PSY333H1 Lecture Notes - Interneuron, Spinothalamic Tract, Social Cost

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17 Jun 2012
Lecture 06 Pain (chapter 10)
pain can categorize as some sort of discomfort it tells something is wrong & reason why we
mainly go to the doctor
look at how social and psychological factors influence this physical properties of pain
pain can be unconscious response e.g. hands on burn , before even consciously processing it
the sensation of pain makes you move your hand away
pain as learning technique education & using as reinforcement technique
pain in health psych is thought more chronic common chronic pains are chronic back
pain, headaches, cycle abdominal, sports related pain
Significance of Pain
pain = symptom of chief concern to patients
o leads them to seek medical attention
pain often considered of secondary importance to MD not most important thing doctor
themselves don’t this MDs are more Interested in what causing the pain rather than the
pain itself ( though pain is what brings patient into the office)
Patients fear pain both in illness and treatments (e.g. surgery) most
o fearing that they can’t relieve suffering increase anxiety & Pain can be so persistent
in terminal illness sometimes it’s the most common reason that terminal ill will
seek to end their own life (euthanasia)
o e.g. surgery more fearful)
o this fears could cause low adherence to treatment
$4 billion is spent annually in Canada on over the counter pain med by people common way
of treating is pharmacological way ( e.g. back pain get Advil )]
o Others include Tylenol, Aspirin, Midol, Aleve, Robitussin, T3, Pepto Bsimol and etc.
Why do we feel pain?
is adaptive it’s a evolutionary advantage in survival and reproduction
o It tell us to avoid behaviours that may hurt us
o It forces us to rest & recover after an injury
o it tell us that whatever behaviour that causes pain is maladaptive so we need to cut
out that behaviour
can be reflexive & unconscious
o e.g. Hot stove burner pull hand away before you consciously perceive the heat so
not really consciously aware of the adaptive part of it
can be used as learning mechanism e.g. :
o electric shocks for rats classical conditioning ( i.e. pairing a shock w/ neutral stimulus
to teach them to fear that previously neutral stimulus
o spanking for children operant conditioning (i.e. relationship b/w spank and behaviour
can reduce behaviour )
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Pain as an inhibitory mechanism
Learning is conditioning using pain as something that will inhibit behaviours
Classical Conditioning ( not in lecture ) Pavlov’s dog
o Pavlov took his dog & put out some meat & looked at what he did
Dog would salivate salivation = unconditioned response
Juicy meat = unconditioned stimulus ( innate response to it)
o Then take the meat & pair it w/ neutral stimulus ( that wouldn’t typically elicit
salivation) & eventually the dogs associated the sound w/ presentation of the food
o And would salivate to the sound of the tuning fork = conditioned stimulus
o Salivation to tuning fork = conditioned response
operant conditioning Learning based on consequences
o positive = add something ; negative = take away something
o reinforcement : consequences increases likelihood of behaviour in the future
Positive reinforcement application of desirable stimulus ( reward; candy)
Negative reinforcement removal of negative (undesirable) stimulus ( e.g. don’t
have to do a chore if good)
o punishment consequences decrease likelihood of behaviour in the future
o Positive punishment application of aversive stimulus (e.g. Spanking)
o Negative punishment take way something good ( e.g. T.V. time)
using pain to learn positive punishment & negative reinforcement involves aversive and
potentially painful stimuli e.g. electric shock, spanking etc.
How do we know when someone is in pain?
pain behaviours are behaviours that occur in response to pain such as:
o 1. facial & audible expression of distress
o 2. distortions in posture or gait
o 3. negative affect
o 4. avoidance of activity - ( that they would engage in normally tell us some sort of
discomfort w/ their body)
What is pain: Elusive Nature
pain is a subjective experience Degree to which pain is felt and how incapacitation it is
depends on how it is interpreted
o not something physically objective same cut could in 2 different people can produce
different subjective experience of pain
It is heavily influenced by context in which it is experienced
o Beecher’s example of soldiers vs. civilians 25% wounded (from war) soldiers vs. 80%
of civilians after surgery( from domestic injury e.g. car accident ) asked for morphine
Why? For soldiers pain cues survival ( is seen something that will get them out
of war alive so pain as positive consequences that they survived an injury
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For civilians injury will stop them from doing activities & cues life
threatening pain as negative consequences
Shows how people differ in the way they conceptualize pain & there also social
ramifications of avoiding pain in these roles
o Sports injury but continue to play - e.g. football gets back up and continue to play
o arousal SNS (gets activated) & this arousal diminishes pain sensitivity
(Adreline released dampen down on pain sensitivity)
o stress & psychological distress aggravate experience
What is Pain?
can refer to many different sensations:
o Sharp pain step on nail, cut on glass
o Dull ache lower back pain, migraines,
o Blistering sunburn , burn on hand
o Small but irritating cut your finger ( paper cut)
Can classify pain sensation by length of how long we feel it for
o Acute pain - intense, short-lived , disappears as injury heals ( < 6 months)
o Chronic pain begins as acute pain but doesn’t go away ( > 6 moths) e.g. lower-
back pain, headaches, arthritis
Recurrent acute vs. intractable benign vs. progressive
Recurrent acute - short term - but occurs again and again headaches
intractable-benign - doesn’t go away but not life threatening lower back pain
Progressive it increase in intensity in overtime e.g. cancer , condition
worsen , pain worsen
Pain - an unpleasant sensory and emotional experience associated w/ actual or potential tissue
damage, or described in terms of such damage ( is the definition by international association for the
study of pain)
Pain Pathology
despite enormous variability in how we perceive pain there is an innate and hard-wired
physiological basis for pain
o free nerve endings in periphery ( when engaged initiate pain sensation )
o send messages to spinal cord
o spinal tracts carry message to midbrain & thalamus
o then to higher cortex which consciously perceive the sense of pain (conscious attention
in brain)
Having a cut
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