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Pain research has shown that fear-avoidance beliefs determine disability from back pain to a significant degree. It is assumed that anxiety regarding certain movements or activities motivates avoidance behavior. It has not yet been established whether chronic low back pain (CLBP) patients actually experience fear of movement when confronted with back pain-related movements. Startle response measures reliably differentiate the affective quality of a stimulus. This study investigates whether CLBP patients show a startle response typical for aversive stimuli when confronted with pictures of back pain-related movements. In 36 patients with CLBP (mean age 45 yrs), 18 headache patients (mean age 45 yrs) and 18 healthy controls (mean age 43 yrs), the startle response was examined in the presence of pictures of back pain-related movements (e.g., bending) and pleasant movements. Back pain patients did not show the predicted startle potentiation when viewing back pain-related pictures, although they rated these pictures as more aversive than did the other two groups. Results may indicate that it is not fear of pain that motivates avoidance behavior and determines disability, but rather an individual's beliefs and attitudes concerning back stressing movements. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Describes the development and validation of the Inventory for Assessing Causal Attributions and Control Attributions in Chronic Pain Patients. The inventory includes 4 scales assessing psychological and medical attributions related to the cause of pain and the control of pain. Results from several studies confirm the overall validity of the inventory. (English abstract) (PsycINFO Database Record (c) 2016 APA, all rights reserved)

We report the results of a randomized controlled trial that compared the efficacy of an internet-based self-help treatment for paediatric headache including chat communication (cognitive-behavioural treatment, CBT) with an internet-based psychoeducation intervention (EDU). In the CBT group, significant pre- to post-treatment decreases were found for headache frequency and pain catastrophizing, but not for headache intensity or duration. In the EDU group none of the variables (frequency, intensity, duration, pain catastrophizing) showed improvement. No significant between group differences were found for headache variables and pain catastrophizing at post-treatment. The patients reported high satisfaction with the internet-based training and a good patient-trainer-alliance. Results were maintained at 6-month follow-up. Due to the small sample size, no general conclusions can be drawn regarding the efficacy of the internet-based training regarding the outcome variables, but the training was well accepted by patients. Further research is necessary to evaluate the therapeutic potential of such interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Tested the hypothesis that a treatment package that includes medical care and cognitive-behavioral treatment is more effective than medical treatment alone. This refers to improvement in control over pain, coping strategies, and physical and mental disability. The program was conducted in a group setting in accordance with a treatment manual and consisted of 12 weekly 2.5-hr sessions. A 2-factor experiment with repeated measures on 1 factor was applied. 94 consecutive patients with low-back pain were randomly assigned to an experimental group having a combined medical and cognitive-behavioral treatment, or to a control group with medical treatment only. Assessments were taken pretreatment, posttreatment, and (in the treated group only) at a 6-mo followup. At each assessment, Ss kept a pain diary over a period of 4 wks, and filled in self-report questionnaires. The sample consisted of 36 experimental and 40 control Ss at posttreatment. Experimental Ss reported less pain, better control over pain, more pleasurable activities and feelings, less avoidance and less catastrophizing. In addition, disability was reduced in terms of social roles, physical functions, and mental performance. Results were maintained at followup. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Background and objectives: The International Affective Picture System (IAPS) is a set of colour photographs depicting a wide range of subject matters. The pictures, which are widely used in research on emotions, are commonly described in terms of the dimensions of valence, arousal and dominance. Little is known, however, about discrete emotions that the pictures evoke. Our aim was to collect dimensional and categorical ratings from a German sample for a subset of IAPS pictures and to identify a set of fear-evoking pictures. Methods: 191 participants (95 female, 96 male, mean age 23.6 years) rated 298 IAPS pictures regarding valence, arousal and the evoked emotion. Results: 64 fear-evoking pictures were identified. Sex differences for categorical and dimensional ratings were found for a considerable number of pictures, as well as differences from the US norms. Conclusions: These differences underscore the necessity of using country-specific and sex-specific norms when selecting stimuli. A detailed table with categorical and dimensional ratings for each picture is provided. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

