Journal of Scholastic Inquiry: Behavioral Sciences, Volume 2, Issue 1, Spring 2014

Emotional Intelligence in Martial Arts

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Journal of Scholastic Inquiry: Behavioral Sciences

Behavioral Sciences Edition, Volume 2, Issue 1 Spring 2014

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Journal of Scholastic Inquiry: Behavioral Sciences

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JOURNAL OF SCHOLASTIC INQUIRY: BEHAVIORAL SCIENCES Spring 2014, Volume 2, Issue 1 Managing Editor Dr. Tanya McCoss-Yerigan Editor-in-Chief Dr. Jamal Cooks General Editor Daniel J. O’Brien APA Editor Jay Meiners Editorial Advisory Board Shirley Barnes, Alabama State University Joan Berry, University of Mary Hardin-Baylor Brooke Burks, Auburn University at Montgomery Timothy Harrington, Chicago State University Mark Wesolowski, Practitioner-Chicago Public Schools Lucinda Woodward, Indiana University Southeast

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TABLE OF CONTENTS Publication Agreement and Assurance of Integrity Ethical Standards in Publishing Disclaimer of Liability Research Manuscripts

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Emotional Intelligence in the Martial Arts: Predictor of Success Chris A. Moser, The University of Findlay Cheri Hampton-Farmer, The University of Findlay Daniel Baczkowski, The University of Findlay Matthew A. Moser

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Psychological Distress in Patients with Pain Elizabeth Bigham, California State University San Marcos Anne McKemy, California State University San Marcos

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Transformational Humane Education Rhondda F. Waddell, St. Leo University Debra Mims, St. Leo University

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Emotional Intelligence in the Martial Arts: Predictor of Success Chris A. Moser The University of Findlay Cheri Hampton-Farmer The University of Findlay Daniel Baczkowski The University of Findlay Matthew A. Moser

Abstract An emerging body of research suggests that social and emotional abilities play an important role in predicting personal and professional success. Although the possesion of analytical and technical skills serves as a minimum requirement for success, emotional intelligence (EI) is often the attribute that distinguishes outstanding performers from average ones. Scant research exists in measuring EI levels among black belt holders. To address this research gap, this study identifies EI competencies that predict success for individuals in this group. Just as certain competencies and attributes contribute to success in life and in the workplace, martial artist must also possess and acquire certain skills, qualities, and attributes to excel in their discipline. The purpose of this study is to determine whether black belt martial artists possess higher levels of EI than the general population and to identify specific emotionalquotient subscales that appear to contribute to their success in the martial arts. Utilizing the BarOn EQ-i assessment (Bar-On, 2007), the researchers investigated the EI of 77 adults who held a rank of first-degree black belt or higher and found that the black belt group possessed a higher-than-average total emotional quotient than the general population and scored higher on all 15 EI subscales. The findings of this study will support the need for developing a new model for professional development based on the practices, philosophies, and approaches traditionally found in the marital arts.

Keywords: emotional intelligence, martial arts, psychosocial development, social learning

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Emotional Intelligence among Black Belts: A Predictor of Success Although knowledge provides tools for success, social and emotional abilities also play an important role in determining personal and professional success. In fact, researchers continue the search for factors that contribute to one’s overall success in life. Not unlike other disciplines, those who train in the martial arts must also possess and develop skills, personal qualities, and attributes to excel. In this paper, the authors argue that those who achieve the rank of black belt possess a common set of personal qualities and attributes collectively known as emotional intelligence (EI). In the martial arts, achieving the rank of black belt equals success. Likewise, individuals with high levels of EI are more likely to achieve success. Therefore, EI can be a predictor of success.

Attaining the rank of black belt denotes a high level of accomplishment for those who train in the martial arts. Consequently, the “black belt” designation increasingly used beyond the martial arts signifies a high level of excellence, success, or accomplishment as evidenced by its use in credentials like Six Sigma Black Belt Certification, black belt leader, and black belt commission. Books such as Think Like a Black Belt (Bouchard, 2010) and Leading People The Black Belt Way (Warneka, 2006) assist nonmartial artists in achieving personal and professional success by borrowing from martial arts principles. Whether used in the context of the martial arts, business, or society, the black belt designation has become synonymous with a high level of achievement.

Because achiveing the black belt rank requires discipline and other personal qualities like perserverence, self-control, and self-awareness the authors of this research study investigated the EI of individuals who attained the rank of black belt to identify some of the unique factors that contributed to their success and achievement in the martial arts. This study highlights the EI components that appear to be most prevelent among black belt holders, and it will also provide the foundation for developing a new model for professional development based on the practices, philosophies, and approaches traditionally found in the marital arts.

Perspectives of Emotional Intelligence Although IQ accounts for 20% of one’s success, other factors, including EI, contribute greatly to personal achievements (Goleman, 1995). Because EI levels reflect distinct behaviors and attributes, identifying EQ-i levels can be a predictor of success and has been proven to be a predictor of real-world success. Cherniss, Extein, Goleman, and Weissberg (2006) cited studies in which EI levels were predictors of success, productivity, retention, increased profit, or customer satisfaction among groups like military employees, educators, and workers in the food and hotel industries.

A growing body of research documents a positive relationship between EI and life success and happiness. With a focus on emotions that influence intellect and action, Mayer and Salovey (1997) defined EI as “the ability to perceive emotions, to access and generate emotions

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so as to assist thought, to understand emotions and emotional knowledge, and to reflectively regulate emotions so as to promote emotional and intellectual growth� (p. 5). They argued that emotions influence thought, and they developed a typology for EI (Mayer & Salovey, 1990). In 1995, Goleman advanced the theory in his seminal work, Emotional Intelligence, and provided practical applications for human development by claiming that individuals who possess high levels of EI have the ability to identify emotions in themselves and others and that this awareness leads to appropriate responses. More recently, scholars like Fiori (2009) have found that EI is an unconscious function rather than something one consciously controls. Growing interest in this research area has led to practical applications. Empirical studies cite positive relationships between EI and outcomes such as quality of life, academic/occupational success, resistance to stress, health, and the quality of social/marital relationships (Nelis, Quoidbach, Mikolajczak, & Hansenne, 2009).

Although the possession of analytical and technical skills possibly serves as a minimum requirement for success, EI is often the attribute that distinguishes outstanding performers from average ones (Dulewicz, Young, & Dulewicz, 2005; Emmerling & Goleman, 2005; Gardner & Stough, 2002; George, 2000; Goleman, 1998). Findings from Feist and Barron’s (2009) study suggest that social and emotional abilities are four times as important as IQ in determining professional success. When Goleman (1998) calculated the ratio of technical skills, IQ, and EI as aspects of excellent performance, EI proved to be twice as important as other skills for leaders at all levels. Moreover, Goleman’s analysis revealed that EI plays an increasingly important role among people in senior leadership positions in which differences in technical skills are negligible.

Because individuals who train in the martial arts, particularly those who earn the rank of black belt, achieve a high level of success, the researchers examined EI levels among black belts to determine whether black belt EI levels are higher than those for the national mean.

Psychological Benefits of Martial Arts With its rise in popularity, martial arts in the United States has become an integral part of the sports and recreation culture (Columbus & Rice, 1998; Ko & Kim, 2010) as evidenced by the number of participants, which increased from 3.8 million in 1993 to 4.6 million in 2004 (Ko & Kim, 2010). In addition, the number of martial arts schools in the U.S. increased by almost 1,000 from 1999 to 2003 (Ko & Kim, 2010Although all martial arts disciplines embody unique cultural beliefs, values, and practices, each discipline differs based on the specific martial art and its adaptation to the cultural and social situation. Historically, Asian martial arts were defined as emancipatory, religious, and/or military praxis. However, most modern definitions of martial arts emphasize either psychological maturation or skill acquisition (Columbus & Rice, 1998).

Today, most martial artists believe that the martial arts are capable of producing both physical and psychological benefits (Weiser & Kutz, 1995).

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Unlike modern martial arts, which place more emphasis on competitive aspects, traditional martial arts focus more on meditative aspects, stressing self-control, conflict avoidance, respect for others, and emphasize kata or poomse training (patterns of kicking and punching rehearsed without an opponent) (Law, 2004). In addition, traditional martial arts incorporate more study of philosophical tenets and values, and character development, (Berce, 2012; Law, 2004; Weiser & Kutz, 1995).

Because martial arts emphasize personal development, increased studies by scholars in psychology indicate that martial arts training enhances psychological well-being (Law, 2004).

