Tobacco smoking has been associated with the development, protraction, and exacerbation of chronically painful conditions. Conversely, there is reason to believe that smokers may be motivated to use tobacco as a means of coping with their pain. To date, no controlled, experimental studies have tested for a causal relationship between pain and smoking motivation. The primary aim of the current study was to test the hypothesis that laboratory-induced cold-pressor pain would enhance smoking motivation, as measured by self-reported urge to smoke and observation of immediate smoking behavior. The effect of a smoking cue was also tested. Smokers (n = 132) were randomly assigned to one of four conditions in this 2 (Pain Manipulation) X 2 (Smoking Cue Manipulation) crossed factorial between-subjects design. Results indicated that both pain induction and the presence of smoking cues increased urge ratings, and pain induction also produced a shorter latency to smoke. The relationship between pain and increased urge to smoke was partially mediated by pain-induced negative affect. This study provides the first experimental evidence that situational pain can be a potent motivator of smoking.

The current study utilized an early-stage translational approach (Tashiro & Mortensen, 2006) to empirically test the immediate effect of a 15-minute mindfulness intervention on acute pain experience. The study employed a three-group, repeated measures experimental design with two active control conditions (sham mindfulness and attention control) and an analogue pain induction procedure (cold-pressor test). The sample consisted of 165 university students. Repeated measures analyses found an interaction effect between condition and time for subjective pain intensity and an interaction effect between gender and time for pain tolerance. Trends show that attention control increased pain intensity, whereas mindfulness decreased pain intensity. Females exhibited greater pain tolerance at post-intervention across conditions. Analyses yielded no significant differences between conditions among dependent variables of pain tolerance, state affect, or state anxiety. A moderate relationship was found between fear of pain and pain tolerance at pre-intervention, but failed to significantly moderate outcome in main analyses. Post-hoc analyses revealed a subset of "high pain tolerant" participants, who endorsed significantly higher trait mindfulness, lower fear of pain, and lower pain catastrophizing compared to the remainder of participants. Negative affect was related to increased pain intensity within the attention control condition. Suggestions for future research and clinical implications of research in this area are discussed.

This study compared the relative efficacy of four imagery techniques in increasing tolerance to cold pressor pain. Relevant pleasant, relevant unpleasant, irrelevant pleasant, and irrelevant unpleasant imagery strategies were compared in a two-way factorial design. Prior research suggested that pleasantness and relevance both affect imagery potency. This study attempted to assess the relative contribution of these two variables to increases in pain tolerance. Also investigated were the roles of several hypothesized mediating variables; namely, contextual valence, self-efficacy, treatment credibility, and involvement in imagery. The subjects were 60 female undergraduates who were randomly assigned to the four imagery groups. Two-way analysis of covariance were performed on all dependent variables, using pain threshold as the covariate. Pearons r.'s were used to test correlational hypotheses.

The first part of the thesis explored the pattern of emotional reactivity amongst individuals with Borderline Personality Disorder (BPD). A previous review (Rosenthal, Gratz, Kosson, Cheavens, Lejuez & Lynch, 2008) claimed that a discrepancy exists in the subjective versus objective patterns of responding to emotional stimuli in those with BPD. The present review assessed the reliability of such findings by reviewing a more homogenous sample of studies that had used similar methodological procedures, in addition to a range of subjective and objective measures. It also aimed to investigate psychophysiological factors associated with this proposed divergent pattern of responding. The methodological quality of all included studies was assessed. The evidence reviewed disputes claims that BPD individuals display diminished physiological reactivity, despite equal or higher self-reported emotional reactivity than controls. Instead, the present review found that individuals with BPD react more severely (both psychologically and physiologically) to experimental stimuli, than controls, particularly when the stimuli is personally-relevant. Disruption of specific brain structures involved in the regulation of emotion within the Autonomic Nervous System (ANS) are implicated in this heightened profile of emotional reactivity. Furthermore, present state dissociation acts as a defence mechanism which appears to limit cognitive processing abilities such as problem-solving, attention and concentration in those with BPD. The second part of the thesis described a randomised controlled study investigating the effects of an attention training technique on pain tolerance. The Attention Training Technique (ATT; Wells, 1990) is a brief technique used in metacognitive therapy to modify attentional control. The effect of ATT versus Progressive Muscular Relaxation (PMR) on pain tolerance was examined in a sample of individuals who had experienced early childhood trauma (N=57). Participants were randomly assigned to either the ATT condition (N = 29) or the PMR condition (N = 28). A laboratory stressor was included: The Cold Pressor Task (CPT) as an objective measure of pain tolerance. Results supported the hypothesis that ATT modified performance on the CPT. Individuals assigned to the ATT condition were able to persist significantly longer with the CPT than those in the PMR condition. Theoretical and clinical implications of the findings are discussed. Results provide preliminary evidence for the possible benefits of ATT within medical settings. The third part of the thesis critically reflected on the methodological issues and dilemmas presented by the systematic review process, as well as the methodological and ethical issues raised by the research study.