The purpose of this study was to analyse the Questionnaire on Hypersensitivity to Sound (GÜF; Nelting & Finlayson, 2004) and to improve its validity based on the analysis of intercorrelations (single item level) with other methods of assessing hyperacusis (uncomfortable loudness level, individual loudness function, self-rated severity of hyperacusis). Subjects consisted of 91 inpatients with tinnitus and hyperacusis. The GÜF showed a good reliability (α = .92). The factorial structure of the questionnaire reported by Nelting et al (2002) was not completely supported by the evidence in this study. The total score and the single items showed small to moderate correlations with the other modes of measuring hyperacusis. Evidence for convergent and discriminant validity were found, but overall the results corroborate the conceptual heterogeneity of the construct hyperacusis and its dependency on the assessment method. Four items of the GÜF with particularly low correlations were excluded from the questionnaire. The revised GÜF total score showed slightly but not statistically significant higher convergent and discriminant validity. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

The aim of the present study was to assess the distribution and characteristics of headache in children aged 7–14 years in Lower Saxony (Germany). For the survey, 8800 households with children were randomly drawn from community registers. Parents received comprehensive questionnaires regarding various aspects of their childʼs headache history and general health by mail. The response rate was 63.5\%. The 6-month prevalence of paediatric headache was 53.2\% and increased with age (39\% at 7 years to 63\% at age 14). Overall, recurrent headache (≥1/week) was experienced by 6.5\% of the total sample and was significantly more common among older girls (≥11 years) than their male counterparts. Boys and girls did not differ markedly from one another regarding headache occurrence and frequency until the age of 11. Mean age of headache onset was 7.5 years, with onset occurring at a significantly younger age among boys than among girls. In accordance with International Classification of Headache Disorders-II criteria, migraine was diagnosed in 7.5\% and tension-type headache in 18.5\% of the cases, hence a large proportion of the children had unclassifiable headache. Of the headache disorders, migraine was rated the most disabling, with the highest average intensity, highest frequency, duration of headache often exceeding 2 h and more frequent use of medication. In general, aura symptoms were rare except for visual disturbances (17\%). Paediatric headache was strongly associated with other health problems, including other pain symptoms. Paediatric headache was also associated with a history of parental headache. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Objective: This cross-sectional study on a randomly drawn population sample of children and adolescents (n = 3399; aged 9 to 15) aimed at the assessment of patterns of associations between psychosocial variables and primary headache disorders like migraine (MIG) or tension-type headache. A headache-free group served as a control. Methods: Data on headache and psychological trait variables (eg, internalizing symptoms), behavioral factors (eg, physical activities), and socio-environmental factors (eg, life events) were gathered by questionnaire. Logistic regression analyses were conducted with headache types (MIG, tension-type, and non-classifiable headache) as dependent variables. Results: The pattern of correlations was largely congruent between the headache disorders. Associations were closest regarding maladaptive psychological traits (in particular internalizing symptoms with an odds ratio > 4 regarding MIG) compared with socio-environmental factors and particularly the behavioral factors. Unfavorable psychological traits and socio-environmental strains demonstrated distinctly stronger associations with MIG than tension-type headache and explained more variance in the occurrence of pediatric headache disorders than parental headache. Sex-specific analyses showed similarities as well as differences regarding the correlations, and in general, the associations were stronger in girls than boys. Conclusions: A common path model as posited by several researchers in the field may explain the parallelism in biopsychosocial vulnerability regarding the different headache disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Objective: External assessment of health-related quality of life (HRQL) in children and adolescents with permanent hearing loss. Method: 292 parents of hearing-impaired children received a standardized, age-adapted HRQL questionnaire (KINDL-R; on average 5.5 years after the provision with hearing aids). 