Research dating back to the late 1960s focused on the personal characteristics of martial artists, how these characteristics influence one’s preferences for participating in a specific martial art, and how these characteristics change or develop as a result of martial arts involvement (Vertonghen & Theeboon, 2010). Traditional martial arts teach values of directness and honesty in communication, assertiveness, empathy, courage, humility, perseverance, gentleness, respect for others, responsibility, and self-improvement (Weiser & Kutz, 1995). Other reported benefits of traditional martial arts training include physical and mental relaxation andbodily control, which are associated with an increase in self-confidence and selfesteem (Ko & Kim, 2010). In addition, those who train in traditional martial arts report increased self-efficacy, assertiveness, self-esteem, and reduced fear and anxiety (Angleman, Russo, Shinzato, & Van Hasselt, 2009).

Just as certain EI competencies and attributes contribute to one’s effectiveness in life and as a leader, those who reach the level of black belt must also possess certain qualities and attributes that enable them to achieve a high level of success in their martial art.

Study Design and Methodology To assess levels of EI among black belts, the researchers recruited black belts to complete the BarOn Emotional Quotient Inventory (EQ-i) and compared their scores with the national average. Participants for this research study were adults who hold the rank of first-degree black belt or higher in traditional martial arts and responded to an email sent to traditional martial arts leaders, instructors, and grandmasters. Researchers asked respondents for the email addresseses of other adults who also hold the rank of black belt. The invitation to participate in the study was extended to individuals who were at least 21 years of age, had achieved the rank of first-degree black belt or higher in traditional martial arts, and had an email address.

Black belts who met the criteria received an email message describing the purpose of the study and a link directing them to an online demographic/leadership competencies survey. A group of adult black belts (N = 8) involved in some form of the traditional martial arts helped the researchers test the demographic/leadership competencies survey. Their feedback prompted survey changes to improve clarity. The researchers informed participants that completion of the demographic/leadership survey and the BarOn EQ-iserved as implied consent. The University’s Institutional Research Review Board approved the email message requesting participation as well as the online demographic/leadership competencies survey.

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Once the subjects completed the online demographic/ leadership competencies survey, they accessed a link directing them to an electonic version of the EQ-i:125. This assessment is a scientifically validated instrument that measures emotionally intelligent behavior and probes frequency and intensity of emotional and social skills. The EQ-i renders four validity scale scores, a total Emotional Quotient (EQ) score, five composite scale scores, and 15 EQ subscale scores. EQ-i scores represent standard scores based on a mean of 100 and a standard deviation of 15, which facilitates the comparison of scores of one individual/group to the scores of a normative group and, theoretically, the general population (BarOn, 2007).

Participants A total of 77 adult black belt holders representing a variety of traditional martial arts disciplines participated in this research study. Each participant completed an electronic version of the demographic/leadership competencies survey and the EQ-i. Seventy-eight percent of the participants were male and 22% were female. All participants were between the ages of 22 and 68 with the median age being 48. The ranks of the respondents ranged from first-degree black belt to ninth-degree black belt with the median rank being third-degree black belt. The number of years that the black belts have participated in the martial arts ranged from 4 to 62 years with the median being 18 years. They represented a variety of martial arts disciplines with 55% in Taekwondo, 19% in Karate, and 26% from other martial arts disciplines Data Analysis Procedures Utilizing the Multi-Health Systems Scoring Organizer, the researchers converted the EQi raw scores for each participant to standard scores in order to compare participants’ scores to the general population scores. The conversion of raw scores to standard scores ensures that the total EQ-i score, as well as each of the five composite scales and 15 subscales, will have the same mean of 100 and a standard deviation of 15 and accounts for a respondent’s age and gender. In addition, the results included positive impression standard scores, inconsistency index scores, and omission rate percentages for each respondent to ensure the validity of the EQ-i results.

These validity indicators fell within acceptable parameters for all respondents and, thus, validated results for all respondents (BarOn EQ-i Technical Manual, 2007). A one-sample t-test allowed researchers to compare the EQ-i standard mean scores of the black belt group to the standard mean scores of the normative sample. Researchers compared the standard EQ-i scores of the black belt group to the EQ-i standard scores of a normal population with a 95% confidence level.

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Results Similar to IQ, EQ raw scores are converted to standard scores with the mean EQ score being 100 points and the standard deviation fixed at 15 points. The sample black belt group’s total EQ mean of 106.57 was greater than the mean of 100 found among the general population.

The authors present the summative descriptive statistics of the EQ-i results for the sample black belt group in Table 1. As indicated in Figure 1, the black belt group had a standard deviation of 11.08 compared with a standard deviation of 15 for the general population.

The sample black belt group scored higher than the general population on each of the five composite scales measured by the EQ-i—intrapersonal (108.39), interpersonal (103.90), stress management (107.55), adaptability (104.34), and general mood (104.61). The sample black belt group had a lower standard deviation in each of the five composite scales compared to the general population-- intrapersonal (10.23), interpersonal (13.84), stress management (11.25), adaptability (10.67), and general mood (11.1). The distribution plots found in Figures 2 through 6 illustrate comparisons for each composite scale of the sample black belt group to the general population.

The population means for the black belt group in each composite subscale are higher than the means for the general population in all 15 composite subscales as measured by the EQ-i.

The sample black belt group scores were highest in the following composite subscales: stress tolerance (108.91), assertiveness (107.51), self-awareness (107.40), and self-actualization (107.21)(see Table 1). Furthermore, the black belt group had a lower standard deviation for all 15 subscales compared to the general population, and the lowest standard deviations were in selfactualization (8.55), optimism (9.36), problem solving (9.55), and reality testing (10.82) (see Table 1).

Discussion The purpose of this study was to determine whether a black belt martial artist possesses higher levels of EI than the general population and to identify the specific EQ subscales that appear to contribute to a black belt holder’s success in the martial arts. Adult black belt holders in this sample possessed a higher overall level of EI than the level found in the general population, and the black belt group scored higher than the general population in all five composite scales and 15 subscales of EI measured by the EQ-i.

These findings confirm prior research studies measuring EI as well as research studies investigating the psychosocial benefits of participating in martial arts, and they support other findings that demonstrate a positive relationship between EI and quality of life, success, and achievement (Nelis et al., 2009). In addition, research about the outcomes of participating in martial arts has reported benefits in physical and mental relaxation, reduced fear, increased selfconfidence, assertiveness, self-improvement, self-esteem, and respect for others (Angleman et al., 2009; Ko & Kim, 2010; Weiser & Kutz, 1995). Likewise, the results of this study also

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suggest that the higher-than-average EI levels of the black belt participants in this study may be a contributing factor in their ability to achieve a high level of success and distinction in their martial arts disciplines.

The authors discovered that the black belt group scored higher than the general population in all 15 conceptual components of EI as measured by the EQ-i subscales. A noteworthy finding of this study was that the black belt group scored highest on the EQ-i subscale areas of stress tolerance, assertiveness, self-awareness, and self-actualization.

Specifically, the black belt group scored highest in the stress tolerance subscale with a mean of 108.91. Bar-On (2007) defines stress tolerance as the ability to withstand adverse events and stressful situations by actively coping with stress. The discipline of martial arts has come to be recognized for its capacity to promote health, both physical and mental, and the reported benefits of traditional martial arts training include physical and mental relaxation and lower levels of stress and anxiety (Ko & Kim, 2010; Weiser & Kutz, 1995). The physical activity and meditation techniques, integral aspects of martial arts training, may contribute to one’s ability to effectively cope with stress outside of the martial arts setting. Traditional martial arts training also emphasizes conflict avoidance techniques when encountering a threat. Therefore, a martial artist learns to control his or her fear and emotions and remain calm, confident, and composed when confronted with a threat or stressful situation. This ability to remain calm and confident in stressful situations enables the martial artist to be mindful and intentional about how he or she responds to any given situation and to be aware of his or her choices and the consequences of those choices. Trainees also learn stress tolerance through the practice of meditation. This practice also helps trainees learn how to confront aggression by utilizing non-techniques for diffusing a situation.

Assertiveness was the next highest subscale score in the black belt group with a mean of 107.57. Bar-On (2007) defines assertiveness as the ability to defend one’s rights, express feelings, beliefs, and thoughts in a nondestructive manner. Most traditional martial artists adhere to a set of values, beliefs, philosophical teachings, and/or tenants that are foundational to his or her specific art. Studies suggest that the longer an individual trains in the martial arts, the more interested he or she becomes in developing the values found in martial arts (Ko & Kim, 2010).

The strengths of the black belt group in this EI conceptual component closely align with the values and beliefs of many traditional martial arts disciplines that emphasize direct and honest communication, courage, respect for others, responsibility, and honor (Weiser & Kutz, 1995).

