Health Psychology Exam 2

Health Literacy

"the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions"

Conscientiousness

"the propensity to follow socially-prescribed norms for impulse control, to be task- and goal-directed, to be planful, to delay gratification, and to follow norms and rules," higher levels of conscientiousness found to be associated with higher physical activity and lower levels of risky behavior Alterations in these health behaviors may be the mechanism by which conscientiousness is linked to better coping and health outcomes in the face of stress.

Symptoms of Major Depressive Disorder

-Five or more of the following symptoms are present during the same two-week period and are different from one's normal level of functioning. At least one has to be symptom 1 or 2: -Depressed mood most of the day, nearly every day Diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day Significant weight loss (when not dieting) or significant weight gain or decrease or increase in appetite Insomnia or hypersomnia nearly every day Psychomotor agitation or retardation nearly every day Fatigue or loss of energy nearly every day Feelings of worthlessness or excessive or inappropriate guilt Diminished ability to think or concentrate, or indecisiveness nearly every day Recurrent thoughts of death, recurrent suicidal ideation or a suicide attempt or plan

Direct Effect Hypothesis

1 of 2 hypotheses regarding how social support influences health hypothesizes that social support mediates the relationship between stress and illness simply by its presence and that social support has a direct positive influence on health. Alternatively, according to this hypothesis, the absence of social support is itself a stressor that can lead to illness

2 distinct features of effective palliative care

1. providing effective care of a patient's physical, emotional and spiritual needs in the face of chronic and terminal illness requires representatives from multiple specialties or disciplines. It is a multidisciplinary approach to treatment, and team members may include family physicians, geriatricians, who specialize in the care of elderly patients, internal medicine physicians, pediatricians and physicians from other medical specialties. also include many different people (nurses, doctors, social workers...etc. can't be done by just one person) 2. anything but boring or mundane. The goals are lofty and the skills required, though different from procedural skills such as surgical skills, are interpersonal in nature and complex. It requires the ability to communicate effectively, coordinate care and see the overall trajectory of illness, while mapping out a treatment course, all the while tending to the patient as a whole person in context. There are many physicians and healthcare personnel, who not only see this work as challenging and interesting, but are quite passionate about it. This is a fortunate outcome for all.

Domains of Successful Coping (Cohen and Lazarus)

1. reduce stressful environmental conditions 2. maximize the chance of recovery, if relevant 3. adjust to or tolerate negative events 4. maintain a positive self-image 5. maintain emotional equilibrium 6. continue satisfying relationships with others

Buffering Approach

2/2 social support mediates the stress-illness relationship by creating a buffer to the stressor by affecting an individual's appraisal of the stressor. This hypothesis can be described using SOCIAL COMPARISON THEORY, in which individuals are able to select appropriate coping strategies by comparing themselves to those around them -Another way to describe the buffering hypothesis is through ROLE THEORY. Role theory suggests that as individuals experience differing stressors, they can change their roles to deal most appropriately with the stressor as friend, CEO, mother, wife and so on. Having other people in one's network allows one to select roles as appropriate to meet the demands of the stressor.

Anxiety Disorders

29% of people suffer from at least one often co-occur, are comorbid with other anxiety disorders, as well as with mood disorders. - many physical symptoms including tight chest, heart palpitations, physical restlessness and muscle tension, among others

Oscar's friends were worried about him after he was diagnosed with terminal cancer because he was constantly lashing out at those closest to him, though they had done nothing to offend him. Later, however, he became very despondent and seemed to be withdrawing from family and friends. He was likely first in the _____[A]_____ stage of dying and then in the _____[B]_____ stage.

A; anger B; depression

What do you think are one advantage and one disadvantage of pain management approaches to chronic pain compared to pain treatment?

Again, there are many possible responses. One advantage may be that if one is able to manage pain, then pain ceases to rule their lives and a tremendous feeling of empowerment can result. A possible disadvantage is that it can remain stressful to have ongoing pain that is not controlled and one may experience episodes of breakthrough pain.