No description available.

No description available.

The present study investigated the impact of certain and uncertain socialinformation on pain perception and memory. We hypothesized that theuncertain feedback group would experience higher pain intensity. Further, thatthe uncertain group would remember fewer pictures than the certain group.Participants were 42 undergraduate students from a medium-sized universityin Sweden who received, depending on group assignment, either certain oruncertain feedback about the pain intensity in the upcoming cold-pressor test.Following feedback, the participants performed two categorization tasksduring which they had to indicate whether the picture showed a living thing oran object. During the second task they also had to perform the cold-pressortest. Thirty minutes after the cold-pressor test participants performed asurprise recall test with regard to the pictures presented during thecategorization tasks. The two groups did not differ in self-reported uncertaintyabout their expectation of pain during the cold-pressor test but the uncertainfeedback group expected the cold-pressor test to be more painful than thecertain feedback group. We found no differences between the groups in eitherperception or recall. Finally, recall was impaired for pictures presentedduring the cold-pressor test, independent of group. In sum, our hypotheseswere not supported. Suggestion for future research is to manipulate thefeedback in another way to make it clearer for the participants. / Den aktuella studien utredde betydelsen av osäker och säker socialinformation för smärtintensitet och minne. Studiens hypotes var att den osäkragruppen skulle uppleva högre smärtintensitet och att den osäkra gruppenskulle komma ihåg mindre bilder än den grupp som fick säker information.Deltagarna var 42 studenter på ett medelstort universitet i Sverige, beroendepå vilken grupp de hamnade i fick de antingen osäker eller säker socialinformation om smärtintensiteten på det kommande kallvattentestet. Efter densociala informationen utfördes två kategoriseringsuppgifter där de skulle angeom en bild föreställde något levande eller ett objekt, både före och underkallvattentestet, med ett överraskande minnestest 30 minuter efterkallvattentestet på de bilder som visades under kategoriseringsuppgiften. Detvar ingen skillnad på grupperna i osäkerheten om deras förväntan avkallvattentestet. Däremot förväntade sig den gruppen som fick osäkerinformation att kallvattentestet skulle vara smärtsammare än de som fick densäkra informationen. Vi hittade ingen skillnad mellan grupperna i varkensmärtupplevelsen eller minnet. Till sist, minnet försämrades för bilderna sompresenterades under kallvattentestet, oberoende av vilken grupptillhörighetdeltagarna hade. För att summera så stöddes ingen av våra hypoteser. Förslagför kommande forskning är att manipulera hur den sociala informationen gesför att göra det mer tydligt för deltagarna.

