A mixed-methods investigation into the us versus them mentality in Facebook groups for chronic pain.

OBJECTIVE: Social media groups for chronic pain have become increasingly popular, but the effects of these groups are largely unknown, and members may be exposed to both helpful and harmful group processes. We created a Facebook intervention for adults with chronic pain and used a mixed-methods design to evaluate the effects of group membership on social support, including examining social dynamics that may benefit or impede existing pain care. METHOD: A total of 119 adults participated in either peer-led or professionally-guided Facebook groups for 1 month. Chronic pain support was assessed at baseline, post-intervention, and 1-month follow-up, and qualitative data were collected to explore social dynamics. RESULTS: Chronic pain support increased for participants in both group types from baseline to post-intervention and then decreased at follow-up. Thematic analysis of qualitative data (i.e., participant posts and comments in response to posts) revealed an overarching theme: us versus them-a dichotomizing view of the world that distinguishes people with pain (us) versus everyone else who does not understand pain (them). Participants discussed their tendency to withdraw socially due to feeling misunderstood regarding their pain. CONCLUSIONS: Facebook groups for chronic pain enhance perceptions of support among peers. Although generally beneficial, group cohesion may facilitate an us versus them mentality, resulting in isolation and potentially poorer outcomes. Future research should explore ways to maintain benefits of the us versus them mentality, while reducing its costs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Facing Pain Together: A Randomized Controlled Trial of the Effects of Facebook Support Groups on Adults With Chronic Pain.

Despite the popularity and affordances of social media groups for people with chronic conditions, there have been few controlled tests of the effects of these groups. This randomized controlled superiority trial examined the effects of Facebook groups on pain-related outcomes and tested whether a professional-led group leads to greater effects than a support group alone. We randomly assigned 119 adults with chronic pain to one of two Facebook group conditions: a standard condition (n = 60) in which participants were instructed to offer mutual support, or a professional-led condition (n = 59) in which the investigators disseminated empirically-supported, socially-oriented psychological interventions. Four groups were run (2 standard, 2 professional-led), each lasting 4 weeks and containing approximately 30 participants. Measures were administered at baseline, post-intervention, and 1-month follow-up. Across conditions, participants improved significantly in primary outcomes (pain severity and interference; medium-large effects) and a secondary outcome (depressive symptoms; small-medium effect), and they retained their outcomes 1 month after the groups ended. The 2 conditions did not differ on improvements. Overall, this study supports the use of social media groups as an additional tool to improve chronic pain-related outcomes. Our findings suggest that professional intervention may not have added value in these groups and that peer support alone may be driving improvements. Alternatively, the psychosocial intervention components used in the current study might have been ineffective, or more therapist direction may be warranted. Future research should examine when and how such guidance could enhance outcomes. PERSPECTIVE: Findings from this randomized trial support the use of both standard and professional-led Facebook groups as an accessible tool to enhance the lives of adults with chronic pain. This article provides direction for how to improve social media groups to optimize outcomes and satisfaction for more users.

Instructional Set Moderates the Effect of GRE on Faculty Appraisals of Applicant Competence: A Vignette Study With Implications for Holistic Review.

While there is movement to create more equitable and holistic admission review processes, faculty continue to place strong emphasis on a single piece of information when making admissions decisions: standardized test scores. This study used an experimental design to test whether instructions provided to faculty prior to assessing doctoral applicants could support holistic review by reducing the weight of the general record examination (GRE) in faculty appraisals of competence and merit for graduate study. Tenured and/or tenure-track faculty (N=271) were randomly assigned to one of three instructional conditions: Control (no instruction), "Diamond in the Rough," and "Weed Out." In addition, faculty participants were randomly assigned to read one of two vignettes of a prospective first-generation student who either received high or average GRE scores. Faculty then rated the applicant's competence using a three-item survey. As expected, faculty who read the vignette describing the candidate with the high GRE rated him as more competent than faculty who read the average GRE vignette. In addition, being instructed to seek out diamonds in the rough buffered the effect of the GRE score on competence. Faculty were also asked to indicate whether they would need additional information to make an admissions decision. They were more likely to ask about grades and research skills than about psychosocial factors that might contextualize the candidate's performance and perceived competence. The results of this study have implications for creating more equitable doctoral admissions processes that center equity, diversity, and inclusion in decision making.

Development of a Multicomponent Intervention to Initiate Health Behavior Change in Primary Care: The Kickstart Health Program.

