☆ L7: Meditation and Pain ☆ Flashcards
Define pain. Why is pain adaptive?
Pain is characterized by (1) a feeling resulting from injury, linked to the healing process, and can be studied relatively easy
OR
(2) a feeling that injury has occurred, can extend beyond the healing process, and is a private experience that is difficult to study objectively
Pain is adaptive because it enables us to identify danger and withdraw
What is meant by the term ‘pain impact’?
Pain impact refers to the degree to which pain disrupts one’s mood and lifestyle.
Tests for assessing pain impact very by age group, illness, and verbal proficiency.
Differentiate between acute and chronic pain. How might chronic pain arise?
Acute pain is brief and overlaps with the healing process following injury.
Chronic pain is persistent (greater than three months) and persists beyond the healing period.
Injury induces changes in the nervous system that can lead to chronic pain.
Describe the ‘chronic pain demographic.’
Rates of chronic pain increase significantly with age.
Chronic pain rates are higher in individuals with low income, obesity, and women.
Explain the difference between allodynia, hyperalgesia and spontaneous pain.
Allodynia: things that were not painful before become painful; lowered threshold; innocuous stimuli illicit pain
Hyperalgesia: things that were already painful before become more painful; things hurt more than normal; harmful stimuli illicit enhanced pain
Spontaneous pain: recurring pain without identifiable stimulus
Pain perception has several dimensions. What are these dimensions? How are they measured in the laboratory?
Unpleasantness: the emotional quality we attach to a painful experience
▻ Measurement: self-report via pain unpleasantness scales
Threshold: the point on a stimulus gradient at which pain is first experienced
▻ Measurement: measured experimentally by exposing people to stimuli of various strengths
▻ Sensitivity is the inverse of threshold. Low threshold = high sensitivity, high threshold = low sensitivity
Intensity: The strength of the painful experience
▻ Measurement: self-reported pain intensity rating scales
✮ Meditation has the greatest effect on threshold ✮
What aspect of pain is typically most sensitive to meditation? Are there any exceptions to this rule?
Threshold is most sensitive to meditation
What factors contribute to how we perceive pain?
Physiological, genetics, behavioural, affective, socio-ethnocultural, sensory
Attention and emotion affect pain. Explain how.
Attention: distraction generally lowers pain intensity
Emotion: a good mood generally lowers pain unpleasantness
What is pain catastrophization? Why might catastrophization be affected by mindfulness?
Pain catastrophization is the act of describing pain in more exaggerated terms, reminating on pain, and/or feeling more helpless about pain than is typical.
Results in pain being reported as more intense and distressing than expected.
Mindfulness may reduce pain catastrophization by promoting non-judgmental acceptance.
▻The effects of mindfulness and MCBT are greatest in individuals with high levels of catastrophizing.
Describe the pain matrix. What brain regions are involved? What specific role in pain do these regions play?
Prefrontal cortex (PFC), insular cortex, somatosensory cortex (SS1/SS2), anterior cingulate cortex (ACC)
All of these regions exhibit meditation-induced neuroplasticity.
Changes in the structure of these regions is associated with chronic pain
Give various mechanisms by which meditation may reduce pain. Be prepared to explain these mechanisms in two to three sentences.
Breathing changes: breathing affects pain and changes in meditation higher HF-HRV during meditation is associated with lower pain unpleasantness
Cognitive relationship with pain changes: by encouraging nonjudgmental acceptance, mindfulness may reduce pain catastrophization
Mood improvements via the neuroplasticity in mood regulation networks: anxiety and depression are frequently comorbid with pain and may complicate its treatment. Meditation may help reduce pain by treating its comorbid conditions.
Pain related processing changes via neuroplasticity in the pain matrix: meditation is associated with changes in unpleasantness (but not intensity) anxiety, and PFC activity
Explain controversies in how meditation affects pain processing by the brain.
One controversial perspective is that meditation treats pain by affecting endorphin transmitters. According to this theory, endorphins act on opioid receptors to reduce pain. However, if endorphins were key to meditation’s effects, the analgesic affects of meditation should be abolished by an opioid receptor blocker, such as naloxone and this is not the case.
Compare the effects of meditation-induced analgesia to placebo analgesia.
Meditation-induced analgesia has…
• Stronger effects on intensity and unpleasantness
• Greater effects on the networks involved in the cognitive evaluation of pain
• Effects of mindfulness cannot be reversed by naloxone whereas placebo effects can be
Meditation is an alternative treatment for pain. Compare the safety and efficacy of meditation as a treatment to that of drugs.
My meditation is better than no treatment at treating pain.
However, data is lacking on comparisons to other EBTs, such as drugs.
Although drugs have a stronger effect on pain, meditation is safer, more affordable, and could be paired with another EBT.
