PSY-250 Lecture Notes - Lecture 19: Posterior Grey Column, Group C Nerve Fiber, Hypochondriasis
1 May 2018
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Chapter 10: Management of Pain and Discomfort
Significance of Pain
• Acute pain is adaptive
• Makes us aware of tissue damage & motivates us to make changes
• Main symptom that leads to doctor visits
Physiology of Pain
• Begins with the activation of “nociceptors”
– “Pain Receptors”
• Then, pain messages start to travel to spinal cord via afferent pathways (A & C fibers)
– Afferent means its going towards the CNS
• A Fibers
– Involved in sharp, acute pain
– Pain is well localized
– Myelinated neurons
– Transmission occurs more quickly
– Sharp Sensations of Pain
– Signal is transmitted to thalamus and cerebral cortex
• C Fibers
– Involved in SLOW, aching pain (Chronic Pain)
– Pain is diffused
– Neurons have thinner myelin sheaths
– Transmission is slow
– Signal is transmitted to hypothalamus and cortex
Gate Control Theory
• As messages reach the spinal cord, neural mechanisms in the dorsal horn act like a “gate”
– If gate opens message reaches brain feel pain
– If gate closes message is inhibited no pain
Pain Modulators
• Biological
– Extent of injury (severe, extensive injuries typically open the gate)
– Endogenous opioids (endorphins close the gate)
– Drugs (opiates close the gate)
• Psychological
– Anxiety & depression (open the gate)
– Personality…
– Cognitive errors…
Personality and Pain
• The “neurotic triad”‐ high scores on the hypochondriasis, depression, & hysteria
subscales of the MMPICan open the gate.
o Hypochondriasis: when people score high on this, they pay
attention/monitor their bodily symptoms OFTEN
▪ Often involves a misinterpretation of what actually is going on with their
body
o Depression: low self-worth, learned helplessness, hopelessness
o Hysteria: looking at how someone responds to stress, but also overlaps with
hypochondriasis, relating to how people respond to their bodily symptoms
▪ Will over react in a disproportionate fashion to their current health state
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Document Summary
Significance of pain: acute pain is adaptive, makes us aware of tissue damage & motivates us to make changes, main symptom that leads to doctor visits. Physiology of pain: begins with the activation of nociceptors . Pain receptors : then, pain messages start to travel to spinal cord via afferent pathways (a & c fibers) Afferent means its going towards the cns: a fibers. Signal is transmitted to thalamus and cerebral cortex. Signal is transmitted to hypothalamus and cortex: c fibers. Gate control theory: as messages reach the spinal cord, neural mechanisms in the dorsal horn act like a gate . If gate opens message reaches brain feel pain. If gate closes message is inhibited no pain. Extent of injury (severe, extensive injuries typically open the gate) Drugs (opiates close the gate: psychological. Cognitive errors and pain: low perceptions of control are associated with greater pain, the following cognitive errors are also associated with more pain:
