week 7 college c16

Question 1

What are the two most frequently reported reasons for consulting a primary care physician?

Answer 1

The two most frequently reported reasons are low back pain and headaches.

Question 2

What are the two main categories for the classification of pain?

Answer 2

Pain can be classified according to cause and according to duration.

Question 3

What is nociceptive pain and what causes it?

Answer 3

Nociceptive pain is associated with the musculoskeletal system and is due to tissue damage such as muscles, bones, joints, or skin, for example, a fracture or burn wounds

Question 4

What is neuropathic pain and what are its symptoms?
which nervous system is involved?
duration?
symptoms?

Answer 4

Neuropathic pain is a consequence of damage to the central or peripheral nervous system, often permanent and difficult to treat. Symptoms include needle pricks, electrical shocks, burning sensations, and the feeling of ants crawling under the skin.

Question 5

define allodynia and hyperalgesia

Answer 5

allodynia, where pain is experienced from a stimulus that doesn’t normally cause pain
hyperalgesia, where the pain experienced is disproportionate to the pain stimulus.

Question 6

What is mixed pain?

Answer 6

Mixed pain includes both nociceptive and neuropathic elements, such as in the case of a herniated disc.

Question 7

What is idiopathic pain?

Answer 7

Idiopathic pain is pain for which no clear organic cause can be found, and there is no diagnosis referring to a clear structural (organic) problem, such as fibromyalgia. ​

Question 8

What is acute pain?
time frame?
occurance?
example

Answer 8

Acute pain is pain that lasts for less than 3 to 6 months. It may occur only once, usually involving ` injury, and generally disappears once the injury has healed, such as a bone fracture or toothache. Acute pain can also be recurrent, as in the case of migraine` headaches.

Question 9

What is chronic pain
timeframe?
what are its types?

Answer 9

Chronic pain continues for more than 3 to 6 months. There are two types of chronic pain: pain with an identifiable cause, such as rheumatoid arthritis (RA), and pain with no identifiable cause, such as fibromyalgia or chronic low back pain.

Question 10

What are the three explanatory models of pain?

Answer 10

Biological, Psychobiological, Psychological.

Question 11

What are the two processes involved in the Gate-Control Theory?

Answer 11

Pain signals from an injury pass through a spinal ‘gate’ to the brain,
and
cognitive-emotional processes from the brain influence the pain signals at the spinal ‘gate’.

together they determine the amount of pain perceived.

Question 12

What role do cognitions and emotions play in the Gate-Control Theory?

Answer 12

Cognitions and emotions can activate nerves that affect the spinal ‘gate’, influencing pain perception.

Question 13

What are the two main psychological theories related to pain?

Answer 13

Learning Theory and Cognitive-Behavioural Theory.

Question 14

what is the function of the ‘gate’ in the gate-control theory?

Answer 14

activation of both systems result in a variety of chemicals produced within the gate. Some inhibit pain (calming thoughts) (close gate) some increase pain (anxiety)(open gate)

Question 15

How did Fordyce apply Operant Conditioning to pain?

Answer 15

Fordyce (1968) proposed that pain responses are learned and maintained through reinforcement.

Fordyce observed that certain pain behaviors could be reinforced inadvertently. For example, if someone regularly receives sympathy, attention, or medication when displaying pain behaviors, they might unconsciously learn to exhibit these behaviors more frequently or intensely.

Question 16

How does chronic pain relate to learned behaviors?

Answer 16

Chronic pain behavior can be understood in terms of behaviors that have been learned and are maintained by different types of reinforcement.

eg.

A person who experiences chronic back pain receives extra attention and care from their family whenever they express pain through verbal complaints or grimacing. As a result, they may subconsciously learn to exhibit these pain behaviors more frequently to continue receiving this attention and care, inadvertently maintaining or increasing their pain expressions.

Question 17

What theory explains the effect of virtual reality on pain experience and how?

Answer 17

The gate control theory. Conscious attention is necessary to experience pain By creating a virtual reality, the patient’s attention is
directed away from the body (pain) to the virtual
world.

Question 18

How do reward systems affect pain behaviors?

Answer 18

Reward systems can either increase or decrease pain behaviors depending on how they are applied, either by reinforcing the pain behavior or encouraging alternative, healthier behaviors

Question 19

How does Learning Theory differ from Cognitive-Behavioral Theory in the context of pain?

Answer 19

Learning Theory does not consider cognitive and emotional aspects of pain and focuses solely on behavior,

Question 20

What are the six cognitive factors that influence pain according to the Cognitive-Behavioral Model?

