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1.
Front Digit Health ; 4: 866119, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35712230

RESUMEN

Accumulating evidence supports the use of virtual reality (VR) as an effective pain and anxiety management tool for pediatric patients during specific medical procedures in dedicated patient groups. However, VR is still not widely adopted in everyday clinical practice. Feasibility and acceptability measures of clinicians' experiences are often missing in studies, thereby omitting an important stakeholder in VR use in a clinical setting. Therefore, the aim of this mixed-methods study was to investigate the feasibility, acceptability, tolerability (primary outcomes), and preliminary effectiveness (secondary outcome) of Relaxation-VR in both pediatric patients aged 4-16 years and clinicians. Relaxation-VR is a VR application prototype aimed to provide distraction and relaxation for a variety of patient populations and procedures and is used to reduce anxiety, stress (tension) and pain for children in hospital. Multiple measures of acceptability, feasibility and tolerability, and pre-to-post changes in measures of pain, anxiety, stress and happiness were assessed in pediatric patients. At the end of the study, acceptability and feasibility of VR use was assessed in clinicians. Results indicate that VR use (in particular, the Relaxation-VR prototype) for both distraction and relaxation is acceptable, feasible and tolerable for a variety of pediatric patients aged 4-16 years, as assessed in both patients and clinicians, and can reduce anxiety, pain and tension (stress), and increase happiness in a hospital setting.

2.
Psychol Res ; 85(4): 1801-1813, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32333107

RESUMEN

Studies of perceptual generalization have recently demonstrated a close relationship between stimulus perception and conditioned responding, suggesting that incorrect stimulus perception might account for certain characteristics of generalization gradients. In this study, we investigated whether common phenomena, such as the area and peak shift in conditioned responding, relate to perceptual errors. After a differential conditioning procedure, in which one circle was paired with the presentation of an aversive picture whereas a different-sized circle was not, we combined a generalization test with a three-alternative forced-choice perceptual categorization task where participants had to indicate on every trial whether the presented circle was one of the two circles from the conditioning phase or a different one, after which US-expectancy ratings were collected. The typical peak and area shift were observed when conditioned responses were plotted on a physical dimension. However, when stimulus perception was incorporated generalization gradients diverged from the typical gradient. Both the area and peak shift largely disappeared when accounting for perceptual errors. These findings demonstrate the need to incorporate perceptual mechanisms in associative models.


Asunto(s)
Afecto/fisiología , Condicionamiento Clásico/fisiología , Discriminación en Psicología/fisiología , Generalización Psicológica/fisiología , Adulto , Toma de Decisiones/fisiología , Humanos , Individualidad , Masculino , Adulto Joven
3.
Exp Psychol ; 66(1): 23-39, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30777514

RESUMEN

People apply what they learn from experience not only to the experienced stimuli, but also to novel stimuli. But what determines how widely people generalize what they have learned? Using a predictive learning paradigm, we examined the hypothesis that a low (vs. high) probability of an outcome following a predicting stimulus would widen generalization. In three experiments, participants learned which stimulus predicted an outcome (S+) and which stimulus did not (S-) and then indicated how much they expected the outcome after each of eight novel stimuli ranging in perceptual similarity to S+ and S-. The stimuli were rings of different sizes and the outcome was a picture of a lightning bolt. As hypothesized, a lower probability of the outcome widened generalization. That is, novel stimuli that were similar to S+ (but not to S-) produced expectations for the outcome that were as high as those associated with S+.


Asunto(s)
Generalización Psicológica/fisiología , Aprendizaje/fisiología , Adulto , Análisis de Varianza , Aprendizaje Discriminativo/fisiología , Femenino , Generalización del Estimulo/fisiología , Humanos , Masculino , Probabilidad
4.
Behav Res Ther ; 111: 1-8, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30253271

RESUMEN

Experimental research has shown that generalization of fear extinction from a generalization stimulus (GS) is minimal compared to generalization of fear extinction from the conditional stimulus itself (CS+). This poses a challenge to extinction-based treatments of anxiety because the exact CS is often not known or unavailable. However, experimental studies failed to disentangle differences in stimulus identity (CS + or GS) from differences in the level of fear (GS typically elicits less fear than CS+). Here, we test the hypothesis that a high level of fear is key to extinction learning and generalization, rather than the identity of the stimulus under extinction (CS + or GS). For that purpose, we took advantage of the peak-shift phenomenon that describes the conditions under which a GS can elicit equal or higher levels of responding, compared to the CS+. Hence, we compared the generalizability of fear extinction following exposure to the CS + itself, to a 'weak' GS that elicits less fear, and to a 'peak' GS that elicits as much fear as the CS+. First, the results replicated, with a new set of stimuli, the observation that extinction of a skin conductance response and US-expectancy generalizes only weakly from a weak GS to CS+. Second, extinction generalized strongly from a peak GS towards CS+, as hypothesized. Third, extinction with the peak GS even outperformed extinction with the CS+, as it generalized more strongly across the generalization gradient. Together, these results support exposure treatment strategies that focus on the fear-eliciting potential of stimuli (often described as a fear hierarchy), rather than their learning history. We propose that stimulus typicality and/or intensity may explain the enhanced effects of a 'peak' GS over the CS+ in enhancing the generalization of fear extinction.


