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58 Cards in this Set
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Unpleasant sensory and emotional experience associated with actual/potential tissue damage Pain linked to tissue pressure/damage; burn/sprain Pain that doesn't have an organic basis Long-term pain as a part of excessive concern for one's physical symptoms/health |
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How long does acute pain last for? When is something classified as chronic pain? A day with high levels of pain is followed by? |
Less than three months When it lasts longer than expected/>3 months A night of poor sleep (and poor sleep tends to be followed by heightened pain the next day) |
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What are the three types of chronic pain? The three factors in each type? Ex of each? |
Chronic-recurrent pain - benign, episodic; myofascial pain (jaw/head/neck) Chronic-intractable-benign pain - continuous; chronic low back pain Chronic-progressive pain - continuous, malignant; cancer, rheumatoid arthritis |
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What are the three unique properties the body uses to perceive pain? |
Body doesn't have specific receptor cells that transmit only information about pain Body responds to lots of noxious stimuli (pressure/lacerations/heat/cold) Pain perception includes a strong emotional part |
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What happens when there is noxious stimulation? What do nociceptors do? Why does referred pain occur? |
Chemicals that promote immune system activity cause inflammation at the injury and activate endings of nerve fibres in the damaged area signalling injury Neurons in the PNS that signal injury to the spinal cord and then to the brain When sensory impulses from an internal organ, and the skin use the same path to spinal cord |
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What is neuropathic pain? What do they come from? What are neuralgia, causalgia, phantom limb pain? (These syndromes start with tissue damage from disease/injury but pain persists and gets more intense after healing is complete) |
Pain with no noxious stimulus present From current/past disease or damage in the peripheral nerves Neuralgia - shooting/stabbing pain along a nerve Causalgia - burning pain triggered by minor stimuli Phantom limb pain - pain in an area that does not exist |
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What does the specificity theory argue? What does the pattern theory propose? When do people feel pain? Ex? |
That the body has a separate sensory system for perceiving pain (like vision/hearing do); no No separate system for perceiving pain, instead the receptors for pain are shared with other senses When types of activity get very high in the brain and occur with intense stimulation; hit hard = painful, caressed = not Don't explain why pain perception is affected by psychological factors |
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What is the cold-pressor procedure? How can pain be mitigated during it? What is the muscle-ischemia procedure? |
Putting arm in room-temp water then colder slowly; giving positive self-statements with explanations of how to use the statements to increase personal control Reduce blood flow to the arm |
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What is the gate-control theory? What is the gating mechanism? What happens after the signals pass through the gate? What happens when they reach critical level? |
Theory that psychological factors affect people's perception of pain
The spinal cord They activate transmission sells which send impulses to the brain Person begins to perceive pain |
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What three factors control the opening and closing of the gate? Anxiety and boredom open/close the gate? Positive emotions and distraction open/close the gate? |
1 - Amount of activity in pain fibres - opens gate 2 - Amount activity in other peripheral fibres (harmless/mild irritation) - closes gate 3 - Messages descending from the brain - opens and closes gate Open; close |
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What happens if an electrode is placed in the periaqueductal grey area (midbrain)? |
The electrical stimulation makes one not able to feel pain |
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What has the phenomenon where stimulation to the brainstem produces insensitivity to pain been called? READ PAGES 272-275 |
Stimulation-produced analgesia (SPA) |
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Give two reasons why placebos reduce pain? What are two of these triggering processes? |
Reduce stress leading to lower pain experienced Psychological processes trigger the release of opioids in the body, inhibiting transmission of pain signals Expectancies and classical conditioning |
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What are four types of pain behaviours? What are three ways pain behaviours are strengthened/maintained? |
1 - Facial/audible distress (moan/grimace) 2 - Distorted ambulation/posture (stooping/holding painful area) 3 - Negative affect (irritable) 4 - Avoidance of activity (lying down frequently/staying home from work) Operant conditioning, not having to do certain activities they don't like, compensation |
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Do men and women have the same pain threshold? What three things do people with chronic pain experience? |
Yes, the stimulus intensity they start to feel pain is similar, except they differ in their reactions to pain Depression, anxiety, anger |
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What two things does the social communication model of pain propose? |
The person in pain and the caregiver influence pain experience through personal histories, differences in pain expression, and methods of pain management Social environment also affects subjective pain (participants exposed to pain in lab adjust their responses to match others who are present at the time) |
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What does the communal coping model of pain focus on? Why would people catastrophize? How effective is it in acute pain? Chronic? The model shows that what is necessary for managing pain in a social context? Catastrophizers show more ___ and less _____ behaviours, supporting the idea that catastrophizing is a social function |
