Qigong Training Positively Impacts Both Posture and Mood in Breast Cancer Survivors With Persistent Post-surgical Pain: Support for an Embodied Cognition Paradigm.

Theories of embodied cognition hypothesize interdependencies between psychological well-being and physical posture. The purpose of this study was to assess the feasibility of objectively measuring posture, and to explore the relationship between posture and affect and other patient centered outcomes in breast cancer survivors (BCS) with persistent postsurgical pain (PPSP) over a 12-week course of therapeutic Qigong mind-body training. Twenty-one BCS with PPSP attended group Qigong training. Clinical outcomes were pain, fatigue, self-esteem, anxiety, depression, stress and exercise self-efficacy. Posture outcomes were vertical spine and vertical head angles in the sagittal plane, measured with a 3D motion capture system in three conditions: eyes open (EO), eyes open relaxed (EOR) and eyes closed (EC). Assessments were made before and after the Qigong training. The association between categorical variables (angle and mood) was measured by Cramer's V. In the EO condition, most participants who improved in fatigue and anxiety scales also had better vertical head values. For the EOR condition, a moderate correlation was observed between changes in vertical head angle and changes in fatigue scale. In the EC condition, most of the participants who improved in measures of fatigue also improved vertical head angle. Additionally, pain severity decreased while vertical spine angle improved. These preliminary findings support that emotion and other patient centered outcomes should be considered within an embodied framework, and that Qigong may be a promising intervention for addressing biopsychosocially complex interventions such as PPSP in BCSs.

Affect-biased attention and predictive processing.

In this paper we argue that predictive processing (PP) theory cannot account for the phenomenon of affect-biased attention - prioritized attention to stimuli that are affectively salient because of their associations with reward or punishment. Specifically, the PP hypothesis that selective attention can be analyzed in terms of the optimization of precision expectations cannot accommodate affect-biased attention; affectively salient stimuli can capture our attention even when precision expectations are low. We review the prospects of three recent attempts to accommodate affect with tools internal to PP theory: Miller and Clark's (2018) embodied inference; Seth's (2013) interoceptive inference; and Joffily and Coricelli's (2013) rate of change of free energy. In each case we argue that the account does not resolve the challenge from affect-biased attention. For this reason, we conclude that prediction error minimization is not sufficient to explain all mental phenomena, contrary to the claim that the PP framework provides a unified theory of all mental phenomena or the brain's cognitive functioning. Nevertheless, we suggest that empirical investigation of the interaction between affective salience and precision expectations should prove helpful in understanding the limits of PP theory, and may provide new directions for the application of a Bayesian perspective to perception.