There is a growing movement to integrate behavioral health specialists into primary care settings in order to better manage patients' health behaviors. Group interventions in healthcare settings can provide services to multiple individuals simultaneously; however, the participants' experiences taking part in these activities and the logistics of integrating them into clinical settings are largely under-studied. This article describes the development and implementation of a novel group intervention for health behavior change, The Kickstart Health Program, which integrates components of cognitive, behavioral, acceptance, and experiential therapies. Participant feasibility, acceptability, experiences, and treatment course were assessed. Acceptability among a small sample of attendees was high, and initial data on behavior change suggest there were benefits to patients who attended the program. Increases in mindfulness practice and decreases in exercise barriers from baseline to 10-week follow-up were detected as were improvements in overall perceived health and well-being. Participants expressed that the program was acceptable and successful at helping them reach their individual health goals; however, enrollment barriers negatively impacted the feasibility of the program in regard to attendance. Modification to the enrollment process such as embedding referrals into the electronic medical record, encouraging spouse or family co-enrollment, and peer coaching may address these barriers. The Kickstart Health Program has the potential to improve health behaviors and paves the way for unique studies of dissemination and implementation of efficacious behavioral health interventions into real-world healthcare settings.

Who Are We Missing? Examining the Graduate Record Examination Quantitative Score as a Barrier to Admission into Psychology Doctoral Programs for Capable Ethnic Minorities.

The field of psychology must racially/ethnically diversify to create a workforce that can meet the needs of education, training, and interventions in an increasingly pluralistic society. Systemic bias in psychology doctoral programs' admissions process may partially account for relatively few psychologists being underrepresented minorities (URMs). The use of the Graduate Record Examination Quantitative score (GRE-Q) is one important modifiable barrier. The purpose of the current study is to go beyond replicating the association between the GRE-Q and desired doctoral outcomes by examining if a cut-off score for the GRE-Q as a proxy for potential to succeed in psychology doctoral programs disproportionately impacts URMs. Participants (N = 226) were psychology doctoral students at a Carnegie-classified Highest Research Activity (R1) large Midwestern university, who were admitted to graduate school from 2001 to 2011. Our findings show that, while controlling for undergraduate grade point average (GPA) and prior master's degree attainment, the GRE-Q predicted grades in two required graduate statistics courses and overall graduate GPA. Importantly, all students, regardless of their GRE-Q score, demonstrated competence in their statistics coursework, as assessed by their course grades. Moreover, we found that guidelines that bar admission into the psychology doctoral program for students with low GRE-Q scores would have disproportionately impacted URMs, resulting in 44% being barred admission versus only 17% of their White/Asian/Pacific Islander counterparts. Practical implications include introducing holistic review protocols into the admissions process, while educating faculty on how heavy emphasis on the GRE-Q contributes to inequitable exclusion of capable URMs.

"What Should I Do First?" The Effect of Manipulated Goal Conflict on Affect, Motivation, and Helping Behavior in Chronic Pain Couples.

Although support provision by a partner is an important resource for individuals with chronic pain (ICPs), it poses a challenge for partners because it competes with other important personal goals of partners. The current study examined the impact of experimentally induced goal conflict in partners on their motives for helping, quality of provided help, and on partners' and ICPs' affect. Sixty-eight couples, with at least one person having chronic pain, performed 2 series of household activities, with partners either asked to be simply available for help (ie, control condition) or to additionally work on a puzzle task (ie, goal conflict condition). Couples reported on interpersonal (eg, helping motives) and intrapersonal (eg, affect) outcomes. In addition, quality of partners' helping behavior and ICPs' pain behavior were videotaped and coded afterward. In the goal conflict condition, ICPs were less satisfied with the received help and they experienced more pain. Also, the quality of the provided help was lower and partners experienced less positive and more negative affect. Addressing partners' goal conflict in clinical practice may help to avoid its negative impact on both ICPs and partners. Perspective: This article provides a compelling argument to include partners in chronic pain treatment by demonstrating the detrimental effects of partners' experienced conflicts in goals upon the quality of help they provide, partners' affective functioning, and ICPs' pain-related outcomes.

"Now I have hope": Rebuilding relationships affected by chronic pain.

