The results are consistent with the notion that anxiety fosters attentiveness to possible environmental threats, and might have implications for the clinical management of acute pain.
Fordyce's (1976) analysis of pain behaviour provides a framework for evaluating the extent to which empirical studies of the operant treatment of chronic pain have adhered to appropriate behaviour–analytic principles. These are the identification of target behaviours and their reinforcing contingencies, the specification of individualised reinforcers to be used in treatment, and the generalisation and maintenance of treatment effects. Twenty-five studies that reported having used an operant approach in the management of chronic pain problems were reviewed. With one exception, none of the studies reported sufficient data to indicate the degree of adherence to behaviour–analytic principles. Until more such data are reported, it will continue to be difficult to determine clearly those factors that contribute to the efficacy of operant approaches to chronic pain management.
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