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Psyc 365 Ch 11 Pain

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PSYC 365
David Cox

Psyc 365 Ch 11 – Pain Significance of Pain - Pain occurs before serious injury (touching hot stove) - Basis of learning to prevent injuries - Sets limits on activity and enforce inactivity and rest Pain Perception - when contact with injurious stimuli, signals follow a route from: o afferent (sensory) neurons  cells that conduct impulses from a sense organ TO the CNS or from lowr to higher levels in spinal cord and brain o nociceptors  afferent nerve endings that respond to pain o A-delta fibers  Afferent fibers that detect sharp, distinct pain. Fast o C-fibers  Afferent fibers that detect dull or aching pain. Slow Theories of Pain - Gate control theory o Suggests that a neural mechanism in the dorsal horns of spinal cord acts like a gate that can increase or decrease the flow of nerve impulses from peripheral fibers to the central nervous system o Not many limitations – leading pain theory  One limit is that it is unable to explain phantom limb pain  The experience of pain in an absent body part o Central Control trigger  Activates selective cognitive processes that influence the gate via descending fibers - Neuromatrix Theory o An extension of gate control theory, but with greater emphasis placed on the brain’s role in pain perception o A genetically determined neuromatrix or network of brain neurons distributed throughout many areas of the brain. A network of neurons that generates patterns, processes info that flows through it, and produces a pattern felt by the whole body o Neurosignature patterns  Patterns that may be generated from sensory inputs Neuroschemical basis of pain and pain inhibition - in a classic study with rats electrodes from implanted in the midbrain area known as periaqueductal grey area. They were tested to see if they would feel pain if clamped on the tail and they did. They were then tested again while the electrode was stimulated, and then again while performing abdominal surgery on them and the rats did not experience pain. This has been called stimulation-produced analgesia (SPA) - this study prompted a search for neurochemical basis of pain - endogenous opoids are naturally occurring opiate-like substances produced within the body that regulate pain. They appear to relieve it by slow or blocking transmission of nerve impulses. o 3 types: beta-endorphin, proenkephalin, prodynorphin Acute vs Chronic Pain - Acute <6months - Chronic >6months o Chronic recurrent pain  Intermittent intense episodes of acute pain followed by relief o Chronic intractable benign pain  Continous pain that varies in intensity o Chronic progressive pain  Continous pain that gradually intensifies as a person’s condition worsens - Psychosocial pain o Respondent pain  Pain that occurs in response to noxious stimulation or tissue damage o Operant pain  Pain that is reinforced by a person’s environment o Pain behaviours  Alterations in behaviour by a person experiencing pain to either reduce pain or prevent it from getting worse o Factors  Gender differences  Women report pain more frequent, severe, and lengthy than men  Key issues: o 1. Perception and response to pain o 2. Psychosocial and bio factors o 3. Response by health care system  Pain threshold o Point at which the intensity of stimulus is perceived as pain  Pain tolerance o Duration of time or intensity at which a person is willing to endure a stimulus beyond the point where it began to hurt  Women may report pain more (more descriptively), and attend to pain more  Biology may predispose women to more pain, or they may overdramaticize, or they may be more truthful (males might not be accurate due to societal pressures) o Cultural differences  Different meanings attached to main (expressions of pain might be ridiculed, or encouraged)  Stereotypes associated with pain (body piercing)  Healthcare interpretations of pain differ Measurement of pain - Difficult to describe pain objectively but an important measure for determining treatment - Psychophysiological measures o EMG (activity in muscles), EEG  Looking for evoked potentials (electrical responses brought about by stimulus) o Autonomic activity  HR, respiration rate, BP, hand surface temp, skin conductance, may provide clues to presence of pain - Behavioural assessment o Analyzes pain behaviours to see pain’s disruption to life o in day to day assessments we can look at how much time person spends in bed, or how many complaints they have. Do they have a limp?
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