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Biomedical subjects

G Crombez

Publications and source records attributed to G Crombez.

At least 19 recordsLinked to original sources
PubMed2006

Catastrophic thinking and heightened perception of pain in others.

Past research has shown that pain catastrophizing contributes to heightened pain experience. The hypothesis advanced in this study was that individuals who score high on measures of pain catastrophizing would also perceive more intense pain in others. The study also examined the role of pain behaviour as a determinant of the relation between catastrophizing and estimates of others' pain. To test the hypothesis, 60 undergraduates were asked to view videotapes of individuals taking part in a cold pressor procedure. Each individual in the videotapes was shown three times over the course of a 1min immersion such that the same individual was observed experiencing different levels of pain. Correlational analyses revealed a significant positive correlation between levels of pain catastrophizing and inferred pain intensity, r=.31, p<.01. Follow-up analyses indicated that catastrophizing was associated with a heightened propensity to rely on pain behaviour as a basis for drawing inferences about others' pain experience. Catastrophizing was associated with more accurate pain inferences on only one of three indices of inferential accuracy. The pattern of findings suggests that increasing reliance on pain behaviour as a means of inferring others' pain will not necessarily yield more accurate estimates. Discussion addresses the processes that might underlie the propensity to attend more to others' pain behaviour, and the clinical and interpersonal consequences of perceiving more pain in others.

Adult↗
PubMed2006

The relation between catastrophizing and the communication of pain experience.

The Communal Coping Model of pain catastrophizing proposes that pain catastrophizers enact pain behaviors in order to solicit support or empathy from their social environment. By this account, pain catastrophizers might be expected to engage in behavior aimed at maximizing the probability that their pain will be perceived by others in their social environment. To test this prediction, 40 undergraduates were videotaped during a cold pressor procedure. A separate sample of 20 (10 men, 10 women) undergraduates were asked to view the video sequences and infer the pain ratings of the cold pressor participants. Correlational analyses revealed that higher levels of pain catastrophizing of the cold pressor participants were associated with observer inferences of more intense pain, r=.39, p<.01. The relation between cold pressor participants' level of pain catastrophizing and observer inferences of pain intensity was mediated by the cold pressor participants' pain behavior. Although pain catastrophizing was associated with observers' inferences of more intense pain, cold pressor participants' level of pain catastrophizing was not associated with observers' accuracy in inferring self-reported pain. Implications of the findings for theory and clinical practice are addressed.

Adaptation, Psychological↗
PubMed2006

The role of physical workload and pain related fear in the development of low back pain in young workers: evidence from the BelCoBack Study; results after one year of follow up.

AIMS: To study the influence of work related physical and psychosocial factors and individual characteristics on the occurrence of low back pain among young and pain free workers. METHODS: The Belgian Cohort Back Study was designed as a prospective cohort study. The study population of this paper consisted of 716 young healthcare or distribution workers without low back pain lasting seven or more consecutive days during the year before inclusion. The median age was 26 years with an interquartile range between 24 and 29 years. At baseline, these workers filled in a questionnaire with physical exposures, work related psychosocial factors and individual characteristics. One year later, the occurrence of low back pain lasting seven or more consecutive days and some of its characteristics were registered by means of a questionnaire. To assess the respective role of predictors at baseline on the occurrence of low back pain in the following year, Cox regression with a constant risk period for all subjects was applied. RESULTS: After one year of follow up, 12.6% (95% CI 10.1 to 15.0) of the 716 workers had developed low back pain lasting seven or more consecutive days. An increased risk was observed for working with the trunk in a bent and twisted position for more than two hours a day (RR 2.2, 95% CI 1.2 to 4.1), inability to change posture regularly (RR 2.1, 95% CI 1.3 to 3.5), back complaints in the year before inclusion (RR 1.7, 95% CI 1.1 to 2.8), and high scores of pain related fear (RR 1.8, 95% CI 1.0 to 3.1). Work related psychosocial factors and physical factors during leisure time were not predictive. CONCLUSION: This study highlighted the importance of physical work factors and revealed the importance of high scores of pain related fear in the development of low back pain among young workers.

