Pain Psychology PDF

Pain psychology 1. Definition of Pain Pain- an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage, or described in terms of such damage. 2. Definition of psychology Psychology- the mental characteristics or...

Pain psychology 1. Definition of Pain Pain- an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage, or described in terms of such damage. 2. Definition of psychology Psychology- the mental characteristics or attitude of a person or group. It is the scientific study of the human mind and its functions, especially those affecting behaviour in a given context 3. Factor influence pain (≠ nociception): - Psychological - Social (in a team> wanna win> continuous with pain) 4. Factor influence pain: Biological - excessive loaded - tissue pathology - system dysfunction - nociception = high-intensity noxious stimuli = thermal mechanical/ chemical threshold> fibres to fire exceed = Physiologically ‘normal’ pain: a message about actual or potential tissue damage conveyed via the lateral spinothalamic tract Hyperalgesia amplified pain; an increased response to a stimulus (intensive pain) that is normally painful 痛覺過敏 exaggerating pain when normally you feel pain Allodynia ‘tenderness’ or pain evoked by a normally 異常知覺痛 non-noxious stimulus Hyperaesthesia Increased sensitivity to stimulation, excluding the 痛覺過敏 special senses; light touch, cold and tickle (and TENs!) can cause discomfort feeling pain/ discomfort when normally you should not have this feel Dysaesthesia An unpleasant abnormal sensation, whether 不悅異常感 spontaneous or evoked - inflammation - genetic 5. Factor influence pain: Psychological factor - beliefs - thoughts - knowledge perception - - feelings - actions 6. Factor influence pain: Social factor - family - friends - colleagues - access to care - community - culture - society 7. Multidimensional model of pain + understanding of it - inner 2: basic; other: cant express by black and white - - having layers - multitude of factors involved in the model - there are factors apart from physiological> influence the overall perception/ interpretation/ experience of pain 8. Factor influence recovery: self-efficacy - definition: individual’s belief in their capacity to execute behaviours necessary to produce specific performance attainments - Low: tasks harder than they actually are ; - High: tasks easier than they actually are - Strong physiological influence> overall outcome of a patient 9. Factor influence recovery: (pathological) anxiety - - feeling of fear, dread, and uneasiness> ^ inappropriate responses> emo response> -ve> affect daily functioning 10. Factor influence recovery: helplessness - no control over their situation - feeling alone> dealing with their painful journey - no options/ ways to help recovery - interlink> other psychological factors 11. expectations - The ideas or perceptions we have about our pain are also mirrored in our expectations and may have a considerable impact on our experience of pain. - power to drive our overall experience> outcome of the pain journey 12. re-define pain - clinician acknowledges the pain but describes it in a way that gives the patient control 13. importance for clinicians- influence… - part of the subjective history - goal setting - prioritisation of goals - management strategies/ techniques to be used - be holistic in our approach - biopsychosocial approach - management: 1. cognitive behavioural therapy 2. biofeedback 3. patient education * Pain Gate Mechanism - sensory input>changed/ modulated impulses along neurones sending impulses from brain> spinal cord - emo/ attention/ stress/ memory> (^/ ^≠) pain message *spinal cord - neurons release> ‘neuro-transmitters’> effect on the neurones in dorsal horn - Q: Over the name and ask for the name. - DCML neuron pathway: activated by deep touch > activated inhibitory interneuron > send chem e.g. enkephalin> open the membrane of axion terminal on the A-β fibers> less signal sent from the A-β fibers> less excitatory of secondary neurone , less hyperpolarisation, less action potential frequency > less pain signal sent to the brain -  - pain is reduced by activating a non-painful sensation - at the spinal cord > thalamus - gate: the substantial gelitanosa of the spinal cord> pain signal be interrupted diameter type fibres myelinated stimulated function non-noxious stimuli (light touch, pressure, and / A-β fibers large v hair movement.) quick noxious stimuli (pain and temperature, specifically sharp, intense, tingling noxious, fast Basic A-δ fibers small v (thin) sensations) simulation type slowest transmission (pain and chronic pain temperature, namely prolonged burning C fibers / x sensations.) - normal sensation: non-noxious stimuli (e.g. light tough/ TENS, warmth) ‘modulated’ in the spinal cord> block the pain message/ soothing> brain