Agoraphobia

Anxiety about being in places/situations from which escape might be difficult/embarrassing should a panic attack happen Avoidance of such situations

Coping Styles

Approach Avoidant Problem-focused Emotion-focused Rumination

What factors do you think contribute to health literacy?

Consider the roles of education level, community resources such as libraries and public health departments, financial resources that allow access to computers and internet information, etc.

Types of Social Support (Wills)

Esteem Support: other people increase one's self-esteem Informational Support: other people are available to offer advice Social Companionship: support through activities Instrumental Support: physical help

5. Gate-control theory of pain allows for the influence of psychological and experiential components in the experience of pain. Discuss two experiential correlates that influence pain and how they fit with gate-control theory. (3 points)

Experiential correlates of pain include secondary gain, the meaning of pain, the context of pain, cultural influences and gender. These can serve to either increase or decrease the experience of pain. For instance, if the pain is perceived as meaningful (e.g., to benefit someone else), it is likely to decrease the experience of pain. If the pain is perceived as not being meaningful, it is likely to be experienced as more painful. *

3. What is health literacy and how is it related to health disparities?

Health Literacy is the capacity to have access to certain health services and information in order to make accurate health choices. Health literacy is related to health disparities, because as there are racial differences between income and poverty levels, African Americans earn less and are more likely below the poverty line. Because they have a lower socioeconomic status, they are less likely to be able to afford proper health care or have the education background in order to gain that information. Therefore, health literacy is much lower for them, and they are in turn more prone to not getting the correct health care because of it.

Describe one improvement that pattern theory offers over specificity theory.

It does not propose specific regions of the brain associated with pain, which fits with the lack of evidence of such sites. Additionally, pattern theory allows for stimulation of nociceptors without automatic experience of pain (i.e., sub-threshold stimulation) accounting for the lack of pain in the presence of some stimulation.

Why do you think that depression confers risk for developing physical illness?

It is not known exactly why depression is linked to later physical illness. We have seen how depression is associated with negative health behaviors, but these don't fully account for the link. Perhaps depression has significant negative effects on immune, cardiovascular or other system functioning which leaves one vulnerable to illnesses associated with these systems.

2. nociception

Nociception is the sensory nervous system pain response to stimuli.

4. Briefly describe three aspects of cognitive approaches to pain control. (3 points)

One aspect of cognitive approaches is biofeedback which lets someone monitor and control bodily functions through rewards. Another aspect is hypnosis which lets someone remove all thoughts of pain and to relax through it. Lastly, guided imagery is a cognitive approach where someone uses creativity to take them to an "escape" of their pain. Yes.

5. Describe two aspects of family support in the treatment of chronic illness.

One aspect of family support is to make sure the family member with the chronic illness is being taken care of emotionally and physically by their family. This could be in aspects of visiting them in the hospital, comforting them, providing medicine for them, and so on. A second aspect of family support is for the family to encourage praise towards the medical treatment they might be receiving. As someone with a chronic illness, they might feel devastated or like the treatment is not working, however if they have the right mindset and can encourage them to feel better.

4. What are two components of palliative care?

One component of palliative care is to provide the correct care from many different team members. In order to make the patient most comfortable physically, emotionally, and spiritually, it is necessary for many, such as nurses, social workers, geriatricians, and so on. A second component of palliative care is being able to use multiple different skill sets such as treating them physically, communicating with them, and overall making sure that the patient is feeling overall the best they can in their situation; representing that palliative care embodies many different aspects.

5. When considering social support, what are one difference and one similarity between tangible assistance and emotional support? (2 points)

One difference between tangible assistance and emotional support is that tangible assistance consists of means that one can physical use or touch. This could be in terms of medical devices, people providing services, or medicine. Emotional support is more of feeling that you are being supported and helped in a certain situation. They are similar however in they both serve the purpose of helping an individual in whatever circumstance they may be in to get back on their feet.