INTRODUCTION: A novel couple-based intervention was created to address the individual and interpersonal needs of people with chronic pain and their romantic partners, as research has shown that pain negatively impacts both partners. A pilot study revealed positive outcomes in both partners, though the extent to which improved relationship functioning contributed to these outcomes is unknown. The purpose of this study was to examine couples' experience of the treatment to determine whether addressing relational flexibility was appraised by couples as playing an important role in this novel intervention. METHOD: Fourteen couples who completed the treatment participated in interviews and gave feedback about the intervention. Interviews were analyzed using a multiphase thematic analysis to provide information about the treatment effects and mechanisms of change from the couples' perspectives. RESULTS: Couples described the intervention as essential in rebuilding their relationships, which had been negatively impacted by the effects of chronic pain. DISCUSSION: The presence of chronic pain had contributed to feelings of isolation, helplessness, and resentment within relationships. Participants valued this dyadic treatment because it enhanced their communication, connection, and intimacy. Their reports reinforce the importance of targeting both partners in pain treatment when relationship distress is present, as the improvements made in individual treatment are unlikely to be maintained if patients return to environments that are unsupportive and distressed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A Novel Couple-Based Intervention for Chronic Pain and Relationship Distress: A Pilot Study.

Chronic pain contributes to psychological and relationship distress in individuals with pain as well as their partners. Prior pain interventions have addressed this important social context by engaging partners in treatment; however, partners have not been considered co-participants who can benefit directly from therapy, but rather incorporated as pain management coaches or guides. This manuscript assesses the feasibility, acceptability, and preliminary outcomes of a novel intervention which targets both partners and focuses on improving well-being in couples in which one or both partners experiences chronic pain and relationship distress. Fifteen couples participated in Mindful Living and Relating, a 6-session in-person intervention, and completed baseline and post-treatment outcome measures. Both quantitative and qualitative methods were used to evaluate participants' engagement in and experiences of the intervention, as well as preliminary outcomes. Results suggest that couples were engaged in, and reported satisfaction with, the treatment. Participants who completed the therapy (N = 28; 14 couples) reported reductions in depressive symptoms and improvements in relationship satisfaction and partner responsiveness, and individuals with pain reported reductions in pain interference. In post-treatment interviews, couples reported their preference for couple therapy over individual therapy for pain and relationship distress. Although the conduct of the therapy was feasible for couples who enrolled in the trial, initial recruitment difficulties suggested feasibility challenges. Recommendations are made for researchers who are interested in designing psychological interventions to improve quality of life in the context of chronic illness.

A Dyadic Perspective on Coping and its Effects on Relationship Quality and Psychological Distress in Couples Living with Chronic Pain: A Longitudinal Study.

OBJECTIVE: Dyadic coping is a process of coping within couples that is intended not only to support the patient with chronic pain but also to maintain equilibrium in the relationship. This study aims to investigate the effect of patient-perceived and spouse-reported dyadic coping on both the patient and their partner's relationship quality and anxiety, stress, and depression over time. METHODS: One hundred thirty-nine couples, with one partner experiencing chronic pain, participated in this study. Spanning three measurements over six months, couples reported on their anxiety, stress, depression, relationship quality, and dyadic coping. RESULTS: Patient-perceived supportive dyadic coping was positively associated with both partners' relationship quality but was negatively associated with spouses' stress over time. Patient-perceived negative dyadic coping was negatively associated with both partners' relationship quality and positively associated with patients' depression and spouses' depression and stress over time. Spouse-reported supportive dyadic coping showed a positive association with their own relationship quality and a negative association with spouses' depression at baseline and patients' depression at three-month follow-up. Spouse-reported negative dyadic coping was negatively associated with their relationship quality at baseline and positively associated with their partner's anxiety and stress at six-month and three-month follow-up, respectively. Similar inference was observed from the findings of growth curve model. CONCLUSIONS: As compared with spouse report, patient perception of dyadic coping is a better predictor of both partners' relationship quality and psychological outcomes over time. Both partners may benefit from early psychosocial intervention to improve their dyadic coping, relationship quality, and psychological outcomes.

How Do I Help My Partner in Pain? Partners' Helping Behaviors Are Linked to Lower Pain and Greater Perceived Validation During an Experimental Pain Task.

BACKGROUND: Observers' responses to people with illness are important predictors of quality of life, yet findings are mixed regarding the types of responses that affect illness-related suffering. PURPOSE: The purpose of this study was to examine whether perspective taking positively affects observers' responses to their romantic partner experiencing experimentally induced pain and whether responses based in Self-Determination Theory and communication models of illness are related to perceived validation and pain outcomes. METHODS: Undergraduate romantic couples (N = 122) completed baseline questionnaires; then one partner was randomly assigned to complete the cold pressor task, whereas the other partner observed. Couples were randomly assigned to one of two groups: a perspective-taking group in which observers were privately instructed to take the perspective of the pain participant or a control group. Afterward, both partners completed surveys, and pain participants completed a video recall task in which they recalled partner behaviors that were coded by trained raters using a theoretically derived manual. RESULTS: Pain participants in the perspective-taking group identified significantly less invalidating communication from their partners, fewer behaviors that thwarted their competence, and more behaviors that supported their autonomy. Across groups, pain participants who received more normalizing communication that supported their competence felt more validated by their partners, had lower pain intensity, and exhibited greater pain tolerance, whereas those who received more invalidation showed worse outcomes. CONCLUSIONS: The results from this study suggest that attention to different types of partner behaviors is essential when developing behavioral medicine treatments for pain and illness.