Focuses on the interpersonal context of the pain experience, especially the response of catastrophizing To elicit assistance/empathy from others; effective in acute pain, but can lead to disrupting balance and causing social conflict and rejection if chronic Effective communication Pain, coping behaviours |
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Instead of altering the problem itself, what do those with chronic pain do? What are two types? Are they effective? |
Use emotion-focused coping strategies Overt behavioural coping - resting/relaxing/medications Covert coping - hoping/praying/diverting attention No. |
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How do those with chronic pain score on the MMPI (Minnesota Multiphasic Personality Inventory) What are the two factors that cause the development of depression in those with chronic pain? What is pain acceptance? Four characteristics? |
High on the neurotic triad (hypochondriasis/depression/hysteria) Inability to change one's situation, catastrophizing Engage in activities despite pain Pay less attention to pain, greater self-efficacy, function better, use less pain meds |
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What are three self-report methods of pain? What are the three types of pain rating scales? What's the benefit of these scales? |
Interviews, pain rating scales and diaries, pain questionnaires Visual analogue scale (line); box scale/numeric scale (0-10); verbal rating scale (no pain-worse) Can be used frequently and track trends |
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What three dimensions are assessed during a pain questionnaire? In the McGill pain questionnaire, what does each word represent? This combined total is called? The verbal rating scale in the MPQ that rate your pain right now create a separate score called? What three things did the MPQ show? What is a limitation of the MPQ? |
Affective (emotional-motivational); sensory; evaluative An assigned value of the degree of pain in each class; the pain rating index; present pain intensity Proved pain is multidimensional, people with similar pain choose same words, people with very different types of pain choose different words; English language |
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Pain behaviour can be assessed in what two types of situations? Psychophysiology looks at mental/emotional processes reflected by changes that make physiological activity, what are the three main ways to measure psychophysiology? |
Structured clinical sessions - patient performs activities and then performance is assessed Everyday activities - assessor assesses patient EMG - measures muscle tension over an extended period of time Autonomic activity - HR/skin conductance (not really useful tho as it is very variable) EEG - evoked potentials |
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What is clinical pain? Why is it important to reduce/eliminate acute clinical pain post surgery? |
Pain that needs professional care Pain can impair immune and endocrine function/slow healing/increase infection/increase chance of chronic pain |
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Is surgery better for acute or chronic pain? What happens during neuroablation? Why is it rarely done? What happens in a synovectomy? |
Acute Part of the PNS or spinal cord is removed/disconnected to prevent pain signals from reaching the brain Seldom provide long-term relief and has side effects like numbness Surgeon removes membranes that are inflamed in arthritic joints |
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How effective are surgical methods for long term pain reduction compared to nonsurgical methods? When is surgery for chronic skeletal pain conditions the most appropriate? |
Little evidence, less effective for people with depression and used at a far lower rate in other developed countries like England/Denmark When person is severely disabled and nonsurgical treatment failed |
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What three things are drug prescriptions based on? What are the 3 arrangements to give painkilling chemicals? What are two more? |
Characteristics of the drug, patients, and socio-cultural factors (Latin America rare to use narcotics for pain relief) Prescribed schedule; as needed (PRN) Epidural block - inject narcotics/anaesthetics epidurally (near membrane around spinal cord) to prevent pain signals to brain Patient-controlled analgesia - patient presses button that goes directly into them via an IV |
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Are narcotics effective for chronic pain? Except for pain where? Give three reasons why increases in using narcotics for chronic pain are occurring cautiously? |
Yes, rely on low daily doses of each drug? Back pain - associated with substance abuse 1 - People can become addicted 2 - Studies need to be done as to how daily doses alter patient lives and functioning 3 - Researchers need to find out why tolerance/addiction to narcotics are less likely when used for pain relief |
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The need for other approaches in helping pain patients is suggested in researching findings on what three psychosocial factors? |
1 - Chronic headache patients use maladaptive ways to cope with everyday stressors more than regular people 2 - Arthritis patients with high helplessness before drug treatment report worse treatment success than low helplessness patients 3 - Patients who get placebo drugs in double-blind procedures report lots of pain relief |
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What are the four goals of psychological treatments for pain? |
Reducing frequency/intensity of pain; improve emotional adjustment to pain; increase social/physical activity; reduce analgesic drugs |
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What are the two main goals in operant conditioning for treating pain? How? What are three limitations of this? |