Intolerance of uncertainty concerns how one views and reacts touncertainty, where one who’s highly intolerant would find it verydiscomforting when confronted with uncertain situations. The purposeof this study was to examine the associations between intolerance ofuncertainty, pain catastrophizing, emotion regulation andpsychopathic traits. These variables were to be examined in thecontext of a Beads Task and a Cold Pressor Test (CPT). Wehypothesized that there would be a positive significant associationbetween intolerance of uncertainty, pain catastrophizing, emotionregulation, psychopathic traits. We also hypothesized that there wouldbe a difference depending on the difficulty of the Beads Task. To doso, data was collected from 60 university students (32 females and 28males). The results showed that there was a significant, positiveassociation between intolerance of uncertainty, pain catastrophizing,emotion regulation and the Beads Task measurements. Some of theseresults were similar to previous studies. / Intolerans mot osäkerhet berör hur en person uppfattar och reagerarpå osäkerhet, där någon som är intolerant upplever osäkra situationersom obehagliga. Syftet med denna studie var att undersökaassociationerna mellan intolerans mot osäkerhet,smärtkatastrofiering, känsloreglering och psykopatiskapersonlighetsdrag. Dessa variabler undersöktes i sammanhang medBeads Task och ett Kallvattentest. Där några av hypoteserna var attdet finns positiva signifikanta associationer mellan intolerans motosäkerhet, smärtkatastrofiering, känsloreglering och psykopatiskapersonlighetsdrag. Vi hade också en hypotes att det kommer finnas enskillnad beroende på svårighetsgraden av Beads Task. För att göradetta samlades data in från 60 universitetsstudenter (32 kvinnor och28 män). Resultaten visade på en signifikant, positiv associationmellan intolerans mot osäkerhet, smärtkatastrofiering,känsloreglering och Beads Task-måtten. Några av dessa resultat varlikt de i tidigare studier.

Abstract The aim of the present study was to describe the effects of different types of cold exposures on blood pressure (BP) and heart rate (HR) and to test how these cold-induced effects are modulated by antihypertensive drugs representing different kind of mechanisms of action. The tested drugs represented the following antihypertensive drug subgroups: metoprolol from beta-blocking agents, carvedilol from alfa- and beta-blocking agents, lisinopril from angiotensin converting enzyme inhibitors, eprosartan from angiotensin II antagonists, amlodipine from calcium channel blockers and hydrochlorothiazide from diuretics. The main outcome measures were the levels and changes in systolic (SBP) and diastolic blood pressure (DBP) and HR before, during and after cold exposure. The normotensive and mildly hypertensive subjects were exposed either to –15°C for 15 minutes (with winter clothing), 5°C for 45 minutes (minimal clothing) or to a cold pressor test (CPT). Before measurements at –15°C, metoprolol, carvedilol, lisinopril, eprosartan, hydrochlorothiazide or placebo were given for a week in a double-blind and crossover manner. In one test procedure (5°C and CPT) the test subjects ingested amlodipine for three days or were without drug ingestion before the tests in a crossover manner. Both SBP and DBP were markedly increased by all types of cold exposure. Cold-induced rises of SBP/DBP were