Research ethics in inter- and multi-disciplinary teams: Differences in disciplinary interpretations.

As research teams are increasingly comprised of members from multiple disciplines, ranging from the physical sciences, life sciences, social and behavioral sciences to the arts and humanities, it is important to revisit how research is conducted at several levels. Coupled with the national concern over rigor and reproducibility in research, it is therefore crucial to ensure that all members of such multidisciplinary teams view the need for ethics in the conduct of research in similar ways. Towards this end, Wayne State University developed a course in the Responsible Conduct of Research (RCR) which was mandatory for all its 1500 doctoral students across all disciplines in its 75 PhD programs. We found that student perceptions of the validity, applicability and usefulness of the course varied by discipline. This was in spite of iterative changes made to the course by faculty in those disciplines to make the content palatable to all. The findings show that more work needs to be done to fully incorporate the needs of social sciences and humanities disciplines in a comprehensive university course. This is especially important as these students become members of large multidisciplinary research teams in order to uphold the highest levels of rigor, reproducibility and ethics.

Visualization of gender, race, citizenship and academic performance in association with career outcomes of 15-year biomedical doctoral alumni at a public research university.

It has long been thought that biomedical doctoral students pursue careers primarily as tenure-track/tenured faculty at research institutions. Recent reports showed, however, that the majority of biomedical doctoral alumni engage in a variety of careers. Wayne State University (WSU) undertook a project to understand the career trajectories of its biomedical doctoral alumni to create programs to better prepare its students for careers in multiple pathways. Data were collected on career outcomes of WSU's biomedical doctoral alumni who graduated in a 15-year period from 1999-2014. Careers were classified into three tiers by Employment Sector, Career Types and Job Functions and career paths were examined by alumni gender, race, U.S. citizenship status, and association with certain academic characteristics. Several statistically significant differences in career paths among all demographics were found. For example, women were more likely to be in teaching and providing healthcare, men in faculty and research; Black alumni pursued careers in Government at higher rates and Whites in For-Profit careers; Asians and non-U.S. citizens spent more time in training positions than others. There was no association of academic characteristics such as GRE, GPA, and Time-to-Degree completion with careers in the two largest sectors of Academia or For-profit. Since our trainees are engaged in this rich variety of careers essential to advancing biomedical science and research nationally, it is imperative for the graduate training community to embrace all careers as successful, and transform the model for biomedical doctoral training to foster student success across this broad career spectrum.

A Couple-Based Psychological Treatment for Chronic Pain and Relationship Distress.

Chronic pain impacts individuals with pain as well as their loved ones. Yet, there has been little attention to the social context in individual psychological treatment approaches to chronic pain management. With this need in mind, we developed a couple-based treatment, "Mindful Living and Relating," aimed at alleviating pain and suffering by promoting couples' psychological and relational flexibility skills. Currently, there is no integrative treatment that fully harnesses the power of the couple, treating both the individual with chronic pain and the spouse as two individuals who are each in need of developing greater psychological and relational flexibility to improve their own and their partners' health. Mindfulness, acceptance, and values-based action exercises were used to promote psychological flexibility. The intervention also targets relational flexibility, which we define as the ability to interact with one's partner, fully attending to the present moment, and responding empathically in a way that serves one's own and one's partner's values. To this end, the intervention also included exercises aimed at applying psychological flexibility skills to social interactions as well as emotional disclosure and empathic responding exercises to enhance relational flexibility. The case presented demonstrates that healthy coping with pain and stress may be most successful and sustainable when one is involved in a supportive relationship with someone who also practices psychological flexibility skills and when both partners use relational flexibility skills during their interactions.

Animal Assisted Therapy for Incarcerated Youth: A Randomized Controlled Trial.

