Pennebaker Symptom and Exercise Studies

How does attending to internal cues or external cues affect feelings of exertion during exercise?

Prediction: Exercise with fewer external distracters will lead to more attention to internal cues.

Symptom reporting is a function of (Internal Cues) ÷ (External Cues)

Procedure Subjects all run same distance: oval track OR cross-country

Predictions All Ss run same speed, but those on oval / x-country report more symptoms, OR

All Ss report same symptoms, but oval / x-country run faster.

Result? x-country run faster (9.2 min v. 10.1 min) no symptom diff

Phase I No Sound No Sound No Sound

Phase 2 Breathing Street No Sound

Pennebaker Treadmill Study DesignProblem with running study: did pace really differ b/c of attention to internal v. external cues?

Treadmill study done to address this problem

Ss run on treadmill, which keeps time and effort: constant

Ss wear headphone, playing either:

a. Themselves breathing b. Street sounds c. Nothing at all

Pennebaker Treadmill Study Results

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Day 1:Baserate

Day 2:Conditions

Mea

n S

ymp

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Breathing

Control

Sounds

Conclusion: When exertion is held constant, Ss become more / less aware of their own physiological state.

Key Take Home Points from Running and Treadmill Studies

No diffs. in NUMBER of symptoms reported, only in how much symptoms were noticed. This supports / doesn't support Pennebaker?

Relevance of Pennebaker to health/physical symptoms. Who has more health complaints?

___ Depressed ___ Non-Depressed

___ Work/live alone ___ Work/live with few others

Do professional athletes distract from / attend to internal states?

___ Distract ___ Attend

X

X

X

Purpose: Can external cues distract people from internal reflex?

Ss see movie. Portions of movie pre-rated for interestingness.

Researchers count number of coughs at each 30 sec. portion.

Coughing Study

Predict? Fewer coughs at more interesting moments.

Correlation of coughs to interestingness r = -.57.Result

James Pennebaker

Purpose: Do we need time to register threatening events as upsetting?

Ss watch 5 min. shop safety film, finger chopped off by machine.Version 1. 0 sec. time gap between gory scene and next sceneVersion 2. 3 sec gap, time to reflectVersion 3. 8 sec gap, even more time to reflect

Warning vs. No Warning conditionsHalf subs warned that about gory sceneHalf subs not warned.88

Outcome: Who is most upset by movie?

Emotion Dead-time Study

Emotion Dead-time Study

No Warning

Warning

0 Sec Delay 3 Sec Delay 8 Sec Delay

A 1

A 2

B 1

B 2

C 1

C 2

Which Condition is most emotionally upset by movie?

No Warning 0 second gap 3 second gap 8 second gap

Warning 0 second gap 3 second gap 8 second gap

Emotion Dead-time Study

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0 secdelay

3 secdelay

8 secdelay

Up

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No Warning

Warning

Can we have symptoms that we feel, but subconsciously?

Small balloon inserted into small intestine.

Balloon inflated, EEG (cortex) is monitored

Ss asked if they feel anything. Say "Nope", butEEG rises and falls with balloon inflation

People can be trained to detect balloon inflation

Unconscious Awareness of Symptoms(Adams, 1980)

EEG: Electroencephalogram

Ss work on treadmill, get physically worked-up.

Ss rate how much they favor/disfavor politicians.

Ss rate either:Group 1. Immediately after treadmillGroup 2. 10 min. after treadmillGroup 3. 20 min. after treadmill

Which Group rates politicians most extremely?

Do Symptoms Affect Opinions?Dolf Zillman

Group 1 Group 2 Group 3

Do Symptoms Affect Opinions?Dolf Zillman

Time of Rating After Exertion

Immediate 5-10 minutes 15 minutes

Arousal Level

Much Higher, Evident

Higher, but not Evident

Low (baseline)

Nature of Rating

Moderate Extreme Moderate

Symptoms, Misattribution, and Attraction

Which is the better movie to

induce attraction?

____ Love Conquers All

____ The Rollercoaster From Hell X

Swinging bridge study (Dutton & Aron,1974)

1. Male Ss cross / don't cross scary bridge

2. Ss then complete TAT cards with pretty experimenter.

3. Ss rate cards as more sexual if cross bridge. Why?

4. Ss more likely to phone experimenter for debriefing if crossed bridge.

Class 5

Pain

Why Does Pain Happen?

The Mysterious Case of Rowland Scott Quinlan

Quinlan successful architect, severe injury at job-site.

Surgery technical success but Q. experiences debilitating pain attacks.

Why?

Not organic; no evidence of major phys. trauma, continued damage

Clues: Neg mood, depression induce pain

Pos. mood alleviates pain

Is Quinlan faking? Is he delusional?

His situation, in fact, is very common – extreme pain, no phys. cause.

Cartesian Model of Pain

Implications of, Challenges to Cartesian Model of PainImplications

1. Pain seen as consequence, but not a problem in itself

2. Med training neglects pain.

3. Patients disagree: Pain is THE most important issue

Challenges

Henry Beecher WW II observations of wounded soldiers.

Athletes vs. shut-ins, dancers vs. non-dancers, extroverts vs. introverts

Placebo studies: Placebo or anesthesia, with or without reassurance.

Key terms: Pain threshold, pain tolerance

Dancing Through Pain

Subjects: Dancers and Non-dancers

Cold-Pressor Task:

Pain Threshold: When pain beginsPain tolerance: When pain is unbearable.