higher during the exposure to 5°C and –15°C (19–35/20–24 mmHg) than during CPT (13/16 mmHg). Metoprolol, carvedilol, lisinopril, eprosartan and amlodipine decreased the level of BP during the exposure to 5°C and –15°C compared to placebo or no drug. The antihypertensive drugs, with dosages used in this study, did not affect the cold-induced rise of BP compared to no drug or placebo. HR increased during CPT, but decreased during exposure to 5°C and –15°C. Metoprolol and carvedilol decreased HR during exposure to –15°C compared to placebo. The present study demonstrates for the first time the effects of antihypertensive drugs on BP in hypertensive subjects exposed to cold similar to normal outdoor exposure in winter. Although the magnitude of the cold-induced rise in BP was not affected by the drugs, the drug-induced decrease in the level of BP kept the peak values in the cold closer to the recommended threshold limit values. / Tiivistelmä Tutkimuksen tarkoituksena oli selvittää eri mekanismeilla vaikuttavien verenpainelääkkeiden vaikutusta verenpainevasteisiin ja sydämen lyöntitiheyteen kylmässä sekä verrata erilaisten kylmäaltistusten vaikutusta verenpaineeseen ja sydämen lyöntitiheyteen. Tutkitut lääkkeet edustivat seuraavia verenpainelääkeryhmiä: metoprololi beetasalpaajia, karvediloli yhdistettyjä alfa- ja beetasalpaajia, lisinopriili ACE-estäjiä, eprosartaani angiotensiini II antagonisteja, amlodipiini kalsiumestäjiä ja hydroklooritiatsidi diureetteja. Tärkeimmät mitatut vasteet olivat systolisen ja diastolisen verenpaineen ja sydämen lyöntitiheyden tasot ja muutokset ennen kylmäaltistusta, kylmäaltistuksen aikana ja sen jälkeen. Lisäksi mitattiin lämpötilavasteita ja tuntemuksia. Normo- ja hypertensiiviset koehenkilöt altistettiin joko –15°C:seen 15 minuutin ajaksi (talvivaatetuksessa), 5°C:seen 45 minuutin ajaksi (minimaalisella vaatetuksella) tai tehtiin ns. käden kylmävesitesti (CPT). Testisarjoissa (–15°C) metoprololi, karvediloli, lisinopriili, eprosartaani ja hydroklooritiatsidi tai plasebo annettiin viikon ajan kaksoissokko- ja vaihtovuoromenetelmällä. Yhdessä testisarjassa (5°C ja CPT) koehenkilöt ottivat amlodipiinia 3 päivän ajan tai olivat ilman lääkettä ennen testikertoja vaihtovuoroisessa järjestyksessä. Kaikki kylmäaltistustyypit nostivat merkittävästi sekä systolista että diastolista verenpainetta. Systolisen ja diastolisen verenpaineen nousu oli korkeampi koko kehon kylmäaltistuksissa (5°C tai –15°C) (19–35/20–24 mmHg) kuin ns. kylmävesitestissä (13/16 mmHg). Metoprololi, karvediloli, lisinopriili, eprosartaani ja amlodipiini laskivat verenpaineen tasoja koko kehon kylmäaltistuksessa verrattuna plaseboon. Yksikään verenpainelääkkeistä ei vaikuttanut merkittävästi kylmän aiheuttamaan verenpaineen nousuun verrattuna tutkimuskertaan ilman lääkettä tai plaseboon. Sydämen lyöntitiheys nousi ns. kylmävesitestin aikana, mutta laski koko kehon kylmäaltistuksissa (5°C ja –15°C). Metoprololi ja karvediloli laskivat sydämen lyöntiheyttä kylmäaltistuksessa (–15°C) verrattuna plaseboon. Tämä tutkimus kuvaa ensimmäistä kertaa, kuinka verenpainelääkkeet vaikuttavat verenpainetasoihin ja -vasteisiin kylmäaltistuksessa, joka simuloi tyypillisiä ulko-olosuhteita talvella. Vaikka lääkkeet eivät estäneet kylmän aiheuttamaa verenpaineen nousua, ne laskivat verenpaineen tasoa, jolloin verenpaine pysyi kylmässäkin lähempänä suositusrajoja.

