L8

Question 1

What purpose does pain serve?

Answer 1

warns self or others of tissue damage/injury/disease; evokes care

Question 2

Consequences of pain

Answer 2

poor health behaviors, loss of employment/income, depression, fear, anxiety, social isolation, sleep disorders, marital and family dysfunction

Question 3

Characteristics of a fish’s experience of pain

Answer 3

they have neurons called nociceptors, produce the same opioids (body’s innate painkillers) as mammals, and their brain activity during injury is similar to that in terrestrial vertebrates

Question 4

Specificity theory of pain

Answer 4

pain is directly proportional to tissue damage; the body has a separate sensory system for perceiving pain

Question 5

Pattern theory of pain

Answer 5

there is no separate system for perceiving pain, rather pain is felt when certain patterns of neural activity occur due to intense stimulation

Question 6

2 stages of the experience of pain due to injury (specificity theory)

Answer 6

(1) pain messages originate in nerves associated with damaged tissue and travel to the spinal cord; (2) a signal is sent to a motor nerve and the brain, where pain is perceived

Question 7

3 ways that the specificity theory of pain is a biomedical approach

Answer 7

assumes one-to-one correspondence to injury/disease; may lead to unfortunate (e.g. blaming the patient, assuming psychiatric disorder); focuses on pharmacological, surgical, or other medical interventions to control pain

Question 8

Gate-control theory

Answer 8

pain is not directly proportional to tissue damage, rather there is a hypothetical neural pain gate in the spinal cord that opens or closes to modulate signals to the brain

Question 9

Mechanisms in the gate-control theory

Answer 9

inhibitor and projector neurons that respond to sensory input and send certain signals to the brain

Question 10

3 factors involved in gate-control theory

Answer 10

amount of activity in pain fibres, amount of activity in peripheral nerves, messages that descend from the brain

Question 11

What opens the gate in terms of physical factors?

Answer 11

extent of injury, inappropriate activity level or inactivity

Question 12

What closes the gate in terms of physical factors?

Answer 12

medication, counter stimulation (e.g. massage, heat)

Question 13

What opens the gate in terms of emotional factors?

Answer 13

anxiety or worry, tension, depression, relationship problems

Question 14

What closes the gate in terms of emotional factors?

Answer 14

positive emotions, relaxation, social support

Question 15

What opens the gate in terms of cognitive factors?

Answer 15

boredom, focusing on pain

Question 16

What closes the gate in terms of cognitive factors?

Answer 16

distraction, concentration, involvement and interest in activities

Question 17

Neuropathic pain

Answer 17

pain in the absence of noxious stimulus that results from current or past disease/damage in peripheral nerves (e.g. neuralgia, causalgia, phantom limb pain)

Question 18

Neuralgia

Answer 18

an extremely painful syndrome in which the patient experiences recurrent episodes of intense shooting or stabbing pain along a nerve that often follows infection

Question 19

Causalgia or complex regional pain syndrome

Answer 19

recurrent episodes of severe burning pain that are often triggered by minor stimuli (e.g. clothing resting on the area)

Question 20

Phantom limb pain

Answer 20

recurrent or continuous pain experienced in an amputated limb or one with no functioning nerves

Question 21

Neuromatrix theory

Answer 21

a neuromatrix comprises a widespread network of neurons across many areas of the brain that generates a pattern felt as a whole body possessing a sense of self

Question 22

What does the neuromatrix do?

Answer 22

generates pain and other sensations in the absence of signals from sensory nerves

Question 23

Where in the brain is pain produced?

Answer 23

CNS (brain, spinal cord)

Question 24

Pain according to the IASP

Answer 24

an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage; always subjective

Question 25

3 ways to assess pain

Answer 25

self-report measures (e.g. rating scales, interviews, questionnaires), behavioral assessment approaches, psychophysiological measures (e.g. EMG, EEG)

Question 26

Examples of pain rating scales

Answer 26

visual analogue scale, box scale or numeric rating scale, verbal rating scale

Question 27

3 broad dimensions involved in pain

Answer 27

affective (emotional-motivational), sensory, and evaluative

Question 28

2 types of situations for assessing pain behaviors

Answer 28

everyday activities and structured clinical sessions

Question 29

Pain behaviors

Answer 29

observable behaviors that occur in response to pain; part of the sick role and are often unknowingly strengthened or maintained by operant conditioning

Question 30

4 types of pain behaviors

Answer 30

facial and audible expression of distress, distortions in posture or gait, negative affect (mood, anxiety, depression), avoidance of activity

Question 31

Organic vs psychogenic pain

Answer 31

pain that has a clearly identifiable physical cause (e.g. tissue damage or pressure); pain resulting from psychological processes

Question 32

Factors that affect pain

Answer 32

physiological and psychosocial factors

Question 33

What do people with chronic pain experience?

Answer 33

high levels of depression, anxiety, anger, which are associated with high levels of subsequent pain/disability

Question 34

Examples of maladaptive coping

Answer 34

destructive thinking and helplessness

Question 35

How are pain and stress linked?