Adult↗
PubMed2003

[Anxiety in the dental office: theoretical aspects and treatment strategies].

Although mild tension and fear when visiting the dentist are considered normal, some patients experience extreme anxiety for dental treatment, which interferes with treatment and oral health, and causes significant distress. The present article reviews the literature on the definition and occurrence of dental fear. Causal and maintenance factors of dental fear are identified and a conceptual model of these factors is presented. From this model several interventions are presented that can be used to treat moderately anxious patients and pathological dental fear. The effects of these treatments are discussed.

Dental Anxiety↗
PubMed2002

Effects of distraction on treadmill running time in severely obese children and adolescents.

OBJECTIVE: (1) To examine the effects of attentional distraction on running time in an incremental treadmill test in obese youngsters; (2) to investigate whether distraction works at the same extent at the beginning and at the end of residential treatment; and (3) to explore the underlying mechanisms of the possible distraction effects. METHODS: Thirty severely obese youngsters (10 boys, 20 girls, age range 9-17) who were following a 10 month residential treatment, performed a treadmill test until exhaustion in four different sessions using a within subjects design. The two sessions at the beginning of the treatment and the two sessions at the end the treatment were counterbalanced, one with attentional distraction (music) and one without distraction. RESULTS: Obese youngsters ran significantly longer during distraction. This distraction effect seemed to be larger at the beginning compared to at the end of obesity treatment. The absence of differences between the condition with music and the condition without music on perceived bodily symptoms is in line with the idea that it took longer to perceive sufficient bodily sensations to decide to stop the treadmill test in the distraction condition. This interpretation is further corroborated by the physiological data indicating a superior peak performance in the condition with distraction. CONCLUSIONS: Attentional distraction has a positive effect on perseverance in obese youngsters. Further research has to show the usefulness of attentional distraction as a technique to increase exercise adoption and adherence in obesity treatment.

Adolescent↗
PubMed2002

The effects of catastrophic thinking about pain on attentional interference by pain: no mediation of negative affectivity in healthy volunteers and in patients with low back pain.

BACKGROUND: Previous studies have shown that catastrophic thinking about pain enhances attentional interference in healthy volunteers. OBJECTIVE: To investigate whether the attentional effects of pain catastrophizing can be accounted for by the more general predisposition of negative affectivity. METHODS: Sixty-seven pain-free students participated in the first experiment, and 33 patients with chronic low back pain participated in the second experiment. In both experiments, participants performed an auditory reaction time task while being exposed to a series of threatening electrocutaneous stimuli. Retardation in reaction times to auditory probes during pain was taken as an index of the attentional interruption by pain. Participants also completed self-report instruments of negative affectivity and pain catastrophizing. RESULTS: In both experiments, pain catastrophizing enhanced attentional interference by pain. This effect was most pronounced immediately after the onset of the electrocutaneous stimulus. The effect remained after controlling for the effects of negative affectivity. CONCLUSIONS: Catastrophic thinking about pain enhances attentional interruption by pain in normal samples, as well as in clinical samples of patients with chronic back pain. This effect is specific to pain catastrophizing and cannot be explained by the more general disposition of negative affectivity.

Adult↗
PubMed2001

Worry and chronic pain patients: a description and analysis of individual differences.

Patients with chronic pain often report negative and aversive rumination about pain and its consequences. Little is known about how and why patients with chronic pain worry. This study provides a description of worrying by chronic pain patients. Eighteen female and 16 male chronic pain patients reported, over a 7-day period, their experience of pain-related and non-pain-related worry. Results indicated that, in comparison with non-pain related worry, worry about chronic pain is experienced as more difficult to dismiss, more distracting, more attention grabbing, more intrusive, more distressing and less pleasant. Further analyses suggest that these characteristics of worry about chronic pain do not arise from a general disposition to worry or from a general disposition to anxiety. Worry is, however, related to awareness of somatic sensations. These results are discussed within an attentional model in which worry functions to maintain vigilance to threat.

