B2 L30 Psychological Perspectives for Pain & its Management Flashcards
What is the biomedical model?
- Mind-Body Dualistic & Reductionistic
- Tissue Damage:
- Pain relationship –> 1:1
- Treatment Model:
- Step 1: Find the pain generator
- Step 2: Remove it or fix it And, if you can’t remove it? …And can’t fix it?
- Step 3: Palliative approach (medicate)
What are the 3 steps to the treatment model of the biomedical model?
- Step 1: Find the pain generator (eg. through ultrasound… imaging)
- Step 2: Remove it or fix it (eg. cast) And, if you can’t remove it? …And can’t fix it?
- Step 3: Palliative approach (medicate)
When should physios refute evidence? 3 factors
- Mental interpretations
- reports indicate solders requiring to take less medication than normal civilians due to different interpretation of their injury (interpretation influences pain)
- Influence of social context
- Pain in the absence of direct stimulation
What is the paradigm shift?
“The presence of the biochemical defect… at best defines a necessary but not sufficient condition for the occurrence of the human experience of the disease, the illness.”
When does the treatment model work?
Works well for acute injuries
What is the biopsychosocial model?
overlaps and inter-relation determines whether disease and pain is prolonged
Pain is complex and _______
multidimensional
Pain is influenced by ______, ______, ______, and ______ factors
internal/external; biological; psychological; social
Treatment can intervene at _______ of these levels
any one (or more)
What is the gate control theory?
The brain plays a dynamic, interpretive role
- Psychological processes can shape the way painful stimuli are interpreted
- Rationale for psychological interventions for pain
- We use this in session 1
- Also helps shift clients who are “stuck” in a biomedical understanding
________ processes can shape the way painful stimuli are interpreted
psychological
In the gate control theory, what does an “open” gate mean, in terms of pain?
More pain
In the gate control theory, what does an “closed” gate mean, in terms of pain?
Less pain
Why do we use psychological treatment for pain? 2 reasons
- Can have the neurological plasticity
- Can increase brain matter- reverse effect (pain decrease brain matter)
What are 5 factors that influence pain?
- Mood
- Neurochemical changes
- Genetics
- Attention/expectation
- Sensitisation
What is IASP’s definition of pain?
“An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”
What are the 2 definitions of chronic pain?
- Pain that persists beyond the normal/expected healing time
- Pain experienced at least ½ of the days of the month for the past 3 to 6-months
What is epidemiology of chronic pain? Cost and effect?
- Affects 3.2 million Australians
- Costs $34.4 billion annually
- Chronic pain increases with age (since is an ageing population = more pain starting to affect people –> increase cost)
- Has been under-diagnosed and under-treated in the past
What are 3 co-morbid conditions of chronic pain?
- Depression: 40-50%
- Lifetime prevalence of suicidal ideation = 20%
- Rates of suicide 5-14% = twice as high as in the general population
- Anxiety: 44-51% - May be especially common when cause un-dx
- Comorbid sleep disorder prevalence of 53-88%
What are 3 predictors of disability?
- Attention (e.g., hypervigilance) (absorbed on pain- in fear-avoidance- strong predictor of disability over time)
- Maladaptive Primary Appraisals: Threat, Loss
- Threat appraisals most common in pain
- Lead to hypervigilance, fear-avoidance
- Threat appraisals most common in pain
- Secondary Appraisals: (great predictor of poor pain improvement) Pain catastrophizing is a negative mental set about actual or anticipated pain (eg. this pain is terrible, this pain has ruined my life)
- Pain management self-efficacy (often arising from challenge appraisals) is protective & motivates action (more positive outlook –> enhance and build confidence)
What are 7 evidence-based psychological treatments for chronic pain?
- Pharmacological interventions
- Behavioural Therapy
- Cognitive Behavioural Therapy
- Hypnosis
- Mindfulness-Based Therapies
- Acceptance-Based Therapies
- Condition Specific Therapies
How is attention a predictor of disability?
Attention (e.g., hypervigilance) (absorbed on pain- in fear-avoidance- strong predictor of disability over time)
How is Maladaptive Primary Appraisals: Threat, Loss a predictor of disability?
Maladaptive Primary Appraisals: Threat, Loss
- Threat appraisals most common in pain
- Lead to hypervigilance, fear-avoidance
How is Secondary Appraisals a predictor of disability?
(great predictor of poor pain improvement)
- Pain catastrophizing is a negative mental set about actual or anticipated pain (eg. this pain is terrible, this pain has ruined my life)
- Pain management self-efficacy (often arising from challenge appraisals) is protective & motivates action (more positive outlook –> enhance and build confidence)
