The physiological and emotional effects of touch: Assessing a hand-massage intervention with high self-critics.

Research demonstrates that highly self-critical individuals can respond negatively to the initial introduction of a range of therapeutic interventions. Yet touch as a form of therapeutic intervention in self-critical individuals has received limited prior investigation, despite documentation of its beneficial effects for well-being. Using the Forms of Self-Criticism/Self-Reassuring Scale, 15 high- and 14 low- self-critical individuals (from a sample of 139 females) were recruited to assess how self-criticism impacts upon a single instance of focused touch. All participants took part in a hand massage- and haptic control- intervention. Salivary cortisol and alpha amylase, as well as questionnaire measures of emotional responding were taken before and after the interventions. Following hand massage, analyses revealed cortisol decreased significantly across all participants; and that significant changes in emotional responding reflected well-being improvements across all participants. Supplementary analyses further revealed decreased alpha amylase responding to hand massage as compared to a compassion-focused intervention in the same (highly self-critical) individuals. Taken together, the physiological and emotional data indicate high self-critical individuals responded in a comparable manner to low self-critical individuals to a single instance of hand massage. This highlights that focused touch may be beneficial when first engaging highly self-critical individuals with specific interventions.

Do therapeutic imagery practices affect physiological and emotional indicators of threat in high self-critics?

OBJECTIVES: Imagery is known to be a powerful means of stimulating various physiological processes and is increasingly used within standard psychological therapies. Compassion-focused imagery (CFI) has been used to stimulate affiliative emotion in people with mental health problems. However, evidence suggests that self-critical individuals may have particular difficulties in this domain with single trials. The aim of the present study was to further investigate the role of self-criticism in responsiveness to CFI by specifically pre-selecting participants based on trait self-criticism. DESIGN: Using the Forms of Self-Criticism/Self-Reassuring Scale, 29 individuals from a total sample of 139 were pre-selected to determine how self-criticism impacts upon an initial instance of imagery. METHODS: All participants took part in three activities: a control imagery intervention (useable data N = 25), a standard CFI intervention (useable data N = 25), and a non-intervention control (useable data N = 24). Physiological measurements (alpha amylase) as well as questionnaire measures of emotional responding (i.e., the Positive and Negative Affect Schedule, the Types of Positive Affect Scale, and the State Adult Attachment Scale) were taken before and after the different interventions. RESULTS: Following both imagery interventions, repeated measures analyses revealed that alpha amylase increased significantly for high self-critics compared with low self-critics. High self-critics (HSC) also reported greater insecurity on entering the imagery session and more negative CFI experiences compared with low self-critics. CONCLUSIONS: Data demonstrate that HSC respond negatively to imagery interventions in a single trial. This highlights that imagery focused therapies (e.g., CFI) need interventions that manage fears, blocks, and resistances to the techniques, particularly in HSC. PRACTITIONER POINTS: An initial instance of imagery (e.g., CFI) can be frightening for people who have a tendency to be self-critical. This research provides examples of physiological and emotional responses to imagery type therapies in high and low self-critics, and associated clinical implications. Therapists may find it helpful to be mindful that when introducing imagery based therapies, highly self-critical patients need interventions that manage fears, blocks, and resistances to the techniques.

Predictors of painkiller dependence among people with pain in the general population.

OBJECTIVES: Self-medication with painkillers is widespread and increasing, and evidence about influences on painkiller dependence is needed to inform efforts to prevent and treat problem painkiller use. DESIGN: Online questionnaire survey. PARTICIPANTS: People in the general population who had pain and used painkillers in the last month (N = 112). MEASUREMENTS: Pain frequency and intensity, use of over-the-counter and prescription painkillers, risk of substance abuse (Screener and Opioid Assessment for Patients with Pain [SOAPP] scale), depression, anxiety, stress, alexithymia, pain catastrophizing, pain anxiety, pain self-efficacy, pain acceptance, mindfulness, self-compassion, and painkiller dependence (Leeds Dependence Questionnaire). RESULTS: In multiple regression, the independent predictors of painkiller dependence were prescription painkiller use (ß 0.21), SOAPP score (ß 0.31), and pain acceptance (ß -0.29). Prescription painkiller use mediated the influence of pain intensity. Alexithymia, anxiety, and pain acceptance all moderated the influence of pain. CONCLUSIONS: The people most at risk of developing painkiller dependence are those who use prescription painkillers more frequently, who have a prior history of substance-related problems more generally, and who are less accepting of pain. Based on these findings, a preliminary model is presented with three types of influence on the development of painkiller dependence: 1) pain leading to painkiller use, 2) risk factors for substance-related problems irrespective of pain, and 3) psychological factors related to pain. The model could guide further research among the general population and high-risk groups, and acceptance-based interventions could be adapted and evaluated as methods to prevent and treat painkiller dependence.