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Shan Z, Ren C, Gu M, Lin Y, Sum FHKMH, McGrath C, Jin L, Zhang C, Yang Y. Effects of Low-Level Laser Therapy on Dentin Hypersensitivity in Periodontally Compromised Patients Undergoing Orthodontic Treatment: A Randomised Controlled Trial. J Clin Med 2023; 12:1419. [PMID: 36835953 PMCID: PMC9961942 DOI: 10.3390/jcm12041419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/09/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVES This study aimed to assess the effects of low-level laser therapy (LLLT) on dentin hypersensitivity (DH) in periodontally compromised patients undergoing orthodontic treatment. METHODS This triple-blinded randomised controlled trial included 143 teeth with DH from 23 periodontally compromised patients. Teeth on one side of the dental arch were randomly assigned to the LLLT group (LG), while those on the contralateral side were allocated to the non-LLLT group (NG). After orthodontic treatment commenced, patients' orthodontic pain (OP) perceptions were documented in pain diaries. DH was assessed chairside by a visual analogue scale (VASDH) at fifteen timepoints across the orthodontic treatment and retention. VASDH scores were compared among timepoints by the Friedman test, among patients with varying OP perceptions using the Kruskal-Wallis tests, and between the LG and NG with the Mann-Whitney U test. RESULTS DH generally decreased over the observation (p < 0.001). The VASDH scores differed among patients with varying OP perceptions at multiple timepoints (p < 0.05). The generalized estimating equation model showed teeth in the LG had a significantly lower VASDH score than the NG at the 3rd month of treatment (p = 0.011). CONCLUSION LLLT could be potentially beneficial in managing DH in periodontally compromised patients undergoing orthodontic treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Yanqi Yang
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
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Garcia-Guerrero S, O’Hora D, Zgonnikov A, Scherbaum S. The action dynamics of approach-avoidance conflict during decision-making. Q J Exp Psychol (Hove) 2023; 76:160-179. [PMID: 35236183 PMCID: PMC9773158 DOI: 10.1177/17470218221087625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Approach-avoidance conflict is observed in the competing motivations towards the benefits and away from the costs of a decision. The current study investigates the action dynamics of response motion during such conflicts in an attempt to characterise their dynamic resolution. An approach-avoidance conflict was generated by varying the appetitive consequences of a decision (i.e., point rewards and shorter participation time) in the presence of simultaneous aversive consequences (i.e., shock probability). Across two experiments, approach-avoidance conflict differentially affected response trajectories. Approach trajectories were less complex than avoidance trajectories and, as approach and avoidance motivations neared equipotentiality, response trajectories were more deflected from the shortest route to the eventual choice. Consistency in the location of approach and avoidance response options reduced variability in performance enabling more sensitive estimates of dynamic conflict. The time course of competing influences on response trajectories including trial-to-trial effects and conflict between approach and avoidance were estimated using regression analyses. We discuss these findings in terms of a dynamic theory of approach-avoidance that we hope will lead to insights of practical relevance in the field of maladaptive avoidance.
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Affiliation(s)
- Santiago Garcia-Guerrero
- School of Psychology, National University of Ireland, Galway, Ireland,Santiago Garcia-Guerrero, School of Psychology, National University of Ireland, University Road, Galway H91 TK33, Ireland.
| | - Denis O’Hora
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Arkady Zgonnikov
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Stefan Scherbaum
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
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Kryza-Lacombe M, Tanzini E, Yali AM, O'Neill S. Executive Functioning and the Pursuit of Happiness. LEARNING AND MOTIVATION 2021; 76. [PMID: 34565894 DOI: 10.1016/j.lmot.2021.101758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Executive functioning and happiness are each associated with successful learning and other desirable individual and societal outcomes; however, it is unclear whether a relation exists between them. Executive regulation of happiness pursuits in daily life, operationalized as hedonic (e.g., pursuing pleasure) and eudaimonic (e.g., pursuing personal growth) motives for action, may be a way the constructs relate to each other. In this initial investigation, we aimed to explore whether objectively measured executive functioning skills relate to happiness motives. A sample of 119 college students completed six objective neuropsychological measures of executive functioning and self-reported levels of hedonic and eudaimonic motives for action in daily life. Correlation and regression analyses examined the relations among temporal discounting and two latent executive functioning factors (inhibitory control and working memory) with hedonic and eudaimonic motives, as well as their interaction. Results suggested a possible association between higher levels of eudaimonic motives and preference for higher delayed rewards, as well as poorer working memory. Further analyses suggested that endorsing high levels of eudaimonic and hedonic motives simultaneously (i.e., the "full life") was associated with poorer inhibitory control and working memory performance, whereas endorsing low levels of both simultaneously (i.e., the "empty life") was associated with a preference for more immediate monetary rewards. Findings are discussed in the context of goal conflict and risk assessment among individuals who endorse the "full life". Overall, these findings suggest that complex relations may exist between executive functioning and trait-level happiness pursuits, and have implications for possible interventions aimed at enhancing happiness-related motives and cognitive processes to facilitate learning. Given the exploratory nature of the present study, further investigations are necessary.