Asunto(s)
Condicionamiento Clásico/fisiología , Extinción Psicológica/fisiología , Miedo/fisiología , Generalización Psicológica/fisiología , Femenino , Respuesta Galvánica de la Piel/fisiología , Humanos , Masculino , Adulto Joven
5.
Appetite ; 126: 147-155, 2018 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-29634989

RESUMEN

The treatment of anxiety-based psychopathology often hinges upon extinction learning. Research in nutritional neuroscience has observed that the regular consumption of perilla oil (50% alpha-linolenic acid (ALA)) facilitates extinction learning in rats (Yamamoto et al., 1988). However, acute facilitation of extinction learning by oils rich in ALA has not been reported for rats or humans, though the acute consumption of rapeseed oil (10% ALA) has been observed to improve cognitive processing speed in humans (Jones, Sünram-Lea, & Wesnes, 2012). For this reason, the present laboratory work examined the effects of adding walnut oil (12% ALA) to a chocolate milkshake on the acquisition, generalization, and extinction of a fear-based prediction in young adults. It compared performance between subjects. The other participants consumed a similar milkshake with either an equicaloric amount of cream (saturated fat), or with no added fat (control). Acquisition and generalization of the fear-based prediction were similar for all groups. However, those who consumed walnut oil extinguished most rapidly and profoundly. Implications for extinction learning are discussed.


Asunto(s)
Grasas de la Dieta/administración & dosificación , Ingestión de Alimentos/psicología , Extinción Psicológica/efectos de los fármacos , Juglans , Aceites de Plantas/administración & dosificación , Animales , Método Doble Ciego , Femenino , Humanos , Masculino , Leche , Ratas , Adulto Joven
6.
Behav Res Ther ; 93: 116-122, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28410461

RESUMEN

The current experiment investigated whether overgeneralization of fear could be due to an inability to perceptually discriminate the initial fear-evoking stimulus from similar stimuli, as fear learning-induced perceptual impairments have been reported but their influence on generalization gradients remain to be elucidated. Three hundred and sixty-eight healthy volunteers participated in a differential fear conditioning paradigm with circles of different sizes as conditioned stimuli (CS), of which one was paired to an aversive IAPS picture. During generalization, each subject was presented with one of 10 different sized circles including the CSs, and were asked to categorize the stimulus as either a CS or as novel after fear responses were recorded. Linear mixed models were used to investigate differences in fear generalization gradients depending on the participant's perception of the test stimulus. We found that the incorrect perception of a novel stimulus as the initial fear-evoking stimulus strongly boosted fear responses. The current findings demonstrate that a significant number of novel stimuli used to assess generalization are incorrectly identified as the initial fear-evoking stimulus, providing a perceptual account for the observed overgeneralization in panic and anxiety disorders. Accordingly, enhancing perceptual processing may be a promising treatment for targeting excessive fear generalization.


Asunto(s)
Condicionamiento Clásico/fisiología , Miedo/psicología , Generalización Psicológica/fisiología , Percepción/fisiología , Adolescente , Femenino , Humanos , Masculino , Adulto Joven
7.
Behav Res Ther ; 92: 94-105, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28315585

RESUMEN

Eye Movement Desensitization and Reprocessing (EMDR) therapy for posttraumatic stress disorder involves making eye movements (EMs) during recall of a traumatic image. Experimental studies have shown that the dual task decreases self-reported memory vividness and emotionality. However valuable, these data are prone to demand effects and little can be inferred about the mechanism(s) underlying the observed effects. The current research aimed to fill this lacuna by providing two objective tests of memory performance. Experiment I involved a stimulus discrimination task. Findings were that EM during stimulus recall not only reduces self-reported memory vividness, but also slows down reaction time in a task that requires participants to discriminate the stimulus from perceptually similar stimuli. Experiment II involved a fear conditioning paradigm. It was shown that EM during recall of a threatening stimulus intensifies fearful responding to a perceptually similar yet non-threat-related stimulus, as evidenced by increases in danger expectancies and skin conductance responses. The latter result was not corroborated by startle EMG data. Together, the findings suggest that the EM manipulation renders stimulus attributes less accessible for future recall.


