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Chapter 10

Chapter 10 Notes.docx

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PSYC 3170
Gerry Goldberg

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Chapter 10 Notes  Pain is significant fro managing daily activities  Symptom to most likely have individuals seek treatment  It if fundamentally a psychological experience and the degree to which it is felt and how incapacitating it is depends in large part how it is interpreted  Pain is a substantial cultural component o Members to some cultures report pain sooner and react more intensely than other individuals in other cultures Measuring pain:  Verbal reports: darw on a large, informal vocabulary that people use for describing pain o McGill pain Questionnarie –whetehr pain is throb shoot etc… o Pain Catastrophizing Scale –full pic of dimension of the pain  Pain behaviours: are observable behaviours that arise as manifestations of chronic pain  4 basic types of pain behaviours-measurable-psych,phys,behavioral components o facial and audible expressions of distress o distortions in posture or gait o negative affect o avoidance of activity physiology of pain:  the experience of pain is protective mechanism to bring the consciousness the awareness of tissue damage  nociception (pain perception): that results from mechanical damage to the tissue of the bofy  thermal damage: or the experience of pain due to temperature exposure  polymodula nociception: a general category referring to pain that triggers chemical reactions from tissue damage o nociceptors in the peripheral nerves first sense injury and in response release chemical messengers to spinal cord where they pass the reticular formation and thalamus into cerebral cortex o 2 major types of peripheral nerbve fibers:  A-delta fibers: small myelienated fibers, transmit sharp pain  C-fibers: unmylienated nerve fibers that involve polyumodual pain (dull or aching pain) o Motivational and affective elements of pain appear to be influenced more strongly in C fibres thalamic, hypothalamic and cortical areas Theories of pain:  Gate control theory: (Ronald Melzack and Partick Wall 1965) suggested that pain resulted from the transmission of the pain signals from the site of injury to the brain and that the amount of pain experienced was directly proportional to the amount of tissue damage o Psych factors play role in pain o There is a neutral pain gate that can open and close to modulate pain signals to the brain o Trhough activity of a-delta and C-fibers o View pain as a role of the brain and other central nervous system regions in the pain experience Type of factor Factors that open the Factors that close the gate gate Physical Extent of injury Medications Inappropriate activity level Counter stimulants (massage heat) Emotional Anxiety or worry Positive emotions (joy and Tension interest) Depression Relaxation Cognitive Focusing on pain Distraction or intense Boredom concentration on other things Involvement and interest in life activities o Gate theory has its limitations o Cannot explain phantom limb theory: a phenomenon that takes place commonly among amputee, generate nerve impulses o Neuromatrix theory: there is a network of neurons that extend throughout areas of the brain to create the felt of representation of a unified physical self called the body self neuromatrix o pain is a mulidimentional experience that results from multiple determinants and not sensory factors alone Neurochemical bases of pain and it inhibition  endogeneous opidiod petides: fall into three general families: o Beta-endorphins: produce peptides that project to the limbic system and brain stem, among places o Pronekephalin: ehich peptides that have widespread neuroal, endocrine and central nervous system diatribion o Prodynorphins: found in the gut the posterior pituitary and the brain Chronic and Acute Pain:  Acute pain: typically results from a specific injury that produces tissue damage, such as wound or broken limbs o Produces substantial anxiety and prompts its sufferer to engage in an urgent search for relief  Chronic pain: typically begins with an acute episode, but unlike acute pain, it does not decreased with treatment and passage of time  Chronic begin pain: typically persists for six months or longer and its relatively intractable to treatment (ex: chronic back pain)  Recurrent acute pain: involves a series of intermittent episodes of pain that are acute in character but chronic in inashmuch as the condition persists for more than six months (migraine headaches)  Chronic progressive pain: persists longer than six months and increases in severity over time (cancer) Acute verses Chronic pain:  Acute and chronic pain present differnet psychological profiles because chronic pain often carries overlay of psychological distress, which complicated diagnosis and treatment o Maladaptive coping strategies (catastrophizing illness) while engaging in social withdrawl  Is most of the pain control techniques work well in acute pain but less successful in chronic pain, requires individua
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