Teacher's Pet, an animal assisted therapy (AAT) was assessed in a randomized controlled trial with incarcerated youth from two Midwestern United States detention facilities. The AAT was expected to increase empathy and reduce behavior problems. Participants trained dogs one hour, twice weekly for 10 weeks. A control group walked but did not train dogs for the same duration. Both groups attended one hour, twice weekly animal didactics. Of 138 participants, 117 provided complete data, and 21 had some missing data imputed. Contrary to expectation, both groups increased slightly in self-reported empathy, and staff and youth rated internalizing problems. The time youth spent with dogs plus animal didactics may have increased empathy. Increased internalizing problems could be attributed to youth gaining greater emotional awareness. Alternately, this brief intervention may not have any immediate effects, given the small changes observed. Additional follow-up of these youth and other comparison groups are needed.

Dog Training Intervention Shows Social-Cognitive Change in the Journals of Incarcerated Youth.

There is limited research assessing the effectiveness of Animal-Assisted Therapy in at-risk adolescent populations. In a recent study, 138 adjudicated adolescents participated in a randomized controlled trial of an animal-assisted intervention, in which participants either trained shelter dogs (Teacher's Pet group) or walked the dogs (control group), with both groups participating in classroom work related to dogs (1). Journal writing was a part of class activities for all youth in the study. Conventional assessments of youth behavior made by staff or youth themselves did not demonstrate the expected differences between the groups favoring the dog training group, as youth in both groups showed a significant increase in staff and youth rated internalizing behavior problems and empathy from the beginning to the end of the project (1). However, subsequent analysis of the journal content from 73 of the adjudicated youth reported here, did reveal significant differences between treatment and control groups, favoring the Teacher's Pet group. Youth participating in the dog training intervention showed through their journal writing greater social-cognitive growth, more attachment, and more positive attitudes toward the animal-assisted intervention compared to youth in the control group. The 73 youth whose journals were available were very similar to youth in the larger group. Their results illustrate that journaling can be a useful method of assessing effects of similar animal-assisted interventions for at-risk youth. Writing done by youth receiving therapy appeared to promote self-reflection, desirable cognitive change, and prosocial attitudes that may signify improving quality of life for such youth. The expressive writing of participants could reveal important effects of treatment beyond the behavioral changes that are often the targeted outcomes of animal-assisted interventions.

Improving Diabetes-Related Parent-Adolescent Communication With Individualized Feedback.

Objective: To pilot a brief individualized feedback intervention to improve the communication skills of parents with an adolescent with type 1 diabetes. Methods: Parent-adolescent dyads (N = 79) discussed a diabetes-related problem, while an interventionist rated the parent's communication skills to give feedback to the parents. Parents were then randomized to a brief feedback session to target person-centered communication skills or an educational session. Dyads discussed another diabetes care problem to assess for change in communication skills. Independent raters coded parent communication skills from video recordings to rate behaviors in the service of examining possible changes in communication skills. Dyads completed ratings of perceived closeness and empathy after each conversation. Results: Controlling for overall positive communication at baseline, parents who received feedback showed more improvement in specific person-centered communication skills than parents in the control group. Adolescents in the feedback group reported greater increases in parental empathy and intimacy from pre- to postmanipulation than the control. Conclusions: The feedback intervention showed preliminary efficacy for increasing person-centered communication skills and perceived empathy and intimacy.

What's in a Name? The Case of Emotional Disclosure of Pain-Related Distress.

Pain behavior plays a key role in many theoretical models of pain, with many of these models conceptualizing pain behaviors as potentially detrimental to patient functioning. We propose that a certain class of behaviors-talking to others about one's pain-related distress (ie, emotional disclosures of pain-related distress)-can be distinguished from other behaviors traditionally conceptualized as pain behaviors. Emotional disclosures of pain-related distress include verbally disclosing one's anger, sadness, or worry about the pain and its effects to another person. In this article, conceptual and empirical evidence is offered to indicate that these verbal behaviors are distinct from other pain behaviors such as bodily expressions and motions, facial expressions, pain ratings, and paraverbal expressions. Emotion and relationships models are also applied to assert that disclosures of pain-related distress may have functions that are not shared with other pain behaviors. In addition to an expanded conceptualization of these verbal expressions of distress about pain, further directions are provided to spur new research as well as clinical recommendations concerning appropriate responses to these behaviors. PERSPECTIVE: This article offers an expanded conceptualization of one type of pain behavior-emotional disclosure of pain-related distress-by showing the theoretical and empirical distinctions between this behavior and other pain behaviors. This perspective may enhance clinical work and research aimed at identifying adaptive responses to these behaviors to improve pain adjustment.