Part 3: The Function & Neurobiology of Pain Flashcards
(95 cards)
1
Q
What is pain?
A
An unpleasant sensory and emotional experience with actual or potential tissue damage.
2
Q
What is the purpose of pain?
A
To protect an organism and to increase its chances of survival.
3
Q
How does pain serve as a warning?
A
It occurs before serious injury occurs, to promote immediate withdrawal from a harmful injury and prevent further injury.
4
Q
How does pain facilitate healing?
A
Sets limits on activities and enforces rest.
5
Q
How does pain facilitate learning?
A
Serves as an aid to learning, by avoiding injurious objects or situations in future. This learning process involves language and symbols.
6
Q
What are the 3 types of pain?
1.
2.
3.
Hint CAT
A
What are the 3 types of pain?
- Chronic
- Acute
- Transient
7
Q
What is transient pain?
A
Pain of brief duration and little consequence. A normal part of daily life that doesn’t warrant seeking health advice.
8
Q
What is acute pain?
A
Pain of recent onset and limited duration. Usually related to injury or disease. Does not overwhelm the body’s capacity to heal.
9
Q
What is chronic pain?
A
Pain lasting 3+ months in duration, or beyond the expected time for healing. It may exceed the body’s capacity to heal.
10
Q
Why are psychologists interested in pain?
- 2.
3.
A
Why are psychologists interested in pain?
- Pain is highly prevalent.
- Pain has a profound impact on QoL.
- Pain has a profound effect on society.
11
Q
Pain is highly prevalent:
According to Breivik et al. (2006), what percentage of Europeans suffer from chronic pain?
A
19%
12
Q
Pain is highly prevalent:
According to Breivik et al. (2006), what is the most common form of chronic pain?
A
Back pain, followed by headache.
13
Q
Pain is highly prevalent:
According to the BPS (2015), how many people in England live with chronic pain?
A
14 million.
14
Q
Pain is highly prevalent:
According to the BPS (2015), in 2011, what percentage of women and men reported chronic pain?
Men:
Women:
A
Men: 31%
Women: 37%
15
Q
Pain is highly prevalent:
According to a systematic review by Fayaz et al. (2016), what proportion of the UK’s population have chronic pain?
Between / and /.
A
Between 1/3 and 1/2.
16
Q
Pain is highly prevalent:
Who conducted an internet based survey of the prevalence of chronic pain in the US?
Hint: J et al. (201_)
A
Pain is highly prevalent:
Who conducted an internet based survey of the prevalence of chronic pain in the US?
Johannes et al. (2010)
17
Q
Pain is highly prevalent:
Internet based survey of chronic pain in the US (Johannes et al., 2010).
What percentage of Americans had chronic pain?
A
30.7%
18
Q
Pain is highly prevalent:
Internet based survey of chronic pain in the US (Johannes et al., 2010).
Was the prevalence of pain higher in men or women?
A
Women.
19
Q
Pain is highly prevalent:
Internet based survey of chronic pain in the US (Johannes et al., 2010).
Of those who had chronic pain, what proportion had daily pain?
A
1/2.
20
Q
Pain is highly prevalent:
Internet based survey of chronic pain in the US (Johannes et al., 2010).
Of those who had chronic pain, what percentage reported severe pain?
A
32%
21
Q
Pain can have a profound effect on QoL:
Who investigated instances of probably anxiety and depression?
Hint: P and B (200_)
A
Pain can have a profound effect on QoL:
Who investigated instances of probably anxiety and depression?
Pallant and Bailey (2005)
22
Q
Pain can have a profound effect on QoL:
According to Pallant and Bailey (2005), what percentage of cases had probable anxiety and depression?
Anxiety:
Depression:
A
Anxiety: 38.2%
Depression: 30.1%
23
Q
Pain can have a profound impact on QoL:
Who investigated the prevalence of anxiety and depressive symptoms in fibromyalgia patients?
Hint: T T and F (200_)
A
Pain can have a profound impact on QoL:
Who investigated the prevalence of anxiety and depressive symptoms in fibromyalgia patients?
Thieme, Turk and Flor (2004)
24
Q
Pain can have a profound impact on QoL:
Prevalence of anxiety and depressive symptoms in fibromyalgia patients (Thieme, Turk and Flor, 2004).
What was the prevalence of:
Anxiety disorder symptoms:
Depressive disorder symptoms:
A
Anxiety disorder symptoms: 32.2%
Depressive disorder symptoms: 34.8%
25
Pain can have a profound impact on QoL:
Who investigated fear of pain and activity in fibromyalgia patients?
Hint: T R and B (200_)
Pain can have a profound impact on QoL:
Who investigated fear of pain and activity in fibromyalgia patients?
Thieme, Turk and Burwinkle (2004)
26
Pain can have a profound impact on QoL:
Fear of pain and acitivity in fibromyalgia patients (Thieme, Turk and Burwinkle, 2004).
