Sensory Decision Theory Research Articles

A MODEL OF CLINICAL PAIN

A method is described utilizing repetitive electrical stimulation for the production of long-term continuous pain which approaches the quality of clinical pain. This technique provides for on-line monitoring of actual power delivered to the subject. Incremental stimuli of high and low intensities were randomly superimposed on continuous painful background electrical stimulation. Subjects were studied in a triple crossover design with acupuncture, codeine and baseline treatments. Data were evaluated by Sensory Decision Theory (SDT) procedures. The codeine compound significantly raised the response criterion to higher intensity stimuli but did not effect perception of low intensity stimuli, indicating an analgesic but not an anesthetic effect. No significant differences were found between control and acupuncture results for either pain discriminability or pain report criterion. The results are discussed with regard to the physiological effects of electrical stimulation and the merits of this new stimulation technique.

Effects of moderate and high doses of marihuana on thermal pain: a sensory decision theory analysis.

Sixteen habitual marihuana users, selected for their good mental and physical health, were hospitalized for three months in the New York State Psychiatric Institute. During the first month, the subjects were drug free; during the second month, they smoked marihuana cigarettes provided by NIDA (2% THC, 20 mg per cigarette) at the rate of 3 to 12 a day. A modified Hardy-Wolff dolorimeter was used to present 20 thermal stimuli of 30-second duration in a random manner at nine different intensities. Subjects responded from a 14-category scale, and data were analyzed according to sensory decision theory analysis. During the third month, the subjects were again drug free. At the noxious thermal intensities, there was a decrease in the pain report criterion during the first two weeks of smoking. The pain enhancement effect was followed by return to the presmoking pain level during weeks 3 and 4 and in the postsmoking period, indicating that tolerance had developed. There was also an increase in pain discriminability during the four weeks of smoking which extended for one week after smoking. Tolerance developed to the pain report criterion but not to the thermal discriminability. This study suggests that marihuana may have hyperalgesic activity and probably enhances the perception of pain, in moderate smokers. In contrast, heavy smoking had little effect on discriminability and caused an increase in the pain report criterion.

Sensory decision theory describes evoked potentials in pain discrimination.

ABSTRACTThe relationship between two procedures for assessing laboratory pain. Sensory Decision Theory (SDT) psychophysics and quantification of evoked potentials, was explored to determine whether the two methods measure a common perceptual process. Evoked potentials (EPs) were recorded from vertex while subjects performed a conventional SDT discrimination task that required repetitive judgment of two painful electrical tooth stimuli delivered in random order over trials. Peak‐to‐peak amplitudes and peak latencies were obtained for summation‐averaged waveforms between 50 and 500 msec routed to four categories corresponding to SDT response classifications: hits, false affirmatives, misses and correct rejections. EPs associated with hits and false affirmatives had significantly greater amplitudes at N157‐P237 than those associated with misses and correct rejections. Peak latencies were not related to response categories. These results suggest that N157‐P237 amplitudes associated with dental pain are appropriately described by the SDT psychophysical model, and they demonstrate that the two paradigms assess a single perceptual process associated with pain.

Analgesic effect of low frequency electrotherapy on cutaneus pain: Comparison of three types of electrodes, evaluated by sensory decision theory (SDT) analysis

Analgesic effect of low frequency electrotherapy on cutaneus pain: Comparison of three types of electrodes, evaluated by sensory decision theory (SDT) analysis

Dental dolorimetry for human pain research: Methods and apparatus

Electrical stimulation of human tooth pulp provides a means of safely producing human pain in the laboratory. This paper describes a dolorimetry and data collection system for stimulating volunteers, recording responses and analyzing data. The system allows multilevel stimulation in pseudorandom sequences and analysis of results using the methods of Sensory Decision Theory. It consists of modified commercial equipment, specially designed circuitry, an interface, and a programmable calculator. Fundamental problems and safety considerations for electrical dental stimulation are reviewed. Reliability of stimulation and response measurement is discussed.

Sensory decision theory analysis of the effects of anxiety and experimental instructions on pain.

Sensory decision theory analysis of the effects of anxiety and experimental instructions on pain.

Sensory decision theory analysis of the effects of anxiety and experimental instructions on pain.

Sensory decision theory analysis of the effects of anxiety and experimental instructions on pain.

