PSY333 Chapter Notes
Chapter 10 Pain and Its Management
Chronic back pain is one of the most common causes of disability in Canada
Chronic pain, that is a pain lasting longer than 6 months or long after an
injury has healed, has been called a silent epidemic affecting 1 in 10
Canadians, with rates even higher among those 65+
Many Canadians who suffer from chronic pain also have one or more other
chronic health condition
Costs in health care utilization and lost productivity add up to about $10
billion annually
Over $4 billion is spent annually on over-the-counter medicine, with
much of this used for the relief of pain
o Those with chronic pain use pain relievers, tranquilizers, and
sleeping pills 2-4 times more than those without chronic pain
Pain is the symptom most likely to lead an individual to seek treatment
o Its typically considered of secondary importance to MDs, the
cause of the pain is more important
People with chronic pain are most likely to experience anxiety and
depression
Inadequate relief from pain is the most common reason for patients
requests for euthanasia or aid in dying
o Patients fear pain in illness and treatment the most
Pain is fundamentally a psychological experience, and the degree to which it
is felt and how incapacitating it is depends on its interpretation
Pain has a substantial cultural component members of some cultures
report pain sooner and react more intensely to it than individuals of other
cultures
o Compared to European Canadians, Chinese reported a lower tolerance
for pain in experimentally induced pain
Certain ways of coping with pain can influence how pain is interpreted and
therefore affect how individuals experience and report pain
o Pain catastrophizing is when people magnify their pain which leads to
more dramatic pain reports and has also been established as a risk
factor for prolonged pain and disability
o In contrast, resilience (toughness) appears to be protective for pain
catastrophizing, as individuals who are resilient are able to bounce
back from moments of intense pain by experiencing positive emotions
o People who catastrophize pain are more likely to attend to and
estimate greater pain from the pain behaviors displayed by others
One barrier to the treatment of pain is the difficulty people have describing it
objectively
o Typically draw on a informal vocabulary like shooting pain or
throbbing pain or constant dull pain
Pain behaviors are observable behaviors that arise as manifestations of
chronic painPSY333 Chapter Notes
o Four basic types of pain behaviors have been identified: (1) facial and
audible expressions of distress; (2) distortions in posture or gait; (3)
negative affect; and (4) avoidance of activity
Pain is now viewed as a complex biopsychosocial event involving
psychological, behavioral, and physiological components
Researchers from UBC and Dalhousie found that children who expressed
their pain verbally reported more pain and the tendency to make pain
verbalizations was associated with age (with older children less likely to
make verbalizations)
o Daughters pain reporting behaviors may be directly influenced and
shaped by their mothers behavior towards them (not so much for
sons)
The experience of pain is a protective mechanism to bring into consciousness
the awareness of tissue damage
o Scientists have distinguished among three kinds of pain perception:
the first is mechanical nociception (pain perception) that results
from mechanical damage to the tissue of the body; the second is
thermal damage, or the experience of pain due to temperature
exposure; the third is referred to as polymodal nociception, a
general category referring to pain that triggers chemical reactions
from tissu
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