Psychology Of Pain

Question 1

What is pain?

Answer 1

Pain is a percept (a perceived object that exists in the mind of the person perceiving it)
It is aversive and unpleasant

Question 2

What is the prevalence of pain?

Answer 2

Pain is the commonest presenting symptoms to medical professionals
High prevalence

Question 3

What is the difference between acute and chronic pain?

Answer 3

Acute- short lasting pain

Chronic- long lasting pain

Question 4

What is nociception?

Answer 4

The process of pain generation (the detection of tissue damage)

Question 5

In which what’s can pain occur in the absence of tissue damage ?

Answer 5

Neuropathic pain (pain generated by peripheral nervous system)
Phantom pain (pain felt in a limb that is no longer there)
Thalamic pain syndromes (damage to the thalamus)

Question 6

What is the mechanism of peripheral pain?

Answer 6

• Damaged cells release substances that excite nerve endings (such as histamine, serotonin, K+, prostaglandins, leukotrienes)
• Action potential generated in the periphery can reflexively excite blood vessels and other cells to produce inflammation
• Information enters the dorsal horn of the spinal cord and is relayed
• Pain fibres release glutamate as a transmitter and substance P as a neurotransmitter ion the spinal cord

Question 7

What are the different types of free nerve endings?

Answer 7

A-delta fibres are large and myelinated, responsible for signalling sudden sharp pain
C fibres are smaller and unmyelinated, signalling dull pain

Question 8

What is the gate theory of pain?

Answer 8

(Proposed by 1965 by Melzack and Wall)
When the ‘gate’ is open the action potential can travel through the projection neutron and cause pain
When the ‘gate’ is closed, the action potential doesn’t travel through the projection neurone and doesn’t cause pain

Question 9

When does actuate pain become chronic ?

Answer 9

Varies between 3 and 6 months

When it becomes a substantial illness burden

Question 10

What classifies chronic pain?

Answer 10

ICD-10 classification

Question 11

What is the main division in classifying chronic pain?

Answer 11

Nociceptive- persistent damage or inflamed tissue activating receptors
Neuropathic- persistent damage of malfunction of nervous system itself

Question 12

What is the fear avoidance of pain model?

Answer 12

People experience pain
Based on their pain experience they fear or do not fear pain
The fear of pain leads to avoidance of activity, then disability/depression, then a worse pain experience

Question 13

What are other factors that may affect pain?

Answer 13

Biology of pain pathways
Cognitive aspects of pain
Emotional aspects of pain
Memories of pain

Question 14

What are some psychogenic pain relief intervention ?

Answer 14

Placebo effect
Hypnosis
Stress
Cognitive

Question 15

What are the 4 main branches in psychological pain management?

Answer 15

Operant behaviour therapy
Cognitive behaviour therapy
Mindfulness based therapy
Acceptance and commitment therapy

Question 16

What is operant behavioural therapy?

Answer 16

Focuses on extinguishing maladaptive behavioural responses

-focuses on behaviour

Question 17

What is cognitive behavioural therapy?

Answer 17

A biopsychosocial approach to behavioural and cognitive responses to pain

Question 18

What is mindfulness based stress reduction?

Answer 18

Learning a non judgemental approach to pain

Question 19

What is acceptance and commitment therapy?

Answer 19

Based on developing psychological flexibility

-acceptance of mental events and pain and learning to cease avoidance and other problematic behaviours