The role of the Amygdala in the perception of reward

This study set out to examine the role of the amygdala in a number of appetitively motivated tasks. Experiment one was a position discrimination task with reversals, which in later reversals involved manipulation of some secondary reinforcers associated with a correct response, and the introduction of a magnitude of reward component. Rats with NMDA-induced amygdala lesions performed at a similar level to shams at the initial discrimination and first three reversals, proceeding to reverse faster than controls in the subsequent three reversals. Manipulation of secondary reinforcers led to an equal and significant decline in performance for both groups, with the lesioned animals retaining their significant superiority in reversal performance. Alteration of the task from a 2 vs 0 pellet discrimination to a 2 vs 1 led to a drastic increase in task difficulty, but both groups completed three reversals and did not differ significantly in performance. Experience of handling the lesioned animals led to the confirmation, in experiment two, that they were significantly more hostile/reactive to handling than shams (using die "blind" ratings of experienced animal handlers). Experiment three attempted to refine die picture of this behavioural change by measuring gross activity levels - no differences between groups were found. The finding of enhanced reversal performance and the absence of a magnitude of reward deficit amongst lesioned animals in experiment one were unanticipated, problematic and demand replication. No strong support was provided for either of the principal contemporary theories of amygdala involvement in secondary reinforcement. Increased reactivity to handling was found to be consistent with a minority of the past literature, and activity levels were as anticipated. It is argued that the notion of "stimulus-reward associations" as an amygdala function is incoherent and unhelpful, and that references to the functions of the amygdale as a whole rather than of subnuclei can be equally misleading

Parental behaviour in paediatric chronic pain: A qualitative observational study

Parental behaviour appears to influence the adjustment of children with chronic pain. However, research in this area has failed to produce consistent evidence. Studies have tended to rely on self-report measures derived from adult pain populations. This qualitative, observational research provides descriptive data of parental behaviour in a clinical environment. A qualitative observational study was made of parents and adolescents in a physically stressful setting. Modified grounded theory was used to analyse verbal and non-verbal behaviours. Eight parent–adolescent dyads seeking treatment for chronic pain were videoed during physical exercise sessions. Verbal and non-verbal behaviours were recorded and transcribed. Four overarching categories emerged: ‘monitoring’, ‘protecting’, ‘encouraging’ and ‘instructing’. These often had both verbal and non-verbal aspects. Within these categories, more precise behavioural groups were also identified. This research identifies categories of parental behaviour that were derived directly from observation, rather than imposed on the basis of results from different populations. Four categories of behaviour were derived, which clarify and extend dimensions used in existing self-report instruments. Careful description of parental behaviours showed features that past research has neglected, and highlighted potential drawbacks of apparently positive parental actions

The cognitive and motor deficits of Parkinson's disease.

Deficits of attentional and motor set that are seen in patients with PD were investigated in the research reported in this thesis. A deficit of attentional set is a failure of selective attention to one aspect of a complex stimulus. Deficits of motor set manifest as an inability to form a state of motor 'readiness' that can speed movement initiation. Attentional set was investigated with tasks that require patients to shift attention between perceptual dimensions (extradimensional - ED - shifting tasks), and motor set was studied using reaction time (RT) tasks. Study 1 rejected the hypothesis that the mechanism of 'learned irrelevance' causes ED shift deficits in patients with PD. Studies 2 and 3 confirmed that learned irrelevance also plays no role in determining the difficulty of ED shifts in healthy subjects. The experimental manipulation used in Study 4 succeeded in creating changes in scores that resembled those seen in patients with PD. Thus, it appears that patients with PD may have a deficit similar to that induced by the experimental manipulation - that is, an inability to attend to all dimensions present when hypothesis testing after an ED shift. A quantitative analysis of past RT studies of PD showed that the ability to speed movement initiation when given advance information about an upcoming movement - a form of motor set - is intact in patients with PD. In contrast, the motor set that underlies rapid simple RT performance is consistently dysfunctional in patients with PD. Study 5 investigated temporal and spatial motor set in PD, finding that these two mechanisms are functionally separate and that temporal motor set is intact in PD. A final study (Study 6) investigated the cognitive consequences of a novel neurosurgical treatment for PD, finding it to be largely a neuropsychologically 'safe' procedure

