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Background: Approximately half of all patients who undergo surgical repair of extremity fractures report persistent postsurgical pain (PPSP) at 1-year post-surgery. Psychological factors such as anxiety, depression, catastrophization, poor coping, high somatic complaints, and pessimism about recovery are risk factors for the development of PPSP. It is possible that interventions such as cognitive behavior therapy (CBT) that target psychological factors may reduce the incidence of PPSP in this population. Aims: The current report reviews the role of psychological factors in the development of PPSP and discusses the rationale and protocol development for a multi-site randomized-controlled trial investigating the effectiveness of CBT in reducing PPSP in patients with surgically treated extremity fractures. [ABSTRACT FROM AUTHOR]

Background and objectives The present study investigated the effects of computerized interpretation training and cognitive restructuring on symptomatology, behavior, and physiological reactivity in an analogue social anxiety sample. Methods Seventy-two participants with elevated social anxiety scores were randomized to one session of computerized interpretation training ( n = 24), cognitive restructuring ( n = 24), or an active placebo control condition ( n = 24). Participants completed self-report questionnaires focused on interpretation biases and social anxiety symptomatology at pre and posttraining and a speech task at posttraining during which subjective, behavioral, and physiological measures of anxiety were assessed. Results Only participants in the interpretation training condition endorsed significantly more positive than negative interpretations of ambiguous social situations at posttraining. There was no evidence of generalizability of interpretation training effects to self-report measures of interpretation biases and symptomatology or the anxiety response during the posttraining speech task. Participants in the cognitive restructuring condition were rated as having higher quality speeches and showing fewer signs of anxiety during the posttraining speech task compared to participants in the interpretation training condition. Limitations The present study did not include baseline measures of speech performance or computer assessed interpretation biases. Conclusions The results of the present study bring into question the generalizability of computerized interpretation training as well as the effectiveness of a single session of cognitive restructuring in modifying the full anxiety response. Clinical and theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

Background and Objectives: The present study investigated the effects of computerized interpretation training and cognitive restructuring on symptomatology, behavior, and physiological reactivity in an analogue social anxiety sample.Methods: Seventy-two participants with elevated social anxiety scores were randomized to one session of computerized interpretation training (n = 24), cognitive restructuring (n = 24), or an active placebo control condition (n = 24). Participants completed self-report questionnaires focused on interpretation biases and social anxiety symptomatology at pre and posttraining and a speech task at posttraining during which subjective, behavioral, and physiological measures of anxiety were assessed.Results: Only participants in the interpretation training condition endorsed significantly more positive than negative interpretations of ambiguous social situations at posttraining. There was no evidence of generalizability of interpretation training effects to self-report measures of interpretation biases and symptomatology or the anxiety response during the posttraining speech task. Participants in the cognitive restructuring condition were rated as having higher quality speeches and showing fewer signs of anxiety during the posttraining speech task compared to participants in the interpretation training condition.Limitations: The present study did not include baseline measures of speech performance or computer assessed interpretation biases.Conclusions: The results of the present study bring into question the generalizability of computerized interpretation training as well as the effectiveness of a single session of cognitive restructuring in modifying the full anxiety response. Clinical and theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

The combination of challenge and humor inherent in teasing creates an ambiguous situation that can either increase bonding or create tension in a relationship, depending on how the teasing is interpreted. Although it is well established that individuals with social anxiety interpret ambiguous social situations negatively, no research has examined how individuals with social anxiety react to and interpret teasing. Ninety undergraduate students with high ( n = 56) and low ( n = 34) levels of social anxiety read vignettes depicting teasing scenarios, and rated how they would feel and behave in the situations. Participants also completed a self-report measure of recalled childhood teasing. Compared to the low social anxiety group, participants in the high social anxiety group reported that they would experience more negative affect in response to the teasing scenarios, and interpreted the teasing scenarios as more malicious and mean-spirited. As well, participants in the high social anxiety group reported being more likely to change the behavior that was the focus of teasing (e.g., changing the way they dress if the focus of teasing was their outfits) compared to participants in the low social anxiety group. Recalled childhood teasing partially mediated group differences on negative affect and behavior change in response to the teasing scenarios. The present results are consistent with the information processing bias literature and have implications for the social functioning of individuals with high levels of social anxiety. [ABSTRACT FROM AUTHOR]