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Affiliation(s)
| | - Elise Tanzini
- The City College of New York, City University of New York, New York, USA
| | - Ann Marie Yali
- The City College of New York, City University of New York, New York, USA.,The Graduate Center, City University of New York, New York, USA
| | - Sarah O'Neill
- The City College of New York, City University of New York, New York, USA.,The Graduate Center, City University of New York, New York, USA
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Abstract
Pain is considered a hardwired signal of bodily disturbance belonging to a basic motivational system that urges the individual to act and to restore the body's integrity, rather than just a sensory and emotional experience. Given its eminent survival value, pain is a strong motivator for learning. Response to repeated pain increases when harm risks are high (sensitization) and decreases in the absence of such risks (habituation). Discovering relations between pain and other events provides the possibility to predict (Pavlovian conditioning) and control (operant conditioning) harmful events. Avoidance is adaptive in the short term but paradoxically may have detrimental long-term effects. Pain and pain-related responses compete with other demands in the environment. Exposure-based treatments share the aim of facilitating or restoring the pursuit of individual valued life goals in the face of persistent pain, and further improvements in pain treatment may require a paradigm shift toward more personalized approaches.
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Affiliation(s)
- Johan W S Vlaeyen
- Research Group on Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, 3000 Leuven, Belgium; .,Experimental Health Psychology, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, 9000 Ghent, Belgium.,Centre for Pain Research, University of Bath, Bath BA2 7AY, United Kingdom
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Chen S, Jackson T. Causal effects of challenge and threat appraisals on pain self-efficacy, pain coping, and tolerance for laboratory pain: An experimental path analysis study. PLoS One 2019; 14:e0215087. [PMID: 31013292 PMCID: PMC6478370 DOI: 10.1371/journal.pone.0215087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/26/2019] [Indexed: 01/14/2023] Open
Abstract
Background Primary appraisals of pain as a potential threat influence pain perception and coping but comparatively less is known about related effects of challenge appraisals or causal effects of primary appraisals on secondary appraisals of perceived pain coping capacities (e.g., pain self-efficacy). Methods To address these gaps, young Chinese women (N = 147) and men (N = 88) were randomly assigned to one of three appraisal conditions prior to engaging in a cold pressor test (CPT): (1) a higher threat appraisal condition featuring task orienting information describing symptoms and consequences of frostbite, (2) a lower threat appraisal condition featuring orienting information about safety of the CPT, or (3) a challenge appraisal condition featuring orienting information describing benefits of persistence despite discomfort for future life satisfaction. Results Compared to peers in the higher threat condition, challenge condition cohorts experienced smaller decreases in task-related self-efficacy, more cognitive coping, and less catastrophizing as well as more overall pain tolerance. A path analysis indicated that self-efficacy changes, cognitive coping and catastrophizing fully mediated links of subjective challenge and threat appraisals with pain tolerance. Conclusions Initial appraisals about the nature of pain influence, not only pain tolerance and coping, but also perceived coping capacities. Perspective Through examining particular theory-based pain appraisal and coping processes, this experiment is the first to identify both perceived coping capacities (pain self-efficacy) and coping responses as factors that explain why appraisals of pain as a challenge or threat have differential effects on pain tolerance.
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Affiliation(s)
- Shuanghong Chen
- Key Laboratory of Cognition & Personality Southwest University, Chongqing, China
| | - Todd Jackson
- Key Laboratory of Cognition & Personality Southwest University, Chongqing, China
- Department of Psychology, University of Macau, Taipa, Macau S.A.R
- * E-mail:
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Topical Review: Basic Psychological Needs in Adolescents with Chronic Pain-A Self-Determination Perspective. Pain Res Manag 2019; 2019:8629581. [PMID: 30723533 PMCID: PMC6339741 DOI: 10.1155/2019/8629581] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/10/2018] [Indexed: 12/16/2022]
Abstract
This topical review outlines the resilience pathway to adaptive functioning in pediatric pain within a developmental perspective. Self-Determination Theory proposes that the satisfaction of one's basic psychological needs (for autonomy, relatedness, and competence) is crucial for understanding human flourishing and healthy development. However, the role of the basic psychological needs received little attention in a pediatric-pain population. Yet, we propose that need satisfaction may be a resilience factor and need frustration a risk factor, for living with chronic pain. In this topical review, we first discuss two major models that have been developed to understand pain-related disability: the fear-avoidance model of pain and the ecological resilience-risk model in pediatric chronic pain. Both models have been used with children and adolescents but do not include a developmental perspective. Therefore, we introduce Self-Determination Theory and highlight the potentially moderating and mediating role of the basic needs on pain-related disability in children and adolescents. Taken together, we believe that Self-Determination Theory is compatible with the fear-avoidance model of pain and the ecological resilience-risk model in pediatric chronic pain and may deepen our understanding of why some adolescents are able to live adaptively in spite of chronic pain.
