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Lecture 7

PSY333H1 Lecture Notes - Lecture 7: Transcutaneous Electrical Nerve Stimulation, Tylenol (Brand), Acupuncture


Department
Psychology
Course Code
PSY333H1
Professor
Nevena Simic
Lecture
7

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LECTURE 7 Pain
Final exam chapter 10-12
Pain can cause unconscious response (example: putting
your hand on a hot stove and you automatically take it
off)
Significance Of Pain
Pain = symptom of chief concern to patients
-Leads them to seek medical attention
Pain often considered of secondary importance to MD
Physicians are interested in what’s causing the pain
because they want to find out the underlying cause of
symptom
Patients fear pain in illness and treatment most
-Fearing that they can’t relieve suffering inc
anxiety
-Most common reason for euthanasia
$4 billion is spend annually in Canada on over-the-
counter pain meds
Why Do We Feel Pain?
Pain is adaptive
-Tells us to avoid behaviors that may hurt us
-Forces us to rest & recover after an injury
Can be reflexive & unconscious
-Hot stove burner
Can be used as a learning mechanism
-Electric shock for rats
-Spanking for children
Pain As An Inhibitory Mechanism
Operant Conditioning
-Learning based on consequences
-Positive = add; Negative = take away
Reinforcement: consequence increases likelihood of
behavior in the future
-Positive Reinforcement - application of a desirable
stimulus (reward; candy)
-Negative Reinforcement - removal of a negative
stimulus (don't have to do a chore if good)
Punishment: consequence decrease likelihood of
behavior in the future
-Positive Punishment - application of aversive
stimulus (spanking)

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-Negative Punishment - take away something good (tv
time)
Using pain to learn
Positive Punishment and Negative Reinforcement involve
aversive, potentially painful stimuli
-Electric shock
-Spanking
-Soothing burns
How Do We Know When Someone Is In Pain?
Pain behaviors are behaviors that occur in response to
pain such as
1) Facial & audible expressions of distress
2) Distortions in posture or gain
3) Negative affect
4) Avoidance of activity
What Is Pain: Elusive Nature
Pain is a subjective experience
-Degree to which pain is felt and how incapacitating
it is depends on how it is interpreted
Heavily influenced by context in which it is
experienced
-Beecher’s example of soldiers versus civilians
o 25% wounded soldiers ask for morphine versus 80% of
civilians after surgery
o What is pain for the soldier? For the patient?
Stereotype that soldiers are supposed to be strong and
manly and not feel pain
Elevation of opioid
For soldiers the symptom of pain meant they survived
but for the civilian it was a life threatening as
opposed to life affirming
-Sports injury continue to play
o SNS arousal diminishes pain sensitivity
What Is Pain?
Can refer to many different sensation
-Sharp pain: cut yourself on glass, step on nail
-Dull ache: lower back pain, migraine, headaches
-Blistering: sunburn, burn on hand
-Small but irritating: cut your finger with paper cut
Acute Pain
-Intense
-Short-lived
-Disappears as injury heals

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-<6 months
Chronic Pain
-Begins as acute pain
-Doesn't go away
-E.g., Lower-back pain, headaches, arthritis
-Recurrent acute vs. Intractable-benign (not
threatening - headaches) vs. Progressive (increases
in intensity over time cancer, as the condition
worsens the pain does too)
Pain: An unpleasant sensory and emotional experience
associated with actual or potential tissue damage, or
described in terms of such damage
Pain Physiology
Despite enormous variability in how we perceive pain,
there is an innate and hard-wired physiological basis
for pain
Overview:
-Free nerve endings in periphery
-Send messages to spinal cord
-Spinal tracts carry message to midbrain & thalamus
-Conscious attention in brain
Nociception
Contact with stimulus Stimuli can be mechanical
(pressure, punctures and cuts) or chemical (burns)
Reception A nerve ending senses the stimulus
Transmission A nerve sends the signal to the central
nervous system. The rely of information usually
involves several neurons within the central nervous
system
Pain center reception The brain receives the
information for further processing and action
Can be conscious or unconscious)
3 kinds of pain perceptions (nociception)
-Mechanical (crushing, tearing, etc.)
-Thermal (heat or cold)
-Chemical (iodine in a cut, tear gas)
Differences in types of pain attributed to differences
in pain receptors (nociception)
Unevenly distributed in body
-None in brain
Patients undergoing brain surgery don't need
anesthetics
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