Psychological Methods of Pain Control: Basic Science and Clinical Perspectives. Progress in Pain Research and Management

Abstract

This is another in the series of excellent books from IASP Press that consistently produces current and high quality texts. Pain is a multidimensional problem that involves sensory, emotional and evaluative processes. The psychological aspects of acute and chronic pain assessment and treatment are very important. Recent advances in sophisticated brain imaging have allowed a much better understanding of some of the psychological influences on the pain experience. The editors have assembled an impressive group of internationally recognized experts in this field to contribute to our understanding of this topic. The authors explore the complex inter-relationship between sensory and affective components of pain and how these dimensions can be modulated by cognitive factors and treatments. The book has four sections. The first section reviews the general mechanisms of pain modulation. It covers the four-stage model of pain processing, taking the reader through the mechanisms of psychological influences on pain, in a clear and concise manner. This section also explains how the pain experience can be modified by psychological factors, at various different neural levels and within specific dimensions. The text moves away from the classical model of dichotomous centres and pathways for sensory and affective pain components and describes more integrated and parallel systems. This section also covers important, pre-clinical, animal data that adds to our understanding. The final chapter in this section by McGrath and Dade is a clear exposition of strategies to decrease acute and chronic pain and more importantly disability. The second section covers pain modulation by attention, cognitive factors and emotions. The chapter on attention and distraction includes some fascinating data on functional brain imaging. The chapter that explores the interaction between pain and emotion includes data on pain-related fear and anxiety that is, especially, clinically relevant. Linton's chapter on environmental and learning issues is particularly relevant, as it covers the process whereby acute pain becomes chronic and moves on to how an understanding of this may lead to improvement in treatment strategies. The whole of the third section of the book explores the modulation of pain by placebos, which is of great importance both experimentally and clinically. The first chapter in this section is the clearest account of neural mechanisms for the placebo effect that I have ever seen. This section also includes the clinical impact of the placebo effect, the ethics of placebos in research, factors that alter the magnitude of the placebo effect, brain imaging studies, and methods of altering the placebo response. The final section of the book covers hypnosis. It includes an excellent summary of the neurophysiology of hypnosis, with recent brain imaging data. A final chapter by Barber on the mechanisms and clinical applications of hypnosis for analgesia is excellent. This book has something in it for all basic scientists and healthcare professionals involved in acute and chronic pain assessment or management. It expands our understanding of the neural mechanisms for many phenomena that have previously been difficult to understand and explain. It is clearly written and easy to read. I can recommend it unreservedly.