Another key philosophy found in most traditional martial arts disciplines teaches the belief that one should stand up for what is virtuous or just as well as for his or her personal rights and the rights of others. The development of these values and beliefs, combined with increased levels of self-confidence, may contribute to the ability to openly and honestly express one’s feelings, beliefs, and opinions even when it is emotionally difficult. Martial arts participation requires respect toward one’s instructors, seniors, and fellow students through the act of bowing and addressing others in a manner appropriate for his or her rank, status, or age. In addition, explicit value statements and other philosophical teachings emphasize integrity. Other values central to

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many martial arts disciplines include honesty, truthfulness, and never betraying the trust of another person. Likewise, martial arts training requires students to adhere to the highest standards of integrity, ethical conduct, and behavior not only when training or interacting with their instructors and peers but also in all facets of their lives.

As stated previously, martial arts training, based on philosophical tenets, emphasizes the ability to control and manage one’s emotions when encountering stressful or threatening situations. Consequently, the emotional self-awareness subscale received the third highest score with a mean of 107.40 among the black belt participants. Bar-On (2007) defines emotional selfawareness as the ability to recognize one’s feelings. In addition to providing a deep understanding of one’s emotions, strengths, weaknesses, and drives, emotional self-awareness extends to a person’s values and goals (Goleman, 1998). The martial arts foster the integration of mind and body and teach practitioners to relax, focus, and develop self-awareness while striving for improvement (Weiser & Kutz, 1995). In addition, traditional martial arts training emphasizes the whole person striving to achieve harmony between the outer world, one’s body, and one’s inner energy (Berce, 2012). One way that martial arts training enhances emotional self-awareness is through meditation. Meditation helps the martial artist become aware and regulate emotions that may impede his or her ability to focus or maintain self-control when training.

The black belt sample possessed significant strength in the subscale of self-actualization with a mean of 107.21. Bar-On (2007) defines self-actualization as the ability to realize one’s potential capacities, which involves developing enjoyable and meaningful activities and being enthusiastic and committed to long-term goals. The pursuit of enlightenment and selfimprovement have been identified as motivator for martial artists (Ko & Kim, 2010). Trainees acquire these through teachings of fundamental philosophies that include self-improvement and the growth and development of both mind and body (Berce, 2012; Law, 2004; Weiser & Kutz, 1995). Perseverance and having an indomitable spirit are core values of most traditional martial arts disciplines, and they contribute to the belief that one can overcome challenges and obstacles and should strive to achieve one’s potential as a martial artist and as a person. A martial arts student can realize potential capabilities and attain goals through individual and group instruction that incorporate praise and positive reinforcement when a student masters a new skill or technique. Once a participant becomes proficient in a specific set of skills and techniques, they must successfully complete a promotion test demonstrating their competence in their current rank. Upon successful completion of this test participants are rewarded with a higher belt (rank) and the responsibility to learn advanced techniques and skills. The belt system found in traditional martial arts enables participants to pursue and achieve goals as they progress through the ranks and recognizes student accomplishments and achievements. Attaining a black belt in the martial arts, a lengthy process, requires a great deal of commitment.

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Limitations Although this study found that the adult black belt group possessed a higher overall level of EI than that of the general population , the study did not examine other factors that may have accounted for the sample group’s higher-than-average EQ scores, such as the reinforcement of similar values in the individuals’ home, religious culture, or social group. Therefore, high EI levels reported in this study cannot be attributed solely to one’s attainment of a black belt or participation in the martial arts.

Another limitation the researchers acknowledge is that sample selection methods may have affected the results. The researchers did not attempt to control for the effects of selfselection. In addition, the participants in this study may have excelled in the rank of black belt as a result of possessing higher levels of EI prior to their involvement in the martial arts. Moreover, the higher EI levels of the black belts participating in this study could be due to the attrition of individuals with lower levels of EI dropping out of the martial arts prior to attaining the rank of black belt. In addition, several influential factors such as individual and demographic characteristics, martial arts discipline, training environment and methods, number of years of martial arts involvement, and other factors could account for higher levels of EI among the participants of the study.

Finally, the results cannot be generalized beyond the scope of this study because of the relatively small sample size (77 black belt participants). Controlling for the numerous influential factors that might impact EI development, using a larger sample, and employing a longitudinal research design to investigate EI development throughout the training life of a martial artist would provide a better understanding of EI development as a result of participating in traditional martial arts.

Conclusion The black belt martial artists taking part in this study possess an overall higher level of EI than what would be found in the general population. Furthermore, the black belt group scored significantly higher in all five composite scales, as well as 13 of the 15 conceptual subscales, as measured by the EQ-i. The four conceptual subscales that received the highest scores among the black belt group were stress tolerance, assertiveness, self-awareness, and self-actualization.

The results of this study confirm previous research findings identifying psychosocial benefits of participation in traditional martial arts (Angleman et al., 2009; Berce, 2012; Ko & Kim, 2010; Law, 2004; Vertonghen & Theeboon, 2010; Weiser & Kutz, 1995). Many of the benefits identified through martial arts participation closely align with the EI competencies and attributes identified as predictors of personal and professional success. This study expands understanding of the benefits gained from participating in the martial arts by examining the unique qualities and attributes that have contributed to the success and achievement of black belt leaders. Furthermore, this study adds to a body of literature about how some of these EI

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competencies are foundational to the values, beliefs, tenets, and teachings of the traditional martial arts.

Although the findings indicate that the black belt participants in this study possess higher levels of EI than would be found in the general population, the researchers did not attempt to determine whether their higher levels of EI were the direct result of their involvement in the martial arts. As stated previously, several influential factors other than martial arts participation could account for the reported higher levels of EI among the black belt participants taking part in this study. However, it appears that many of the beliefs, values, and practices embodied in traditional martial arts could contribute to EI development among their participants. In addition, research suggests that EI development occurs through motivation, extended practice, individualized attention, and feedback (Goleman, 1998), which are all integral to martial arts training. Moreover, black belt leaders are held in high regard among martial arts students and exert a great deal of influence on the behavior of others through modeling the values, qualities, and attributes deemed important to their martial arts disciplines. Following describes some of the qualities of a black belt leader and his or her function within the framework of the martial arts: A master in the martial arts is fully in control of himself [sic]. He, if anyone, is aware of his own weaknesses and strengths. What is more, he is working on the elimination of the one and the advancement of the other. He places the basic principles of the martial arts before personal desires. He displays his confidence in his succeeding, and accepts failure as only a temporary set-back on the road to success. Finally, the master contributes to the welfare of all by helping all toward good citizenship. (Shim, 1980, p. 105) Findings from this study provide the foundation for future research about how EI levels in different groups can predict levels of success. Further research that compares EI levels of males and females, age groups, and ethnicities to determine how gender, age, or ethnicity impact differences in levels of EI would extend the findings from this study. To better understand how participation in traditional martial arts may contribute to EI development, the authors plan to examine the benefits of martial arts training among different age groups and identify correlations between martial arts training and EI development. However, the promising results of this study, along with the findings of other empirical studies on this topic, support the need for developing a new model or framework for professional development based on the practices, philosophies, and approaches traditionally found in the marital arts.

Author Biographies Dr. Moser, Assistant Professor and Director of the Human Resource Development Program at The University of Findlay, completed his Masters and EdD at Ball State University in Muncie, IN. With over 20 years’ experience teaching graduate courses in the areas of Leadership, HR Development and Adult Education, he has worked as a HR Manager and Corporate Trainer and as a private trainer and consultant in the areas of Leadership

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Development, Organizational Behavior, Sales/Customer Service, and HR Management. He is certified to administer and interpret the BarOn EQ-i and holds the rank of 2nd Degree Black Belt in Tae Kwon Do. Dr. Cheri Hampton-Farmer, Assistant Professor at The University of Findlay and chair of the Communication Department, completed her Masters and PhD at Bowling Green State University in Bowling Green, OH. Her research examines human behavior through the lens of communication, highlighting practical applications in areas like patient-centered care, organizational culture within a tire mold manufacturing facility, identifying systems within the academy that foster collaboration and increase productivity, and nurturing communication strategies for leaders and social movements.

Dr. Daniel Baczkowski, Assistant Professor at The University of Findlay in the Department of Mathematics, completed his MA in Mathematics at Miami University and his PhD in Mathematics at the University of South Carolina. His research interests include number theory, approximation theory, and related problems in analysis; more specifically, problems involving coverings of the integers, counting lattice points close to smooth curves and applications to problems involving gaps in number theory, and Diophantine equations involving factorials. Such topics often deal with the distribution of prime numbers, a topic with particular applications toward information security.

Mr. Matthew Moser, President of Historic Grading and Authentication, completed his Masters of Business Administration at Bowling Green State University in Bowling Green, OH. In addition to establishing four businesses which he currently manages, his work experience includes serving as an Assistant Vice-President/Branch Manager in the banking industry. His academic interests include finance and statistical analysis.

References Angleman, A. J., Russo, S. A., Shinzato, Y., & Van Hasselt, V. B. (2009). Traditional martial arts versus modern self-defense for women: Some comments. Aggression and Violent Behavior, 14, 89-93.

