Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


31st Annual Convention; Chicago, IL; 2005

Event Details

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Symposium #171
Implications and Outcomes of Acceptance in Relation to Acute and Chronic Pain Behavior
Sunday, May 29, 2005
10:30 AM–11:50 AM
Private Dining Room 1 (3rd floor)
Area: CBM; Domain: Applied Research
Chair: Ann Branstetter-Rost (Southwest Missouri State University)
Abstract: This symposium presents a chronicological review of the usefulness of acceptance based interventions in the treatment of pain. The first presentation will present data comparing the effects of two instructional sets (distraction versus focused attention) on acute pain tolerance. The second presenter will provide data illustrating the efficacy of a CBT intervention as compared to an acceptance intervention in acute pain tolerance. The third and forth presenters will discuss data using CBT and acceptance interventions for individuals with chronic pain conditions.
Focused Attention Versus Thought Suppression in Avoidant Pain Behavior
CHRIS S. LORANCE (Southwest Missouri State University), Mikaela J. Hildebrandt (Southwest Missouri State University), Beth McCorkle (Southwest Missouri State University)
Abstract: Active thought suppression of aversive content has been shown to correspond with increased anxiety, heart rate, and galvanic skin response. Active thought suppression of current aversive sensory experiences (i.e. pain) however, has been related to improved coping with pain, and greater pain tolerance. Similarly, focused attention upon a painful stimulus has also been shown to be related to increased pain tolerance. The current study seeks to investigate which technique (focused attention or thought suppression) works most effectively to increase pain tolerance. In a counterbalanced design, four subjects completed the cold pressor task two times. During time one they were instructed to focus their attention on the feelings and sensations in their hand. At time two, participants were instructed to think about anything other than the sensations in their hand. Results indicate that the focused attention instructions yielded higher pain tolerance (as measured by time in ice water) as compared to thought suppression. This indicates that for brief, acute pain, it may be more beneficial to focus on the pain rather than engage in imagery or other distraction type tasks.
Comparing Standard Care and ACT: Acute Pain Tolerance and Subjective Ratings
MIKAELA J. HILDEBRANDT (Southwest Missouri State University), Chris S. Lorance (Southwest Missouri State University), Beth McCorkle (Southwest Missouri State University), Tanya N. Kimbrough (Southwest Missouri State University), Ann Branstetter-Rost (Southwest Missouri State University)
Abstract: Pain management strategies often encourage individuals to cope with pain by purposefully diverting their attention to something more pleasant. However, when investigated in the context of acute laboratory pain, this strategy demonstrates limitations. Specifically, individuals who engage in distraction techniques during a cold pressor task report increases in psychological distress as the pain endures (McCaul & Haugtvedt, 1982). Studies comparing the efficacy of distraction techniques to acceptance-based interventions in acute laboratory settings report that individuals who employed acceptance strategies to a cold pressor task demonstrated significant increases in pain tolerance when compared to those who utilized distraction (Hayes et al., 1999). The current study compares two interventions, an acceptance based training and a standard care, distraction training on pain tolerance using the cold pressor task. Results indicate that individuals in the acceptance condition demonstrated significantly greater increases in pain tolerance as compared to the standard care condition. There was not a significant group difference, however, in subjective ratings of pain severity.
Comparison of Treatment Outcomes for Individuals with Recurrent Headache: Does ACT Offer More Than Standard Care Interventions?
MIKAELA J. HILDEBRANDT (Southwest Missouri State University), Chris S. Lorance (Southwest Missouri State University), Beth McCorkle (Southwest Missouri State University), Scott Hemphill (Southwest Missouri State University), Shelly K. Muckey (Southwest Missouri State University), Ann Branstetter-Rost (Southwest Missouri State University)
Abstract: Research suggests that individuals with recurrent headache (HA) may respond to noxious stimulation differently than individuals who do not report a history of chronic pain. Specifically, individuals with chronic HA who report engaging in escape or avoidant behavior more frequently are less tolerant of acute laboratory pain (Bishop, Holm, Borowiak, & Wilson, 2001). Additional findings suggest that HA patients also rate the noxious stimulation as more painful than normal controls (Hassinger, Semenchuk, & O’Brien,1999). The current study investigates the efficacy of two different psychological pain interventions (ACT and CBT) with individuals who report suffering from recurrent HA in the context of acute laboratory pain. Outcomes from the current study indicate that participants increased pain tolerance and decreased reported subjective pain ratings following both the acceptance based intervention and distraction intervention. Further studies need to investigate the efficacy of pain interventions in a broader context.
Efficacy of ACT in Rehabilitation for Patients with Chronic Pain Conditions
RIKARD K. WICKSELL (Astrid Lindgren Children's Hospital), Josefin Ahlqvist (Astrid Lindgren Children's Hospital), Gunnar Olsson (Astrid Lindgren Children's Hospital), Melin Lennard (Uppsala University, Sweden)
Abstract: Chronic pain with an unclear origin is common in adults as well as children. Pharmacological therapies and cognitive behavior therapy have generally focused on reducing pain and have mixed reports of success. In this study we apply the ACT approach in a rehabilitation program for children. In a case series of 15 individuals, substantial improvement in functioning was reported following the ACT intervention. Results will be further examined using a randomized controlled trial.



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