Pain acceptance in adolescents: Development of a short form of the CPAQ-A

© 2018 The Author(s). Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. Objective: Acceptance of pain is a predictor of pain-related disability and treatment outcome in adolescents with pain. This variable has been previously measured using the Chronic Pain Acceptance Questionnaire for Adolescents (CPAQ-A, McCracken, Gauntlett-Gilbert, & Eccleston, European Journal of Pain, 14, 316-320, 2010). We set out to create a short, eight-item, form of this instrument that retained its factor structure and clinical utility. Methods: We used data collected from two independent samples of adolescents attending residential treatment for disabling chronic pain (N = 187 and N = 159). Both groups completed the 20-item CPAQ-A and indices of functioning and distress. We carried out item reduction and confirmatory factor analysis (CFA) on the first sample, repeating this on the second sample and examining the new scale's correlations with clinically relevant variables. Results: An eight-item scale was created with four items assigned to each established factor (Pain Willingness and Activity Engagement). CFA confirmed this factor structure and it replicated in Sample 2. The new scale (the CPAQ-A8) was sensitive to treatment and correlated as well with clinically important variables as its full-length version. Some items in the new scale differed from the adult CPAQ-8. Conclusions: Measures of pain acceptance have been previously developed and validated in pediatric and adult samples. This study showed that pain acceptance can be indexed by a brief, yet factorially valid, short form of the CPAQ-A that uses fewer than 50% of the items of the full-length scale and has demonstrated acceptable validity and sensitivity-to-treatment

Acceptance of shame and embarrassment:Scale development and initial findings in a clinical sample

Objectives: The ability to accept painful feelings is associated with decreased distress and better functioning. We set out to design an instrument that specifically measures acceptance of shame and embarrassment, as this may be important for the social functioning and mood of people with chronic conditions. Methods: An item set was presented to 415 non-clinical adults and to 200 people with chronic pain. Item and factor analysis were used in the creation of an instrument; the reliability and validity of this instrument were examined. Regression analysis was used to examine the ability of this instrument to predict social functioning and mood in the clinical group. Results: A 17-item unifactorial instrument was created that had good psychometric properties in both groups (theAcceptanceofShameandEmbarrassment Scale,ASES).Itcorrelatedwithothermeasuresofacceptance, and of social discomfort. It had specific predictive power in the prediction of social functioning and mood in the clinical group. Conclusions: The ASES is a reliable and valid instrument measuring the ability to accept shame and embarrassment. This ability is associated with better social functioning and mood in people with chronic pain; this form of acceptance should be targeted in treatment

Acceptance of shame and embarrassment:Scale development and initial findings in a clinical sample

Objectives: The ability to accept painful feelings is associated with decreased distress and better functioning. We set out to design an instrument that specifically measures acceptance of shame and embarrassment, as this may be important for the social functioning and mood of people with chronic conditions. Methods: An item set was presented to 415 non-clinical adults and to 200 people with chronic pain. Item and factor analysis were used in the creation of an instrument; the reliability and validity of this instrument were examined. Regression analysis was used to examine the ability of this instrument to predict social functioning and mood in the clinical group. Results: A 17-item unifactorial instrument was created that had good psychometric properties in both groups (theAcceptanceofShameandEmbarrassment Scale,ASES).Itcorrelatedwithothermeasuresofacceptance, and of social discomfort. It had specific predictive power in the prediction of social functioning and mood in the clinical group. Conclusions: The ASES is a reliable and valid instrument measuring the ability to accept shame and embarrassment. This ability is associated with better social functioning and mood in people with chronic pain; this form of acceptance should be targeted in treatment

MY-PAIN-ID: Development and preliminary validation of a measure to assess identity development of young adults with chronic pai

Young adults living with chronic pain face unique developmental challenges that can disrupt identity formation, a key psychosocial milestone during this life stage. Despite the known relevance of identity to psychological well-being, treatment adherence, and quality of life, no psychometrically robust identity measures currently exist that are tailored to this population. Existing tools are often adapted from normative developmental contexts, lacking both content validity and relevance to lived experiences of chronic pain. The current study aims to develop a condition-specific and age-appropriate measure of identity for young adults aged 16–24 living with chronic pain. The study will proceed in three phases: 1) Item generation through expert and lived experience review and literature synthesis; 2) Conducting cognitive interviews with individuals with lived experience to refine item clarity, relevance, and comprehensiveness; and 3) Field testing to examine psychometric properties. This study aims to produce a clinically useful identity measure, enabling more accurate assessment of identity-related challenges and informing the development of targeted psychosocial interventions for young adults with chronic pain