Pain: Psychological Perspectives

Pain: Psychological Perspectives

Pain: Psychological Perspectives

Pain: Psychological Perspectives

Synopsis

The recent focus on pain research has led to a dramatic advances in the psychological processes that represent and control pain, including the synthesis of sensations, feelings, and thoughts underlying pain behavior and the ontogenetic, socialization and contextual determinants of pain. This invaluable new resource presents a state-of-the-art account of the psychology of pain from leading researchers. It features contributions from clinical, social, and biopsychological perspectives, the latest theories of pain, as well as basic processes and applied issues. The book opens with an introduction to the history of pain theory and the epidemiology of pain. It then explores theoretical work, including the gate control theory/neuromatrix model, as well as biopsychosocial, cognitive/behavioral, and psychodynamic perspectives. Issues, such as the link between psychophysiological processes and consciousness and the communication of pain are examined. Pain over the life span, including child and adult pain, pain in the elderly, and ethno-cultural and individual differences are the focus of the next three chapters. The final sections of Pain: Psychological Perspectives address current clinical issues: pain assessment and acute and chronic pain interventions; the unavailability of psychological interventions for chronic pain in a number of settings, the use of self-report, and issues related to the implementation of certain biomedical interventions; and the latest ethical standards and the theories on which these standards are based. Intended for practitioners, researchers, and students involved with the study of pain in fields, such as clinical and health psychology, this new book will also appeal to professionals in related areas, such as physicians, nurses, and physiotherapists. Pain: Psychological Perspectives is ideal for advanced courses on the psychology of pain, pain management, and related courses that address this topic in detail.

Excerpt

Pain is primarily a psychological experience. It is the most pervasive and universal form of human distress and it often contributes to dramatic reductions in the quality of life. As demonstrated repeatedly in the chapters to follow, it is virtually inevitable and a relatively frequent source of distress from birth to old age. Episodes of pain can vary in magnitude from events that are mundane, but commonplace, to crises that are excruciating, sometimes intractable, and not so common, but still not rare. The costs of pain in human suffering and economic resources are extraordinary. It is the most common reason for seeking medical care, and it has been estimated that approximately 80% of physician office visits involve a pain component (Henry, 1999–2000).

The distinction between pain and nociception provides the basis for focusing on pain as a psychological phenomenon. Nociception refers to the neurophysiologic processing of events that stimulate nociceptors and are capable of being experienced as pain (Turk & Melzack, 2000). Instigation of the nociceptive system and brain processing constitute the biological substrates of the experience. But pain must be appreciated as a psychological phenomenon, rather than a purely physiological phenomenon. Specifically, it represents a perceptual process associated with conscious awareness, selective abstraction, ascribed meaning, appraisal, and learning (Melzack & Casey, 1968). Emotional and motivational states are central to understanding its nature (Price, 2000). Pain requires central integration and modulation of a number of afferent and central processes (i.e., sending messages . . .

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