6. What are two differences between chronic and acute pain aside from duration? (2 points)

One difference is that chronic pain is more often correlated with larger psychological distresses such as anxiety, depression, or substance abuse. Because of the extra stressors, the chronic pain continues to last longer. Another difference between chronic and acute pain is that acute treatment and control is usually less problematic as it provides better information about specific pained tissue. Chronic pain usually must take various types of treatment in order to be effective.

3. In two to three sentences, describe at least three characteristics of pain. (3 points)

Pain has many characteristics, however one of the leading ones is that is subjective, or varies person to person on severity. Another characteristic is that it is an unpleasant emotional and sensory experience either with actual or possible tissue damage. Lastly, a characteristic is that pain can vary because of perceived control, or the extent to which someone believe they can control or cope with the pain they have.

Palliative Care for Kids

Palliative care for children is the active total care of the child's body, mind and spirit, and also involves giving support to the family. It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease. Health providers must evaluate and alleviate a child's physical, psychological and social distress. Effective palliative care requires a broad multidisciplinary approach that includes the family and makes use of available community resources; it can be successfully implemented even if resources are limited. It can be provided in tertiary care facilities, in community health centers and even in children's homes.

Specific Phobia

Persistent fear that is excessive or unreasonable, cued by presence or anticipation of specific object or situation. Subtypes: animal, natural environment (e.g,. storms), blood-injection, situational (e.g., bridges, tunnels)

Panic Disorder

Presence of one or more panic attacks: Discrete period of intense fear/discomfort with 4+ of the following that start abruptly and peak within ten minutes: Palpitations, pounding heart, or accelerated heart rate Sweating Trembling or shaking Sensations of shortness of breath or smothering Feeling of choking Chest pain or discomfort Nausea or abdominal distress Feeling dizzy, unsteady, lightheaded or faint Derealization (feeling of unreality) or depersonalization (feeling detached from oneself) Fear of losing control or going crazy Fear of dying Parasthesias (numbness or tingling sensations) Chills or hot flushes

Palliative Care for adults

Provides relief from pain and other distressing symptoms Affirms life and regards dying as a normal process Intends neither to hasten or postpone death Integrates the psychological and spiritual aspects of patient care Offers a support system to help patients live as actively as possible until death Offers a support system to help the family cope during the patient's illness and in their own bereavement Uses a team approach to address the needs of patients and their families, including bereavement counseling, if indicated Will enhance quality of life and may also positively influence the course of illness Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

Biggest Factor of dealing with stress

SES individuals who have, or perceive that they have, adequate resources to handle stressful events cope more effectively and have better health outcomes

Self-Esteem

Self-esteem revolves around how one feels about themselves. If someone has high self-esteem it means they are confident and proud of who they are and on the contrary, one would have negative feelings about themselves.

8. The use of _____[B]_____ has been associated with improved coping with traumatic events possibly because it allows people to receive emotional support as well as information about the stress or coping techniques and positive reinforcement from others.

Social Support

3. Explain the role of socioeconomic status (SES) in the relationship between stress and health. Your response should be one to three sentences. (2 points)

Socioeconomic Status (SES) is the greatest factor between stress and health. If someone is in a higher SES, then usually they have better access to health care or programs that could help their well-being. On the other hand, someone with lower SES would not have as great of access to medical assistance; however are also probably more susceptible for risky behaviors or health problems because of their economic condition.

7. One approach to helping individuals cope more effectively with stress is to teach techniques of _____[A]_____, which usually involves identifying stressors, acquiring skills to cope with stressors and then practicing those skills in stressful situations.

Stress Management

4. What are two advantages of an approach coping style relative to an avoidant coping style? (2 points)

The approach coping style confronts and actively deals with stressors, where the avoidant minimizes or ignores them. By actively dealing with them, it creates for less stress in the long term, where by avoiding it can build up anxiety within an individual. Another advantage of the approach coping style is that by planning in advance, it can actually lead to better health and well-being. On the other hand, in an avoidant coping style one can feel like they are in less control of their life and can lead to depression or other negative life occurrences.