Adult↗
PubMed2000

Worrying about chronic pain: vigilance to threat and misdirected problem solving.

Worry is reviewed to inform a cognitive-behavioural understanding of chronic pain. How worry comes to dominate is discussed as 'vigilance' and why worry comes to dominate is discussed as 'problem solving'. These two aspects are applied to worrying about chronic pain. Chronic pain is re-presented as chronic vigilance to threat that may lead to a perservation of attempts at solving the problem of achieving escape from pain. Attempts will be frustrated by the insolubility of the problem of chronic pain. The clinical and theoretical implications of this application are discussed.

Anxiety↗
PubMed2000

The emotional stroop task and chronic pain: what is threatening for chronic pain sufferers?

Using a computer version of the emotional stroop task, it was investigated whether chronic pain patients display an involuntary attentional shift towards pain-related information (sensory, affective pain words and injury related words). Multiple regression analyses were used to investigate which pain and psychosocial variables (pain severity, pain-related fear, pain catastrophizing and negative affect) were predictive of attentional bias. Results indicated: (1) that there was an attentional bias towards the sensory pain words; and (2) that current pain intensity was predictive of the effect. No other attentional effects were found. The results are discussed in terms of possible reasons for the difficulty of demonstrating attentional bias in chronic pain patients.

Attention↗
PubMed2000

Pre-extinction of sensory preconditioned electrodermal activity.

In the present study, sensory preconditioning of human electrodermal activity was demonstrated. In the first phase of the experiment, two pairs of neutral pictures of human faces were presented (A/B and C/D) sequentially. In the second phase, one picture of one pair was immediately followed by an electrocutaneous stimulus (B+), and one picture of the other pair was not (D-). In the third phase the other picture of each pair (A and C) was tested. The effect of A and C alone presentations (pre-extinction) between the first and the second phase was investigated. When only those participants that showed reliable B+/D- differentiation were considered, the extinction group did not show stronger conditioned electrodermal activity to A than to C, whereas the control group did. These findings suggest that sensory preconditioning of anticipatory/preparatory responding only occurs when the pre-conditioned stimulus (A) actually predicts the conditioned stimulus (B).

Adult↗
PubMed1999

Attention to chronic pain is dependent upon pain-related fear.

Pain interrupts, distracts, and is difficult to disengage from. In this study, the role of pain-related fear in moderating attentional interference produced by chronic pain was investigated. Forty chronic pain patients completed a list of questionnaires assessing pain severity, pain-related fear (Tampa Scale for Kinesiophobia), and negative affect (Negative Emotionality scale). Attentional interference was measured by a numerical interference test. Multiple regression analysis revealed that the attentional interference was best predicted by the interaction between pain severity and pain-related fear. These results are discussed in terms of how pain-related fear creates a hypervigilance to pain.

Adult↗
PubMed1999

Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability.

There is growing evidence for the idea that in back pain patients, pain-related fear (fear of pain/physical activity/(re)injury) may be more disabling than pain itself. A number of questionnaires have been developed to quantify pain-related fears, including the Fear-Avoidance Beliefs Questionnaire (FABQ), the Tampa Scale for Kinesiophobia (TSK), and the Pain Anxiety Symptoms Scale (PASS). A total of 104 patients, presenting to a rehabilitation center or a comprehensive pain clinic with chronic low back pain were studied in three independent studies aimed at (1) replicating that pain-related fear is more disabling than pain itself (2) investigating the association between pain-related fear and poor behavioral performance and (3) investigating whether pain-related fear measures are better predictors of disability and behavioral performance than measures of general negative affect or general negative pain beliefs (e.g. pain catastrophizing). All three studies showed similar results. Highest correlations were found among the pain-related fear measures and measures of self-reported disability and behavioral performance. Even when controlling for sociodemographics, multiple regression analyses revealed that the subscales of the FABQ and the TSK were superior in predicting self-reported disability and poor behavioral performance. The PASS appeared more strongly associated with pain catastrophizing and negative affect, and was less predictive of pain disability and behavioral performance. Implications for chronic back pain assessment, prevention and treatment are discussed.