Abstract The purpose of this study was to find out and compare the physiological effects of different types of non-hypothermic cold exposure tests in man. In whole-body cold exposures lightly clothed subjects were exposed to 10°C for 2 hours (single exposure), as well as repeatidly for 2 h and 1 h on ten successive days in separate studies. For local cold exposures, cold pressor tests (immersion into ice-cold water) of both hands and both feet were used. In whole-body cold exposures, several hormonal and metabolic parameters as well as cold sensations were measured. In local cold exposures the measured parameters were blood pressure, heart rate and skin temperatures. The single 2-h whole-body cold air exposure decreased rectal and skin temperatures and body heat content, but increased the metabolic rate. At the same time the serum noradrenaline concentration increased indicating a general activation of the sympathetic nervous system. Serum free fatty acid concentration increased whereas cortisol, GH and prolactin concentrations fell. No significant changes were found in serum concentrations of adrenalin, TSH, T3, T4, testosterone or LH. Serum total proteins were enhanced apparently due to cold-induced hemoconcentration. After repeating the 2-h whole-body cold exposure for five days the increase in serum noradrenaline level was markedly lower in the cold. At the same time hemoconcentration, judged from serum protein concentrations, was attenuated and the subjects became habituated to the cold sensations. However, the results showed that the repeated 1-h cold exposure in 10°C was not sufficiently intensive to reduce the noradrenaline response. Comparison of the hand and foot cold pressor tests to whole-body cold exposure tests showed that all tests caused significant increases in systolic and diastolic blood pressures, but that heart rate increased significantly only in the cold pressor test of feet. During the 2-h cold air exposure the heart rate fell. This caused a reduction in rate pressure product (RPP, the product of heart rate and systolic blood pressure). In both cold pressor tests the rate pressure product increased, indicating the enhancement of the O2-need in the heart muscle. The results showed no significant correlation in systolic or diastolic blood pressures between whole-body and local cooling of hands or feet. The lack of the association between local and whole-body cold exposure tests may be due to differences in severity and site of the tests: whole-body cold exposure tests cause general cold discomfort while cold pressor tests cause local cold pain. / Tiivistelmä Tämän tutkimuksen tarkoituksena oli selvittää ja verrata eri tyyppisten lievien kylmäaltistustestien fysiologisia vaikutuksia ihmiseen. Yksittäisessä koko kehon kylmäaltistuksessa koehenkilöt olivat kevyesti vaatetettuina kahden tunnin ajan 10°C:n lämpötilassa. Toistetussa koko kehon kylmäaltistuksessa koehenkilöt oleskelivat myös 10°C:n lämpötilassa kahden tai yhden tunnin ajan kymmenenä perättäisenä päivänä. Paikallisessa kylmäaltistuksessa käytettiin kylmävesitestiä (ns. cold pressor koe). Testi tehtiin sekä käsille että jaloille. Koko kehon kylmäaltistuksessa mitattiin useita hormonaalisia, aineenvaihdunnan ja lämpötasapainon vasteita, sekä verenpainetta ja sydämen syketiheyttä. Paikallisissa kylmäaltistuksissa mitattiin verenpainetta, sydämen syketiheyttä ja iholämpötiloja. Yksittäinen koko kehon kahden tunnin kylmäaltistus laski syvälämpötilaa, iholämpötiloja ja kehon lämpösisältöä. Samanaikaisesti kehon lämmöntuotanto kasvoi. Seerumin noradrenaliinipitoisuus lisääntyi ilmentäen sympaattisen hermoston tehostunutta aktivoitumista. Seerumin vapaiden rasvahappojen pitoisuus kasvoi, samoin kokonaisproteiinipitoisuus, mutta kasvuhormonin, kortisolin ja prolaktiinin osalta todettiin pitoisuuksien vähenemistä. Merkitseviä muutoksia ei tapahtunut seerumin adrenaliinissa, TSH:ssa, T3:ssa, T4:ssä, testosteronissa tai LH:ssa. Toistetussa kahden tunnin pituisessa kylmäaltistuksessa seerumin noradrenaliinipitoisuudessa tapahtunut kasvu oli merkitsevästi vähäisempää viiden päivän jälkeen. Samanaikaisesti seerumin proteiinipitoisuus kylmässä väheni ja kylmätuntemukset muuttuivat lievemmiksi. Sen sijaan yhden tunnin toistettu altistus 10°C:ssa ei ollut riittävän voimakas vähentämään kylmän aiheuttamaa veren noradrenaliinipitoisuuden kasvua. Verenpaineen ja sydämen syketiheyden reaktioita verrattiin samoilla koehenkilöillä yksittäisessä kahden tunnin koko kehon kylmäaltistuksessa ja kylmävesitesteissä. Kaikki nämä testit kohottivat merkitsevästi systolista ja diastolista verenpainetta. Sydämen syketiheys laski koko kehon kylmäaltistuksessa. Jalkojen kylmävesitestissä sydämen syketiheys nousi merkitsevästi, mutta käsien testissä tämä nousu ei ollut merkitsevä. Verenpaineen nousu koko kehon kylmäaltistuksessa ei korreloinut merkitsevästi paikallisissa kylmäaltistuksissa mitattuihin verenpaineen nousuihin. Selittävänä tekijänä tähän lienee näiden kylmäaltistusmuotojen erilaisuus. Lievä koko kehon kylmäaltistus aiheuttaa yleistä epämiellyttävyyttä, kun taas äkilliseen, nopean iholämpötilan laskun aiheuttamaan paikalliseen kylmäaltistukseen liittyy usein kiputuntemuksia.