Psychology of Pain Evidence and Examples

  • Created by: Psych951
  • Created on: 28-12-18 11:39

Beecher 1956 - Psychology's role in Pain

  • 25% Soldiers and 80% of civillians requested pain relief in hospital during WW2 despite having same degree of injury
  • Pain represented end of the war so soliders percieved their pain less negatively 
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Cowen et al 2015 - Physiological Measures

  • Monitor: Autonomic nervous system activity; Biopotentials (electrical activity across biological units; Neuroimaging; Biomarkers; Composite algorithms
  • Objective and have other strengths such as detail
  • Not validated enough - Self-report is an unreliable validation 
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Merkel et al 1997 - Observational measures

  • FLACC behaviour scale 
  • Face0 no negative expression, 1 grimace/frown, 2 clenched jaw
  • Legs = 0 normal/relaxed, 1 restless or tense, 2 kicking or drawn up
  • Activity = 0 normal movements, 1 squirming or shifting, 2 rigid or jerking
  • Cry = 0 no crying, 1 whimpers/complaints, 2 steady crying 
  • Consolability = 0 Content and relaxed, 1 Reassured by occasional hugs or talking distractions, 2 difficult to comfort 
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MPQ Questionnaire - Self-report measure

  • 78 adjectives relating to senses, emotions and evaluations
  • 18 languages covering duration, intensity quality, location
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Verloot et al 2006 - Catastrophising

  • Sample of school children and clinical sample of children with chronic pain
  • Pain catastrophising significantly accounted for variance of pain, disability and somatic complaints and negative affect 
  • Mediated relationship between negative affect, somatic complains and functional disability 
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Connelly et al 2012 - Depression and anxiety

  • E-diaries to evaluate components of emotion regulation in predicting daily pain and function
  • Diary entries were used to calculate emotional variability and infer adaptive emotion modulation 
  • Greater variability of negative emotion predicted higher pain and activity limitation 
  • Attenuation of negative emotion reduced pain 
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Walker et al 2002 - Social factors

  • Used social consequences of pain questionnaire
  • Positive attention and activity restriction predicted greater symptom maintenance but this was moderated by self-worth and academic competence
  • Success in social roles effect extent to which people identify with sick role and find it rewarding
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Gilbert et al 2013 - ACT treatment

  • ACT based residential treatment for 98 adolescents
  • Pre-treatment, post-treatment and 3-month follow up - No significant reduction in pain intensity
  • Improvements in physical functioning and pain specific variables 
  • Initial improvements in depression and psychosocial functioning but not at 3 months
  • School absence and medication use reduced 
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Review studies - CBT treatment

  • Van Tulder et al 2000 and Eccleston et al 2009 
  • Helps to treat chronic pain in adults although sometimes effects were small
  • Arguments that quality of care isn't improving but rather methodological measurements 
  • Very effective for children 
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Keogh 2008 - Sex differences

  • Differences in pain perception and experience both in lab and natural settings - Women report more pain 
  • Differences in susceptibility - Women more pain in arthiritis but men in headaches 
  • Dependent on age - Reproductive years
  • Differences in responses to treatments
  • Sex hormones and health seeking behaviours 
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Tossani 2013 - Mental pain

  • Mental pain involves emotions with a sense of loss or incompleteness
  • Hard to define and issues of comorbidity
  • At an increased intensity, psychological pain can lead to mental health issues and suicide
  • Can help provide distress threshold 
  • Inhibited central pleasure and disinhibited central pain 
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Hadjistavropoulos et al 1996 - Pain judgements

  • Social context is key to pain experience 
  • Use expressions rather than language to communicate pain
  • Use cues to make judgements about others' pain e.g. eyebrow lowering or mouth opening
  • Good at matching confidence to accuracy of judgements - Extreme expressions were identified more accurately than genuine or masked 
  • Training can be useful in understanding pain experience 
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