Effects of doxepin on perception of laboratory-induced pain in man

Beneficial effects have been observed in University of Washington Pain Clinic patients treated with tricyclic antidepressants, but such effects occur much earlier than predicted mood elevation. A laboratory investigation of pain perception was employed to test the hypothesis that doxepin, a tricyclic antidepressant, has analgesic properties. Healthy, normal volunteers were tested over a 4-week period during which they repeatedly performed Sensory Decision Theory tasks while undergoing painful dental stimulation. Doxepin and a placebo were administered after baseline measurement for 4 weeks under double blind conditions. No significant changes due to drug administration were observed in detection threshold or sensory sensitivity indices, but response bias against reporting the stimuli as painful changed dramatically after subjects began ingesting capsules. This effect was evident in both drug and placebo groups, and it was maintained across repeated weeks of testing. These observations suggest that the instructions given patients when the drug is administered have a profound effect on pain report.

Changes in somatic sensitivity during transcutaneous electrical analgesia

Patients with chronic pain in one limb, who experienced pain reduction with transcutaneous neurostimulation, were examined for sensory perception in that limb before and during electrical analgesia. Contralateral limbs and normal subjects served as controls. Sensory stimuli were quantified, a range of stimuli were presented and data were analyzed according to sensory decision theory. Results showed that, compared to controls, painful limbs show considerable impairment in sensory sensitivity. With transcutaneous Neurostimulation, however, sensitivity is improved towards normal, whereas electrical stimulation slightly impairs perception in normal limbs. These results suggest that electrical analgesia involves both peripheral small-fiber blockade and large-fiber stimulation; the latter is more noticeable in the normal limb, but the former effect is predominant when pain reduction occurs in a painful limb.

Social modeling influences on sensory decision theory and psychophysiological indexes of pain.

Subjects exposed to social models dissimulating tolerance or intolerance generally exhibit matching behavior in their verbal ratings of painful stimulation. It has been unclear, however, whether these changes reflect voluntary alteration of evidence or genuine changes in distress. This study used alternative measures and controlled for methodological limitations of earlier studies by examining nonpalmar skin potential in addition to palmar skin conductance and heart rate indexes of psychophysiological response to electric shock, and by evaluating verbal expressions of pain with sensory decision theory methodology. Of 20 female volunteer subjects, half served as controls, and half were exposed to a tolerant female model. Both the subject and the model verbalized ratings of discomfort provoked by a series of electric shocks of increasing intensity. Subjects then underwent a series of preselected random shocks. Sensory decision theory analyses revealed lower discriminability of the shocks among subjects exposed to a tolerant model. Several indexes of nonpalmar skin potential and heart rate reactivity exhibited lower reactivity in the tolerant group. Tolerant modeling was also associated with decreases in subjective stress. The results were consistent with the position that changes in pain indexes associated with exposure to a tolerant model represented variations in fundamental characteristics of painful experiences as opposed to suppression of information.

Social modeling influences on sensory decision theory and psychophysiological indexes of pain.

Social modeling influences on sensory decision theory and psychophysiological indexes of pain.

Sensory decision theory methods in pain research: a reply to Rollman.

Abstract Positive reviews of the developing literature on Sensory Decision Theory (SDT) pain research have been provided by Lloyd and Appel [21] and Hall [17]. In contrast, Rollman [24] has criticized the application of SDT methodology to the study of pain, arguing that it is “an error in logic to utilize SDT parameters to reach definitive conclusions about mechanisms altered during pain modulation”, and he has attacked the procedures employed by decision theory researchers in data collection and analysis. This paper is a response to Rollman written from the perspective of a single group of SDT pain researchers. I will first bring to issue certain fundamental statements that appear recurrently throughout Rollman's paper, and I will argue that many of his criticisms lack substance because these assertions are inappropriate. In addition, I will deal briefly with some of Rollman's specific methodologic criticisms, limiting my comments to those points that are salient to the multidisciplinary audience of this journal, and I will briefly describe the pain model that has been implicit in the work of our laboratory group.

The perception of induced dental pain in young and elderly women.

Pain threshold for electrical stimulation of healthy, unfilled teeth was studied in young and elderly women. Using the methodology of Sensory Decision Theory, ability to discriminate between suprathreshold shocks (d') and response bias were also assessed. No difference in threshold was observed betweeen the young and elderly groups. The elderly women were poorer at discriminating between suprathreshold shocks than the young women. These results were interpreted to reflect the integrity of highthreshold dental pulp afferents in the elderly and a central nervous system deficit on the part of the elderly for discriminating between such shocks. Significant age differences in response bias were also observed. Elderly subjects were biased against reporting shock as very faint pain compared to the young subjects and they restricted the range of their criteria across the six-point rating scale.

