Autonomic responses to heat pain: Heart rate, skin conductance, and their relation to verbal ratings and stimulus intensity

In human pain experiments, as well as in clinical settings, subjects are often asked to assess pain using scales (eg, numeric rating scales). Although most subjects have little difficulty in using these tools, some lack the necessary basic cognitive or motor skills (eg, paralyzed patients). Thus, the identification of appropriate nonverbal measures of pain has significant clinical relevance. In this study, we assessed heart rate (HR), skin conductance (SC), and verbal ratings in 39 healthy male subjects during the application of twelve 6-s heat stimuli of different intensities on the subjects’ left forearm. Both HR and SC increased with more intense painful stimulation. However, HR but not SC, significantly correlated with pain ratings at the group level, suggesting that HR may be a better predictor of between-subject differences in pain than is SC. Conversely, changes in SC better predicted variations in ratings within a given individual, suggesting that it is more sensitive to relative changes in perception. The differences in findings derived from between- and within-subject analyses may result from greater within-subject variability in HR. We conclude that at least for male subjects, HR provides a better predictor of pain perception than SC, but that data should be averaged over several stimulus presentations to achieve consistent results. Nevertheless, variability among studies, and the indication that gender of both the subject and experimenter could influence autonomic results, lead us to advise caution in using autonomic or any other surrogate measures to infer pain in individuals who cannot adequately report their perception.     

Training total communication

ABSTRACT

Background: Many people with severe or moderate aphasia begin to use nonverbal methods of communication spontaneously, but some need special training to do so. Use of total communication, including different nonverbal techniques, is often recommended to enable communication and participation in social interaction. Emphasis has also been placed on the importance of a communication partner in facilitating interaction and co-constructing the meaning in a discussion.

Aims: The aim of the present study was to examine the way people with severe or moderate aphasia perceive they communicate, and if they and their partners perceive changes in the use of different means of communication during an intervention where the aphasic participants are stimulated to use total communication and the communication partners are guided to support the interaction and to facilitate the use of different means of communication.

Methods & Procedures: The data were collected during a regular rehabilitation course. The course was carried out in two parts (8 + 4 days) with a 3-month interval. A total of 38 aphasic respondents, mainly with severe or moderate aphasia, aged 26 to 65 years, and 38 of their partners aged 29 to 71 years participated in the study. The research involved an initial, interim, and delayed post-test questionnaire design stretched over a 9-month period. An investigator-constructed, self-assessment questionnaire called Use of Different Communication Methods (UDCM) was used. With the aphasic participants a pictorial version of the questionnaire was administered in the form of an interview. The partners completed the questionnaire independently.

Outcomes & Results: The results indicate that persons with aphasia and their partners perceive the use of different communication methods quite similarly. The participants with aphasia perceive they use mostly the remaining ability of speech they possess and spontaneous nonverbal communicative methods and in lesser degree low-tech and high-tech devices. Both parties perceived that the use of spontaneous nonverbal means of communication and low-tech devices increased during and after the intervention.

Conclusions: The results indicate that people with severe and moderate aphasia and their partners perceive that total communication, i.e., all available means of communication as for instance, limited speech, spontaneous nonverbal means of communication and low-tech devices is often in use. They also perceive that the use of these different communication methods can further be increased by training and by guiding the communication partner to facilitate and support the use of them.     

Nonverbal expression of psychological states in psychiatric patients

Summary Nonverbal behavior, especially facial expression, appears as one of the most important means for communicating affective states. Studies on groups of psychiatric patients and control subjects are reported in which nonverbal behavior is analyzed from videotaped dialogues. Using a quantitative approach, results on facial behavior, speech, and gaze are described, which shed light on the expressive and communicative functions of nonverbal behavior. From longitudinal observations on depressed patients it emerged that individual-specific associations have to be taken into account for the relationship between expressive behavior and mood changes.The predominance of facial behavior in the speaker role of an individual found in patients and control groups points to the integrated communicative function of the verbal and nonverbal elements. However, recovered schizophrenic patients exhibited a dissociation of these elements. Implications for our understanding of nonverbal communications are discussed.     

