of speech and tongue” and his related avoidance behavior (Exodus 4, 10–13). Stuttering occurs in all cultures and ethnic groups (Andrews et al. 1983; Zimmermann et al. 1983), although prevalence might differ. Insofar as many of the steps in how we produce language normally are still a mystery, disorders like stuttering are even more poorly understood. However, genetic and neurobiological approaches are now giving us clues to causes and better treatments.

Inter-individual distances during open-field tests in Japanese quail ( Coturnix japonica) selected for high or low levels of social reinstatement behaviour

Inter-individual distances (IIDs), during open-field tests, were measured in single sex pairs of quail of lines divergently selected for high (HSR) or low (LSR) levels of social reinstatement (SR) behaviour. Tests were carried out when the chicks were 1-, 3- and 6-weeks of age. IIDs were established within 1 min and remained stable thereafter. In HSR and mixed line pairs, but not LSR line pairs, IIDs increased with age. IIDs were shorter in HSR line pairs than in LSR or mixed line pairs at 1- and 3-weeks of age but not at 6-weeks of age when IIDs were similar in all pair-types. At 1- and 3-weeks of age, IIDs in mixed line pairs were intermediate to those in HSR and LSR line pairs. The sex of the pair-members did not influence IIDs. Previous studies have shown that selection for SR behaviour, in quail chicks, has effects that persist into later life and influence characters not present in the birds’ behavioural repertoire at the time of testing for the purposes of selection. Such behaviour patterns include aggression, sexual behaviour and socio-sexual proximity behaviour. All of these behaviour patterns are expressed at higher levels in HSR line birds than LSR line birds. Differences in IIDs between HSR and LSR line birds may, therefore, be due to an interaction between environmental and genetic effects. In young HSR chicks, social reinstatement is the primary motivation and IIDs are short. However, as the HSR line chicks’ age, IIDs reflect an interaction between social attraction and aggression related avoidance behaviour that tends to increase IIDs. In LSR line chicks aggression and social motivation are low at all ages and IIDs tend to remain stable.

Overload protection: avoidance response to heavy plantar surface loading.

Current footwear which are designed for use in running are examples of intentional biomechanical model integration into device design. The inadequacy of this footwear in protecting against injury is postulated to be due to fixation on inadequate models of locomotory biomechanics that do not provide for feedback control; in particular, an hypothesized plantar surface sensory-mediated feedback control system, which imparts overload protection during locomotion. A heuristic approach was used to identify the hypothesized system. A random series of loads (0 to 164 kg) was applied to the knee flexed at 90 degrees. In this testing system, plantar surface avoidance behavior was the difference between the sum of the leg weight and the load applied to the knee, and the load measured at the plantar surface; this was produced by activation of hip flexors. Significant avoidance behavior was found in all of the subjects (P less than 0.001). On all surfaces tested, including modern athletic footwear (P less than 0.001), its magnitude increased directly in relation to the load applied to the knee (P less than 0.001). There were significant differences in avoidance behavior in relation to the weight-bearing surfaces tested (P less than 0.05). With the identification of a feedback control system which would serve to moderate loading during locomotion, an explanation is provided as to why current athletic footwear do not protect and may be injurious; thus allowing the design of footwear which may be truly protective.

Migrations and Activity Levels of Overwintering Atlantic Herring (Clupea harengus harengus) along Southwest Newfoundland

Recoveries of tagged Atlantic herring (Clupea harengus harengus) released with abdominally inserted magnetic tags indicated a rapid and random dispersion of tagged fish within the total population of herring along southwest Newfoundland. Recoveries further indicated a general westward movement of herring along southwestern Newfoundland from January to March, also reflected in the spatial distribution of commercial catches during this period. Metabolic rates of these overwintering herring, estimated from changes in body energy from December to March, were more than double the standard level, suggesting a high degree of activity, possibly due to avoidance behavior in relation to predatory actions by cod overwintering in the same area. Key words: tagging, movements, predation, metabolic levels