Sensory Experience Of Pain Research Articles

Pain and Fear of Cancer Recurrence in Survivors of Childhood Cancer.

Theoretical models suggest that anxiety, pain intensity, and pain catastrophizing are implicated in a cycle that leads to heightened fear of cancer recurrence (FCR). However, these relationships have not been empirically examined. The objective of this study was to examine the relationships between anxiety symptoms, pain intensity, pain catastrophizing, and FCR in childhood cancer survivors and their parents and to examine whether pain catastrophizing predicts increased FCR beyond anxiety symptoms and pain intensity. The participants were 54 survivors of various childhood cancers (Mage=13.1 y, range=8.4 to 17.9 y, 50% female) and their parents (94% mothers). Children reported on their pain intensity in the past 7 days. Children and parents separately completed measures of anxiety symptoms, pain catastrophizing, and FCR. Higher anxiety symptoms were associated with increased pain intensity, pain catastrophizing, and FCR in childhood cancer survivors. Higher anxiety symptoms and pain catastrophizing, but not child pain intensity, were associated with FCR in parents. Hierarchical linear regression models revealed that pain catastrophizing explained unique variance in both parent (ΔR2=0.11, P<0.01) and child (ΔR2=0.07, P<0.05) FCR over and above the effects of their own anxiety symptoms and child pain. The results of this study provides novel data on the association between pain and FCR and suggests that a catastrophic style of thinking about pain is more closely related to heightened FCR than one's anxiety symptoms or the sensory pain experience in both childhood cancer survivors and their parents. Pain catastrophizing may be a novel intervention target for survivors and parents struggling with fears of recurrence.

Pain Experiences and Their Relation to Opioid Misuse Risk and Emotion Dysregulation.

Pain is a complex, multidimensional experience but often is measured as a unidimensional experience. This study aimed to separately assess the sensory and affective components of pain and identify their relations to important pain-related outcomes, particularly in terms of opioid misuse risk and emotion dysregulation among patients with chronic pain receiving treatment in Appalachia. Two hundred and twelve patients presenting to a multidisciplinary pain center completed the Difficulties in Emotion Regulation Scale (DERS-18), Screener and Opioid Assessment for Patients with Pain—Revised (SOAPP-R), and short-form McGill Pain Questionnaire (SF-MPQ). The sensory experience of pain was unrelated to emotion dysregulation (r = 0.06, p = 0.57) and weakly related to opioid misuse risk (r = 0.182, p < 0.05). In contrast, the affective experience of pain was moderately related to emotion dysregulation (r = 0.217, p < 0.05) and strongly related to opioid misuse risk (r = 0.37, p < 0.01). In addition, emotion dysregulation predicted variance in opioid misuse risk above and beyond the affective and sensory experiences of pain ((b = 0.693, p < 0.001). The results suggest patients with a strong affective experience versus sensory experience of pain and challenges with emotion regulation may require a more comprehensive intervention to address these underlying components in order to reduce their risk of misusing opioid medications.

Dispositional empathy is associated with experimental pain reduction during provision of social support by romantic partners.

Background and aims While social interactions like verbal support and physical touch have repeatedly been shown to reduce experimental pain, analgesic effects of passive social support, i.e. the sole physical presence of a supportive other, remain unclear. Moreover, little is known about individual factors influencing the extent of pain attenuation during social support. This study investigated analgesic effects of passive support by a romantic partner and the role of partner empathy therein. Methods In 48 heterosexual couples, sensitivity to pressure pain was assessed; each participant was tested alone and in the passive presence of his/her partner. Dispositional empathy was quantified by a questionnaire. Results In the presence, as compared to absence, of their partners men and women exhibited higher pain threshold and tolerance, as well as lower sensory and affective pain ratings on constant pressure stimuli. Partner empathy was positively associated with pain tolerance and inversely associated with sensory pain experience. Conclusions The results confirm the analgesic effects of social support, which may even occur without verbal or physical contact. Partner empathy may buffer affective distress during pain exposure, thereby reducing pain sensitivity and promoting pain coping. These processes may occur solely due to a partner's physical presence and do not necessarily require direct empathetic feedback.

Supraspinal Modulation: Something to be Remembered

Pain has always been a challenging issue in patients with acute and chronic conditions. Pain results from activation of sensory receptors specialized to detect actual or impending tissue damage. However, a direct correlation between activation and nociceptors and the sensory experience of pain is not always apparent. Emotional state, the degree of anxiety, attention and distraction, past experiences, memories, and many other factors can either enhance or diminish the pain experience. Many active agents are used to block and alleviate pain sensation in acute and chronic settings. When an inadequate treatment for acute pain and neuralgia occurred, it would induce complex processes involving both central and peripheral sensitization contributing to persistent post-surgical pain and worsening neuralgia that would lead to chronic pain issues. The important thing to be considered is that this pain process is an intertwined, interconnecting and sustainable process that could not be cut abruptly. Our aim is to remind professionals to accept that the pain pathway is not straight forward but rather a convoluting idea that can evolve and expand. Imagining areas could be defined one day through high technology advances and would lead us into defining the depth of this beautiful and complex pathway

Ion Channel Modulation in Spinal/Trigeminal Synaptic Plasticity

Ion Channel Modulation in Spinal/Trigeminal Synaptic Plasticity

Psychobiological Correlates of Improved Mental Health in Patients With Musculoskeletal Pain After a Mindfulness-based Pain Management Program

