Chapter 8: Pain Flashcards
Organic Pain
pain that has a clearly identifiable physical cause
psychogenic pain
pain resulting from psychological processes
today’s scienfitic perspective on pain
today’s scientists recognize that virtually all pain experiences involve an interplay of both physiological and psychosocial factors
The effect of emotion on pain
- positive emotions appear to reduce pain
- negative emotions tend to worsen pain
- most ppl w chronic pain experience high lvls of depression, anxiety and/or anger
- emotions can also obscure the memory of pain (ex. anxiety patients’ memories of pain are determined more by what they expect than by what they actually feel
2 ways pain and stress are linked
- pain is stressful (partly due to lack of perceived control)
- stress can produce pain in addition to worsening the pain experience
Pain and meaning
pain can be more or less intense depending on the meaning of the pain underlying the injury
- ex. enjoyment of pain during sex
classical conditioning and pain meaning
classical conditioning can be one means by which the meaning of pain changes
maladaptive coping with pain
destructive thinking; helplessness
catastrophizing
frequent, magnified negative thoughts about pain; magnification, rumination, helplessness
One of the WORST ways to cope
- catastrophizing increases with pain intensity and seems to play a major role in the transition from acute to chronic pain
primary appraisal in pain
focusing on and exaggerating the threat value of pain
secondary appraisal and pain:
appraisals of helplessness and of inability to cope
adaptive coping with pain
relaxation, distraction, redefinition of pain, readiness to change, taking an active role
acceptance of pain
being inclined to engage in activities despite the pain and disinclined to control or avoid the pain
- ppl with high lvls of pain acceptance pay less attention to their pain, have greater self-efficacy for performing daily tasks, function better, and use less pain medication than those with low pain acceptance.
positive reappraisal
makes pain less severe
ex. positive self-statements - kinda like the placebo effect
social support and pain
social support reduces feelings of pain
ex. verbal support during the cold-pressor task more strongly reduced participant pain ratings compared to the mere presence of other ppl or the person being alone
social communication model of pain
when a person experiences pain they have
1. a subjective experience
2. they express that pain to a certain degree (that then has an impact on the subjective experience of the pain)
3. the other person present will be assessing that pain (formal or informal assessment)
4. the other person then may engage in some attempt to help the person manage their pain (will have an impact on their assessment - they will reassess, AND it may affect the person’s subjective experience of their pain)
social communication and pain
the social communication model places primacy on the interpersonal context of pain
- both the person in pain and the caregiver bring to the table unique qualities and characteristics that interact to influence the pain experience
- the dynamic interplay between patient and caregiver continuously influences the pain experience
- also consider: contextual factors (ex. participants exposed to pain in lab adjust their pain responses to match those of others who are present at the time)
Communal coping model of pain catastrophizing
goal: to manage distress in a social context rather than an individual one
- experiences of pain in a social context lead a person to be more likely to catastrophize (as a result, person appears less able to cope with pain)
- increased attention to pain and pain behaviour still tend to worsen the pain experience (whatever social support and benefit is not worth it to mediate the pain from catastrophizing
- the caregiver then provides support, empathy, assistance
catastrophizing and social support
- high catastrophizers display increased pain behaviour in the presence of another person (and engage in less effective coping)
- when ppl receive a supportive response from their spouse, the negative effects of catastrophizing on pain are significantly reduced
- catastrophizing tends to be harmful nonetheless
Treating the social network
the health and well-being of one’s social network also affects pain outcomes
-ex. in ppl with arthritis, spouse depression predicted increasing pain and disability over one year, controlling for their own depression
-solution? treat the social network too!
Social Pain
the experience of pain as aresult of interpersonal rejection or loss, such as rejection from a social grouo, bullying, or the loss of a loved one
- from an evolutionary perspective is adaptive - signals when social relationships are threatened
- linguistically, we describe social pain and physical pain in similar terms “hurt feelings”, or “broken-hearted”
similarities between social pain and physical pain
negatve social experiences rely on the same neural system supporting the affective component of physcial pain (dorsal anterior cingulate cortex -dACC and Anterior insula -AI)
fMRI research shows that the dACC is associated w a degree of distress/pain; the AI is associated with emotional processing