Adult↗
PubMed1999

Pain demands attention: a cognitive-affective model of the interruptive function of pain.

Pain interrupts and demands attention. The authors review evidence for how and why this interruption of attention is achieved. The interruptive function of pain depends on the relationship between pain-related characteristics (e.g., the threat value of pain) and the characteristics of the environmental demands (e.g., emotional arousal). A model of the interruptive function of pain is developed that holds that pain is selected for action from within complex affective and motivational environments to urge escape. The implications of this model for research and therapy are outlined with an emphasis on the redefinition of chronic pain as chronic interruption.

Affect↗
PubMed1999

Fear of movement/(re)injury, avoidance and pain disability in chronic low back pain patients.

Chronic pain syndromes such as chronic low back pain are responsible for enormous costs for health care and society. For these conditions a pure biomedical approach often proves insufficient. Numerous studies have shown that there is little direct relationship between pain and disability and suggest that the biopsychosocial approach offers the foundations for a better insight in how pain can become a persistent problem. The main assumption is that pain and pain disability are not only influenced by organic pathology, if found, but also by psychological and social factors. In this contribution, a behavioural analysis of chronic musculoskeletal pain will be discussed, with special attention to the role of pain-related fear in the development and maintenance of chronic pain disability, and the behavioural rehabilitation perspective of chronic pain management.

Avoidance Learning↗
PubMed1998

Neither extended sequential nor simultaneous feature positive training result in modulation of evaluative flavor-flavor conditioning in humans.

In previous attempts to induce Pavlovian modulation of human evaluative flavor-flavor associations, the recurrent finding was that exposure to a Feature Positive (FP) schedule (XA+/A-), in which flavor A was reinforced by the aversive flavor Tween20 if and only if it was accompanied by a feature stimulus X, did not result in the expected X-modulated dislike for target A, but in simple unconditional A-US associations. The first experiment reported here investigated if more extended training results in a shift from simple A-US learning to the development of X-modulated A-US associations. Participants were exposed to a 32-trial, 4-session sequential FP schedule using flavors both for feature and target stimuli. The modulatory and/or excitatory power of the stimuli was assessed after each training session. After initial training, participants again acquired a simple unmodulated target A-US association. Contrary to expectations, the additional training sessions did not result in participants gradually learning the XA+/A- discrimination, but rather seemed to corroborate the already established A-US association. This was true whether or not participants acquired valid explicit knowledge about the conditional X-->(A-US) relation. The second experiment tested the hypothesis that what can be described as conditional flavor preferences may actually be based on a configural learning process. Participants were exposed to a single-session, eight-trial XA+/A- simultaneous discrimination schedule, the parameters of which were selected so as to enhance the probability of configuring XA, while simultaneously making it likely to observe a pattern of evaluations similar to an X-modulated dislike for A (X was less salient than A). Even though there was good evidence that participants noticed flavor X, they again failed to solve the XA+/A- discrimination and most probably acquired an association between the more salient flavor A and the US. The possibility is discussed that evaluative learning, unlike expectancy learning, might ultimately prove not to be subject to modulation.

Adult↗
PubMed1998

Attentional disruption is enhanced by the threat of pain.

Using a primary task paradigm this study investigated whether attentional disruption to a low-intensity electrocutaneous pain stimulus is enhanced by the threat of intense pain. Healthy volunteers (n = 38) performed a tone discrimination task in the presence of two types of distractors (a low-intensity electrocutaneous stimulus and a control stimulus) which they were instructed to ignore. In some trials, tone probes were presented immediately (250 ms) after distractor onset, further on (750 ms) during the distractor, and immediately (250 ms) after distractor offset. In a threat condition half of the participants were informed that a high-intensity painful stimulus would occur. As predicted, those participants who received the threat instructions, displayed a specific larger disruption of task performance immediately after the onset of the low-intensity pain stimulus in comparison with the control group.

Adolescent↗