1 - Reduce patient's reliance on medication Slowly reducing amount of meds in cocktail 2 - Reduce disability accompanying chronic pain conditions Changing consequences of behaviour to only promote well behaviour 1 - Some people revert to old ways 2 - Not effective for chronic-progressive pain (like cancer) 3 - Unhelpful social environment can render treatment largely useless |
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What are three ways to reduce underlying physiological processes that can be exacerbated by fears and stress? |
Fear reduction - In vivo exposure Relaxation - progressive muscle relaxation/meditation Biofeedback - voluntary control over bodily functions like HR |
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What are four things need to be kept in mind about the effectiveness of relaxation and biofeedback? Is biofeedback and relaxation effective in the long-term? |
Treatment for headaches is only about 40-50% Its 2x as effective as placebo It's more effective for kids and people who show certain psychophysiological patterns Patient cognitive strategies also contribute to the success Yes |
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What is passive coping and why is it bad? What is active coping? Is it effective? What are the three ways? Which is most effective for chronic pain |
Going to bed/curtailing social activities Leads to feelings of helplessness/depression which leads to more passive coping Keep functioning by ignoring pain/keeping busy; yes; distraction/imagery/redefinition |
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What three parts to distraction affect how well it works? What are the two forms of self-statements in pain redefinition? What is acceptance and commitment therapy (ACT)? |
Amount of attention required Extent the task is interesting Task's credibility to the person Coping statements emphasizing person's ability to deal with the pain Reinterpretive statement to negate the unpleasant parts of the discomfort Accepting the condition and emotions |
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What are pain clinics? What are the four main types of pharmaceuticals? |
Organizations developed just to treat pain conditions Peripherally acting analgesics Centrally acting analgesics Local anaesthetics Indirectly acting drugs (transquilizers/antidepressants) |
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What does crisis theory describe? Crisis theory states the outcome of the crisis/adjustment the person makes, depends on the coping process, which depends on what three contributing influences? |
Factors that influence how people adjust Illness-related factors - disfiguring/painful/life-threatening Background and personal factors - age/gender/social class/hardiness/self-blame physical and social environmental factors - hospital vs home environment/special equipment/family/friends |
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Explain the three basics of the coping process What are two types of adaptive tasks? |
Starts with cognitive appraisal of the significance of the health problem to their life Outcome of the appraisal leads to adaptive tasks Then apply coping skills to deal with these tasks Tasks related to the illness/treatment Tasks related to general psychosocial functioning |
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What are the three things must one learn in tasks relating to the illness/treatment? What four things must the patient try to do in tasks related to general psychosocial functioning? |
Coping with symptoms/disability of the health issue Adjusting to hospital environmental/medical procedures/regimens to treat the health issue Developing/maintaining relationships w/doctors Control negative feelings, remain positive Maintain self image & competence Preserve relationships with family/friends Prepare for uncertain future |
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What are two main psychosocial factors can worsen asthma? What four other emotional factors affect asthma? What final factor can affect asthma? |
Stress and negative emotions Excitement Anxiety - increases symptom perception) Self-efficacy - lower asthma-related self-efficacy = more negative emotions on physiological stress response and asthma symptoms Suggestion - placebo Family factors - structured routine = less asthma |
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In what two ways is epilepsy related to psychosocial processes? |
Emotional arousal - ex. anxiety can increase likelihood/severity Epileptics & families - can adjust poorly |
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What are two ways people do not adhere to diabetes regimens? What two ways do they not adhere to non-medical aspects? What two psychosocial factors affect diabetes? What are two ways stress can affect diabetes? |
Poor literacy and perceiving symptoms Diet and exercise advice Social supports & self efficacy - higher in both leads to self reports of higher adherence to dietary/exercise/glucose testing Epinephrine (decreases insulin production), cortisol (liver increases glucose production) |
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What three things were found to help emotional adjustment in those with arthritis? |
Subjects thinking practitioners had greater control over the course of the disease than they did themselves Subjects thinking they could control their daily symptoms Subjects who saw themselves as active partners in decisions about treatment |
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What are six types of adjustment problems in chronic illness? |
Physical - Unable to cope with disability/pain Vocational - Difficulty revising educational/career plans/finding new job Self-concept - Body image/self-esteem Social - Difficulty doing activities Emotional - Denial/anxiety/depression Compliance - Not adhering to program |
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What are the eight psychosocial interventions that can help adjust to a health problem and its medical regimen? What type of programs help combine these techniques to help patients adhere to the regimen, adapt to new roles, and cope with their emotions? What two types of care to patients with chronic illness benefit from? |
Education Support services Behavioural methods Relaxation Biofeedback Cognitive methods Interpersonal therapy Family therapy Self-management programs Collaborative care; integrated care |