Asunto(s)
Movimientos Oculares/fisiología , Memoria a Corto Plazo/fisiología , Recuerdo Mental/fisiología , Condicionamiento Psicológico/fisiología , Discriminación en Psicología/fisiología , Miedo/fisiología , Miedo/psicología , Femenino , Respuesta Galvánica de la Piel/fisiología , Humanos , Masculino , Estimulación Luminosa , Tiempo de Reacción/fisiología , Adulto Joven
8.
Psychosom Med ; 78(2): 248-58, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26575858

RESUMEN

OBJECTIVES: Interoceptive fear learning and generalization have been hypothesized to play a key role in unexplained abdominal and esophageal pain in patients with functional gastrointestinal disorders. However, there is no experimental evidence demonstrating that fear learning and generalization to visceral sensations can be established in humans and alter visceral perception. METHODS: In a novel fear learning-generalization paradigm, an innocuous esophageal balloon distension served as conditioned stimulus (CS), and distensions at three different pressure levels around the pain detection threshold were used as generalization stimuli. During fear learning, the CS was paired with a painful electrical stimulus (unconditioned stimulus) in the conditioning group (n = 30), whereas in the control group (n = 30), the unconditioned stimulus was delivered alone. Before and after fear learning, visceral perception thresholds for first sensation, discomfort, and pain and visceral discrimination sensitivity were assessed. RESULTS: Fear learning was established in the conditioning group only (potentiated eye-blink startle to the CS (t(464.06) = 3.17, p = .002), and fear generalization to other stimulus intensities was observed (t(469.12) = 2.97, p = .003; t(464.29) = 4.17, p < .001). The thresholds for first sensation habituated in the control group, whereas it remained constant in the conditioning group (F(1,43) = 9.77, p = .003). CONCLUSIONS: These data show that fear learning using visceral stimuli induces fear generalization and influences visceral perception. These findings support the idea that in functional gastrointestinal disorder, fear learning and generalization can foster gastrointestinal-specific anxiety and contribute to visceral hypersensitivity.


Asunto(s)
Miedo/psicología , Interocepción/fisiología , Aprendizaje/fisiología , Dolor Visceral/psicología , Adulto , Condicionamiento Psicológico/fisiología , Señales (Psicología) , Estimulación Eléctrica , Miedo/fisiología , Femenino , Generalización Psicológica/fisiología , Humanos , Masculino , Dolor Visceral/fisiopatología , Adulto Joven
9.
Neurosci Biobehav Rev ; 59: 201-7, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26571437

RESUMEN

For almost a century, Pavlovian conditioning is the imperative experimental paradigm to investigate the development and generalization of fear. However, despite the rich research tradition, the conceptualization of fear generalization has remained somewhat ambiguous. In this selective review, we focus explicitly on some challenges with the current operationalization of fear generalization and their impact on the ability to make inferences on its clinical potential and underlying processes. The main conclusion is that, despite the strong evidence that learning influences perception, current research has largely neglected the role of perceptual discriminability and its plasticity in fear generalization. We propose an alternative operationalization of generalization, where the essence is that Pavlovian conditioning itself influences the breadth of fear generalization via learning-related changes in perceptual discriminability. Hence a conceptualization of fear generalization is incomplete without an in-depth analysis of processes of perceptual discriminability. Furthermore, this highlights perceptual learning and discriminability as important future targets for pre-clinical and clinical research.


Asunto(s)
Conducta/fisiología , Condicionamiento Clásico/fisiología , Miedo , Aprendizaje/fisiología , Redes Neurales de la Computación , Pensamiento/fisiología , Animales , Humanos
10.
Exp Psychol ; 61(2): 134-41, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24149244

RESUMEN

The peak of learned responding normally occurs at the learning stimulus itself, but can shift to a different stimulus after discriminative learning. This provides important information about the nature of the generalization mechanism, and reveals alternative pathways through which learned responses can increase. Over two experiments, we established the peak-shift effect in a human predictive learning paradigm. Participants were asked to predict the occurrence of a neutral outcome (drawing of a lightning bolt) based on preceding geometrical figures (rings of different sizes). During learning, the middle-sized ring was sometimes followed by the outcome, whereas a larger ring was never followed by the outcome. At test, we presented larger and smaller rings (Experiment 1), or only a slightly smaller ring (Experiment 2). We consistently observed highest prediction of the outcome to the slightly smaller ring. Predictive estimations in humans can reach their height to stimuli that have never actually participated in the learning experiences. We argue that the results are most in line with an associative learning account, rather than an adaptation-level or a rule-learning account.


Asunto(s)
Aprendizaje por Asociación , Aprendizaje Discriminativo , Generalización Psicológica , Análisis de Varianza , Condicionamiento Psicológico , Femenino , Humanos , Masculino
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