What advantage does gate-control theory offer over the other theories of pain presented?

The primary advantage is the allowance for a role of psychological factors in the experience of pain.

6. Briefly describe the three criteria of successful coping outcomes presented in the textbook. (3 points)

The three criteria of successful coping are: 1) decrease in physiological arousal, 2) a return to pre-stress activities, and 3) reduced psychological distress.

How do you think these things are related to income and race?

There can be no doubt that many of the negative influences on health outcomes cluster together. Individuals with low health literacy tend to be of lower SES and often members of racial minorities. Each of these factors are linked to negative health outcomes and compound the issue of health disparity.

Stigma

a mark of disgrace associated with a particular circumstance, quality, or person. -associated w mental illness

Clinician tasks for good end of death

addressing fears of patients and families in an honest, open manner. Communication is a major component that must be attended to throughout the course of a terminal illness up to and after the death of the patient. Control of physical symptoms such as pain, dyspnea (also known as air hunger, which is severe shortness of breath), nausea and vomiting, comprise another clinician task. Similarly, clinicians must work to control psychological symptoms in patients including anxiety and fear of abandonment. To the extent possible, clinicians are responsible for helping with the spiritual work of dying, providing dignity to the dying patient and attending to the needs of family members. These tasks are multiple, challenging and critical for helping ensure a good death. It is important to start the dialogue about these issues early in the process of dying and it is important to recognize that planning for a good death is as healthy and critical as planning for other major aspects of life.

Biopsychosocial Model

aining precedence in the field of healthcare. This model proposes that psychological and social factors, in addition to physical factors play important roles in overall health. (from lesson 1)

Catastrophic Thinking

aka catastrophizing referred to in cognitive behavioral therapy as a dysfunctional thought or cognitive error tendency to predict the future negatively without consideration of other, more likely outcomes -three main components: rumination, magnification and helplessness

Pain

an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage subjective

Analgesic Drugs (painkillers)

ange from over-the-counter (OTC) varieties such as acetaminophen (Tylenol) to more intense narcotic medications that require prescriptions, such as codeine and Vicodin

Co-Rumination

associated with increased symptoms of depression sharing negative thoughts with others that also have that and it can lead to make it worse

What makes it different from just feeling depressed?

at least five of the symptoms simultaneously over a two-week period.

Emotion-focused

attempts to deal with and regulate the emotions that the stressful event elicits within the individual. ex: when faced with the stress of an upcoming exam, emotion-focused coping might lead to attempts to relax and dispel the anxiety that results from thoughts of the exam

Perceived Control

both cognitive and behavioral control -Cognitive control is the extent to which individuals are able to control their thoughts to cope with pain, for example through distraction. Behavioral control is the ability to alter behavior in a way that either eases painful stimuli or enhances coping, for example, relaxing tense muscles to ease pain. -Having an internal locus of control means generally believing that what happens in one's life is largely within one's own control-more adaptive pain coping

congenital universal insensitivity to pain (CUIP)

can't feel pain

very common theme in end-of-life care and research

concern over pain management

Depression

correlated greatly with chronic pain in cases of chronic pain, individuals begin to feel helpless and hopeless and depression can be a result of the experience of chronic pain the same neurotransmitters in the brain, serotonin, norepinephrine and so on, are involved in both depression and pain

physicians prefer to reserve their time for

curative care thereby providing less than adequate palliative care for many patients in need. This is not true of all physicians or medical settings. In fact, there is a growing body of research in the medical literature discussing the field of palliative care

Religiosity

degree of belief and involvement in religious ideas and activities. An individual high in religiosity might attend services of some kind on a regular basis and have a strong belief in a spiritual philosophy.

