KHA359 Lecture Notes - Lecture 5: Paracetamol, Threshold Of Pain, Opiate
30 Jun 2018
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Health Psychology Week 5: Pain and Pain Management
Pain definition:
- Functional: a warning of potential damage to the body
oA signal for onset of disease
oIt has a purpose; feel it for a reason
- Unpleasant: uncomfortable, hurts
- Acute pain has survival benefits
oAlert us to the fact something is wrong
oUsually act on this
oCUIP: insensitivity to pain; pain receptors but you cannot feel it
- Chronic pain can be destructive and problematic
oDetrimental to overall functioning in life
- Pain may be experienced in areas of the body that no longer exist
oAmputees, very typical, around 8/10 amputees experience this
oPhantom limb: pain or syndrome
oMedically recognized
- Acute pain: pain that lasts less than three to six months
oUsually the result of some injury
oRecurrent: eg. Migraines
oMay occur only once
- Chronic pain: continues for more than three to six months, begins with acute
pain two broad types
oOne has known reason and identifiable pain, or those that are not know
the cause
oChronic benign pain: long term pain is experienced to a similar degree
over time. Eg. Lower back pain
oChronic progressive pain: pain becomes progressively worse over time
due to the progression of a disease such as arthritis
oChronic malignant pain: pain is due to underlying malignancy
- Nature of pain:
oType: eg. Stabbing, shooting
oSeverity: mild discomfort to excruciating
oPattern: brief, continuous, intermittent
oMeanings of pain differ: what does this specific pain mean to the
person?
Arthritis
Child labour and delivery: may be painful but for around .3%
of women it is organismic
- Prevalence in Australia of pain:
oAround 3.2 million Australians experienced chronic pain in 2007
oProjected to rise to 5 million in 2050
oMore females experience chronic pain than males
oMostly experienced around middle age
oDrops off as people begin to die
Percentages illustrate better as the number of people who died
is not included
oSeverity of pain:
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Mostly low levels of chronic pain
oDuration of chronic pain:
Large proportion who have experienced it for 1-10 years
After ten years this is far less
Maybe to do with chronic illness, individuals likely to
die
oPrevalence of pain compared to other diseases:
Fourth only below visual disorders, muscuskeletal disorders,
cardiovascular
oExpenditure: third on list
- Causes of pain:
o38% due to some kind of injury
o29% some kind of health problem
o32% no clear reason: this is interesting
- SES correlates of pain:
oPain experienced more in low SES
oKnown because more people on benefits
oUnemployment figures
- Self rated pain:
oNo pain experienced: people rate their health as good –excellent
oChronic pain and no interference: good or very good
oChronic pain and interference:
Fair – good ratings mainly
oEven though pain is experienced and effecting them daily, they still
rate their health as good
Maybe pain is experienced but dramatized
Some kind of mismatch occurring
- Pain and mental health:
oIn the chronic pain and interference (experienced pain but limit their
daily activities because of this)
oHigher levels of anxiety and depression in these individuals
oOver 30% have a t score on psychological distress measure of more
than 60 (the equivalent of one SD):
SHOWS THESE PEOPLE are typically more distressed than
normal
- Living with pain:
oNot just unpleasant: has wider ranging effects on life
oTend to organize activities around their experiences of pain
oPrevented from engaging in physical, social, work activities
oSelf-care hard for some
oAffects relationships
oAffects financial situation: eg. Job loss
oMay result in depression: directionality unclear
oLack of activity leads to further pain: stiff joints
This leads to further depression and the cycle continues
oGains: Bokan, Ries and Katon identified three kinds of gain or reward
associated with pain
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Primary: intrapersonal gain
When expressions of pain result in the cessation or
reduction of an aversive consequence
Eg. By grissling someone could get out of doing work
Decrease in aversive consequence
Secondary interpersonal gain:
When pain behaviours result in a positive outcome:
such as expressions of sympathy or care
Others feel altruistic about what they’ve done
Increase in sympathy and care
Tertiary gain: involves feelings of pleasure or satisfaction
someone other than the individual in pain may experience when
they help them
Carer feels good
Other: if a person believes they are going to be harmed by a
pain, they will avoid activity to get relief from the pain
Reinforcement of inactivity occurs
Cycle: reinforced behaviour leads to inactivity, leads to further
muscle weakness and more pain, which starts the cycle again
Bad side effects of this:
Dramatization of complaints
Disuse through inactivity
Drug misuse as a result of over medication in response
to pain behaviours
Dependency on others due to learned helplessness
oImpaired use of personal coping skills
Disability due to inactivity
- Models of pain:
oSpecificity theory: biological model
Pain receptors within the skin and elsewhere transmit
information to a centre in the brain that processes pain-related
information
Once activated this pain centre produces experience of
pain
Further information has been added to this over time
Pain threshold and when you experience the pain
Limitations:
Pain in the absence of pain receptors
Pain receptors that do not transmit pain: CUIP
Psychological influence on experience of pain
These discount the biological theory of pain
oPsychological factors that influence our experience of pain:
Mood:
People whoa re anxious and depression: decrease in
tolerance and increase in self reports of pain
Tolerate pain for less time than no depressed or anxious
people
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Document Summary
Health psychology week 5: pain and pain management. Functional: a warning of potential damage to the body: a signal for onset of disease, it has a purpose; feel it for a reason. Acute pain has survival benefits: alert us to the fact something is wrong, usually act on this, cuip: insensitivity to pain; pain receptors but you cannot feel it. Chronic pain can be destructive and problematic: detrimental to overall functioning in life. Pain may be experienced in areas of the body that no longer exist: amputees, very typical, around 8/10 amputees experience this, phantom limb: pain or syndrome, medically recognized. Acute pain: pain that lasts less than three to six months: usually the result of some injury, recurrent: eg. migraines, may occur only once. Lower back pain: chronic progressive pain: pain becomes progressively worse over time due to the progression of a disease such as arthritis, chronic malignant pain: pain is due to underlying malignancy.