Bar-On, R. (2007). BarOn Emotional Quotient Inventory technical manual. Toronto, Canada: Multi-Health Systems Inc. .

Berce, J. (2012). New leadership approach for better public management. Journal of US-China Public Administration, 9(3), 290-302.

Bouchard, J. (2010). Think like a Black Belt. Brunswick, ME: San Chi Publishing.

Cherniss, C., Extein, M., Goleman, D., & Weissberg, R. (2006). Emotional Intelligence: What does the research really indicate? Educational Psychologist, 4(4), 239-245.

Columbus, P. J., & Rice, D. (1998). Phenomenological meanings of martial arts participation.

Journal of Sport Behavior, 21(1), 16-29.

Dulewicz, C., Young, M., & Dulewicz, V. (2005). The relevance of emotional intelligence for Leadership performance. Journal of General Management, 30(3), 71-86.

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Emmerling, R. J., & Goleman, D. (2005). Leading with emotion: Emotional intelligence predicts success. Leadership Excellence, 22(7), 9.

Feist, G., & Barron, F. (2006). Emotional intelligence and academic intelligence in career and life success. Paper presented at the annual convention of the American Psychology Society.

Fiori, M. (2009). A new look at emotional intelligence: A dual-process framework. Personality and Social Psychology Review, 13(1), 21-44.

Gardner, L., & Stough, C. (2002). Examining the relationship between leadership and emotional intelligence in senior level managers. Leadership and Organization Development Journal, 23, 68-78.

George, J. M. (2000). Emotions and leadership: The role of emotional intelligence. Human Relations, 53(8), 1027-1055.

Goleman, D. (1995). Emotional intelligence. New York, NY: Bantam.

Goleman, D. (1998). What makes a leader? Harvard Business Review, 76, 93-104.

Ko, Y. J., & Kim, Y. K. (2010). Martial arts participation: Consumer motivation.

International Journal of Sports Marketing & Sponsorship, 11(2), 105-123.

Law, D. L., (2004). A choice theory perspective on children’s Taekwondo. International Journal of Reality Therapy, 24, 13-18.

Mayer, J. D. & Salovey, P. (1997). What is emotional intelligence? In P. Salovey & D. J. Sluyter (Eds). Emotional development and emotional intelligence, New York, NY: Basic Book.

Mayer, J. D., & Salovey, P. (1990). Emotional intelligence. Imagination, Cognition, and Personality, 9, 185-211.

Nelis, D., Quoidbach, J., Mikolajczak, M., & Hansenne, M. (2009). Increasing emotional intelligence: (How) is it possible? Personality and Individual Differences, 47, 36-41.

Shim, S. K. (1980). The making of a martial artist. Detroit, MI: Sang Kyu Shim Vertonghen, J., & Theeboon, M. (2010). The social-psychological outcomes of martial arts practice among youth: A review. Journal of Sports science and Medicine, 9, 528-537.

Warneka, T. H. (2006). Leading people the Black Belt way. Cleveland, OH: Asogomi Publishing InternationalWeiser, M., & Kutz, I. (1995). Psychotherapeutic aspects of the martial arts. American Journal of Psychology, 49(1), 118-127.

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Table 1 Summative Descriptive Statistics for Black Belt Group (N = 77) One-Sample Test Test Value = 100

EQ-i Scales and Forms

Mean

Std. Deviation

Standard Error Mean

95% Confidence Interval of the Difference Lower

Upper

t df

Sig. (2-tailed)

TOTAL_EQ

106.57

11.079

1.263

4.06

9.09

5.205

76

.000

INTRAPERSONAL

108.39

10.229

1.166

6.07

10.71

7.197

76

.000

Self-Regard

105.57

11.373

1.296

2.99

8.15

4.299

76

.000

Emotional Self-Awareness

107.40

12.564

1.432

4.55

10.25

5.170

76

.000

Assertiveness

107.57

11.625

1.325

4.93

10.21

5.715

76

.000

Independence

106.68

11.163

1.272

4.14

9.21

5.247

76

.000

Self-Actualization

107.21

8.554

.975

5.27

9.15

7.394

76

.000

INTERPERSONAL

103.90

13.844

1.578

.75

7.04

2.470

76

.016

Empathy

102.08

13.476

1.536

-.98

5.14

1.353

76

.180

Social Responsibility

103.19

12.097

1.379

.45

5.94

2.317

76

.023

Interpersonal Relationship

103.74

14.771

1.683

.39

7.09

2.222

76

.029

STRESS_MANAGEMENT

107.55

11.255

1.283

4.99

10.10

5.883

76

.000

Stress Tolerance

108.91

10.836

1.235

6.45

11.37

7.214

76

.000

Impulse Control

103.90

11.478

1.308

1.29

6.50

2.978

76

.004

ADAPTABILITY

104.34

10.669

1.216

1.92

6.76

3.568

76

.001

Reality Testing

101.84

10.817

1.233

-.61

4.30

1.496

76

.139

Flexibility

103.75

14.365

1.637

.49

7.01

2.293

76

.025

Problem Solving

105.56

9.548

1.088

3.39

7.73

5.108

76

.000

104.61

11.095

1.264

2.09

7.13

3.646

76

.000

Optimism

106.14

9.355

1.066

4.02

8.27

5.762

76

.000

Happiness

103.12

12.693

1.446

.24

6.00

2.155

76

.034

GENERAL_MOOD

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Figure 1. Total EQ-i distribution plot of the mean with standard deviation of the general population campared to the black belt sample.

Figure 2. Intrapersonal EQ-i distribution plot of the mean with standard deviation of the general population campared to the black belt sample.

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Figure 3. Interpersonal EQ-i distribution plot of the mean with standard deviation of the general population campared to the black belt sample.

Figure 4. Stress Management EQ-i distribution plot of the mean with standard deviation of the general population campared to the black belt sample.

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Figure 5. Adaptability EQ-i distribution plot of the mean with standard deviation of the general population campared to the black belt sample.

Figure 6. General Mood EQ-i distribution plot of the mean with standard deviation of the general population campared to the black belt sample.

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Psychological Distress in Patients with Pain Elizabeth Bigham California State University San Marcos Anne McKemy California State University San Marcos Abstract General psychological discomfort is often present in patients with back pain. Patients with chronic pain tend to have increased psychological distress compared to patients with acute pain.

It has been suggested that the somatization scale of the Symptom Checklist-90-R (SCL-90-R) can be used to distinguish psychological discomfort from physical discomfort better than the SCL-90-R’s composite global severity index (GSI). This project compared the SCL-90-R’s somatization scale scores and GSI scores for patients treated for chronic back pain to scores for patients treated for other pain. Further analysis compared the sample group to the normative group. The findings indicated that the SCL-90-R may not capture the complex psychological distress experienced by patients with back pain.

Keywords: psychological distress, chronic pain, acute pain

Literature Review Nociception, the awareness of physical pain, is a natural response to an injury or invasion that has been registered by the body via afferent nerve fibers when noxious stimuli have been detected (Hainline, 2005; Schaible, & Richter, 2004). Pain is considered to be acute when the pain subsides subsequent to the original source of painful stimulus. Acute pain is a normal, short-lived physiological occurrence that serves a protective role in the body, and it is said to originate from stimuli outside the body that the central nervous system reacts to (Hainline, 2005).

In the case of chronic pain, however, a disturbance in the natural order occurs, and the pain remains long after the original causal factors have been extinguished, lasting anywhere from weeks to years (Hainline, 2005; Dantzer, 2005). Officially, pain is considered to be “chronic” when it continues four weeks past the original precipitating event or stimulus. Chronic pain is believed to be propagated from inside the body when a malfunction in processing occurs within the nervous system’s somatosensory region (Hainline, 2005; Martenson, Cetas, & Heinri, 2009).

Whether it is acute or chronic in nature, nociception is extremely subjective, and the degree of sensitivity to various pain stimuli varies greatly between individuals.

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Due to nociception’s subjective nature, it is often difficult to measure the extent to which the actual physical manifestation of pain matches the patient’s complaint. In addition, many studies have indicated a large comorbidity between chronic pain and psychoemotional disorders such as general anxiety disorder, depression, and somatoform disorders (Barsky, Orav, & Bates, 2005; Lowe et al., 2008; Manchikanti, Cash, Pampati, & Fellows, 2008; Manchikanti, Pampati, Beyer, & Damron, 2002; Merikangas et al., 2007; Rivera et al., 2005; Kroenke, 2007). Research

by Manchikanti et al. (2002) revealed a high concordance rate between the registered amount of pain conditions and psychological distress. Patients who had more than one type of pain condition reported higher levels of general psychological distress and suffered more from depressive disorders, general anxiety disorder, and somatization disorders than people with fewer pain conditions or no chronic pain. Comprehensive programs that include stress reduction are beneficial in reducing pain (Samuelson et al., 2010; Nakao et al., 2001).