Pattern Theory

differs from specificity theory as it proposes that stimulation of nociceptors in the body generate patterns of impulses that are transmitted to the dorsal horn of the spinal cord. If the patterns exceed a given threshold, information about pain is then transmitted to the brain, and pain is perceived. This theory does more to account for the flaws in Specificity Theory, but has some problems of its own. For instance, some individuals experience pain in the absence of stimulation of nociceptors (for example, phantom limb pain), other individuals don't experience pain immediately, but after the event, as athletes not feeling pain until after competition. These phenomena suggest that there is a role for psychosocial factors that are not accounted for by pattern theory. In short, Pattern Theory, though in some ways an improvement over specificity theory, may not be sufficiently comprehensive to explain the experience of pain.

Psychological Aspects of Pain

fear or anticipation of pain can actually increase the perceived experience of pain

Cognitive Behavioral Therapy (CBT)

form of psychotherapy that addresses the thoughts and behaviors that lead to negative emotional states such as depression and anxiety. CBT has been shown to be consistently effective in addressing these problems as well as helping individuals cope more adaptively with stress

Antidepressants

fourth class of medications such as Cymbalta, which have some demonstrated efficacy in helping to treat chronic pain.

Rumination

going over and over the same idea, or focusing exclusively on one idea, such as pain

Individuals who receive _____[C]_____ care are often able to face death in comfortable surroundings, sometimes even at home, with a focus on improving social support rather than searching for cures.

hospice

Problem-focused

individuals tend to focus on assessing the situation, as well as formulating and acting on a plan to deal with it. ex: in the exam example, problem-focused coping would involve assessing the areas of course content and following a study plan to ensure sufficient knowledge of those content areas

Negative Affectivity (Neuroticism)

individuals vary in the degree to which aspects of neuroticism/negative affectivity describe them. tendency to experience negative emotions such as depression/sadness, anxiety/worry or anger/hostility associated with a wide variety of negative psychological outcomes including depression, anxiety, substance abuse Individuals high in neuroticism are also more likely to experience a variety of health problems

Anger

intense emotion that can be quite motivating and mobilizing and linked to some negative health outcomes. In the case of pain, research has shown that anger can exacerbate pain anger can increase muscle reactivity which can contribute to pain

Transcutaneous electric nerve stimulation (TENS)

involves electrical stimulation of nerve endings as a means of reducing pain conflicting evidence for the effectiveness of each of these methods of controlling pain, particularly where chronic pain is concerned

Mindfulness

involves the ability to be fully present in the current moment and to pay attention to the thoughts, emotions and sensations one is feeling at any given time. Mindfulness calls on individuals to be free of judgment and to accept things as they are in the moment. This technique has become more widely adopted in clinical psychological interventions designed to help people cope with life stressors, as well as anxiety, depression and chronic pain, to good effect.

Lack of Access to health insurance

is a key mediator of the relationship between race and healthcare disparity, including increased frequency of poor health outcomes for those without health insurance.

Major Depressive Disorder (depression)

is between 10-25 percent among women and 5-12 percent among men -common and can range from mild to extremely debilitating. -one of several MOOD DISORDERS outlined in the Diagnostic and Statistical Manual of Mental Disorders

Approach strategies

lead to better health and well-being than avoidant styles tend to acknowledge, confront and actively deal with stressors as they occur, and even to plan for the eventuality of stressful situations. ex: when faced with an upcoming exam, an individual with an approach coping style might start to review past lessons and actively study for the exam

Acute Pain Treatment

less problematic from a treatment perspective than chronic pain provides information to the individual about tissue or other damage and resolves when the injury is healed

Substance Abuse

linked with mood and anxiety disorders as well as chronic pain individuals may turn to alcohol, marijuana, narcotics or other drugs to avoid having to face and cope with the pain opportunity for biopsychosocial interventions to help individuals learn to cope adaptively with chronic pain as this population may be considered at-risk for substance abuse problems

What do you think are one advantage and one disadvantage of treatment of chronic pain, relative to pain management?

many possible answers here. One advantage may be that if pain can be effectively treated, individuals don't have to alter their lives to accommodate it. One disadvantage may be that it is often difficult to fully alleviate chronic pain and many of the treatment options have side effects associated with them.

