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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The differentiation between primary versus secondary gains is useful for an understanding of the management of chronic low back pain. Primary gain is defined as the direct reduction of pain and emotional distress. Secondary gain is defined as the reduction of anticipatory pain-fear through the avoidance of the occasions of rearousal of pain. This differentiation helps to clarify the diagnosis as well as the treatment of back pain. A person's fear of pain is considered to be the central psychological factor that interferes with successful treatment of chronic low back pain. Research provides insight into how the person both internally and externally protects against pain-fear. The Hysterical Conversion Scale on the MMPI is interpreted to be a measurement of the current level of pain-fear rather than a statement about the physical versus psychological nature of the pain. The reduction of pain-fear is shown to explain the behavior of hysterical conversion patients. Treatment suggestions are made that focus on reducing the patient's fear of pain. These include: considerations for when to operate; a recommendation to give the patient accurate expectations about the pain he/she will experience during treatment; and a specialized pain counselor in hospitals and clinics in order to help manage the level of pain-fear among low back patients.
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PMID:Diagnosis and treatment of personality factors in chronic low back pain. 14 49

Pain experience is conceptualized as a combination of stimulus sensations (e.g., aching) and emotional distress. In Experiment 1, less distress was reported to cold pressor stimulation by subjects first told about stimulus sensations than by subjects who were uninformed or were told about symptoms of bodily arousal (e.g., tension). Adding a pain warning to sensation information blocked distress reduction, presumably by eliciting an emotional interpretation of the stimulus. In Experiment 2, subjects attending only to hand sensations reported less distress than subjects attending to their bodies. This decrease in the power of the stimulus to provoke emotion is presumably mediated by a schema of hand sensations formed by attention. In Experiment 3, subjects attending to hand sensations early in the immersion and distracting themselves later reported the same low levels of distress as did subjects who attended to hand sensations throughout. Subjects distracted throughout and subjects attending to hand sensations later showed no distress reduction. Therefore, stimulus schematization must precede distress reduction. Implications for distress control are discussed.
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PMID:Effects of preparatory information about sensations, threat of pain, and attention on cold pressor distress. 44 34

Maternal rearing behavior was examined in relation to children's reparation for transgressions and altruism as bystanders to distress in others. The children were 1 1/2-2 1/2 years old. Mothers were trained in techniques of observing. They recorded their child's reactions and their own behaviors in everyday encounters with expressions of distress in others (sorrow, discomfort, pain). Distress was also simulated by mothers and investigators. Mothers' empathic caregiving was rated during home visits. Mothers' affectively delivered explanations regarding the distresses their children had caused to others were associated with children's reparations for transgressions. Such explanations were also associated with children's altruism when they were bystanders to another's distress. Empathic caregiving by mothers was positively associated with children's reparation and altruism. Findings are discussed in relation to theories of altruism, conscience, and child rearing.
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PMID:Child rearing and children's prosocial initiations toward victims of distress. 48 76

Psychologic assessment and treatment of the family of the chronic pain patient has been thought to be of benefit in the outcome of pain therapy. The present study was designed to determine the presence of psychologic symptoms in the spouses of pain patients and the relationship of distress levels between the marital pair. Forty-four couples were studied. Demographic data was collected and each individual completed the SCL-90, a widely used and validated measure of psychologic symptom severity. There was a significant correlation (P = less than 0.001) on psychiatric distress scores between pain patients and their spouses particularly when pain patient distress scores were high. Distress levels tended to decrease with age and were highest among the unemployed and lowest in the retired. In addition spouses were significantly higher than nonpatient norms on most symptom subscales. These data underline the importance of conjoint assessment of the chronic pain patient and the spouse, and have implications for treatment.
Pain 1979 Dec
PMID:Pain and the marital relationship: psychiatric distress. 53 Jul 40

The relationship of pain to personality and the significance have been discussed. Pain may first be evidence of tissue damage, secondly it may be used as a means of communicating emotional distress to others and thirdly, it may be a means of manipulating others, expressing hostility or relieving guilt. The evidence is clear that an understanding of mental life and its relation to pain is important if this symptoms is to be dealt with effectively, irrespective of whether it is physical or psychogenic in origin.
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PMID:Psychological and psychiatric aspects of pain. 66 53

