Health Psych Chapter 10

Pain

an unpleasant sensory and emotional experience associated with potential or actual tissue damage

What is the most common reason for requests for euthanasia or assisted suicide?

inadequate relief from pain

The elusive nature of pain

degree to which pain is felt depends on how it is interpreted, context in which it is experienced, cultural components, and gender differences

Cultural component of pain

members from some cultures react more intensely to it than those from other cultures

Gender differences of pain

women show greater sensitivity to pain

Degree to which pain is felt depends on

how it is interpreted, context in which it is experienced, cultural component, and gender differences

Measuring pain

verbal reports, pain questionnaires, methodological tools, and pain behaviors

Verbal reports

large, informal vocabulary that people use for describing pain

Pain questionnaires

ask about the nature of pain and its intensity; address the psychological components of pain (how much fear it causes, and how much it has taken over a person’s life)

Pain behaviors

arise from chronic pain; help in assessing how pain has disrupted a patient’s life and help define the characteristics of different kinds of pain syndromes

Physiology of pain

protective mechanism to bring tissue damage into conscious awareness; accompanied by motivational and behavioral responses

How do negative emotions impact pain

they exacerbate pain, or make it worse

Mechanical nociception

results from mechanical damage to the tissues of the body

Nociception

pain perception

Thermal damage

experience of pain due to temperature exposure (burning or frostbite)

Polymodal nociception

pain that triggers chemical reactions from tissue damage

Gate-control theory of pain

nociceptors sense injury and release chemical messengers to the spinal cord

A-delta fibers

small myelinated fibers

What do A-delta fibers respond to

mechanical or thermal pain

How do A-delta fibers respond

transmit sharp, brief pains rapidly

C-fibers

unmyelinated nerve fibers

What do C-fibers respond to

polymodal pain

How do C-fibers respond

transmit dull, aching pain

Periductal gray

a region in the midbrain involved in the modulation of pain; results in pain relief when stimulated

What are processes in the cerebral cortex involved in?

cognitive judgements about pain

Endogenous opioid peptides

natural pain suppression system of the body

Stress-induced analgesia (SIA)

phenomenon where acute stress reduces sensitivity to pain

Acute pain

results from a specific injury that produces tissue damage; disappears when the tissue is repaired; short duration, lasting for six months or less

Chronic pain

begins with an acute episode but does not decrease with treatment and the passage of time

Chronic benign pain

persists for six months or longer, relatively unresponsive to treatment, and severity of pain varies

Recurrent acute pain

intermittent episodes of pain that are acute in character but chronic in condition, recurs for more than six months

Example of recurrent acute pain

migraine headaches, where individuals experience episodes of severe headache pain that can recur regularly over time

Example of chronic benign pain

chronic lower back pain

Chronic progressive pain

persists longer than six months and increases in severity over time, associated with malignancies or degenerative disorders

Example of chronic progressive pain

osteoarthritis, a condition where joint cartilage gradually deteriorates, leading to pain and stiffness that worsen over time

Back pain

70-85% of Americans have back trouble at some point in their lives

Headaches

approximately 45 million Americans have chronic recurrent headaches

Cancer pain

the majority of advanced cancer patients suffer moderate to severe pain

Neurogenic pain

pain resulting from damage to peripheral nerves or the central nervous system

Psychogenic pain

pain not due to an identifiable physical cause, such as stomach pain

Pain-prone personality

predisposes a person to experience chronic pain

Personality attributes associated with chronic pain

neuroticism, introversion, and use of passive coping strategies

Counterirritation

inhibiting pain in one part of the body by stimulating or mildly irritating another area

Sensory control of pain

exercise and other ways of increasing mobility help the chronic pain patient

Psychological control of pain

requires patients to actively participate and learn; more effective for managing slow-rising pains

Pain control techniques

pharmacological, surgical, sensory, and psychological

What is the most effective strategy for coping with low level pain?

distraction

Cognitive behavioral therapy

encourages patients to reconceptualize a problem from overwhelming to manageable

Pain management programs

interdisciplinary efforts, bringing together neurological, cognitive, behavioral, and psychological expertise concerning pain

Steps of pain management programs

initial evaluation and individualized treatment

Components of pain management

patient education, involvement of family, and relapse prevention