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Pain .pdf

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University of Toronto St. George
Nevena Simic

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 dont 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 cant relieve suffering increase anxiety & Pain can be so persistent in terminal illness sometimes its 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 its 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 ) Pain as an inhibitory mechanism Learning is conditioning using pain as something that will inhibit behaviours Classical Conditioning ( not in lecture ) Pavlovs 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 wouldnt 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. dont 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 Beechers 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 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 doesnt go away ( > 6 moths)
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