The authors examined the longitudinal relation between joint attention and socioemotional functioning in a low-risk, typically developing sample of children when the children were toddlers and again during the early school-age years. Fifty-eight mothers and their children were observed in the home or laboratory engaging in 1 unstructured and 4 semistructured tasks designed to assess joint attention episodes when the children were toddlers. Approximately 4 years later, the mother–child dyads were contacted again and mothers completed the Child Behavior Checklist as a measure of their children’s socioemotional outcome at the early school years. The authors found that lower frequencies of joint attention episodes at toddlerhood predicted higher internalizing behaviors at early school age. Preliminary findings are discussed in terms of their theoretical implications for work on early mother–child interactions and children’s typical and atypical sociemotional development. [ABSTRACT FROM PUBLISHER]

lthough joint attention processes are known to play an important role in adaptive social behavior in typical development, we know little about these processes in clinical child populations. We compared early school age children with selective mutism (SM; n = 19) versus mixed anxiety (MA; n = 18) and community controls (CC; n = 26) on joint attention measures coded from direct observations with their parent during an unstructured free play task and two structured tasks. As predicted, the SM dyads established significantly fewer episodes of joint attention through parental initiation acts than the MA and CC dyads during the structured tasks. Findings suggest that children with SM may withdraw from their parents during stressful situations, thus missing out on opportunities for learning other coping skills. We discuss the implications of the present findings for understanding the maintenance and treatment of SM. [ABSTRACT FROM AUTHOR]

We examined receptive language and academic abilities in children with selective mutism (SM; n = 30; M age = 8.8 years), anxiety disorders (n = 46; M age = 9.3 years), and community controls (n = 27; M age = 7.8 years). Receptive language and academic abilities were assessed using standardized tests completed in the laboratory. We found a significant group by sex interaction for receptive vocabulary scores such that, within females, the SM and mixed anxiety groups had significantly lower receptive vocabulary scores than community controls. We also found that children with SM and children with anxiety disorders had significantly lower mathematics scores than community controls. Despite these differences in mathematics and receptive vocabulary performance, children with SM and children with anxiety disorders still performed at age-level norms, while more children in the community control group performed above age-level norms. Findings suggest that despite their speaking inhibition in the school setting, children with SM are still able to attain the receptive vocabulary and academic abilities that are expected at their age levels. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

MOUNTING EVIDENCE points to joint attention as a mediating variable in children's adaptive behavior development. Joint attention in interactions between hearing mothers and congenitally deaf (n = 27) and hearing (n = 29) children, ages 18-36 months, was examined. All deaf children had severe to profound hearing loss. Mother-child interactions were coded for maternally initiated and child-initiated success rates in establishing joint attention; mothers completed ratings of their children's adaptive behavior. Hearing mother-deaf child dyads had significantly lower maternally initiated success rates. No significant between-group differences on child-initiated success rates were shown. Maternal ratings of adaptive behavior were significantly lower for deaf children, and related positively and significantly to both child-initiated and maternally initiated success rates. The findings suggest that mother-child interactions that are low in successful establishment of joint attention might mediate the development of socioemotional problems evident in deaf children with hearing families. [ABSTRACT FROM AUTHOR]

The authors examined parent-child interactions among three groups: selectively mute, anxious, and non-anxious children in different contexts. The relation between parental control (granting autonomy and high power remarks), child factors (i.e., age, anxiety, verbal participation), and parent anxiety was investigated. Parental control varied by context but parents of children with SM were more controlling than parents in the comparison groups in all contexts. Regression analyses indicated that child and parent anxiety predicted parental control, with increased anxiety associated with increased control. Older child age predicted less parent control. Group categorization moderated the relation between age and high power remarks, such that age was not a significant predictor for children with SM. Finally child-initiated speaking predicted high power remarks over and above other variables. These results support previous theories that parents take over for their children when they fail to meet performance demands, especially when the child or parent is anxious. [ABSTRACT FROM AUTHOR]