Dancers’ threshold, tolerance 3 times greater than non dancers.

Gender makes no difference.

A History of Pain

Von Frey (1894): specificity model

Specific receptors, one dedicated to cause pain

Goldschneider (1894): Pattern theory of pain, one receptor, but pattern of input causes pain.

Current approach: specificity + pattern

A-delta fibers: mylinated, sharp/quick pain

C-fibers: nonmylinated, slower, chronic dull pain

Pain is result of balance of a-deltas + C-fibers ,

PLUS Neurotransmitters: Substance P

PLUS Cerebral activity: attention, emotions, meaning

Nioception: The Physiology of Pain Perception

CNS actively involved in pain experience, not just passive receiver.

Pain moderated:a. from periphery on way to brain via spinal cordb. from brain down to periphery

Operation of Gate Theory1. Signals carried via A-Delta or C fiber to spinal cord2. Reach gating mechanism in dorsal horn of spinal cord3. Gate is opened IF: stim reaches threshold AND brain

interprets as pain4. Interpretation is influenced by emotions, prior learning

Anxiety --> more painPos. emotions, distraction, FEAR --> less pain

Gate Theory of Pain(Melzack & Wall, 1965; 1982)

Opiate: Drugs from plants that kill pain. Morphine, heroin

Endogenous opioids (aka endorphines): like opiate, produced by body. Stress triggers endorphine production.

Stress --> opioid release --> immune suppression --> increased susceptibility to illness

Stress, Opioids, and

Illness Susceptibility

Pain Pathways

Melzack's Gate Theory is revolutionary, helpful, but wrong.Some people experience pain without ANY injury.

Doesn’t explain injury-less pain, such as Quinlan

Phantom limb pain

Pain occurs only because of CNS activity—neuromodules.

Neuromodules are like software programs, or tracks on CDs

Should be triggered by major event (i.e., serious injury) but for some people are trigged by minor event (i.e., bad mood).

Neuromodule Approach to Pain

I placed a coffee cup in front of John and asked him to grab it. Just as he said he was reaching out, I yanked the cup away. "Ow!" he yelled. "Don't do that!" "What's the matter?" "Don't do that," he repeated. "I had just got my fingers around the cup handle when you pulled it. That really hurts!" Hold on a minute. I wrench a real cup from phantom fingers and the person yells, ouch! The fingers were illusory, but the pain was real - indeed, so intense that I dared not repeat the experiment. V.S. Ramachandran Phantoms in the Brain

Phantom Limb Pain

Phantom limbs will: Itch, twitch, gesticulate during conversation, and will take actions “on their own”.

Phantom limb paralysis: Brain “learns” that attempts to move missing limb fail, translate it into paralysis, creates excruciating cramps.

Neuromodule Approach to PainFred. Lenz: Locates brain cells panic attacks.

Smell and memory

Emotions launched via peripheral activity: Bite that pencil!

Neuromodules may explain "pain epidemics”

Neuromodule confirmed by new pain killers that reduce brain excitability.

Anti-epileptic drugsSea snail venomABT-594—from frogs. 70X more powerful than morphine.

Take home point: Pain is "all in the head"

Injury to Periphery

EmotionsMemories of

previous injuries

OWW!!

Neuromodule Model

Alleviating Phantom Limb Pain

Mirror Box

1. Patient places healthy limb and stump into mirror box.

2. Look through top, at angle, “see” two limbs.

3. Move healthy limb in “mirror symmetric movement”, like orchestra conductor or clapping hands.

4. Creates artificial visual feedback of phantom limb being intentionally controlled.

5. Patient then instructed to clench good hand, tightly—sees both hands clenched.

6. Patient told to slowly unclench “both hands”, and phantom limb relaxes, providing relief to chronic pain.

7. Repeated trials led one patient to “loose” phantom arm, but phantom hand now attached to shoulder!

Philip rotated his body, shifting his shoulder, to "insert" his lifeless phantom into the box. Then he put his right hand on the other side of the mirror and attempted to make synchronous movements. As he gazed into the mirror, he gasped and then cried out, "Oh, my God! Oh, my God, doctor! This is unbelievable. It's mind boggling!" He was jumping up and down like a kid. "My left arm is plugged in again. It's as if I'm in the past. All these memories from so many years ago are flooding back into my mind. I can move my arm again. I can feel my elbow moving, my wrist moving. It's all moving again.

Phantom Limb Patient Using Mirror Box Ramachandran, Phantoms in the Brain

V. Ramachandran

(From Ramachandran) 1. Purchase a realistic but fake arm/hand - Sit at table with one hand resting on the table, the other beneath the table. - Position the fake arm/hand on the table in the corresponding position as though both hands/arms are resting on the table. - Have associate tap both real hand that is beneath table and the fake hand in synchrony as you watch the fake hand. - Notice how sensations appear to originate from the fake hand/arm.

2. Carry out the same on naïve associate. - Once the effect has been achieved for a while, pull out previously hidden hammer and hit the fake arm/hand. - Run!

Can Healthy Limbs Be “Fooled”?

1. Infant rats have paw injected with irritant, or not.

2. Mature rats exposed to hot surface:* To injured paw* To uninjured paw* "Control" rats

3. Injured rats respond quicker, but only for hurt paw

4. Injured rats have more pain-nerve endings

5. Implications for humans:* Surgery w/o anesthesia* Treatment of premature infants

Early Trauma and Increased Pain Sensitivity