Answer 20

1. Attention to pain,
2. attributions concerning the cause of the pain,
3. expectations about pain tolerance,
4. control,
5. engagement in activities despite pain (distractions), and
6. expectations about pain relief. (placebo)

Question 21

which three dimensions are important when assessing pain? examples?

Answer 21

1. perception (intensity, duration, frequency, etc.)
2. psychological (emotional and cognitive)
3. behavioral (behavior, functional limitations)

Question 22

what is the difference between unidimensional and multidimensional pain assessment?

Answer 22

unidimensional: Primarily measures one aspect of pain, typically its intensity.

multdimensional: Evaluates multiple aspects of pain, including intensity, location, quality, and the impact on psychological and social function.

Question 23

What is the Symptom Checklist-90-R (SCL-90R)?

Answer 23

The SCL-90R is a psychological assessment instrument with 9 subscales that measure various mental health symptoms, including anxiety, depression, and somatic complaints.

The Brief Symptom Inventory (BSI) is a shortened version of the SCL-90R.

Question 24

What does the Hospital Anxiety and Depression Scale (HADS) measure?

Answer 24

HADS measures anxiety and depression in patients with medical conditions and does not contain any somatic items.

Question 25

What does the Pain Catastrophizing Scale (PCS) assess?

Answer 25

The PCS assesses three aspects of negative thinking related to pain: rumination, magnification, and helplessness.

Question 26

What is a common issue with referrals for psychological treatment?

Answer 26

Patients often show reluctance regarding a referral for psychological treatment.

Question 27

How does relaxation influence pain directly?

Answer 27

Reduces muscle tension, increases blood perfusion, and consequently decreases pain

Question 28

How does relaxation influence pain indirectly?

Answer 28

Feeling more relaxed allows for better stress coping mechanisms, which lessens the impact of stress on the body and reduces pain.

Question 29

What is biofeedback?

Answer 29

Biofeedback is a mind-body technique that involves using visual or auditory feedback to gain control over involuntary bodily functions. This method typically uses electronic or mechanical devices to measure and provide information about physiological processes such as heart rate, muscle tension, skin temperature, and brain waves.

Question 30

How does biofeedback compare to relaxation alone in terms of effectiveness?

Answer 30

Biofeedback is generally no more effective than relaxation techniques alone.

Question 31

via which four ways does hypnosis work with pain management?

Answer 31

• Deep relaxation
• suggestion–>expectations (placebo?)
• cognitive reinterpretation
• destraction

Question 32

What are the effects and advantages of self-help programs in pain management?

Answer 32

Self-help programs are effective in decreasing pain intensity, functional limitations, anxiety, and depression, and they can reach larger patient groups in a cost-effective manner.

Question 33

When is self-help not advisable for pain management?

Answer 33

Self-help is not advisable in cases of clinical depression, cognitive impairment, or social isolation.

Question 34

When is Transcutaneous electrical nerve stimulation (TENS) used?

Answer 34

to block chronic pain signal to the brain during the treatment via electrical stimulation.

Question 35

regarding treating pain. On which cognitive, emotional and behavior does CBT focus?

Answer 35

• cognitive: catastropic beliefs
• emotional: pain related fear and fear of movement.
• behavior: avoidance

Question 36

A technique used in CBT to challenge irrational beliefs (cognitions) is the ABC scheme (within RET). describe this technique

Answer 36

identifies:
* Actual situation: what happend?
* irrational Belief: belief about situation
* Consequences: emotional (anxiety) and behavioral (response of the patient)

Question 37

Despite mostly negative consequences, pain also has benefits on a subconscious level. These can be categorized in: primary, secondary and tertiary gain. explain the categories

Answer 37

Question 38

according to the pattern theory of pain we experience pain only……

Answer 38

when it crosses a threshold

Question 39

match the type of fiber to the type of pain and the velocity of signal: , C plymodal fibers , A beta fibers, A delta fibers

Answer 39

Question 40

• information from A fibers (beta and delta) go to which two brain regions?
• information from C fibres go to which three areas?

Answer 40

• thalamus and cortex
• amygdala, hypothalamus and autonomic nervous system

Question 41

after the brain receives pain information it does what to “close the gates”?

Answer 41

via reticulospinal fibres sends substances such as endorphins to close the gates.

Question 42

what is the purpose of the Mcgill pain questionnaire?

Answer 42

multidimensional picture of type of pain, emotional response, intensity and timing pattern.