洛阳市汉族老人龚氏非文字智力测验常模的制订

目的 :建立龚氏非文字智力测验 (GNIT) 5 6岁以上汉族正常老人区域性常模。方法 :分层取样 ,按年龄、性别、地域、文化程度和职业等变量来分层。抽取河南洛阳市的 5 6～ 10 1岁老年人 14 6 0名。男女接近各半 ,分成 8个年龄组。分三种常模 ,即原始分、离差量表分和离差标准分。结果 :4 0名老人相隔 1～ 2周进行重测 ,各分测验原始分重测相关系数为 0 .5 9～ 0 .89,总原始分重测相关系数为 0 .83;各分测验原始分两两相关系数为 0 .35～ 0 .6 3;5 0名老人在本测验的标准分与我国修订的韦氏成人智力量 (WAIC -RC)的VIQ ,PIQ和FIQ的相关系数分别为 0 .4 3,0 .5 1和 0 .5 4。结论 :本测验在汉族老人中的信效度比较满意。本测验是测量汉族老人智力的有效手段之一     

Effects of Different Attentional Cues on Responding to Joint Attention in Younger Siblings of Children with Autism Spectrum Disorders

We compared responding to joint attention (RJA) in younger siblings of children with ASD (SIBS-ASD; n = 46) and younger siblings of children developing typically (SIBS-TD; n = 35). Children were tested between 12 and 23 months of age in a situation in which an experimenter directed the child’s attention to one of 8 targets. Each child responded to 10 different combinations of verbal and nonverbal cues containing varying levels of attention-specifying information. SIBS-ASD had significantly lower overall RJA scores than SIBS-TD. Moderately redundant cues were most difficult for SIBS-ASD relative to SIBS-TD; adding a point to moderately redundant cues improved RJA for SIBS-ASD, bringing them to a level of RJA commensurate with SIBS-TD.     

When emotion and expression diverge: The social costs of Parkinson’s disease

Introduction: Patients with Parkinson’s disease (PD) are perceived more negatively than their healthy peers, yet it remains unclear what factors contribute to this negative social perception. Method: Based on a cohort of 17 PD patients and 20 healthy controls, we assessed how naïve raters judge the emotion and emotional intensity displayed in dynamic facial expressions as adults with and without PD watched emotionally evocative films (Experiment 1), and how age-matched peers naïve to patients’ disease status judge their social desirability along various dimensions from audiovisual stimuli (interview excerpts) recorded after certain films (Experiment 2). Results: In Experiment 1, participants with PD were rated as significantly more facially expressive than healthy controls; moreover, ratings demonstrated that PD patients were routinely mistaken for experiencing a negative emotion, whereas controls were rated as displaying a more positive emotion than they reported feeling. In Experiment 2, results showed that age-peers rated PD patients as significantly less socially desirable than control participants. Specifically, PD patients were rated as less involved, interested, friendly, intelligent, optimistic, attentive, and physically attractive than healthy controls. Conclusions: Taken together, our results point to a disconnect between how PD patients report feeling and attributions that others make about their emotions and social characteristics, underlining significant social challenges of the disease. In particular, changes in the ability to modulate the expression of negative emotions may contribute to the negative social impressions that many PD patients face.     

Symptoms after sport-related concussions alter gestural functions

ObjectivesSymptoms after sport-related concussions (SRC) are common. Because post-concussion symptoms are often not clearly visible, speech-accompanying gestures may help clinicians to gain additional information about the patient’s history and symptoms during medical consultation. We hypothesized that athletes with SRC and who suffered from persisting symptoms would display more gestures during concussion assessment protocols when compared to non-concussed athletes because of the athletes’ previous motor-sensory experiences made during the concussive event.DesignA retrospective cross-sectional study.MethodsThree matched groups of 40 (active) athletes were investigated in the context of concussion assessment (/and baseline) protocols: 14 symptomatic and 14 asymptomatic athletes with a SRC, and 12 non-concussed athletes. Certified raters using a standard analysis system for nonverbal behaviour analysed videotaped hand movements and gestures during a standardized concussion assessment protocol.ResultsSymptomatic athletes spent significantly more time with in space hand movements, i.e., movements that act in the body-external free space without touching anything and specifically, motion quality presentation gestures than non-concussed athletes.ConclusionsIncreased in space movements, which are functionally gestures, and specifically, motion quality presentation gestures in symptomatic athletes indicate that the more vivid sensory motor experience of the head trauma is reflected in more gestural expressions. Thus, hand movements and gestures differentiate athletes who suffer from post-concussion symptoms from non-concussed athletes indicating the athletes’ motor-sensory experiences of the event and its aftereffects. The present study highlights the fact that gestures can be employed as behavioural markers of symptoms after sport-related concussions.