In short-term circumstances, the release of cortisol from the adrenal glands during stressful situations maintains the human body’s physiological homeostasis, and it affords the temporary energy needed for fight-or-flight responses. Research has shown that patients with acute low back pain show temporary increases in hypothalamic-pituitary-adrenal (HPA) axis activity in response to stress caused by the pain (Strittmatter et al., 2005; Nakagawa & Hosokawa, 1994). Research by Sudhaus et al. (2009) indicated that successful outcome expectancies for coping with pain decreased adrenocortical action for patients with acute lower back pain. Conversely, it has been hypothesized that a relationship exists between the long-term stress induced by chronic low back pain and the lowered levels of HPA activity called hypocortisolism (Heim, Ehlert, & Hellhammer, 2000; Sudhaus et al., 2009; Vlaeyen & Linton, 2000). Differences in HPA activity may be illustrating that patients with acute pain tend to be either on alert if they are not sure of outcomes or not on alert if they expect successful outcomes.

On the other hand, patients with chronic pain are not on alert due to being fatigued, depressed, and stressed from their chronic pain.

Somatization is described as the situation when a patient believes that he or she has a genuine physical condition that physicians have failed to diagnose. Furthermore, persons with this disorder are said to often seek care from many different physicians, trying to find one who will cure them. A patient who continues to seek a solution for medically unexplainable chronic pain may be viewed as somatizing.

Somatization in patients with pain may be explained by an elevated sympathetic nervous system that increases their pain experience. A psychological explanation is that somatization is a conversion of psychological stress. Thus, a patient needs to be guided through the process of identifying and addressing stressors in his or her psychological environment. A physiological explanation is that some people are more sensitive to internal physical sensations (Katzer, Oberfeld, Hiller, Gerlach, & Witthoft, 2012). Because somatization tends to be a familial disorder, there may be a genetically transmitted cause (Hainline, 2005). Negative thinking, fear, and catastrophizing also lead to physiological symptoms. Patients may believe there is a genuine injury that the physician missed and that they could further injure the area if they move, so they

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decrease their activity, which makes the symptoms worse and confirms, to them, there really is a terrible problem that is being overlooked. Cognitive behavioral therapy has been demonstrated to be effective in helping patients identify the source of their catastrophic, negative, or fearful thinking (Thorn, Boothby, & Sullivan, 2002). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition’s (DSM-5) criteria for somatic symptom disorders also support a psychophysiological basis (Creed et al., 2010).

One of the patient’s practical difficulties for being diagnosed with somatization is that it is possible for a physician to miss a diagnosis. Another difficulty is that it is possible that current medical knowledge may not yet explain the genuine underlying condition. Yet another difficulty is that it is possible for a medical provider to not recognize the impact of distress on a physical symptom. Thus, the medically unexplainable versus the medically explainable symptomatic component of diagnosis may interfere with the patient receiving distress-reducing services, which may decrease their pain.

For the physician, the difficulty lies in determining how much of the patient’s pain is an unrecognized medical explanation versus a functional disturbance of brain systems that are impacting the pain. The most objective evidence of somatization, at this point, is the congruency of the physiological evidence, the patients’ reported symptoms, and the patients’ psychological discomfort (Barsky et al., 2005; Lowe et al., 2008; Manchikanti, Cash et al, 2008; Manchikanti, Pampati et al., 2002; Merikangas et al., 2007; Rivera et al., 2005; Manchikanti, Helm et al., 2009). General psychological discomfort, however, is commonly present in patients with back pain, and, furthermore, patients with chronic pain tend to have increased psychological distress compared to patients with acute pain (Hansen & Streltzer, 2005).

The SCL-90-R (Derogatis & Cleary, 1977a; Derogatis, 1994; Derogatis, Rickles, & Rock, 1976) is used in medical settings to assess this general psychological distress. Patients indicate how much they have been distressed by 90 different physical and psychological discomforts (e.g., headaches, nervousness, or shakiness) over the past seven days. Patients rate each item using a 5-point scale that ranges from 0 equaling not at all distressed to 4 equaling extremely distressed. This format provides an assessment of the type and severity of symptoms.

Factor analyses were conducted by Derogatis and Cleary (1977b). Prior research has examined the SCL-90-R’s utility in working with patients with pain, and it has mixed findings regarding the SCL-90-R’s ability to discriminate between psychological and physical discomfort (Bernstein, Jaremko, & Hinkley, 1994; Buckelew, 1988; Hardt, Gerbershagen, & Franke, 2000; Puca et al., 1989; Rief, & Fichter, 1992). For example, it is not clear whether the SCL-90-R’s somatization scale is able to distinguish psychological discomfort from physical discomfort better than the SCL-90-R’s global severity index (GSI). Some authors have questioned its factor structure, suggesting that it has a single factor, while others report that it yields profiles for diagnostic groups (Cyr, McKenna-Foley, & Peacock, 1985; Derogatis, 1994; Derogatis & Savitz, 1999; Torres et al., 2010; Schwarzwald, Weisenberg, & Solomon, 1991; Preupera et al., 2007).

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Methods Archival records were accessed for three male patients and eleven female patients seen at a pain clinic, and their ages ranged from 38 years old to 88 years old (M=60.93, SD=14.77).

Patient data included age, sex, diagnoses, and SCL-90-R responses. All data were entered in a statistical software program, IBM SPSS Statistics.

The SCL-90-R responses were calculated for each of the nine symptom subscales: somatization (12 items), obsessive-compulsive (10 items), interpersonal sensitivity (9 items), depression (13 items), anxiety (10 items), hostility (6 items), phobic-anxiety (7 items), paranoid ideation (6 items), and psychoticism (10 items). Raw scores for each subscale were calculated by dividing a subscale’s total by the number of items in the subscale and then adding .005.

The GSI measures the patient’s overall psychological distress. The GSI raw score was calculated by dividing the total of all responses by the number of responses and adding .005.

The positive symptom total is the number of self-reported symptoms. The positive symptom distress index (PSDI) measures the intensity of symptoms. The PSDI raw score was calculated by dividing the total of all of the responses by the number of nonzero responses and adding .005.

Raw scores were plotted onto a profile sheet that was based on a normative sample of 1,000 people (494 males and 480 females) representing a stratified random sample from a large U.S. Eastern state. The profile sheet was standardized with a mean of 50 and a standard deviation of 10 for easy comparisons. For example, a score of 63 or higher on the somatization subscale was suggested by Derogatis, the scale’s author, as the cutoff point for high somatization (Nakao et al., 2001).

The patients’ diagnosis codes were used to determine the groups for comparison. These codes, which are International Classification of Diseases (ICD) codes, classify diseases based on signs, symptoms, and causes. The ICD is maintained by the World Health Organization.

Patients were divided into two groups: patients with back pain had a primary diagnosis of dorsopathy, a condition that impairs the backbone, and patients with other types of pain with a primary diagnosis that was not dorsopathy (see Table 1). The present study used these groups as the comparisons groups because patients with chronic back pain tend to have more psychological distress than patients with other types of pain (Hansen & Streltzer, 2005).

This project compared the SCL-90-R’s nine subscales, the GSI, and the PSDI scores for patients with chronic back pain to patients with other types of pain to examine whether the SCL90-R’s somatization scale can be used to distinguish the two groups better than the SCL-90-R’s GSI. The hypotheses were that somatization scores would be higher for patients with chronic back pain versus patients with other types of pain and that these differences would be greater than the group differences in the GSI scale.

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Results Hypotheses

The first hypothesis was that somatization scores would be higher for patients with chronic back pain. Levene’s test for equality of variances was not significant, F=.116 and p=.739, so equality of variances was assumed. An independent samples t-test revealed no significant differences in the somatization subscale’s raw scores between the group with back pain (M=1.24, SD=.59) and the group with other types of pain (M=1.16, SD=.62), t(12)=.263, p=.797. The results did not support the hypothesis.

The second hypothesis was that group differences in the somatization subscale’s raw scores would be greater than group differences in the GSI’s raw scores. Levene’s test for equality of variances was not significant, F=2.453 and p=.143, so equality of variances was assumed. An independent samples t-test revealed no significant differences in the GSI subscale’s raw scores between the group with back pain (M=.89, SD=.56) and the group with other types of pain (M=.54, SD=.33), t(12)=1.51, p=.158; thus, there were no differences to compare in the somatization subscale’s raw scores and the composite GSI’s raw scores. The results did not support the hypothesis.