What percentage of patients reported fear of pain and activity?
38.6%
27
Pain can have a profound impact on QoL:
Who investigated fear of movement in chronic lower back pain patients?
Hint: T et al. (201_)
Pain can have a profound impact on QoL:
Who investigated fear of movement in chronic lower back pain patients?
Thomas et al. (2010)
28
Pain can have a profound impact on QoL:
Fear of movement in chronic lower back pain patients (Thomas et al., (2010).
What percentage of patients reported fear of movement?
79.6%
29
Pain can have a profound impact on QoL:
Chronic pain is associated with disturbances in family functioning, including:
1.
2.
3.
4.
Hint: PADE
Pain can have a profound impact on QoL:
Chronic pain is associated with disturbances in family functioning, including:
1. Physical intimacy
2. Alcoholism
3. Depression
4. Emotional intimacy
30
Pain can have profound effects upon society:
According to Maniadakis and Gray (2000), how much does back pain cost the NHS per annum?
£1 billion.
31
Pain can have profound effects upon society:
According to the Chief Medical Officer Annual Report (2008), how much does back pain cost the economy per annum?
£12.3 billion.
32
Functions of the nervous system:
What are the 3 main functions of the nervous system?
1.
2.
3.
Hint: Si, IoD, Mo
Functions of the nervous system:
What are the 3 main functions of the nervous system?
1. Sensory input
2. Integration of data
3. Motor output
33
Functions of the nervous system:
What do the 2 major components (subsystems) of the somatosensory system detect?
1.
2.
Hint: Ms, Ns and T
Functions of the nervous system:
What do the 2 major components (subsystems) of the somatosensory system detect?
1. Mechanical stimuli.
2. Noxious stimuli and temperature.
34
Functions of the nervous system:
Name 5 types of mechanical stimuli:
1.
2.
3.
4.
5.
L-TV-PC
Functions of the nervous system:
Name 4 types of mechanical stimuli:
1. Light
2. Touch
3. Vibration
4. Pressure
5. Cutaneous tension
L-TV-PCa
35
Functions of the nervous system:
The neural process of encoding and processing noxious stimuli, not as a perception of pain, but as a response to a stimuli, is called:
nociception.
36
Functions of the nervous system:
An actual or potentially damaging tissue event is called a:
noxious stimulus.
37
Functions of the nervous system:
Commonly referred to as pain receptors, although this isn't accurate as nociception does not always result in pain, are called:
nociceptors.
38
Functions of the nervous system:
Nociceptors respond to multiple energy forms that produce injury, such as:
1.
2.
3.
Hint: CMT
Functions of the nervous system:
Nociceptors respond to multiple energy forms that produce injury, such as:
1. Chemical stimuli
2. Mechanical stimuli
3. Thermal stimuli
Hint: CMT
39
Functions of the nervous system:
Nociceptors send info along the ____ to the ____.
Functions of the nervous system:
Nociceptors send info along the PNS to the CNS.
40
Functions of the nervous system:
Nociceptors send info the CNS about the ______ and _____ of noxious stimuli.
Functions of the nervous system:
Nociceptors send info the CNS about the location and intensity of noxious stimuli.
41
Functions of the nervous system:
Nociceptors can be found in the:
```
1.
2.
3.
4.
5.
6.
```
Hint: B-V-S, Bv-M-Jc
Functions of the nervous system:
Nociceptors can be found in the:
1. Bone
2. Viscera
3. Skin
4. Blood vessels
5. Muscles
6. Joint capsules
42
Functions of the nervous system:
Where are nociceptors NOT found?
In the CNS.
43
Functions of the nervous system:
What are the 2 main nociceptive fibres?
1.
2.
Functions of the nervous system:
What are the 2 main nociceptive fibres?
1. C-fibres
2. delta-fibres
44
Functions of the nervous system:
Which nociceptive fibres are associated with fast or 1st phase pain?
Delta-fibres.
45
Functions of the nervous system:
Which nociceptive fibres are associated with slow or 2nd phase pain?
C-fibres.
46
Functions of the nervous system:
Which nociceptive fibres are responsible for the sensation of quick, shallow pain in one specific area?
Delta-fibres.
47
Functions of the nervous system:
Which nociceptive fibres are associated with a more general, enduring and deeper pain?
C-fibres.
48
Functions of the nervous system:
Which nociceptive fibres respond to a weaker intensity stimulus?
Delta-fibres.
49
Functions of the nervous system:
Which nociceptive fibres continue to send signals even after cessation of a noxious stimuli?
C-fibres.
50
Modulation of pain:
The brain does not passively receive info form the body, but instead actively regulates sensory transmission. The experience of pain can be modulated by which two factors?
1.
2.
