Part 4: Pain Neuroscience & the Bio-psychosocial Model of Pain

Question 1

Cortical basis of pain perception and processing:

Who described the 3 dimensions of pain?

Hint: M and C (196_)

Answer 1

Melzack and Casey (1968)

Question 2

Cortical basis of pain perception and processing:

According to Melzack and Casey (1968), what are the 3 dimensions of pain?

1.
2.
3.

Hint: S-d, M-a, C-e

Answer 2

Cortical basis of pain perception and processing:

According to Melzack and Casey (1968), what are the 3 dimensions of pain?

1. Sensory-discriminative.
2. Motivational-affective.
3. Cognitive-evaluative.

Question 3

Cortical basis of pain perception and processing:

According to Melzack and Casey (1968), which dimension of pain transmits basic sensory info, such as location, intensity and quality?

Answer 3

Sensory-discriminative.

Question 4

Cortical basis of pain perception and processing:

According to Melzack and Casey (1968), which dimension of pain includes perceptions of unpleasantness of pain and the urge to escape?

Answer 4

Motivational-affective.

Question 5

Cortical basis of pain perception and processing:

According to Meizack and Casey (1968), which dimension of pain includes the meaning and appraisal of the sensory experience?

Answer 5

Cognitive-evaluative.

Question 6

Cortical basis of pain perception and processing:

There is no single cortical area responsible for pain perception. Pain is a complex, multifactorial subjective experience, with a large distributed brain network accessed during nociceptive processing.

This network is called the:

Answer 6

Pain Matrix.

Question 7

Cortical basis of pain perception and processing:

Sensory discriminative component.

What part of the brain is involved in stimulus localisation of nociceptive info?

Answer 7

S1 (primary somatosensory cortex)

Question 8

Cortical basis of pain perception and processing:

Sensory discriminative component.

What parts of the brain are involved in intensity coding of a stimulus?

1.
2.
3.
4.
5.

Hint: S, S, M-t-n, A-c-c, I

Answer 8

Cortical basis of pain perception and processing:

Sensory discriminative component.

What parts of the brain are involved in intensity coding of a stimulus?

1. S1
2. S2
3. Medial thalamic nuclei
4. Anterior cingulate cortex
5. Insular

Question 9

Cortical basis of pain perception and processing:

Sensory discriminative component.

Where is nociception established as a sensory modality?

Answer 9

In the somatosensory system.

Question 10

Cortical basis of pain perception and processing:

Motivational-affective component.

Changes in what part of the brain are associated with changes in perceived pain?

Answer 10

The ACC (anterior cingulate cortex).

Question 11

Cortical basis of pain perception and processing:

Motivational-affective component.

Destruction of what part of the brain is associated with reductions in pain-related emotional distress?

Answer 11

The ACC (anterior cingulate cortex).

Question 12

Cortical basis of pain perception and processing:

Motivational-affective component.

What part of the brain is associated with the emotional component of pain?

Answer 12

The insular cortex.

Question 13

Cortical basis of pain perception and processing:

Motivational-affective component.

Destruction of what part of the brain is associated with pain without unpleasantness?

Answer 13

The insular cortex.

Question 14

Cortical basis of pain perception and processing:

Motivational-affective component.

What parts of the brain are activated when pain-free individuals imagine a painful experience?

Answer 14

The ACC and insular cortex.

Question 15

Cortical basis of pain perception and processing:

Cognitive-evaluative component.

What part of the brain is associated with cognitive and attentional aspects of pain?

Answer 15

The prefrontal cortex.

Question 16

Cortical basis of pain perception and processing:

Cognitive-evaluative component.

Cognitive modulation of pain, including placebo pain relief, is associated with increased activity in what part of the brain?

Answer 16

The prefrontal cortex.

Question 17

Cortical basis of pain perception and processing.

What are the 3 main limitations of the Pain Matrix concept?

2.

Answer 17

Cortical basis of pain perception and processing.

What are the 3 main limitations of the Pain Matrix concept?

1. Differences in specific brain area activities during neuroimaging studies.
2. Neuroimaging studies only look at experimentally induced pain.
3. Not comprehensive enough, other factors are involved.

Question 18

Cortical basis of pain perception and processing.

One of the limitations of the Pain Matrix is it isn’t comprehensive enough as other factors are involved, such as:

1.

2.

3.

4.

Answer 18

Cortical basis of pain perception and processing.

