Psychology of pain (original) (raw)

The role of experience in the assessment of pain in others

Pain is always subjective and therefore a person expe-riencing pain is usually the most competent one to indicate both intensity and unpleasantness of the pain he/she is feel-ing in a given moment. Paradoxically, the very reason that qualifies an individual as the most suitable for assessment of his/her pain is also the same reason that makes his/her assessment susceptible to a number of situational factors. Pain responses are found to be under influence of attention (Arntz & De Jong, 1993; Arntz, Dreessen, & Marckelbach, 1991), emotions (Godinho, Magnin, Frot, Perchet, & Gar-cia-Larrea, 2006; Roy, Piché, Chen, Peretz, & Rainville, 2009) characteristics of the experimenter / audience (Kállai, Barke, & Voss, 2004; Levine & de Simone, 1991; Williams, Park, Ambrose, & Clauw, 2007; Zeman & Garber, 1996), just to name a few -which makes self-assessment of pain inconsistent and therefore unreliable. Since self-reports of pain can sometimes be willingly or inadvertently distorted, and also...

Reconsidering the International Association for the Study of Pain definition

Pain Reports, 2018

Introduction: The definition of pain promulgated by the International Association for the Study of Pain (IASP) is widely accepted as a pragmatic characterisation of that human experience. Although the Notes that accompany it characterise pain as “always subjective,” the IASP definition itself fails to sufficiently integrate phenomenological aspects of pain. Methods: This essay reviews the historical development of the IASP definition, and the commentaries and suggested modifications to it over almost 40 years. Common factors of pain experience identified in phenomenological studies are described, together with theoretical insights from philosophy and biology. Results: A fuller understanding of the pain experience and of the clinical care of those experiencing pain is achievable through greater attention to the phenomenology of pain, the social “intersubjective space” in which pain occurs, and the limitations of language. Conclusion: Based on these results, a revised definition of pain is offered: Pain is a mutually recognizable somatic experience that reflects a person's apprehension of threat to their bodily or existential integrity.

Reconsidering the International Association for the Study of Pain definition of pain

Pain reports, 2018

The definition of pain promulgated by the International Association for the Study of Pain (IASP) is widely accepted as a pragmatic characterisation of that human experience. Although the Notes that accompany it characterise pain as "always subjective," the IASP definition itself fails to sufficiently integrate phenomenological aspects of pain. This essay reviews the historical development of the IASP definition, and the commentaries and suggested modifications to it over almost 40 years. Common factors of pain experience identified in phenomenological studies are described, together with theoretical insights from philosophy and biology. A fuller understanding of the pain experience and of the clinical care of those experiencing pain is achievable through greater attention to the phenomenology of pain, the social "intersubjective space" in which pain occurs, and the limitations of language. Based on these results, a revised definition of pain is offered: Pain is a...

Pain and emotion: relationship revisited

German J Psychiatry, 2005

There is emerging evidence from different neuropsychological and empirical clinical studies that pain is now to the viewed as an experience with strong emotional and other psychological components and not merely as a sensory phe-nomenon. This article attempts an in-depth ...

A biopsychosocial formulation of pain communication

Psychological bulletin, 2011

We present a detailed framework for understanding the numerous and complicated interactions among psychological and social determinants of pain through examination of the process of pain communication. The focus is on an improved understanding of immediate dyadic transactions during painful events in the context of broader social phenomena. Fine-grain consideration of social transactions during pain leads to an appreciation of sociobehavioral events affecting both suffering persons as well as caregivers. Our examination considers knowledge from a variety of perspectives, including clinical health psychology, social and developmental processes, evolutionary psychology, communication studies, and behavioral neuroscience.

Suffering as an independent component of the experience of pain. European Journal of Pain, 2015

European Journal of Pain, 2015

Background: Pain has consistently been viewed as containing two dimensions, a sensory (intensity) and an emotional (unpleasantness). It has been suggested that pain involves higher order cognitive processes that go beyond unpleasantness. We therefore aimed at extending the assessment of pain by introducing an additional dimension of pain-related suffering and identifying noxious stimulation protocols that are most adequate for its psychophysical and psychophysiological characterization. Methods: Twenty-four healthy volunteers received separate series of tonic and phasic noxious mechanical stimuli. Visual analogue scales were used to rate intensity, unpleasantness and suffering and psychophysiological measurements such as heart rate, skin conductance and corrugator electromyography were recorded. Acoustically evoked startle responses were measured in part of the assessments to obtain additional indicators of pain aversiveness. Results: Spearman's correlation coefficients and partial correlations analyses as well as principal component analyses confirmed that suffering constitutes an integral component of pain processing that is distinct from intensity and unpleasantness. Tonic, rather than phasic, stimulation method was more effective in eliciting pain and suffering and under this condition startle responses where higher during long compared to short stimuli. Conclusions: These results suggest that in acute pain, suffering is a constitutive dimension that might even be more crucial in clinical states of pain.

The meaning of pain expressions and pain communication

Meanings of Pain, Vol. II

In her 1926 essay "On being ill" Virginia Woolf laments the poverty of our language for pain: "let a sufferer try to describe a pain in his head to a doctor and language at once runs dry," she notes. Looking at studies of patient-doctor exchanges about pain, particularly those dealing with chronic pain, it seems that Woolf's worry is born out. a Both patients and clinicians frequently report problems around communicating and assessing pain, with patients expressing dissatisfaction with their doctors and doctors often finding exchanges with chronic pain patients difficult and frustrating. Yet we know that positive patient-clinician interaction matters to both parties and that a patient's sense that they are being listened to can increase their overall sense of well-being , as well as promoting adherence to lifestyle changes and medical interventions that lead to reduced levels of experienced pain. So, how could we go about improving pain communication, and thereby enhance quality of life, particularly for chronic pain patients? This chapter explores that question by reflecting on what might be learned from philosophical accounts of the meaning of pain terms, seeing how these views impact on practical issues around pain communication and shed light on a newer model of how to think about pain communication (one that we hope might deliver concrete clinical improvements).