68.8\% of the questionnaires were sent back. Study group: 178 children (91 boys, 87 girls), age 4.0 to 16.11 years; 23 children with multiple handicaps, age 4.0 to 16.0 years. The children were patients of the Goettinger Hoer-Sprachregister. Results: The overall HRQL in children with hearing loss only was not adversely affected by the sensory disorder (Total HRQL 77.2; SD = 9.5 on a scale from 0 to 100). Boys (76.5; SD = 9.9) and girls (77.9; SD = 9.2) did not show a significant difference. The mean Total HRQL-score of the multiple handicapped children was reduced (68.0; SD = 15.3; p = 0.01) compared to those without other impairments. Age and contentment with school/kindergarten of the children with hearing loss were negatively correlated (r = −0.27; p < 0.001). The parents of the children with multiple handicaps rated the LQ of the scales 'somatic well being' (p = 0.003) and 'friends' (p = 0.001) lower. Conclusions: Children with hearing impairment did not exhibit a general reduction of HRQL. HRQL of hearing-impaired children with comorbid disabilities is clearly diminished. Nevertheless the disorder seems to make social interactions more difficult and thus impede the psychosocial development of a child. Interactions between changed attitudes of parents and their effects on the child are to assume. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Several theories suggest that self-focused attention plays an important role in the maintenance of depression. However, previous studies have predominantly relied on self-report and laboratory-based measures such as sentence completion tasks to assess individual differences in self-focus. We present a prospective, longitudinal study based on a sample of 29 inpatients with clinical depression, investigating whether an implicit, behavioural measure of self-focused attention, i.e., the relative frequency of first-person singular pronouns in naturally spoken language, predicts depressive symptoms at follow-up over and above initial depression. We did not find a significant cross-sectional association between depressive symptoms and first-person singular pronoun use. However, first-person singular pronoun use significantly predicted depressive symptoms approximately 8 months later, even after controlling for depressive symptoms at baseline or discharge. Exploratory analyses revealed that this effect was mainly driven by the use of objective and possessive self-references such as ‘me’ or ‘my’. Our findings are in line with theories that highlight individual differences in self-focused attention as a predictor of the course of depression. Moreover, our findings extend previous work in this field by adopting an unobtrusive approach of non-reactive assessment, capturing naturally occurring differences in self-focused attention. We discuss possible clinical applications of language-based assessments and interventions with regard to self-focus. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message * Naturally occurring individual differences in first-person singular pronoun use provide an unobtrusive way to assess patients' automatic self-focused attention. * Frequent use of first-person singular pronouns predicts an unfavourable course of depression. * Self-focused language might offer innovative ways of tracking and targeting therapeutic change.

The impairment of mental time travel is a severe cognitive symptom in patients with brain lesions and a number of neuropsychiatric disorders. Whether animals are also able to mentally travel in time both forward and backward is still a matter of debate. In this regard, we have proposed a continuum of mental time travel abilities across different animal species, with humans being the species with the ability to perform most sophisticated forms of mental time travel. In this review and perspective article, we delineate a novel approach to understand the evolution, characteristics and function of human and animal mental time travel. Furthermore, we propose a novel approach to measure mental time travel in rodents in a comprehensive manner using a test battery composed of well-validated and easy applicable tests.