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Subjective utility moderates bidirectional effects of conflicting motivations on pain perception. Sci Rep 2017; 7:7790. [PMID: 28798478 PMCID: PMC5552734 DOI: 10.1038/s41598-017-08454-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/12/2017] [Indexed: 01/15/2023] Open
Abstract
Minimizing pain and maximizing pleasure are conflicting motivations when pain and reward co-occur. Decisions to prioritize reward consumption or pain avoidance are assumed to lead to pain inhibition or facilitation, respectively. Such decisions are a function of the subjective utility of the stimuli involved, i.e. the relative value assigned to the stimuli to compare the potential outcomes of a decision. To test perceptual pain modulation by varying degrees of motivational conflicts and the role of subjective utility, we implemented a task in which healthy volunteers had to decide between accepting a reward at the cost of receiving a nociceptive electrocutaneous stimulus or rejecting both. Subjective utility of the stimuli was assessed by a matching task between the stimuli. Accepting reward coupled to a nociceptive stimulus resulted in decreased perceived intensity, while rejecting the reward to avoid pain resulted in increased perceived intensity, but in both cases only if a high motivational conflict was present. Subjective utility of the stimuli involved moderated these bidirectional perceptual effects: the more a person valued money over pain, the more perceived intensity increased or decreased. These findings demonstrate pain modulation when pain and reward are simultaneously present and highlight the importance of subjective utility for such modulation.
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Goal Pursuit in Youth with Chronic Pain. CHILDREN-BASEL 2016; 3:children3040036. [PMID: 27879686 PMCID: PMC5184811 DOI: 10.3390/children3040036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/03/2016] [Accepted: 11/11/2016] [Indexed: 01/26/2023]
Abstract
Children and adolescents frequently experience chronic pain that can disrupt their usual activities and lead to poor physical and emotional functioning. The fear avoidance model of pain with an emphasis on the maladaptive behaviors that lead to activity avoidance has guided research and clinical practice. However, this model does not take into consideration variability in responses to pain, in particular the active pursuit of goals despite pain. This review aims to introduce a novel conceptualization of children's activity engagement versus avoidance using the framework of goal pursuit. We propose a new model of Goal Pursuit in Pediatric Chronic Pain, which proposes that the child's experience of pain is modified by child factors (e.g., goal salience, motivation/energy, pain-related anxiety/fear, and self-efficacy) and parent factors (e.g., parent expectations for pain, protectiveness behaviors, and parent anxiety), which lead to specific goal pursuit behaviors. Goal pursuit is framed as engagement or avoidance of valued goals when in pain. Next, we recommend that research in youth with chronic pain should be reframed to account for the pursuit of valued goals within the context of pain and suggest directions for future research.
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Abstract
Adolescents who experience pain often face competing goals and have to choose whether to approach (confront) or avoid pain. This study investigates the decisions adolescents make when their pain conflicts with a valued goal. Adolescents between the ages of 15 and 18 years (N = 170) completed questionnaires on general and pain-specific anxiety, courage, and dispositional avoidance. Adolescents were presented with 16 vignettes (8 high pain intensity, 8 low pain intensity), which described pain conflicting with a goal (eg, doing well at school, seeing friends). Adolescents rated goals for importance and reported how likely they would be to approach or avoid each pain. Adolescents were more likely to avoid and were more fearful of high pain intensity than low pain intensity vignettes. Pain anxiety predicted higher levels of avoidance for both pain intensities. General anxiety was not a significant predictor of avoidance for either pain intensity. Goal importance promoted approach of goals, but only when pain was described as intense. However, pain anxiety predicted avoidance beyond the importance of goals for high pain intensity vignettes. In addition, we compared approach-avoidance of adolescents with and without chronic pain; analyses revealed no differences in approach-avoidance behaviour. We also found that behavioural endurance was predictive of approach and dispositional avoidance predicted higher avoidance, but courage was not predictive of behaviour in this task. We adopt a motivational perspective when interpreting the findings and consider whether the fear-avoidance model should be extended to include the function of avoidance or approach in the pursuit of a desired goal.
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Claes N, Crombez G, Meulders A, Vlaeyen JW. Between the Devil and the Deep Blue Sea: Avoidance-Avoidance Competition Increases Pain-Related Fear and Slows Decision-Making. THE JOURNAL OF PAIN 2016; 17:424-35. [DOI: 10.1016/j.jpain.2015.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/20/2015] [Accepted: 12/10/2015] [Indexed: 02/06/2023]
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Wang Y, Jackson T, Cai L. Causal effects of threat and challenge appraisals on coping and pain perception. Eur J Pain 2016; 20:1111-20. [DOI: 10.1002/ejp.835] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Y. Wang
- School of Psychology Southwest University Chongqing China
| | - T. Jackson
- School of Psychology Southwest University Chongqing China
| | - L. Cai
- Department of Psychology University of Glasgow Scotland
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