Palliative Care

medical care designed to help patients feel more comfortable, rather than to cure disease.

Meta-Analysis

method for combining and interpreting the results of many different studies on a given topic. powerful method for understanding the state of the evidence in a particular domain

Bipolar Disorder

mood disorder characterized by depressive episodes and manic or hypomanic episodes, dysthymia, a milder, more chronic version of depression, and others

WHO's definition of palliative care

ncludes incorporating the principles of palliative care early in the trajectory of chronic and terminal illnesses, rather than waiting until the end stages of the illness, when all curative efforts are futile. What's more, according to the WHO, palliative care involves not merely pain relief, but attending to the emotional and spiritual needs of the patient in addition to physical needs, which is very consistent with the biopsychosocial approach to health and well-being.

Rumination (emotional distress)

one style of emotion-focused coping that is decidedly not beneficial to health tendency to focus on the negative aspect of the stressor, or the negative emotions experienced as a result of the stressor, in a passive and repetitive way holds one in an ongoing state of negative thoughts and emotions and does nothing to help an individual cope with or move past a stressor

the nonsteroidal anti-inflammatory drugs (NSAIDS)

over-the-counter (OTC) medications, such as ibuprofen and naproxen, as well as prescription NSAIDS, such as Meloxicam or Fenoprofen. These medications do not run the same risk of addiction that opioids do, and can sometimes be prescribed in conjunction with opioids

6 aspects of a good death

pain and symptom management clear decision-making preparation for death completion (see meaning in ones life) contributing to others affirmation of the whole person

Gate-Control Theory (GCT)

pain is a multidimensional perceptive experience that is subjective and includes physiological and psychological components recognition that the experience of pain, like other conscious experiences, is complex and includes cognitive and emotional information, as well as information about context, history and meaning of events and stimuli culminated in the development of GCT. is a gating mechanism in the dorsal horn of the spinal cord that either inhibits or allows the transmission of pain information to the brain no direct evidence of gating mechanism in dorsal horn

Muscle Relaxants

physicians may prescribe a third class of medications, muscle relaxants, to help control musculoskeletal pain such as chronic low back pain. Common muscle relaxants include Valium and Flexeril.

Conditioning

process by which individuals learn to respond to cues or stimuli in their environments -If the dentist's office becomes linked with pain, thoughts of going to the dentist may increase both anxiety/fear and perception of pain. (classical conditioning) -Operant conditioning may also play a role in the experience of pain. Individuals with frequent pain naturally engage in pain-related behavior, such as limping, sighing, wincing, and so on. This behavior may be rewarded or reinforced by others who offer sympathy, help or excuse one from unpleasant tasks, thereby increasing the frequency or severity of the pain behavior and possibly also the perception of pain intensity.

Neuroticism

proposed to play a role in both exposure to stress and reactivity to stress. Individuals high in negative affectivity report experiencing greater numbers of stressful events, relative to those who are not high in this trait. Possible reasons that people respond more negatively to individuals high in neuroticism, thereby increasing the number of negative social encounters that can be perceived as stressful -50% genetic

Historically, medical personnel focused entirely on presence or absence of disease and length of survival in chronic illness. Today, however, the focus has expanded to include _____[D]_____, which includes physical, psychological and social functioning.

quality of life

Acceptance and Commitment Therapy (ACT)

relatively new psychological intervention that has shown promise with chronic pain patients -ACT is a blend of cognitive behavioral therapy and mindfulness that seeks not to control or help individuals avoid pain, but to learn to cope with it and live a productive, rewarding life worth living—with the pain -difference between pain and suffering. Pain cannot be avoided in some cases, but suffering is something that an individual can choose to engage in or not.