Exploratory Analyses To better understand the results of the first hypothesis test, a repeated measures analysis of variance was used to compare the pattern of responses of the patients with back pain and the patients with other types of pain. Mauchly’s test indicated that the assumption of sphericity had not been violated, and no significant group effects were revealed, F(1,11)=.045, p=.836 (Figure 1). A single sample t-test was used to compare this sample of 14 patients with pain to the normative group using the t-scores, which were derived from the raw subscale and composite scores. The comparison group’s mean was entered as 50. The analysis revealed significant differences with the present sample being higher in four subscales and both composite scores (see Table 2). Only the somatization subscale met the criteria of a score of 63 or greater as set

by Derogatis.

A second single sample t-test was used to separately compare the two groups to the normative group. Again, the analysis revealed significant differences between each of the groups and the normative group with the somatization scale meeting the criteria of a score of 63 or greater. Additionally, the group of patients with other types of pain also had significant elevations in the depression subscale and the PDSI score (see Table 3).

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Discussion Patients with pain, particularly chronic pain, experience both psychological and physiological distress. The distress exacerbates their experience and their reports of the symptoms. The physician and the patient need to determine how much of the patient’s reporting of symptoms or their experience of symptoms is due to elevations in these caused by distress in order for the physician to correctly diagnose the cause of pain and the patient to receive the appropriate services.

Because psychological distress and physiological symptoms are experiences that are inextricably connected, measures such as the SCL-90-R are commonly used in pain clinics to assess psychological distress. Prior research has demonstrated that patients with back pain have higher levels of psychological distress. These patients should have higher somatization scores on the SCL-90-R than other pain patients and the general population, but there is conflicting evidence as to whether the SCL-90-R consistently discriminates between psychological distress and physical distress in this population.

The SCL-90-R’s somatization subscale may be able to capture the psychological distress experienced by patients with pain, but perhaps it is not able to capture a specific profile of psychological distress experienced by patients with back pain. The present proposal was that the SCL-90-R would be able to discriminate between patients with back pain and patients with other types of pain through higher scores in the somatization subscale. Furthermore, the present study proposed that the overall psychological distress score would discriminate between the two groups less effectively than the somatization subscale. Neither of the hypotheses was supported as the analysis did not reveal differences between the two groups in somatization and overall psychological distress. The small group sizes were surely a factor. The exploratory analyses, however, indicate that the SCL-90-R does capture the psychological distress experienced by patients with pain when compared to a general population. When examined as groups, both of the groups met the criteria for high somatization that were based on the normative group. The group consisting of patients with other types of pain also met the criteria for high depression and high-intensity symptoms, while the group consisting of patients with back pain did not meet these criteria.

It may be that patients with back pain do not experience the same levels of psychological distress that patients with other types of pain experience. The HPA axis studies indicate that HPA axis differences are found in patients with acute pain and that patients with chronic pain have low HPA axis activity. This could indicate that patients go either on high alert if they are concerned or low alert if they expect successful outcomes in the early stages of pain. As time passes, they may be moving from sympathetically driven alert to sympathetic exhaustion as their pain status moves from acute to chronic. Sympathetic exhaustion, particularly the depression, may also have been reflected in these results. The patients in the present study with back pain, however, did not reach the criteria for high depression.

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The concept of psychological distress in patients with pain, or somatization, examined in prior studies may not be capturing the type of psychological distress that is experienced by patients with chronic back pain. Prior investigators have also come to the conclusion that different factors may be needed for different populations (Schwarzwald et al., 1991). The present study’s results indicate that patients with other types of pain are experiencing more psychological distress than patients with back pain, yet prior studies have demonstrated the reciprocal influences of psychological distress and pain. Perhaps patients with back pain have become more tolerant of the concept of “medically unexplainable” due to its high prevalence and the consistency of symptoms, and they have accepted back pain as part of aging.

Pain perceptions are different for different people. Higher levels of psychological distress are associated with higher reports of pain, and multicomponent programs that feature stress reduction are effective at reducing perceived pain. Patients whose psychological distress is not recognized by either a clinician or measure may not receive access to stress reduction programs, which have been effective for patients with both medically explainable and medically unexplainable pain. Using the SCL-90-R may assist the health-care provider in identifying somatization, but it may miss the full spectrum of psychological distress in patients with back pain. Therefore, health-care providers must include a more comprehensive psychological assessment by a mental-health provider when treating patients with back pain to ensure that psychological distress contributing to clients’ pain is clearly identified and addressed prior to conducting more invasive treatments.

Pain continues to be a common experience, impacting more Americans than diabetes, heart disease, and cancer combined, and chronic pain is the most common cause of long-term disability (NIH, 2010). The financial cost to society is immeasurable. Mental-health providers and health-care providers need to continue working with investigators to support the shift to a more holistic view of “medically unexplained” pain. Researchers investigating the psychophysiological mechanisms underlying the relationship between psychological distress and pain perception must work collaboratively with practitioners and researchers from the mentalhealth and health-care fields. Advocates addressing the development and revision of DSM-5 and ICD codes need to continue addressing language that undermines both the patient’s pain and psychological distress’ impact on pain. Institutions that train mental-health practitioners and health-care providers must require interdisciplinary training and opportunities for their trainees to gain a holistic perspective. And efforts need to continue developing measures that capture and quantify the complex psychological distress experienced by patients with different types of pain.

Author Biography Elizabeth Bigham, Ph.D. (Health Psychology) is the Program Director of the Human Development Department at California State University San Marcos. Her research interests are in the psychophysiology of stress and chronic pain, with a focus on the impact of cognitive and physical awareness. She teaches Developmental Counseling, Counseling Interviewing, and

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Theories of Human Development Theory. She is a Member of the Board of the Association of Applied Psychophysiology and Biofeedback and author of children’s bed time stories designed to promote autonomic regulation awareness. The following is an example of collaboration with an undergraduate student. Correspondence regarding this article should be sent to Elizabeth Bigham, Ph.D., Program Director, Department of Human Development, California State University San Marcos, 333 S. Twin Oaks Valley Rd., San Marcos, CA 92096.

Ann McKemy graduated Magna cum Laude from California State University San Marcos in 2014 earning a Bachelor’s degree in Psychology. Her scholarly concerns are directed toward the fields of cognitive and holistic Psychology. She is particularly interested in the study of chronic pain and the concomitant psychosocial aspects associated with it.

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Manchikanti, L., Helm, S., Singh, V., Benyamin, R. M., Datta, S., Hayek, S. M., Fellows, B. Boswell, M.V., ASIPP. (2009). An algorithmic approach for clinical management of chronic spinal pain. Pain Physician, 12(4), 225- 264.

Manchikanti, L., Pampati, V., Beyer, C., & Damron, K. S. (2002). Do number of pain conditions influence emotional status? Pain Physician, 5(2), 200-205.

Martenson, M. E., Cetas, F. S., & Heinri, M. M. (2009). A possible neural basis for stressinduced hyperalgesia. Pain, 142, 236-244.

Merikangas, K. R., Ames, M., Cui, L., Stang, P. E., Ustun, B. T., Von Korff, M., & Kessler, R.C. (2007). The impact of comorbidity of mental and physical conditions on role disability in the US adult household population. Archives of General Psychiatry, 64(10), 1180-1188.

National Institutes of Health (2010). Pain Management Fact Sheet. Accessed 2/1/14 http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=57 Nakagawa, H., & Hosokawa, T. (1994). Study of the stress response to acute pain in the awake human. Pain Clinic, 7, 317-324.

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Somatization and symptom reduction through a behavioral medicine intervention in a mind/body medicine clinic. Behavioral Medicine, 26(4), 169 -176.

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Preupera, H., Renemana, M., Boonstrac, A., Dijkstraa, P., Versteegene, G., & Geertzena,J. (2007). The relationship between psychosocial distress and disability assessed by the Symptom Checklist-90-Revised and Roland Morris Disability Questionnaire in patients with chronic low back pain. The Spine Journal, 7, 525–530.

Puca, F. M., Antonaci, F., Genco, S., Savarese, M. A., Piazzolla, G., & Prudenzano, M. P. (1989). Psychologic factors in chronic headache: Assessment by means of the SCL- 90-R inventory. Cephalalgia, 9(1), 33-51.

Rief, W., & Fichter, M. (1992). The Symptom Check List SCL-90-R and its ability to discriminate between dysthymia, anxiety disorders, and anorexia nervosa.

Psychopathology, 25(3), 128-138.

Rivera, J. J., Singh, V., Fellows, B., Pampati, V., Damron, K. S., & McManus, C. D. (2005).

Reliability of psychological evaluation in chronic pain in and interventional pain management setting. Pain Physician, 8, 375-383.