Investigated whether pain anticipation (PA) and fear-avoidance beliefs (FABs) will lead to behavioral avoidance. 50 patients (mean age 41.4 yrs) with chronic low back pain performed a simple leg-flexion task. Before the test, members of a control group were informed that the movement would not result in any increase of pain, whereas experimental group subjects were told that a slight increase of pain could occur. All patients completed the Fear-Avoidance-Beliefs Questionnaire and the Pain Disability Index. As dependent variables, different behavioral performance parameters were registered by a computerized protocol: number of flexion movements, mean range of motion, and mean work ratio. Furthermore, patients were asked about their pain intensity as well as their fear (at the moment) and finally were asked to judge the unpleasantness of the experiment (using visual analogue scales for each of the 3 variables). Results show that inducing PA by instruction led to significantly lower levels of behavioral performance as well as increased pain intensity and fear during the test. Behavioral performance was significantly correlated with FABs. Results confirm that PA and FABs significantly influence the behavior of patients with low back pain in that they motivate avoidance behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Recent theories in sexuality highlight the importance of automatic and controlled attentional processes in viewing sexually relevant stimuli. The model of Spiering and Everaerd (2007) assumes that sexually relevant features of a stimulus are preattentively selected and automatically induce focal attention to these sexually relevant aspects. Whether this assumption proves true for pedophiles is unknown. It is aim of this study to test this assumption empirically for people suffering from pedophilic interests. Twenty-two pedophiles, 8 nonpedophilic forensic controls, and 52 healthy controls simultaneously viewed the picture of a child and the picture of an adult while eye movements were measured. Entry time was assessed as a measure of automatic attentional processes and relative fixation time in order to assess controlled attentional processes. Pedophiles demonstrated significantly shorter entry time to child stimuli than to adult stimuli. The opposite was the case for nonpedophiles, as they showed longer relative fixation time for adult stimuli, and, against all expectations, pedophiles also demonstrated longer relative fixation time for adult stimuli. The results confirmed the hypothesis that pedophiles automatically selected sexually relevant stimuli (children). Contrary to all expectations, this automatic selection did not trigger the focal attention to these sexually relevant pictures. Furthermore, pedophiles were first and longest attracted by faces and pubic regions of children; nonpedophiles were first and longest attracted by faces and breasts of adults. The results demonstrated, for the first time, that the face and pubic region are the most attracting regions in children for pedophiles. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Medically unexplained somatic symptoms are common, associated with disability and strongly related to depression and anxiety disorders. One interesting, but to date rarely tested, hypothesis is that deficits in both theory of mind (ToM) and emotional awareness may undergird the phenomenon of somatization. This study sought to investigate whether or not differences in ToM functioning and self-reported emotional awareness are associated with somatic symptoms in a sample from the general population.

Studied the predictive validity of a trait inventory assessing habitual coping strategies. Human subjects: 128 normal West German adults (aged 20–56 yrs) (university students and staff). One week after completing the trait inventory, Ss were presented with 2 stories of stressful situations and asked to describe how they would cope with these situations. Correlations between results on the trait inventory and responses to the stressful situations were analyzed. Tests used: The 'Stressverarbeitungsfragebogen' (Coping with Stress Inventory) by W. Janke et al, 1985. (English abstract) (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Treatment goals are either proposed by a patient or deduced from the case formulation of the therapist. To optimize goal-finding procedures in psychotherapy, therapists need an empirical point of reference to estimate the degree of goal attainment that can be expected for a specific treatment goal. To establish such an empirical basis, treatment goal categories of the primary treatment goals of 2,770 inpatients undergoing cognitive-behavioral therapy were categorized by the Bern Inventory of Treatment Goals. The levels of goal attainment were then compared with respect to 48 different goal categories. The results indicate that goal attainment differs according to treatment goal categories, even if confounding characteristics of the patient are controlled for. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Background: Empathy is considered as both a characteristic trait and a variable state. The present experiment examined whether or not prior exposure to pain, perceived similarity, sex and attributed pain intensity are associated with state empathy for pain. Methods: The state empathy of students (38 female, 42 male) in response to pictures displaying exposure to pressure pain was measured via self-reports, using a newly developed state empathy scale with the two subscales of ‘emotional response’ and ‘perspective taking’. Physiological responses were also recorded. Half of the participants were exposed to pressure pain prior to the experiment. Perceived similarity to the person being exposed to pain and their estimated pain intensity were assessed. Results: The results revealed that perceived similarity and sex were significantly related to the emotional dimension of empathy. This sex difference was partially mediated by the estimated intensity of pain. Women rated the intensity of pain more highly and achieved higher scores on the emotional response subscale. Exposure to pain predicted empathy on the perspective-taking subscale, resulting in higher scores when the subject had been exposed to the same pain stimulus. The physiological recordings did not correlate with any of the empathy scores. Conclusions: Greater degrees of perceived similarity, being female and higher estimated pain were linked to a stronger ‘emotional reaction’, whereas previous exposure to pain facilitated ‘perspective taking’. Pointing out similarities between people and their past experiences, as well as focusing on the imagined discomfort being felt by another person, may modulate empathy for pain.