Biobehavioral Assessment of Pain Flashcards
Psychiatric Disorders that cause pain
Anxiety Depression PTSD Personality disorders Somatization
Having a lot of medical issues and you can’t find the cause.
Somatization
Key pain question.
How long have you been in pain?
Where does pain reside?
Doesn’t reside in any one structure.
So pain can be modulated at multiple locations.
These two things can cause pain.
Directly from the brain, or from pain that leads to nociception, which then causes pain.
Pain = ?
Meaning
Does nociception = pain?
No
Peripheral Nociception –> _________ –> __________
Spinal cord integration
Central processing
Local anesthetic blocks what?
Between Peripheral nociception and spinal cord integration
Normal acute pain can be perceived as this.
Anxiety
Chronic pain cycle involves
- Depression
- Inactivity
- Weight gain
- Fear and Anxiety
- Insomnia
- Social isolation
Combines clinical diagnosis with biobehavioral assessment.
Dual-axis coding
PHQ-4 stands for what?
Patient Health Questionnaire
Yellow flags for referral of orofacial pain patients include what?
- EtOH or drug use
- Pain beliefs, illness behavior
- Work-related
- Family and social-related
- Chronicity
- Functional limitation
- Discrepancy in findings
- Overuse of medication
- Inappropriate behavior
- Inappropriate expectations
- Inappropriate responsiveness to (prior) tx.
A red flag for orofacial pain patients.
Suicidal thoughts
What do you do when you see a red flag in your pt?
Reder IMMEDIATELY
What do you do when you see a yellow flag in your pt?
Proceed with caution and consider referral
A comprehensive evaluation of biobbehavioral factors includes what?
1) Collecting Data
2) Constructs relevant to pain
3) Integration of the constructs
How to collect biobehavioral data.
1) Clinical Interview
2) Questionnaires
3) Combination of the two
Disadvantages of a clinical interview.
- Time consuming
- Need high clinical skill
- Bias
Disadvantages of questionnaires
- Language or reading problems
- May not apply
- May be too specific
- Scoring, missing values
Disadvantages of combining clinical interview and questionnaires..
- Need training
- Takes more time than either alone.
Used to determine the CNS pain burden by marking the location of a patient’s pain.
Pain drawing
Types of pain behaviors.
1) Expression of distress
2) Distorted ambulation or posture
3) Negative affect
4) Avoidance of activity
Chronic pain scales measure these things:
Pain persistence, intensity, and interference.
Of all the diseases (sjogren, BMS, Malocclusion), this has the greatest functional limitation in chewing and opening.
TMD
Depression includes this:
Self-harm
Combining data like number of body areas with pain, depression, anxiety, physical symptoms, mastication, mobility, etc.
Integration
Axis II assessment instruments.
- Pain location
- Pain intensity
- Pain disability
- Distress
- Sleep
- PTSD
- Alcohol Use
- Functional limitation
What type of disorder are these?
- Major depressive disorder
- Anxiety disorders
- Sleep disorders
- Somatoform disorders
- Psychological factors affecting physical condition
Psychiatric