Effects of intrasegmental electrical acupuncture on dental pain: evaluation by threshold estimation and sensory decision theory.

The effect of 80 min of low frequency (2 Hz) electric acupunctural stimulation at facial sites on the perception of induced dental pain was evaluated using both pain threshold and sensory decision theory (SDT) procedures. The demonstration of a 187% increase in threshold over a 20 min period of acupunctural stimulation replicated earlier work by Swedish investigators. SDT analyses indicated that the threshold increase reflected a relatively pure sensory change with no significant modification of response bias. However, subjects were able to perceive some of the stimuli presented below threshold level following acupuncture, thus indicating that the threshold concept has been an inadequate description of the phenomenon. This study demonstrated that intrasegmental analgesic stimulation is more efficacious than the extrasegmental meridian point stimulation used in our earlier studies. Possible mechanisms for the observed effect were discussed.

Stomatology Acupuncture compared with 33% nitrous oxide for dental analgesia: a sensory decision theory evaluation: Anesthesiology, 42 (1975) 532–537

Stomatology Acupuncture compared with 33% nitrous oxide for dental analgesia: a sensory decision theory evaluation: Anesthesiology, 42 (1975) 532–537

Detection and decision factors in pain perception in young and elderly men

The effect of age on ability to discriminate between levels of electrical stimulation of tooth pulp and willingness to report shocks as painful was evaluated using the Sensory Decision Theory. While threshold did not increase with age for tooth pulp stimulation as is often observed for thermal pain thresholds, a significant age deficit in ability to discriminate between suprathreshold shocks was observed. Significant changes with age in willingness to report the electrical shocks as painful were also observed. These results indicate that changes with age in pain perception are complex, involving not only possible discrimination deficits but also changes in bias for and against labeling noxious events as painful. These findings stress the need for within individual comparisons of laboratory techniques for evoking acute pain experiences where variables such as age are under consideration.

Comparative effects of acupuncture and transcutaneous stimulation on the perception of painful dental stimuli

The effects of acupunctural stimulation on the perception of induced dental pain were compared with those of placebo acupuncture and transcutaneous electrical stimulation (TES) at an acupuncture site. Each of 4 groups of 15 subjects received one of the following treatments: acupuncture, placebo acupuncture, TES, or control conditions. Every subject was tested twice, once in a baseline session and on another day in a test session. Four levels of painful dental stimuli were delivered repeatedly and in random order to each subject in each session, who rated the perceived intensity of each stimulus on a pain category scale. All three treatment groups showed a significant reduction in magnitude of stimulus ratings after treatment. A Sensory Decision Theory analysis of the data was employed to assess the sensory sensitivity of each subject to each of 4 levels of dental stimulation and the willingness of the subject to label the strongest stimulus as painful. Acupuncture and TES groups showed a small but significant sensory analgesic response to treatment and a significant reduction in willingness to identify the strongest stimulus as painful when contrasted to controls, but placebo acupuncture subjects failed to show significant change on either of the response measures. The effects of acupuncture were most pronounced at the lowest level of stimulation, while TES affected the perception of all levels of dental stimuli. The observed effects appeared to be small, reliable, and dependent on the stimulation of a particular anatomical locus.

Acupuncture compared with 33 percent nitrous oxide for dental analgesia: a sensory decision theory evaluation

Acupuncture compared with 33 percent nitrous oxide for dental analgesia: a sensory decision theory evaluation

Pain sensitivity and the report of pain: an Introduction to sensory decision theory

Pain: March 1975 - Volume 1 - Issue 1 - p 94-95 doi: 10.1016/0304-3959(75)90029-9

Effect of cognitive appraisal on d' and response bias to experimental stress.

The effects of an intellectualization-denial passage designed to modify cognitive appraisal of stressor stimuli (gory scences) were evaluated in terms of sensory-decision theory analysis. The passage was found to reduce "felt stress" ') for certain pairs of the stimuli addressed by the passage content but to less effective in reducing stress (Lx) was reduced rather than increased wi;h presentation of the passage for the included simuli only. Differences in d' between subjects classified within treatment groups as repressors versus sensitizers were obtained for certain stimulus pairs generally in the direction of lower sensitivity for repressors. Results are discussed in terms of the effects of altered cognitive appraisal on the "prevention of stress" and on "defensive"denial.