Hint: C E
Modulation of pain:
The brain does not passively receive info form the body, but instead actively regulates sensory transmission. The experience of pain can be modulated by which two factors?
1. Cognitive
2. Emotional
51
Modulation of pain:
According to Johnson (2005), what is a commonly used mental tool by individuals experiencing pain?
Distraction.
52
Modulation of pain:
Match up the correct moods with their associated outcomes:
Positive mood
Negative mood
Decreased pain perception
Increased pain perception
Positive mood = decreased pain perception.
| Negative mood = increased pain perception.
53
Who argued that any theory of pain must be able to explain a number of observed facts?
Hint: M and W (196_;199_)
Who argued that any theory of pain must be able to explain a number of observed facts?
Melzack and Wall (1965;1996)
54
According to Melzack and Wall (1965;1996), any theory of pain must be able to explain a number of observed facts:
1.
2.
3.
4.
According to Melzack and Wall (1965;1996), any theory of pain must be able to explain a number of observed facts:
1. High level of variability between injury and pain.
2. Resistance of some forms of pain to medical treatment.
3. Different dimensions of pain.
4. Ability of pain to change over time.
55
The transmission of pain from the PNS to the spinal cord is subject to modulation from intrinsic neurones and controls emanating from the brain. This is known as the:
Gate Control Theory of pain
56
Gate Control Theory of pain:
The transmission of nerve impulses from fibres to the spinal cord transmission cells is modulated by:
spinal gates in the dorsal horn.
57
Gate Control Theory of pain:
The transmission of nerve impulses from fibres to the spinal cord transmission cells is modulated by spinal gates in the dorsal horn.
What do these gates determine?
Which competing signals are transmitted in any given moment. E.g. pain, heat, touch.
58
What is the most influential theory accounting for the cognitive modulation of pain?
Gate Control Theory.
59
Gate Control Theory of pain:
When neurological gates are opened, this allows nociceptive signals to reach the:
cortex.
60
Gate Control Theory of pain:
What happens when there is no nociceptive input?
The neurological gates are closed and no pain is experienced.
61
Gate Control Theory of pain:
Which nociceptive impulses open the neurological gate and allow signals to reach the cortex?
C-fibres and delta-fibres.
62
Gate Control Theory of pain:
Why does rubbing a painful area often diminish the feeling of pain?
Large diameter fibres inhibit transmission of nociceptive signals.
63
Gate Control Theory of pain:
Why does distraction and relaxation diminish the feeling of pain?
Distraction and relaxation sends neural impulses from the brain to close the neurological gate.
64
Gate Control Theory of pain:
Why does anxiety and anticipation increase the feeling of pain?
Anxiety and anticipation sends neural impulses from the brain to open the neurological gate.
65
Gate Control Theory of pain:
Which neuro-chemicals are hypothesises to play a role in top-down modulation of pain?
1.
2.
3.
Hint: SEN
Gate Control Theory of pain:
Which neuro-chemicals are hypothesises to play a role in top-down modulation of pain?
1. Serotonin
2. Endogenous opioids
3. Noradrenalin
66
According to Johnson (2005), what is the most commonly used attentional tool used by people experiencing pain?
Distraction.
67
Which attentional tool is a strong component in many CBT packages for pain management?
Distraction.
68
According to Fernandez (1986), what are the 2 ways someone can distract themselves from pain?
1.
2.
According to Fernandez (1986), what are the 2 ways someone can distract themselves from pain?
1. Re-diverting attention towards something else.
2. Distractor tasks.
69
Distraction in pain:
In general, there is evidence that distraction can:
1.
2.
Distraction in pain:
In general, there is evidence that distraction can:
1. Reduce the experience of pain.
2. Increase tolerance.
70
Distraction in pain:
What is the 2 main limitations of studies examining the role of distraction in pain management?
1.
2.
Distraction in pain:
What is the 2 main limitations of studies examining the role of distraction in pain management?
1. They tend to look at acute or experimental pain.
2. Other variables also play a role.
71
Distraction in pain:
The 2 main limitations of studies examining the role of distraction in pain management include the tendency to look at acute or experimental pain, and that other variables also play a role. What are these other variables?
1.
2.
3.
Distraction in pain:
The 2 main limitations of studies examining the role of distraction in pain management include the tendency to look at acute or experimental pain, and that other variables also play a role. What are these other variables?
1. Qualities of the distractor.
2. Qualities of pain.
3. Individual differences.
72
Distraction in pain:
Patients are often encouraged to be involved in doing an action during a painful procedure, this is called:
active distraction.
73
Distraction in pain:
Patients may remain quiet throughout a procedure, casually observing a stimulus rather rather than interacting with it, this is called:
passive distraction.
74
Distraction in pain:
Give 4 examples of active distraction used in clinical settings:
1.
2.
3.
4.