Mindfulness-based pain management programs (MBPMs) aim to improve mental and physical health in individuals with chronic pain. In this study, we investigated whether improvement in mental health might require (1) reduction in the sensory pain experience and brain correlates of that experience, and/or (2) improved perceptions of the controllability of pain and corresponding brain activity related to cognitive control and emotional regulation. Twenty-eight patients with chronic pain were assessed and randomized into an intervention group (who attended an 8-wk MBPM) or a control group (treatment-as-usual), before being reassessed after 8 weeks. Outcome measures included clinical pain, perceived control over pain, mental and physical health, and mindfulness. Neural activity was measured during the anticipation and experience of acute experimental pain, using electroencephalography with source reconstruction. Improvements were found in the MBPM group relative to the control group in mental health, which related to greater perceived control of pain, but not to reductions in clinical or experimental pain ratings. Anticipatory and pain-evoked event-related potentials to acute experimental pain were decreased, but sources of these event-related potentials were estimated to be in regions that modulate emotional responses rather than pain intensity. Mental health and perceived control outcomes correlated with reduced anticipatory deactivations of dorsolateral prefrontal and somatosensory cortices. Increased activity in cognitive control regions of the brain during pain anticipation related to improved mental health and perceived control over pain, but not to decreased pain experience. Greater perceived control may therefore result from improved regulation of the emotional response to pain.

The McGill Pain Questionnaire as a Multidimensional Measure in People with Cancer: An Integrative Review

First published in 1975, the McGill Pain Questionnaire (MPQ) is an often-cited pain measure, but there have been no systematic reviews of the MPQ in cancer populations. Our objective was to evaluate the MPQ as a multidimensional measure of pain in people with cancer. A systematic search of research that used the MPQ in adults with cancer and published in English from 1975 to 2009 was conducted. Twenty-one articles retrieved through computerized searches and nine studies from manual searches met the criteria. Review of the 30 studies demonstrated that pain intensity (n = 29 studies) and pain quality (n = 27 studies) were measured more frequently than pain location, pattern, and behavior parameters. Measuring cancer pain using the MPQ provided insights about disease sites, magnitude of pain, and effectiveness of treatment and intervention. Additionally, the MPQ data informed speculations about pain mechanisms, emotional status, overall sensory pain experience, changes in pain over time, and alleviating and aggravating behaviors/factors. Findings supported the MPQ as an effective multidimensional measure with good stability, content, construct, and criterion validity and showed sensitivity to treatment or known-group effects. The MPQ is a valid, reliable, and sensitive multidimensional measure of cancer pain. Cancer pain is a subjective complex experience consisting of multiple dimensions, and measuring cancer pain with the MPQ may help clinicians to more fully understand whether those dimensions of cancer pain influence each other. As a result, clinicians can provide better and effective cancer pain management.

Human functional brain imaging: The bridge from neurophysiology to the mind

Human brain imaging studies have identified multiple brain regions activated during the experience of pain. Do these complex activation patterns lead to confusion and an “explanatory gap” between classical neurophysiology, psychology, and brain imaging? We propose the contrary, that human functional brain imaging studies can provide a bridge between neurophysiological research and the psychological concept of “pain.” Modern brain imaging techniques allow analysis of the relationship between brain activation patterns and various psychological percepts. However, an essential element in interpreting functional brain imaging observations is a robust psychophysical paradigm that permits the selective manipulation and measurement of individual perceptual features of pain. Functional brain imaging provides a new tool to facilitate our understanding of the complex cognitive, emotional, and sensory experience of pain. Nevertheless, this tool will add little to our knowledge if it is not used wisely.

Anxiety sensitivity and fear of pain in patients with recurring headaches

Anxiety sensitivity (AS) plays an important role in the cognitive, affective and behavioral profiles of patients with chronic pain related to musculoskeletal injury. However, investigators have not considered whether these findings extend to patients with other classes of chronic pain. The primary purpose of this investigation was to address this issue in 72 patients with recurring headaches who completed a self-report questionnaire inventory during a treatment visit to an outpatient neurology clinic. The mean ASI score for the group (mean=24; SD=11) was relatively high. When patients were classified on the basis of ASI scores, 20 (28%) met criteria for high, 41 (57%) for medium and 11 (15%) for low AS. Multivariate analysis of variance confirmed that these groups differed on specific aspects of their cognitive, affective, and behavioral profiles. High AS patients reported greater depression, trait anxiety, pain-related escape/avoidance behavior and fearful appraisals of pain than did patients with medium or low AS. High AS patients also indicated greater cognitive disruption in response to pain than did patients with low AS. Groups did not differ in headache severity, physiological reactivity, change in lifestyle, anger, nor did they differ in use of over-the-counter or prescribed analgesics. Multiple regression analysis identified AS, pain-related cognitive disruption, and sensory pain experience as significant predictors of fear of pain. Lifestyle changes attributed to headache were, on the other hand, predicted by headache severity, physiological and cognitive anxiety and escape/avoidance behavior. These results provide further evidence of the important association between AS and fear responses of patients with chronic pain syndromes. Implications and future directions are discussed.

The relationship of depression and somatic focus to experimental and clinical pain in chronic pain patients

Abstract The present study examined Fields' proposal that depression increases the sensory experience of pain in part through greater somatic focus. Experimental and clinical pain measures were compared to self-report of depression and somatic focus in 60 chronic pain patients. Depression scores were unrelated to pain threshold or tolerance on the cold-pressor test. However, as hypothesized by Fields, path analytic models suggested that depression had a direct influence on the evaluative and affective aspects of pain, but the relationship between depression and sensory pain was mediated by somatic focus. These results provide partial support for Fields' neurobiological model of pain and depression.