Lecture 10 - Part 2

Question 1

do catastrophizers or non-catastrophizers experience more pain -

Answer 1

=catastrophizers

Question 2

what situations do people most do Pain Catastrophizing -

Answer 2

=700+ studies
Rheumatoid arthritis, osteoarthritis, fibromyalgia, sickle cell anemia, soft tissue injuries, neuropathic pain, dental patients, healthy populations

Question 3

why is Pain Catastrophizing predictions necessary -

Answer 3

=One of the most important predictors of pain experience.
• Heightened levels of pain, pain behaviour
• Contributes to higher level of disability following surgery • Predicts increased consumption of analgesic medication • More prolonged hospitalization

Question 4

what are the Pain Catastrophizing: Mechanisms -

Answer 4

=Endogenous Pain Modulation

Attentional Model

Question 5

explain Endogenous Pain Modulation as a pain catastrophizing mechanism -

Answer 5

=direct impact on endogenous pain modulation mechanisms in the brain and spinal cord
• Compromised descending inhibition of pain

Question 6

explain attentional model as a pain catastrophizing mechanism -

Answer 6

=• Heightened “chronic” activation

• Heightened sensitization -> chronic hyperalgesic state

Question 7

how can pain catastrophizing be seen as a communal coping model -

Answer 7

=• An effort to garner social support from others
• Engaging in exaggerated pain expressions to solicit assistance or
emphatic responses

Double edged sword:
• Increases attention to pain • Reinforcement

Question 8

what are the Economic Impact Associated with Pain -

Answer 8

=• $4 billion spent annually in Canada on over-the-counter pain medications.
• Chronic pain costs more than heart diseases, cancer, and HIV combined
• Direct health care costs > $6 billion/year
• Loss of productivity > $19 billion/year

Question 9

what are the three categories of Common Pain Killers -

Answer 9

=Non-Narcotic Analgesics (Non-Opioids)
Local anesthetics, e.g., lidocaine
Opiods (morphine, codine, etc)

Question 10

explain what is included in Non-Narcotic Analgesics (Non-Opioids) -

Answer 10

=NSAIDs (non-steroidal anti-inflammatory drugs) aspirin
ibuprofen (Advil, Motrin)
many others

Acetaminophen (Tylenol)

Question 11

what is another approach to dealing with pain -

Answer 11

=sensory stimulation
virtual reality
psychological control

Question 12

explain sensory stimulation -

Answer 12

=1. Transcutaneous electrical nerve stimulation (TENS) works mainly by stimulating A-beta fibers, closing pain gates
• Counter-irritation
2. Massage
3. Acupuncture

Question 13

explain Virtual Reality -

Answer 13

=3-dimensional simulated environment.
Example
• Burn patients during wound care (U of Washington)

Question 14

explain Psychological Control -

Answer 14

=Evidence for opioid enhancement
• Progressive Muscle Relaxation • Hypnosis
• Meditation

Question 15

what are Comprehensive Pain Treatment Programs -

Answer 15

=Above techniques plus:
Behaviour/operant therapies
• reducing the overt display of pain, not the experience of
pain
• normalize behaviour, fear of movement, reinforcement
contingencies, possibly reduce pain by distraction

Question 16

what s included in Comprehensive Pain Treatment Programs -

Answer 16

=CBT (• Change maladaptive thoughts • Motivational self-talk
• Coping strategies
• Imagery)
, stress management (form of CBT with a focus on problem solving), acceptance and commitment therapy (experience pain without attempting to control it), family therapy (stop enabling)