Pain

Question 1

Two types of pain
What is pain in generL?

Answer 1

Feeling resulting from injury
- Linked to healing process
- Can be studied easily
—
Feeling/Perception that injury has occurred
- Can extend beyond healing process
- Private experience so hard to study objectivy
———
Adaptive response, allowing us to identify danger and withdraw

Question 2

Allodynia
Hyperalgesia
Spontaneous pain

Answer 2

Stimuli that typically wouldn’t be painful is now painful
- Lower threshold, innocuous stimuli elicit pain
—
Stimuli that is painful is now more painful
- Noxious stimuli elicit enhanced pain
—
No clear source if pain
- Recurring pain without an identifiable stimulus

Question 3

Chronic pain rate increases by what?
Risk factors (3)
Tests for assessing pain impact vary by what

Answer 3

Increases w/ age
- Low income
- Obesity
- Women
—
Vary by age group, illness, verbal proficiency

Question 4

Pain symptoms effect on willingness to try meditation

Answer 4

Willingness doubled w/ 1+ symptoms

Question 5

Ways to measure pain:
- Threshold/Sensitivity
- Intensity
- Unpleasantness

Impact of distraction and positive mood

Answer 5

THRESHOLD:
- Point in stimulus gradient at which pain is first experienced
- Low threshold = Weak stim induces pain, High threshold = Strong stim induces pain
- Sensitivity is inverse
—
INTENSITY:
- Self-report of strength of painful exp via pain intensity rating scales
- Scales w/ faces better for children, Scales w/ colour and language better for adults
—
UNPLEASANTNESS:
- Emotional quality attached to painful exp assessed thru self-report via pain unpleasantness scales
—————
Distraction - Reduces intensity
Positive mood - Reduces unpleasantness

Question 6

Pain catastrophization

Answer 6

Act of describing pain in more exaggerated terms, ruminating on pain excessively or feeling more helpless about pain than is typical
- Meditation can reduce this, which makes better treatment outcomes

Question 7

Cortical regions in the pain matrix (4)
- Variations and changes in structure associated w/ what

Answer 7

• Insular cortex
• Anterior cingulate cortex (ACC)
• Somatosensory cortex (SS1/SS2)
• Prefrontal cortex (PFC)
  —
  Variations (Specifically activity in PFC, ACC, and SS) - Individual diffs
  Structure - Chronic pain

Question 8

What kind of meditation can reduce/manage acute and chronic pain?

Zen meditation effect on intensity and unpleasantness

Answer 8

Acute - Transcendental meditation
Chronic - MBSR
—
Lowers after mindfulness meditation

Question 9

Controversies of pain studies (3)

Answer 9

• Duration of pain relief unclear (Does practice duration change it?)
• Studies examine experimentally-induced pain in healthy subjects and generalize to patients
• Lack of experimental studies on meditation’s fx on chronic pain

Question 10

Meditation might affect pain by:
- Changing breathing
- Changing cognitive relationship w/ pain (preventing catastrophization)
- Reducing anxiety/depression via neuroplasticity in mood regulation networks
- Changing pain-related processing via neuroplasticity in pain matrix
- Affecting endorphins

Answer 10

• Study shows slower breathing in meditators (but only acute effects)
• Higher high-frequency HRV during meditation lowers pain unpleasantness
  —
• Non-judgmental acceptance reduces
  —
• Meditation treats anxiety and depression and they tend to be comorbid
  —
• ACC + SS2 thicker in long term Zen meditators (correlated w/ sensitivity, also shows activity change)
• Showed reduced unpleasantness, anticipatory anxiety, and activity in PFC
  —
• Endorphins act on opioid receptors to reduce pain
• But Opioid receptor blockers (naloxone) don’t remove effect of meditation

Question 11

Mindfulness vs Placebo effect on intensity and unpleasantness

Answer 11

Stronger effect in mindfulness but still some effect in placebo
- Also greater effect on anterior cingulate, anterior insula, and OFC activity (regions involved in eval of pain)