The MMPI and Moos' Menstrual Distress Questionnaire (MDQ) were administered to 60 undergraduate women. Partial correlations between MMPI clinical scales and menstrual and premenstrual MDQ symptom scales were computed with intermenstrual (baseline) symptom reports and response set (Gough's F-K index) statistically controlled MMPI variables tended to correlate with some symptom scales (premenstrual pain, negative affect; menstrual behavior change) but not with others (water retention, arousal). Where correlations did occur, common MMPI scales (Sc, Hs, Hy, Pt) were involved. Results suggest that psychological factors are more closely associated with some areas of menstrual symptomatoloty than with others.
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PMID:MMPI correlates of menstrual distress. 123 46

Fear of pain has been implicated in the development and maintenance of chronic pain behavior. Consistent with conceptualizations of anxiety as occurring within three response modes, this paper introduces an instrument to measure fear of pain across cognitive, overt behavioral, and physiological domains. The Pain Anxiety Symptoms Scale (PASS) was administered to 104 consecutive referrals to a multidisciplinary pain clinic. The alpha coefficients were 0.94 for the total scale and ranged from 0.81 to 0.89 for the subscales. Validity was supported by significant correlations with measures of anxiety and disability. Regression analyses controlling for measures of emotional distress and pain showed that the PASS made a significant and unique contribution to the prediction of disability and interference due to pain. Evidence presented here supports the potential utility of the PASS in the continued study of fear of pain and its contribution to the development and maintenance of pain behaviors. Factor analysis and behavioral validation studies are in progress.
Pain 1992 Jul
PMID:The Pain Anxiety Symptoms Scale: development and validation of a scale to measure fear of pain. 151 5

The adversarial nature of some compensation systems could be a major source of psychological stress. To investigate this, we measured emotional state, pain and disability in 19 compensation recipients and in 18 others who had settled their claim for lower back pain. All subjects were unemployed, and sex distribution was similar in both groups. Compensation recipients showed more signs of emotional distress, had greater difficulty coping with pain, and reported that pain disrupted various aspects of their life to a greater degree than subjects who had settled their claim. However, even after settlement, there was clear evidence of emotional distress. The promise of a financial windfall on settlement of a claim could discourage workers from resuming employment after injury. Unfortunately, this course of action increases the risk of pain becoming chronic and of unemployment and financial hardship continuing after settlement. To prevent this potentially disastrous situation, the compensation system should encourage workers to resume some type of employment as soon as possible after injury.
Pain 1992 Feb
PMID:Effect of compensation on emotional state and disability in chronic back pain. 153 63

A six-week cardiovascular exercise program was provided to 11 subjects classified as experiencing classical migraines, while 9 similarly-classified subjects served as waiting-list controls. Measures included the Canadian Aerobic Fitness test, a headache diary to record the Frequency, Intensity, and Duration of migraine episodes and the Pain-Severity, Affective-Distress, and Support scales of the West Haven-Yale Multidimensional Pain Inventory (MPI). Measures were taken on both treatment and control subjects before, mid-way through, and upon termination of the first aerobic program, as well as after a two week follow-up. The aerobic classes were effective in significantly improving cardiovascular fitness. Pain Severity decreased significantly for those receiving aerobic training, who also showed (nonsignificant) trends, over the measurement periods, toward reductions in Affective Distress as well as the Frequency, Intensity and Duration of migraines, but these trends failed to reach statistical significance. Control subjects demonstrated no systematic changes in any of the dependent measures. These results suggest possible long-term benefits of aerobic fitness in the management of classical migraines.
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PMID:The effects of aerobic exercise on migraine. 155 33

We identified five patterns of coping in a sample of 603 cancer patients: "seeking or using social support," "focusing on the positive," "distancing," "cognitive escape-avoidance," and "behavioral escape-avoidance." Relationships of these coping patterns to sociodemographic characteristics, medical factors, stress appraisals, psychotherapeutic experience, and emotional distress were tested using correlational and regression techniques. Type of cancer, time since diagnosis, and whether a person was currently in treatment had few or no relationships to coping. The specific cancer-related problem (e.g., pain, fear of future) was also not associated with how individuals coped. Perceptions of its stressfulness, however, were related to significantly more coping through social support and more of both forms of escape-avoidance. Coping through social support, focusing on the positive, and distancing was associated with less emotional distress, whereas using cognitive and behavioral escape-avoidance was associated with more emotional distress. Implications of the results for understanding coping processes and intervention with cancer patients are discussed.
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PMID:Patterns of coping with cancer. 158 83


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