Samuelson, M., Foret, M., Baim, M., Lerner, J., Fricchione, G., Benson, H., . . . Yeung, A. (2010). Exploring the effectiveness of a comprehensive mind–body intervention for medical symptom relief. The Journal Of Alternative And Complementary Medicine, 16(2), 187–192. DOI: 10.1089=acm.2009.0142 Schaible, H., & Richter, F. (2004). Pathophysiology of pain. Langenbeck's Archives of Surgery, 389, 237-243.

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Sudhaus, S., Fricke, B., Stachon, A., Schneider, S., Klein, H., Von During, M., & Hasenbring, M. (2009). Salivary cortisol and psychological mechanisms in patients with acute versus chronic low back pain. Psychoneuroendocrinology, 34(4), 513-522.

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Table 1 Patients’ Primary Diagnoses

Lumbosacral spondylosis without myelopathy Postlaminectomy syndrome of lumbar region Brachial neuritis or radiculitis nos Spinal stenosis of lumbar region Thoracic or lumbosacral neuritis or radiculitis unspecified Reflex sympathetic dystrophy of the upper limb Unspecified idiopathic peripheral neuropathy Pain in limb

No. of Patients

Group

2 3 1 1 2 2 2 1

Back Pain Back Pain Back Pain Back Pain Back Pain Other Pain Other Pain Other Pain

Table 2 Summary of Comparisons to Normative Group t Scores

Mean

Somatization

Std. Deviatio n 64.14 8.12

Obsessive-compulsive

58.71

8.46

Interpersonal sensitivity

52.07

Depression

Std. Error Mean 2.17

t

df

Sig. (2tailed)

Mean Lower Upper Differenc Interval Interval e 0* 14.14 9.45 18.83

6.51

13

2.26

3.85

13

0.002 *

8.71

3.83

13.6

10.45

2.79

0.74

13

0.471

2.07

-3.96

8.1

59.29

10.02

2.68

3.47

13

0.004 *

9.29

3.5

15.07

Anxiety

52.29

11.34

3.03

0.75

13

0.464

2.29

-4.26

8.83

Hostility

51.14

9.21

2.46

0.46

13

0.65

1.14

-4.17

6.46

53

9.27

2.48

1.21

13

0.247

3

-2.35

8.35

Paranoid ideation

51.43

7.99

2.13

0.67

13

0.515

1.43

-3.18

6.04

Psychoticism

56.71

8.51

2.27

2.95

13

0.011 *

6.71

1.8

11.63

Global severity index

59.21

7.9

2.11

4.37

13

0.001 *

9.21

4.66

13.77

Positive symptom distress index

61.23

5.85

1.62

6.92

12

0*

11.23

7.7

14.76

Phobic-anxiety

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Table 3 Summary of Comparison of Groups to Normative Group

t Scores Back Pain Group Somatization

N

Mean

Std. Deviat ion

Std. Error Mean

t

df

Sig. (2tailed)

Mean Differen ce

Lower Interva l

Upper Interva l

9

64.33

8.47

2.82

5.08

8

.001

*

14.33

7.82

20.84

9

56.56

4.85

1.62

4.05

8

.004

*

6.56

2.83

10.28

9

48.56

7.78

2.59

-0.56

8

.593

-1.44

-7.42

4.54

9

56.56

9.54

3.18

2.06

8

.073

6.56

-0.78

13.89

Anxiety

9

49.78

8.58

2.86

-0.08

8

.940

-0.22

-6.82

6.38

Hostility

9

50.00

8.96

2.99

0.00

8

1.000

0.00

-6.89

6.89

Phobic-anxiety

9

51.44

8.55

2.85

0.51

8

.626

1.44

-5.12

8.01

Paranoid ideation

9

49.44

9.00

3.00

-0.19

8

.858

-0.56

-7.47

6.36

Psychoticism

9

54.22

8.21

2.74

1.54

8

.162

4.22

-2.09

10.53

9

57.78

6.83

2.28

3.41

8

.009

*

7.78

2.53

13.03

9

59.33

4.85

1.62

5.78

8

.000

*

9.33

5.61

13.06

5

63.80

8.41

3.76

3.67

4

.021

*

13.80

3.36

24.24

5

62.60

12.50

5.59

2.25

4

.087

12.60

-2.92

28.12

5

58.40

12.48

5.58

1.50

4

.207

8.40

-7.10

23.90

5

64.20

9.86

4.41

3.22

4

.032

14.20

1.96

26.44

Anxiety

5

56.80

15.19

6.79

1.00

4

.373

6.80

-12.06

25.66

Hostility

5

53.20

10.33

4.62

0.69

4

.527

3.20

-9.63

16.03

Phobic-anxiety

5

55.80

10.85

4.85

1.20

4

.298

5.80

-7.67

19.27

Paranoid ideation

5

55.00

4.53

2.02

2.47

4

.069

5.00

-0.62

10.62

Psychoticism

5

61.20

7.82

3.50

3.20

4

.033

11.20

1.49

20.91

5

61.80

9.81

4.39

2.69

4

.055

11.80

-0.38

23.98

4

65.50

6.24

3.12

4.96

3

.016

15.50

5.56

25.44

Obsessivecompulsive Interpersonal sensitivity Depression

Global severity index Positive symptom distress index Other Pain Group Somatization Obsessivecompulsive Interpersonal sensitivity Depression

Global severity index Positive symptom distress index

*

*

*

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Figure 1. The groups had similar patterns of responding to items within the somatization scale.

Items on Somatization Scale 1. Headaches 2. Faintness or dizziness 3. Pains in heart or chest 4. Pains in lower back 5. Nausea or upset stomach 6. Soreness of your muscles 7. Trouble getting your breath 8. Hot or cold spells 9. Numbness or tingling in parts of your body 10. A lump in your throat 11. Feeling weak in parts of your body 12. Heavy feelings in your arms or legs

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Transformational Humane Education Rhondda F. Waddell St. Leo University Debra Mims St. Leo University

Abstract The Transformational Humane Education project promoted compassion and encouraged responsibility among middle school and high school students enrolled in an alternative school.

Through interdisciplinary collaboration between the schools of undergraduate social work and criminal justice faculty and students, the alternative school’s staff (the principal, behavioral counselors, and teachers) conducted four humane-education sessions with the goal of helping highly at-risk youth - make ethical and humane decisions through working with animals. Each session was conducted with the entire student body. All students completed a pretest and posttest. Humane education enables students to find workable solutions for a healthy, just society and future career paths.

Keywords: humane education, high-risk youth, interdisciplinary collaboration Introduction The purpose of the Transformational Humane Education (THE) project is to promote compassion and encourage responsibility. Humane education is about learning to respect life in homes, communities, and the environment. This study sought to encourage kindness and empathy for both humans and animals, and it promoted understanding of diverse cultures and habitats. Most importantly, humane education strives to establish a sense of responsibility, which makes the world a better, more humane place (Wiel, 2004, p. 6). Humane education enables people to find solutions that work for everyone by approaching human rights, environmental preservation, and animal protection as interconnected dimensions of a healthy society.

The educational techniques utilized in this study focused on the hands-on learning process as it is applied to the core standards for middle school and high school students. David Kolb’s (2007) experiential learning techniques explain the objectives of the teaching process that are planned and articulated prior to undertaking a study experience, which involves activities that

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are meaningful and practical. Experiential learning activities typically involve direct experience in a five-stage process: 1. Exposure to and participation in the experience that is the basis of an educational activity.

2. Experimentation with the activities taught in an experiential educational assignment that is aimed at enhancing learning.

3. Individual reflection and facilitated debriefing during the educational activity aimed at enriching knowledge.

4. Application of the humane-education principles involved in the activity to reinforce prior learning and link it to new proficiencies.

5. Internalization of the new knowledge in a way that facilitates the learner’s recall and application of the additional information.

Alternative education programs are expanding in the United States due to zero-tolerance policies, changes in the Individuals with Disabilities Education Act, increases in youth violence and school failure, and advancement of the developmental trajectories that lead to antisocial behavior. At the same time, there is limited evidence proving the efficacy of alternative education strategies in reducing violence in schools and communities (Tobin & Sprague, 2000).

Tobin and Sprague reviewed a variety of issues related to the need for alternative education, discussed different models of service delivery, recommended practices for humane education focused programs, and briefly described promising models for classroom teaching to meet the needs of students that are at risk for dropping out or being expelled from traditional education programs. Social skills instruction, especially in the areas of empathy, anger management, and conflict resolution, is recommended.

While the importance of normative levels of empathy and prosocial behavior is becoming recognized, it has been suggested that modern, industrialized society is not conducive to the promotion of empathy development in children (Thompson, 2003, p. 1). According to Kelly Thompson (2003), one method for contributing to empathy development is to encourage direct contact with animals. The rationale offered for this is the belief that empathy toward other living beings will be encouraged by developing a bond with animals. Consequently, she suggests that empathy directed at animals will transfer to humans. Some studies have reported that childhood cruelty toward animals is related to interpersonal violence in childhood (Arluke, Levin, Luke, and Ascione, 1999; Hastings et al., 2000). Humane-education programs aim to intervene in the cycle of abuse by decreasing a child’s potential to be abusive toward animals and, as a result, promote prosocial behavior toward humans (Thompson, 2003, p. 2).

