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Cognitive strategies and social modeling determinants of pain Greenstein, Howard Barry

Abstract

Research and clinical observation implicate cognitive and social influences as critical determinants of pain. The present experiment examined the impact of cognitive coping strategies and social modeling influences upon traditional measures of pain threshold and pain tolerance and Sensory Decision theory indices of sensory discriminability and response bias. Following pain pre-testing via cutaneous electrical stimulation, 60 female undergraduates were trained in one of three classes of cognitive strategies via verbal instruction or instruction by videotaped peer models. During post-assessment, half of each group was exposed to a pain-tolerant peer model. Ten subjects served as no-treatment controls. Analyses of pain threshold and pain tolerance data suggested that cognitive strategies may be potent variables in pain reduction. Directional focus of attention did not appear to be the critical determinant of their efficacy. Training in the use of spontaneously-generated strategies appeared to be as effective as instruction in attention-diversion or sensation-transformation strategies. Videotaped instructional modules appeared to be as viable as training by a therapist. The social modeling procedure enhanced the effects of cognitive strategies. Sensory Decision theory analyses revealed that tolerant modeling reduced discriminability at sensory detection levels, while discriminability effects were not evident at supra-pain-threshold levels. Response bias was not affected by the social influence procedure. No remarkable differences in discriminability or response bias were observed between cognitive strategy groups and no-treatment controls, suggesting that effects of cognitive strategies may be primarily mediated through the motivational-affective dimension of pain. At sensory detection levels, cognitive strategy groups displayed differential discriminability under the two instructional modality conditions, suggesting that cognitive determinants may also affect sensory-discriminative aspects of pain. Cognitive and social influences were shown to have potent impact on pain response. Implications of these findings for theory and clinical practice were discussed.

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