Pain and Social Pain

Question 1

Pain

Answer 1

Unpleasant sensory and emotional experiences associated with actual or potential tissue damage.
Intensity measured.
Subjective
Physically manipulated

Question 2

Salience network

Answer 2

what to pay attention to

Question 3

Modulation network

Answer 3

Top-down control, neurochemical painkillers

Question 4

Acute pain

Answer 4

Immediate response from injury/disease
Responsive to pharmacological treatments

Question 5

Chronic pain

Answer 5

Persisting for six months or more
Tends to not be responsive to pharmacologic treatment.

Question 6

Pain assessment

Answer 6

Physiological
Questionnaire: physical experience and pain attitudes
Mood assessment
Observational: direct observations or indirect(self-observations) like diaries or logs.

Question 7

Sensory receptors: nociceptors

Answer 7

Sensory neurons that respond to damaging/potentially damaging stimuli
Primarily free nerve endings specific for pain and temperature
Myelination allows increased passage of information through the neuron

Question 8

Spinothalamic tract

Answer 8

Sensory neurons: conduct and transmit painful stimuli from the peripheral nervous system into the central nervous system (spinal cord).
Nociceptors transmit pain to the ipsilateral side of the spinal cord, where the side stimulated reaches the same side in the spinal cord.
Pain signals cross to the contralateral side of the spinal cord.
Transmission ascends the spinal cord through the brainstem (medulla, pons, midbrain) into the VPL nucleus of the thalamus.
Signals are transmitted from the thalamus to the somatosensory areas of the cerebral cortex.

Question 9

Specificity Theory

Answer 9

There is a causal relationship between pain stimuli and receptors.
Stimulus intensity is the same as the pain intensity.

Question 10

Specificity Theory problems

Answer 10

There is no specific cortical location for pain
Pain fibers for other purposes (pressure and temperature)
It does not explain disproportionate pain reports

Question 11

Pattern Theory

Answer 11

Nociceptors generate summated signals in the spinal cords.
The signal is only transmitted if it passes a threshold.

Question 12

Pain Theory problems

Answer 12

It does not explain deferred pain or pain without injury or injury without pain.

Question 13

Gate Control Theory

Answer 13

The perception of pain is not solely determined by the intensity of the pain signals from damaged tissues but is also influenced by various neural mechanisms that can either enhance or inhibit the transmission of these signals.
With no pain: active inhibitory interneuron suppresses pain pathway.
With strong pain: the C fiber stops inhibition and allows a strong signal.
Pain can be modulated by simultaneous somatosensory input: where nonpainful and painful simultaneous stimulus will result in a decrease of painful stimuli.

Question 14

Pain modulators: physical

Answer 14

Touch can simultaneously modulate pain by decreasing painful stimulus through its inhibition influence.

Question 15

Drugs

Answer 15

Drugs target specifically the pain pathway and send blockades to stop the generation of the pain signal.
Anti-inflammatories, opioids, morphine, cannabis

Question 16

Pain modulators: psychosocial

Answer 16

Emotional cognitive factors: attention, interpretation, coping strategy
External environment factors: Learning, boundaries (culture, family)
Modulates expression and behavior to pain.

Question 17

Pain and conditioning

Answer 17

Classical conditioning: a particular situation or environment is associated with pain/anxiety/depression.
Operant conditioning: Pain is an unpleasant sensation and leads to behavior to express pain.

Question 18

Fear-avoidance model

Answer 18

Attaching fear to pain can lead to avoidance behavior.
Can lead to the maintenance of fear, hypervigilance, muscular reactivity, and physical disuse.
Confrontation leads to a reduction of fear over time.

Question 19

Cortical regions

Answer 19

As pain transmission ascends to the cortex, pain experience is imbued with different features (sensations, emotions, memories).
Anterior Cingulate Cortex and insular cortex: unpleasantness
Somatosensory cortex 1 and 2: sensation, location, modality
Prefrontal cortex: regulation, descending pathway control

Question 20

Limbic areas

Answer 20

Amygdala: emotion, fear
Hippocampus: Memory
Hypothalamus: modulation

Question 21

Cogill: Subjective pain experience

Answer 21

Tried observing where subjective pain occurred in the brain.
A group of individuals rated temperature stimuli applied to their forearms and were split into groups based on pain sensitivity.
Insensitive and sensitive.
It was repeated on their leg whilst having a fMRI to observe which brain areas were used by observing their blood flow.
They found that cortical regions related to sensation, attention, and affect were most associated with pain-sensitive people vs pain insensitive.
Everyone’s thalamus was activated, demonstrating pain pathway was working perfectly for all of them.
The subjective top-down experience controls and creates the difference between pain experience.
It validated subjective pain reports.
dACC: activates for subjective pain

Question 22

Phantom Limb

Answer 22

The sensation that an amputated or missing limb is still attached.
Hyper-excitability in peripheral nerves or CNS near amputation, nerves are hyper-excitable allowing them to trigger pain.
Mirror therapy: mirror neurons can activate to mimic firing activities to what is observed.
It may block the perception of a phantom limb.

Question 23

Congenital Universal Insensitivity To Pain (CUIP)

Answer 23

The inability to perceive physical pain, but can tell the difference from different amounts of non-pain stimuli.
SCN9 gene: responsible for instruction to make alpha subunit part of the sodium channel, absence of functioning channel impairs transmission of pain signals causing insensitivity to pain.
May result in injury and early death.

Question 24

Jaak Panksepp: Social Pain

Answer 24

Guinea pigs were isolated from the group, which caused distress to the animals.
They were injected morphine which alleviated distress vocalizations.
There could be the possibility of the social distress system being tied to the physical pain system.
The endogenous brain opioid system in the cerebellum may be one of the neurochemical regulators of distress associated with social separation as well as the pleasure associated with social connection.

Question 25

Stephens and Robertson: Swearing

Answer 25

A repeated measures design where they observed how swear words may impact the experience of pain, is it swearing or the distraction?
IV: type of swear words
DV: the rating of emotion, humor, distraction; cold pressure pain threshold, cold pressor pain tolerance, pain perception score, change from resting heart rate
The use of conventional swear words demonstrated an increased tolerance to pain.
As there was no difference in tolerance for the use of new swear words, it demonstrated swearing is not much of a distraction but an emotional weight that aids pain tolerance.

Question 26

Eisenberger:

Answer 26

People played cyber ball under 3 conditions
Excluded due to technical difficulties
Included
Excluded due to rejection by other players
Social exclusion individuals experienced greater activity in dACC(subjective pain experience) and regions of the right ventrolateral prefrontal cortex
Demonstrated an overlap in brain circuitry for social and physical pain.

Question 27

Dewall: Social Pain Implications

Answer 27

Randomly assigned participants to receive
Daily dose of Tylenol or placebo
Participants recorded questions regarding the degree to which they felt emotionally hurt during the day.
The placebo group showed no change in hurt feelings
The Tylenol group showed a significant decline in hurt feelings.

Question 28

Dewall: Social Implications (2)

Answer 28

Randomly assigned participants to receive
Morning and at bed dose of Tylenol
Placebo
3 weeks later an fMRI ball tossing social exclusion task was done.
Compared to the placebo group, participants who took acetaminophen showed less activity in dACC and anterior insulin in response to cyberball exclusion.

Question 29

Prevention of psychological and pain disorders

Answer 29

Morphine prevention for PTSD in people experiencing physical injury from a traumatic event.
Opiates interference/prevention of memory consolidation through beta-adrenergic mechanism, lessens impact of PTSD