Answer 35

pain is stressful (partly due to lack of perceived control) and stress can produce or worsen pain

Question 36

Catastrophizing

Answer 36

frequent, magnified negative thoughts about pain (e.g. magnification, rumination, helplessness); increases with pain intensity and plays a major role in the transition from acute to chronic pain

Question 37

2 stages of the appraisal model of pain catastrophizing

Answer 37

primary appraisal and secondary appraisal

Question 38

Primary appraisal

Answer 38

focusing on and exaggerating the threat value of pain

Question 39

Secondary appraisal

Answer 39

appraisals of helplessness and of inability to cope

Question 40

2 types of coping strategies

Answer 40

overt behavioral and covert

Question 41

Examples of overt behavioral coping

Answer 41

getting rest, using relaxation methods, and taking medication

Question 42

Examples of covert coping

Answer 42

hoping or praying the pain will get better, saying calming words to oneself, diverting one's attention

Question 43

Examples of adaptive coping

Answer 43

relaxation, distraction, redefinition of pain/reappraisal, readiness to change, taking an active role

Question 44

Pain acceptance

Answer 44

being inclined to engage in activities despite the pain and disinclined to control or avoid the pain

Question 45

What traits do people with high levels of pain acceptance possess?

Answer 45

pay less attention to pain, have greater self-efficacy for performing daily tasks, function better, and use less pain medication than those with low pain acceptance

Question 46

What reduces pain ratings following a cold-pressor task?

Answer 46

positive self-statements with explanations of how they can help; verbal support

Question 47

Communal coping model of pain catastrophizing (CCMPC)

Answer 47

in a social context, the person in pain catastrophizes and appears less able to cope with pain in order to elicit proximity, support, empathy, and assistance from caregivers

Question 48

When is catastrophizing detrimental?

Answer 48

it may be less adaptive during chronic pain, leading to social conflict and rejection

Question 49

What behavior do high catastrophizers display?

Answer 49

increased pain behavior in the presence of another person and engage in less effective coping

Question 50

Goal of CCMPC

Answer 50

to manage distress in a social context rather than an individual one

Question 51

Social communication model of pain

Answer 51

primarily focuses on the interpersonal context of pain wherein the dynamic interplay between the unique qualities of the patient and the caregiver (e.g. personal histories, pain expression, pain management) influence the pain experience

Question 52

Social pain

Answer 52

the experience of pain as a result of interpersonal rejection or loss (e.g. being an outcast, getting bullied, losing a loved one)

Question 53

What areas of the brain do negative social experiences rely on?

Answer 53

the same neural system supporting the affective component of physical pain (dorsal anterior cingulate cortex and anterior insula)

Question 54

In what ways does acetaminophen or tylenol treat pain?

Answer 54

reduces daily self-reported social pain, neural responses to social rejection in the dACC and AI

Question 55

4 clinical interventions for pain

Answer 55

surgical interventions, chemical/pharmacological treatments, stimulation therapies, physical therapy and rehabilitation

Question 56

Examples of chemical treatments

Answer 56

peripherally active analgesics (e.g. acetaminophen), centrally acting analgesics or opioids (e.g. morphine), local anaesthetics (e.g. novocaine)

Question 57

4 aims of psychological treatments for pain

Answer 57

to reduce the frequency and intensity, improve emotional adjustment, increase social and physical activity, reduce the use of analgesic drugs

Question 58

Common psychological treatments for pain

Answer 58

fear reduction methods (e.g. systematic desensitization); progressive muscle relaxation, meditation, and biofeedback; cognitive methods; psychotherapy (e.g. CBT)

Question 59

Examples of cognitive methods to treat pain

Answer 59

distraction, non-pain imagery, redefinition, promoting acceptance

Question 60

Goal of CBT in treating pain

Answer 60

to help people manage the emotional difficulties associated with pain and encourage acceptance

Question 61

Somatic symptom disorder

Answer 61

long-term pain due to excessive concerns for physical symptoms or health that are usually medically unexplained

Question 62

Acute pain

Answer 62

discomfort experienced with temporary painful conditions that last less than about 3 months

Question 63

Chronic pain

Answer 63

painful condition lasts longer than its expected course or more than a few months

Question 64

3 types of chronic pain

Answer 64

chronic-recurrent pain, chronic-intractable-benign pain, chronic-progressive pain

Question 65

Chronic-recurrent pain

Answer 65

stems from benign causes and involves repeated and intense episodes of pain separated by periods without pain

Question 66

Chronic-intractable-benign pain

Answer 66

discomfort that is typically always present with varying levels of intensity and is not related to an underlying malignant condition

Question 67

Chronic-progressive pain

Answer 67

continuous discomfort due to a malignant condition and becomes increasingly intense as the underlying condition worsens

Question 68

Gender differences in the experience of pain

Answer 68

men and women have similar pain thresholds but women giver higher pain ratings

Question 69

Neurodic trial scales

Answer 69

hypochondriasis, depression, hysteria

Question 70

Relationship between chronic pain and psychological maladjustment

Answer 70

chronic pain is more likely to lead to maladjustment than vice versa

Question 71

Psychophysiology

Answer 71

study of mental or emotional processes as reflected by changes they produce in physiological activity