Lecture 10 - Pain Part 1

Question 1

define pain -

Answer 1

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

Question 2

Pain … What’s the big deal? -

Answer 2

=• #1 complaint to physicians • Massive health care costs • Massive personal costs

Question 3

what is The Significance of Pain -

Answer 3

=• It hurts!
• Minor pains provide low-level feedback • Major pain leads us to seek help
• It affects us and others

Question 4

what is the Old model - Specificity Theory of pain -

Answer 4

=• Direct relationship between the degree of tissue damage and the intensity of pain experienced
• Pain transmission was theorized to have an exclusively ascending pathway from the site of injury to the brain

Question 5

what are problems with the old model - specificity theory of pain -

Answer 5

=Can not explain chronic pain
• Continued pain despite lack of tissue damage
Can not explain differences in pain reports and pain behaviours between individuals
Can not explain phantom limb pain

Question 6

explain Pain as a Psychological Experience -

Answer 6

=• Pain is a fundamentally psychological experience

• The degree to which it is felt/how incapacitating it is depends a lot on how it is interpreted

Question 7

explain the study of soldiers and pain the the 1959 study -

Answer 7

=Beecher (1959) observed wartime injuries
• Only 1⁄4 requested morphine (painkiller) for severe/painful wounds
• Civilian practice, 80% of patients demanded
• Concluded that meaning/interpretation of pain substantially determines how it is experienced
• Soldier: injury = alive (being sent home)
• Civilian: injury = unwelcome interruption of valued activities

Question 8

why is Ronald Melzack important -

Answer 8

=contributions to pain field, collected descriptive words of pain (how people describe pain) and people used them to study and train pan conditions , gate control

Question 9

what is gate control -

Answer 9

=Pain experience is jointly determined by physiological, motivational, cognitive, and affective variables…. there are two paths; ascending and inhibitory descending. Many different fibres but essentially they each play a role in the perception of pain. If the paths are blocked pain cannot be transmitted to/from the brain

Question 10

what are the three fibres involved in gate control theory -

Answer 10

=A-delta fibres, C-fibre, A-Beta bibres

Question 11

A-delta; description, type of pain, function, pain gate modulation (open or close) -

Answer 11

=small, myelinated fibres.
transmit first pain and sharp pain rapidly
affects sensory aspects of pain
opens gate

Question 12

c-fibres; description, type of pain, function, pain gate modulation (open or close) -

Answer 12

=unmyelinated fibres
transmit secondary dull or aching pain
affects motivational and affective elements of pain
opens gate

Question 13

a-beta fibres; description, type of pain, function, pain gate modulation (open or close) -

Answer 13

=large diameter myelinated fivres
transmit info about vibration and position
concurrent stimulation can suppress pain transmitted by c-fibres
closes gate

Question 14

Gate-control theory of pain; factors that open the gate (increase pain) -

Answer 14

=Mental; focusing on the pain, boredom due to minimal involvement in life activities, non-adaptive attitudes
emotional stress; depression, anxiety, worry, tension, anger
physical factors; extent of injury or trauma to the area, readiness of the nervous system to send pain signals

Question 15

Gate-control theory of pain; factors that close the gate (decrease pain) -

Answer 15

=mental; life involvement and increased interest in life activities, intense concentration, adapt attitudes
emotional factors; relaxation, positive emotions, adequate rest
physical factors; medication, counter-stimulation (cold, massage, acupuncture)

Question 16

explain Chronic Pain and Personality Profiles on the MMPI -

Answer 16

=Chronic pain patients typically show elevated scores on the following MMPI subscales:
• Hysteria
• Hypochondriasis • Depression

Question 17

what are Psychological variables implicated in pain outcomes -

Answer 17

=• Expectancies
• Disability beliefs
• Fear of movement
• Pain catastrophizing (main)
• Perceived injustice (main)
• Exploring the mechanisms of action

Question 18

explain Perceived injustice -

Answer 18

=Feelings of being wronged by what happened that caused the pain, i.e. blaming others for one’s pain.
• arise particularly in situations where injury has occurred as a result of another person’s error or negligence (feelings of unfairness and irreparability of loss).

Question 19

explain Pain Catastrophizing -

Answer 19

=”an exaggerated negative mental set brought to bear during actual or anticipated painful experience”

Rumination (“I can’t stop thinking about how much it hurts”) Magnification (“I worry that something serious may happen”)
Helplessness (“There is nothing I can do to reduce the intensity of the pain”)