Prediction of antisocial behavior is important given its adverse impact on both society and the individuals engaging in antisocial behavior. Additional research identifying early predictors of future antisocial behavior is needed (Rhee et al., 2012, p. 1). This study tested the hypothesis that both concern for others and active disregard for others in distress in toddlers and young children predict antisocial behavior during middle childhood and adolescence. In summary, the researchers of this study found that disregard for others in distress during toddler

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hood, and early childhood, but not concern for others, predicted antisocial behavior, and this was assessed via parents, teachers, and self-reports during middle childhood and adolescence. Rhee et al, (2012) encouraged further examination of the hypothesis that concern and disregard for others in young children will predict antisocial behavior later in life and suggest the potential need for early screening of disregard for others and development of potential interventions to help increase empathetic responses.

Methods Participants enrolled in a rural alternative school for students ages 12 through 18 partook in the THE project for over four weeks, and they were the target of this purposive study. All of the participants were middle school or high school level. Four 50-minute lessons in humane education were taught using a variety of educational techniques and models that included experiential education, values clarification, and humane education philosophy. The participants were measured twice during the course by analyzing their answers on the pretest and posttest.

The principal investigator (PI) provided a description of the study, in which both the pretest and posttest were described in detail, to the school’s principal. The principal gave the students the option of either participating in the THE project or attending an alternative study session provided for students who were unwilling or unable to participate. Students who choose to participate in the study took home a consent form for a parent or guardian to sign, an implied consent form to be signed by a parent/or guardian, and a consent form the student signed to participate in the THE project. The parents, guardians, and students were provided a letter of explanation of the project, the consent forms and the assent forms, and the PI’s direct telephone number.

At the beginning and at the end of the four training sessions, students answered 12 truefalse questions. All of these questions addressed topics in the following areas: 1. Students’ knowledge increased in the areas of animal overpopulation, abuse, responsible pet ownership, and solution-based problem solving within the United States.

2. Students’ understanding of humanitarian topics (i.e., hunting and factory farming) with emphasis on involvement to create change.

3. Students’ attitudes regarding controversial issues facing our society (i.e., environmental protection, animal abuse, and human rights violations).

Participants were assured that no risk would be involved in the study and that the PI of the study, a doctorate-level, licensed social worker, was available. A phone number was provided to parents and guardians if they needed to speak with the PI about any questions or concerns they had. Anonymity was ensured and confidentiality was maintained in data collection, storage, and analysis throughout the study by an independent researcher employed as a graduate assistant, who did not teach in the course and did not know the students. She was responsible for collecting the pretests and posttests, and for the coordination of the identifiers set up for each student’s responses. The PI and the co-investigator were responsible for the data

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analysis and the statistical analysis. Because the questionnaire data included repeated measures on the same participants, it was essential to link the data to maintain confidentiality. Students were instructed to create a unique identifier with two characteristics.

The identifiers were to be known only to the students and memory would play a role in their creation. The six-part identifiers consisted of two letters followed by four numbers. The first letter was the first initial of a participant’s mother’s first name, and the second letter was the first initial of a participant’s father’s first name. The four numbers that followed represented the month of the mother’s birthday, expressed as two digits, followed by the month of the father’s birthday. All of the information that was collected for analysis was coded with this identifier. In addition to these unique student identifiers, the original group numbers the students were assigned for active learning exercises were changed to new, specific numbers for use in the study. This provided an additional layer of anonymity. The data analyst was the caretaker of the master list that related to 1) student identifiers to group membership and 2) reassigned group numbers to the original group numbers. The raw data, the master lists, and the final data set were stored in an independent, secure location. In the final data set, the data were pooled and deidentified, preserving the anonymity of individual students. These procedures ensured that the student data used in the analysis were recorded in such a way that they could not be traced back to individual participants. Once the data had been gathered and de-identified by the graduate assistant, the PI and co-investigators were allowed access to the data for analysis.

Results In this study, the pretest and the posttest contained the same questions, and the same scoring guide was used to evaluate both tests. The calculated variations in performance between the pretest and the posttest was the target of the test results, and they revealed no significant variations overall. However, a range of variations for each question emerged. The study results indicated that 90% of the 40 pretests were completed by students in the 7th through 9th grades, and 10% were completed by students in the 10th grade or higher. The participant group that completed the pretest was composed of 81% male students and 18% female students. The gender was unknown for 1% of the students. The pretest participant group was 40% White, 23% Hispanic, and 12% Black. Ten percent of the participants were unknown ethnicity. Also, 78% of the 41 posttests were completed by students in the 7th through 9th grades and 22% of students in the 10th grade and higher. There were 58% male participants and 42% female participants who completed the posttest. The posttest participant group was 23% White, 15% Hispanic, and 5% Black. Fifty percent of the participants were of unknown ethnicity.

When compared between the pretest and posttest participants, responses to careeroriented questions indicated: 1. Minority groups of Blacks and Hispanics students valued humane education and prospective career opportunities in humane education more than Whites and students of unknown ethnicity.

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2. Both of the pretest and posttest sample populations had a small percentage of minorities.

3. The 7th through 9th graders answered more questions correctly on both the pretests and posttests.

4. The level of interest in careers and information on animal rights were highest among Hispanic students at 50%.

5. Hispanic students and Black students demonstrated interest in environmental preservation as a career path. White students lacked interest in the humane education topics studied and career opportunities in this field.

Lessons Learned When humane education topics include animals, this study strongly supports that highrisk middle school students in rural schools express an interest in careers in human rights, animals, and environmental protection. This study found that minority students in rural schools expressed the greatest interest in these humane education career fields. The findings also revealed that the older students in the 10th grade or higher were less interested in humane education careers regardless of minority status. Most importantly, humane education demonstrates that middle school students are interested in advocacy for a healthy society and careers in humane education.

Author Biographies Rhondda Waddell, PhD, LCSW is a Full Professor in the School of Education and Social Services at Saint Leo University, where she is the Director of the Center for Values, Service, and Leadership. Dr. Waddell has more than twenty years of social work and service-learning practice experience. As a professor she delights in the development of an ongoing relationship with students and community partners in collaborative service activities. She received both her PhD and MSW degrees from Florida State University. Dr. Waddell developed and teaches a Veterinary Social Work class, and works closely with her therapy dog, Andy.

Debra Mims is a retired Tampa Police Master Patrol Officer and Full Professor in the School of Education and Social Services at Saint Leo University, and teaches in the Department of Criminal Justice. Debra is currently in the doctoral degree program at Northcentral University. Debra trains and shows agility dogs and is a certified trainer/observer for Therapy Dog International, Inc. In addition, she has a cadaver dog and three certified Critical Incident Stress Management dogs.

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References Arluke, A., Levin, J., Luke, C., & Ascione, F. (1999). The relationship of animal abuse to violence and other forms of antisocial behavior. Journal of Interpersonal Violence, 14, 963-975.

Kolb, D. (1984). Experiential Learning: Experience as the Sources of Learning Development.

Upper Saddle River, NJ: Prentice Hall, Inc. Pearson Education.

Kolb, D. (2007). Kolb’s Learning Style Inventory [Measurement instrument] 12-Item Assessment Tool. United States: Hay Group Transforming Learning.

Rhee, S., Friedman, N., Boeidt, D., Corley, R., Hewitt, J., Knafo, A., & Zahn-Waxler, C. (2012).

Early concern for disregard for others as predictors of antisocial behavior. Journal of child Psychiatry, 54(2), 157-166.

Thompson, K. (2003). Promotion of empathy and prosocial behaviour in children through humane education. Australian Psychologist, 38(3), 175-182.

Tobin, T., & Sprague, J. (2000). Alternative education strategies: Reducing violence in school and the community. Journal of Emotional & Behavioral Disorders, 8(3), 177.

Wiel, Z. (2004). The Power of Humane Education. Gabriola Island, B.C., Canada: New Society Publishers.

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Journal of Scholastic Inquiry: Behavioral Sciences

Volume 1, Page 48

Emotional Intelligence in the Martial Arts: Predictor of Success Chris A. Moser, The University of Findlay Cheri Hampton-Farmer, The University of Findlay Daniel Baczkowski, The University of Findlay Matthew A. Moser Psychological Distress in Patients with Pain Elizabeth Bigham, California State University San Marcos Anne McKemy, California State University San Marcos Transformational Humane Education Rhondda F. Waddell, St. Leo University Debra Mims, St. Leo University

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