Chronic Pain Treatment

represents a more difficult condition to treat.

depression was significantly positively associated with *

smoking and drinking problems, as well as reduced physical activity. -This supports the notion that health problems often cluster and suggests that depression may be a risk factor for some of these negative health behaviors. It is critical to note that no evidence is presented here that depression CAUSES these behaviors.

Opioid

sometimes referred to as narcotic medications or narcotics) to treat pain. These medications work by acting on the opioid receptors in the brain—endogenous pain control system

epidural steroid injections

sometimes used to reduce inflammation in an attempt to reduce pain

Avoidant

tend to minimize, ignore or otherwise avoid recognizing or dealing with stressors When faced with an upcoming exam, individuals with an avoidant coping style may put off studying or minimize the importance or difficulty of the exam. can lead to increased negative events, such as failed exams, a greater sense of uncontrollability of outcomes and overload in many poor grades and trouble graduating

Psychological Control

tendency to believe that one has control over aspects of the environment helps to mitigate the negative effects of stressful events for ex: in CBT one goal may be to examine individuals' thoughts that they have little control over the negative events in their lives and to alter these thoughts and corresponding behaviors to emphasize the control individuals actually do have over such events.

Optimism

tendency to expect positive outcomes rather than negative outcomes viewed as dimensional construct not a dichotomous one

Magnification

tendency to overestimate the degree of threat or harm

Coping

the thoughts and behaviors used to manage the internal and external demands of situations that are appraised as stressful active and changing process various personality traits can affect coping mechanisms

Specificity Theory

theory of pain proposed by René Descartes in 1664 suggests that individual nociceptors (pain receptors) deliver pain stimuli directly to specific corresponding areas of the brain by pain pathways known as A-delta fibers and C-fibers, thereby triggering pain ex: extreme heat applied to the nociceptors of the fingertip would deliver pain impulse that is ultimately registered by the brain as pain in the finger, and the brain would in turn send a signal to move the finger away from the heat source. This theory has fallen out of favor for a number of reasons: -There has not been evidence supporting the notion of specific brain locations for pain. -Pain fibers do not only respond to pain, but to other sensations as well, including temperature and pressure. -There does not seem to be a 1:1 relationship between stimulus intensity and intensity of the pain experience. This seems to differ across individuals and situations. For instance, the same amount of heat could be experienced by one person as intensely painful, but only moderately so for someone else. -Additionally, the same amount of heat could be experienced differently by the same individuals in different circumstances. For these reasons, specificity theory is not the prevailing theory of pain today.

Secondary Gain

there are social rewards that are derived from having a particular illness or condition (getting cared by on others, missing school) same process can heighten pain-related behaviors among individuals with chronic pain. The presence of secondary gains such as no longer having to work or receiving disability benefits and positive treatment from others may increase the levels of functional impairment and avoidant behaviors that accompany chronic pain.

Physical Illness

there is a real link between the experience of depression and subsequent physical illnesses -strongest links in the research literature seem to be between depression and cardiac illnesses, and between depression and chronic pain. **Depressed patients were about 68 percent more likely to develop a physical illness at follow-up, compared to their matched controls who were not depressed. That is pretty powerful predictive validity. -could not be accounted for by control variables

Anxiety

typical consequence of pain. increased anxiety, heightened perception of pain cues and pain avoidance behaviors can serve not only to perpetuate anxiety around pain, but can also increase the likelihood of experiencing pain, as well as the perceived intensity of that pain increased focus on pain, accompanied by the fear and anxiety of it, reduces the cognitive resources to attend to other activities or aspects of life, which can serve to perpetuate the pain experience

Helplessness

underestimation of personal and other resources available for coping

Social Support

understanding that one is valued and cared for by others and part of a larger network of people

Pharmacology

use of medicines most common way that chronic pain is treated in outpatient medical settings

Moderator

variable that changes the relationship between two other variables -stress and well being, moderator being exercise (kind of like an extraneous variable that affects them)