Distraction in pain:
Give 4 examples of active distraction used in clinical settings:
1. Interactive toys.
2. Guided imagery.
3. Relaxation and deep breathing.
4. VR headsets.
75
Distraction in pain:
Give 2 examples of passive distraction use in clinical settings:
1.
2.
Distraction in pain:
Give 2 examples of passive distraction use in clinical settings:
1. Listening to music.
2. Watching movies.
76
Evidence for distraction:
Who examined the effect of pressing a soft ball during catheter insertion on the intensity of pain?
Hint: S et al. (201_)
Sadeghi et al. (2013)
77
Evidence for distraction:
Effect of pressing a soft ball during catheter insertion on the intensity of pain (Sadeghi et al., 2013).
What age were the children?
4-6 yrs.
78
Evidence for distraction:
Effect of pressing a soft ball during catheter insertion on the intensity of pain (Sadeghi et al., 2013).
What was the key finding?
Children in the intervention group reported sig. lower pain intensity than control group.
79
Evidence for distraction:
Who investigated the effect of word-shadowing exercises on chronic back pain?
J and P (199_)
Johnson and Petrie (1997)
80
Evidence for distraction:
Investigating the effect of word-shadowing exercises on chronic back pain (Johnson and Petrie, 1997).
How many participants were recruited?
20
81
Evidence for distraction:
Investigating the effect of word-shadowing exercises on chronic back pain (Johnson and Petrie, 1997).
What were the two phases the experiment?
1.
2.
Evidence for distraction:
Investigating the effect of word-shadowing exercises on chronic back pain (Johnson and Petrie, 1997).
What were the two phases the experiment?
1. Patients completed step-up task.
2. Patients completed step-up task PLUS a distracting word-shadowing exercises.
82
Evidence for distraction:
Investigating the effect of word-shadowing exercises on chronic back pain (Johnson and Petrie, 1997).
What was the key finding of this experiment?
Participants made significantly more steps and spent a long time on the task when also doing the word-shadowing exercise.
83
Evidence against distraction:
Who investigated the effects of distraction from pain during and after painful lifting task in chronic lower back pain patients?
Hint: G et al. (200_)
Goubert et al. (2004)
84
Evidence against distraction:
The effects of distraction from pain during and after a painful lifting task in chronic lower back pain patients (Goubert et al., 2004).
What was the mean age of participants?
46
85
Evidence against distraction:
The effects of distraction from pain during and after a painful lifting task in chronic lower back pain patients (Goubert et al., 2004).
What were the 2 phases of the experiment?
1.
2.
Evidence against distraction:
The effects of distraction from pain during and after a painful lifting task in chronic lower back pain patients (Goubert et al., 2004).
What were the 2 phases of the experiment?
1. Lifting task without distraction.
2. Lifting task with distraction task.
86
Evidence against distraction:
The effects of distraction from pain during and after a painful lifting task in chronic lower back pain patients (Goubert et al., 2004).
What was the effect of distraction DURING the lifting task?
No effect.
87
Evidence against distraction:
The effects of distraction from pain during and after a painful lifting task in chronic lower back pain patients (Goubert et al., 2004).
What was the effect of distraction AFTER the lifting task?
More pain.
88
Evidence against distraction:
The effects of distraction from pain during and after a painful lifting task in chronic lower back pain patients (Goubert et al., 2004).
What was the effect of catastrophic thinking during the lifting task?
1.
2.
Evidence against distraction:
The effects of distraction from pain during and after a painful lifting task in chronic lower back pain patients (Goubert et al., 2004).
What was the effect of catastrophic thinking during the lifting task?
1. More vigilance to pain.
2. Less engagement in the distraction task.
89
Evidence for distraction:
Who investigated the effect of VR during wound dressing?
Hint: H et al. (201_)
Hua et al. (2015).
90
Evidence for distraction:
Effect of VR during wound dressing (Hua et al., 2015).
How many children were recruited for the study?
65.
91
Evidence for distraction:
Effect of VR during wound dressing (Hua et al., 2015).
What was the age range of the participants?
4-16 yrs old.
92
Evidence for distraction:
Effect of VR during wound dressing (Hua et al., 2015).
What was the mean age of participants?
8 yrs old.
93
Evidence for distraction:
Effect of VR during wound dressing (Hua et al., 2015).
What did the distraction group do?
Played an Ice Age 2 video game on the VR connected to the laptop.
94
Evidence for distraction:
Effect of VR during wound dressing (Hua et al., 2015).
What did the control group do?
Used toys, TV, books and parents to distract.
95
Evidence for distraction:
Effect of VR during wound dressing (Hua et al., 2015).
What were the main findings of this study?
1.
2.
Evidence for distraction:
Effect of VR during wound dressing (Hua et al., 2015).
What were the main findings of this study?
1. Kids in VR group felt less pain before, during and after wound dressing.
2. It was quicker to change dressings in VR kid group.
