Chapter 8

Question 1

importance of studying pain / focusing on pain

3 things

Answer 1

• Pain is the symptom of greatest concern to patients.
• Pain is a predictor to whther or not people will use health care services
• pain is influences by psychosocial processes

Question 2

specificity model of pain

definitions & how it works

Answer 2

• Pain is directly proportional to the amount of tissue damage
• injury send pain signal through nerves associalted wiht damage to the spinal cord. Then the signal is sent to motor nerve then to the brain where it is percived

Question 3

limitations of the specificity model of pain.

Answer 3

A biomedical approach
* Assumption of 1:1 correspondence
* Patient blaming
* Focused on pharma/surgical and not pain controlling interventions

Question 4

Gate-Control Theory

Answer 4

• Pain is NOT directly proportional to tissue damage
• Inhibitor & projector neurons responds to sensory inputs and sends certain signals to brain

Question 5

Neuropathic Pain

definition

Answer 5

= pain with the absence of damage to the tissue

Question 6

Neuralgia

Answer 6

Recurrent episodes of intense shooting/stabbing pain along a nerve; often follows infection

Question 7

Causalgia/ complex regional pain syndrome

Answer 7

Recurrent episodes of severe burning pain triggered by minor stimuli (slothing resting on the area)

Question 8

Phantom Limb Pain

Answer 8

• The triggering of other types on input/ lack of normal sensory input/ incongruence between types of input

Question 9

neuromatrix theories of pain

defitions & where is it produced by

Answer 9

• Extension of gate control theory
• the widespread network of neurons allowing a sense of self (AKA Pain is produced in the central nervous system.)
• body-self neuromatrix.
• becasue pain is generated in CNS, the feeling of pain can occuring in the absence of signals from the sensory nerves

Question 10

neurosignature

Answer 10

• from Neuromatrix theory
• Each sensation, including pain, is marked by a unique neurosignature or pattern of activation of the neuromatrix

Question 11

pain according to the IASP

Answer 11

An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

Question 12

How does the IASP definition of pain recognizes the fundamental role of psychology in pain?

Answer 12

• the definition recongizes that pain is subjective and that it could be both sensory or emotional or whatever is identified as the person to be ‘pain’

Question 13

different methods for measuring/assessing pain.

2 methods and why

Answer 13

• Self-Report Measures of Pain: Because pain is thought to be subjective
• Pain behaviours: because not bein gable to communicate pain doesnt mean you arent in pain

Question 14

Self-Report Measures of Pain

what are the methods

Answer 14

• Graphic rating scale → wong-Baker FACES
• For 4-16 y/o
• Numerical rating scale
• Verbal rating scale
• Using adjectives for validity & reliability to assess pain

Question 15

Pain behaviours

Answer 15

• Facial and audible expression of distress. → Neonatal facial Coding scale
• Distortions in posture or gait.
• Negative affect (mood, anxiety, depression).
• Avoidance of activity

Question 16

“Organic” vs. “Psychogenic” Pain

Answer 16

**Organic pain **
= pain that has clearly identifiable phys. cause.

Psychogenic pain
= pain resulting from psych. Processes.

Question 17

How does positive emotioms affect pain

Answer 17

appear to reduce pain

Question 18

How does negative emotions affect pain

Whar doe speopl ein chronic pain experience

Answer 18

• Worsen pain
• people in chronic pain experience high levels of depression, anxietm or anger & all of these in turn further increased pain

Question 19

Pain and Stress

Answer 19

• linked togerthere
• Stress can produce pain & due to lack of perceived control
• Pain its seld is stressful
• Negative feedback loop

Question 20

adaptive methods for coping with pain

meaning

Answer 20

• Relaxation; distraction; redefinition of pain (reappraisal); readiness to change, taking an active ro

Question 21

adaptive methods for coping with pain

3 methods

Answer 21

AcceptanceBeing inclined to engage in activities despite the pain and disinclined to control or avoid the pain.

Positive reappraisal:
Attenuates the feeling of pain

Social support:
reduces pain ratings compared to being alone

Question 22

What does acceptance do for coping with pain

Answer 22

Pays less attention to their pain & have greater self-efficacy to function better and use less pain medication

Question 23

maladaptive methods of coping with pain

Answer 23

Catastrophizing = magnification of negative thoughts, rumination, helplessness.

• Increases with pain intensity
• Plays role in transition of acute to chronic pain
• Primary appraisal → focus on exaggerating threat value of pain
• Secondary appraisal → the appraised helplessness and inability to cope

Question 24

Social factors in pain

Answer 24

• important for pain experience, expression and coping
• social networks’ health & well-being is associated the pain outcome

Question 25

Communal coping model of pain catastrophizing

Answer 25

Caststrophizers increase pain behaviour in the presence of another person. BUT supportive responses reduces negative effects of catastrophization of pain

Question 26

Social communication model of pain:

Answer 26

Attention to the interpersonal context of pain - individuals & caregivers have unique cards on the table that interact/influence pain experience contextual factors: - The adjusting of pain responses to match the others present (eg. Participants exposed to pain in laboratory adjust their pain responses to match those of others who are present at the time )

Question 27

social pain

Answer 27

pain as a result of interpersonal rejection loss. (Bullying, losing loved one)

Question 28

How is social pain related to physical pain | 4 things

Answer 28

**evolutionary perspective** - -- social pain is adaptive 🡪 signals when social relationships are threatened. Social pain and physical pain are describes similarly in words Negative social experiences rely on the same neural system as physical pain (*dorsal anterior cingulate cortex (dACC) and anterior insula (AI)* Acetaminophen (AKA Tylenol) appears to reduce social pain even when it was targeted for physical pain

Question 29

Whats the best way to treat chronic pain and why

Answer 29

combination of pharmacological (e.g., opioids) and non-pharmacological methods Medical (and especially chemical) methods alone are usually not sufficient for controlling pain, particularly when it is chronic. Because psychosocial factors play such an important role in the pain experience (see: gate-control theory) and in the transition from acute to chronic pain

Question 30

psychosocial methods for controlling/managing pain

Answer 30

- Educated * Fear reduction —> relaxation, meditation, biofeedback * Cognitive methods —> distraction, promoting acceptance * psychotherapy —> (CBT) help to manage emotional difficulties associated with pain