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What three emotions are risk factors for heart disease, and increase risk of heart attack with those who already have heart disease? Give three reasons why negative emotions are linked to heart disease What other factor can affect heart disease? |
Anger, depression, anxiety Less healthful lifestyles Negative physiological effects Shared genetic factors increase risk of heart disease and negative emotions Stress (social relationships/job stress) |
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What three emotional factors can impair recovery after heart attack? What's the main thing, if you could sum it up, that helps recovery/return after heart attack? What is cardiac invalidism? |
Excessive: anxiety, depression, denial Optimism and good life Person w/heart disease becomes more dependent and helpless via families promoting it |
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Stroke can result in what two types of aphasia? Denial after stroke is higher than heart disease and cancer, why shouldn't it be used? What is important to discuss during family therapy and support groups? |
Receptive - difficulty understanding verbal info Expressive - difficulty producing language Limits progress in rehab Address practical problems (ex. no transportation) |
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What is anticipatory nausea? Food aversion develops during chemotherapy/radiation therapy due to classical conditioning, how can it be fixed? |
Classical conditioning causing nausea linked with cancer treatment Give strongly flavoured/unfamiliar food before chemo and use it as a scapegoat |
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How can psychosocial vulnerabilities like depression and hopelessness lower lifespan in cancer patients?
Cancer patients adapt surprisingly well, what are four factors that give higher adaptation and QoL?
What three factors affect long term cancer survivors' emotional distress? |
Higher stress and negative emotion can affect immunity and other processes
Being involved in treatment decisions High levels of perceived control Use active, problem-focused coping Find benefits/meaning in difficulties
Site of the cancer, age, gender |
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What are two ways to reduce nausea? What are 3 ways that cognitive-behavioural stress management done with breast cancer patients meeting weekly to discuss difficulties and learn skills improved adjustment? What was the main factor in the success of this stress management program? |
Relaxation and systematic desensitization Reduces depression and increases positive reappraisal Increase immune function Reduce cancer-related anxiety/general anxiety/cortisol levels/inflammation levels Allowing patients to settle down at will |
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Can psychosocial interventions improve cancer survival? Children show better adjust to cancer when they used ______-focused coping in the first months after diagnosis, then ______-focused in the following years What are two other important factors in psychosocial adaptation to cancer? |
No Emotion; problem Age at onset & time since diagnosis - earlier diagnosis and treatment & longer they survive in remission = better long-term adjustment |
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What are three effects of the stigma associated with AIDS? |
Resist acknowledging the disease = spreads Don't get tested/don't tell others People's HIV slows after disclosing illness to others |
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What are the four common patterns of people's adjustment two years after a significant trauma? People who express little negative emotion actually experience less/more grief over time? Widowed men adjust more/less poorly than widowed women Adjustment is more/less difficult if death is sudden (ex. car crash) |
Resilient - adjusting well throughout two years Recovered - difficulty in first months, then improving Chronic - poor adjustment throughout Delayed - moderate difficulty in first months, then worsened Less grief; more; more |
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What are symptoms of complicated grief? When should people seek psychosocial evaluation/intervention? What are two types of psychosocial intervention that helps people adjust to loss? |
Yearning for deceased person/bitterness/depression/disbelief/intrusive thoughts If these symptoms persist at high levels after six months Group discussion/role playing to teach clients to reduce stress using coping methods like problem-focused coping Confronting death in exercises/discussions; thinking about future/etc. |
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What are the two things health psychology research and theory needs to expand their on? |
Incorporate more levels of factors to represent the biopsychosocial systems that work together in affecting health More attention to lifespan changes in the nature of health threats & most effective ways to reduce those threats |
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What two factors affect workplaces giving psychosocial interventions? What does translational research test and attempt to do? What are quality-adjust life years (QUALYs) calculated? What's the value in using QUALYs? |
Intervention efficacy; cost-benefit ratio Interventions in real-world settings and methods for getting health care providers to adopt new evidence-based research Estimate years left after treatment, multiply each year by QoL Look at the cost:benefit of each treatment |
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What two focuses are needed for the elderly? |
Promote successful aging (cognitive functioning/emotional adjustment/physical health) Improve family coping for caring for elderly |
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What five factors will affect the future of health psychology? |
Monetary (affects research/clinical intervention/health promotion activities) Role of health psychologists in primary care (improve outcomes with less health care spending) Education/training in the discipline (other majors taking this course see its merit) Developments in medicine (assessing treatments) |