One of the limitations of the Pain Matrix is it isn’t comprehensive enough as other factors are involved, such as:

1. Activity in pain matrix can be strongly disassociated from pain perception.
2. Can be influence by other factors independent of stimuli intensity.
3. Pain matrix can be evoked by non-nociceptive and non-painful stimuli.
4. Pain matrix is influenced by the context in which stimuli appear.

Question 19

Biopsychosocial model of illness:

Illness is caused by a combination of what factors?

1.
2.
3.

Answer 19

Biopsychosocial model of illness:

Illness is caused by a combination of what factors?

1. Biological.
2. Psychological.
3. Social.

Question 20

Biopsychosocial model of illness:

What are the 3 main strengths of the biopsychosocial model?

1.

2.

3.

Answer 20

Biopsychosocial model of illness:

What are the 3 main strengths of the biopsychosocial model?

1. Better suited for managing long-term, chronic conditions.
2. Emphasises disease prevention and health promotion.
3. Makes explicit the relationship between patient and practitioner.

Question 21

Biopsychosocial model of illness:

What are the 3 main affective (emotional) components of pain?

2. 3.

Answer 21

Biopsychosocial model of illness:

What are the 3 main affective (emotional) components of pain?

1. Depression.
2. Anxiety.
3. Anger.

Question 22

Biopsychosocial model of illness:

Who said pain intensity and disability significantly correlates with anxiety?

Hint: M et al. (200_)

Answer 22

Meredith et al. (2006)

Question 23

Biopsychosocial model of illness:

Who said pain intensity and disability significantly correlates with depression?

Hint: A et al. (199_)

Answer 23

Arnstein et al. (1999)

Question 24

Biopsychosocial model of illness:

Who said pain intensity and disability significantly correlates with anger?

Hint: O et al. (199_)

Answer 24

Okifuji et al. (1999)

Question 25

The role of psychological factors in the experience of pain: The meaning ascribed to pain is called:

Answer 25

appraisal.

Question 26

The role of psychological factors in the experience of pain: If pain is interpreted as harmful (threat appraisal), and believed to be associated with tissue damaged, is may be perceived as:

Answer 26

more unpleasant.

Question 27

The role of psychological factors in the experience of pain: Who compared cancer and labour pain unpleasantness and intensity ratings? Hint: P et al. (198_)

Answer 27

Price et al. (1987)

Question 28

The role of psychological factors in the experience of pain: Comparing cancer and labour pain unpleasantness and intensity ratings (Price et al., 1987). What was the main finding of this study?

Answer 28

Cancer pain was rated are more unpleasant than labour pain, even though the actual pain intensity was rated as the same.

Question 29

The role of psychological factors in the experience of pain: What maladaptive beliefs are associated with increased pain intensity and disability? 1. 2. 3. 4.

Answer 29

The role of psychological factors in the experience of pain: What maladaptive beliefs are associated with increased pain intensity and disability? 1. Pain is a signal of damage. 2. Activity should be avoided. 3. Pain is uncontrollable. 4. Pain is permanent.

Question 30

The role of psychological factors in the experience of pain: Fearful reactions to pain, pain anticipation, or perceived pain consequences promotes a withdrawal from activities or behaviours believed to be the result of pain. This is called the: Hint: F-A mop

Answer 30

Fear-Avoidance model of pain.

Question 31

The role of social factors in the experience of pain: Who compared levels of affective pain and psychological disability in married and unmarried patients? Hint: R et al. (201_)

Answer 31

Reese et al. (2010)

Question 32

The role of social factors in the experience of pain: Comparing levels of affective pain and psychological disability in married and unmarried patients (Reese et al., 2010). What were the 2 key findings of this study? 1. 2.

Answer 32

The role of social factors in the experience of pain: Comparing levels of affective pain and psychological disability in married and unmarried patients (Reese et al., 2010). What were the 2 key findings of this study? 1. Higher levels of affective pain and psychological disability in unmarried patients. 2. Martial distress wasn't found to be a significant factor.

Question 33

The role of psychological and social factors in the experience of pain: Who investigated the role of psychological and social factors in acute post-surgical pain (APSP)? Hint: P et al. (201_)

Answer 33

Pinto et al. (2016)

Question 34

The role of psychological and social factors in the experience of pain: Investigating the role of psychological and social factors in acute post-surgical pain (Pinto et al., 2016). What were the 4 significant predictors of greater APSP intensity? 1. 2. 3. 4.

Answer 34

The role of psychological and social factors in the experience of pain: Investigating the role of psychological and social factors in acute post-surgical pain (Pinto et al., 2016). What were the 5 significant predictors of APSP intensity? 1. Younger age. 2. Previous chronic pain. 3. Pre-surgical anxiety. 4. Rumination.