Psychology of Pain

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Fear/Avoidance Model

Bogduk, 2006: Predictions concerning the nature of suitable interventions that address psychological factors Development of chronic pain from avoidance of physical activity based on fear...decreased exercise from acute pain is "rewarding" and leads to increased disability

Individual Differences

Gender, ethnicity, situational factors, past experiences

Pattern Theory of Pain

Goldscheider, 1984: Pain perception is based on stimulus intensity and central summation

Gate Control Theory of Pain

Melzack & Wall, 1965: There exists an inhibitory neuron that prevents signals from being sent to the brain until pain reception occurs to "open the gate" and inform the brain of pain FOR EXAMPLE: if you rub or shake your hand after hitting it against something, the normal somatosensory input is stimulated, causing the "gate" to close and reducing the perception of pain

Specificity Theory of Pain

Mountcastle, 1974: A sensory experience evoked by tissue damage - highly contested, it does not take tissue damage to inflict pain

Theories of Pain

Pattern Theory (Goldscheider, 1984), Specificity Theory (Mountcastle, 1974), Gate Control Theory (Melzack & Wall, 1965) Note: being unable to describe your pain does not mean you are not in pain, no doctor can understand severity of pain by raised cortisol levels

Chronic Pain (self-reinforcing nature)

Physical: cycle of - fear of pain, avoidance of activity, weakening of muscles, lower pain threshold Psychological: cycle of - helplessness, lower self-esteem, lower self-efficacy, depression, anger, anxiety

Definitions (though inadequate)

Sternbach, 1968: Personal sensations of hurt, signalling current or impending tissue damage, pattern of response

Most important for intro and conclusion

Subjective, unique, related to individual experiences, focus ONLY on chronic pain!


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