A Biopsychosocial Formulation of Pain Communication

Presenter: Maryam Abbasi Health Psychology Course University of Tehran November 2011

Overview of Presentation

The Problem of Pain

Pain is one of the most common complaints made by patients to primary care providers (approximately 50% of patients). prevalence estimates of persistent pain in population samples range between 7% and 64%, depending on survey methodology and population studied . Pain is typically an adaptive reaction to an injury and gradually decreases over time. However, for some people pain persists past the point where it is considered adaptive and contributes to negative mood, disability, and increased use of healthcare system resources.

The Problem of Pain

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Chronic pain = Pain with a duration of 3 months or greater that is often associated with functional, psychological and social problems that can negatively impact a persons life.

Why we should know about Pain Communication?

pain often remains unrecognized, poorly assessed, underestimated, undertreated, or inadequately treated. understanding of the biology of pain is vital but inadequate to the challenge of pain control

Bio-psycho-social perspective on pain has been recognized as necessary for research and practice
Appreciation of socio-behavioral events affecting both patients as well as caregivers The framework gives us a knowledge from a variety of perspectives; Clinical health Psychology, Social and developmental processes, Evolutionary psychology, Communication studies , Behavioral neuroscience

Current Presentation
Focuses on understanding complicated interactions among bio-psycho-social determinants of pain through a detailed examination of the processes of pain communication Pain communication is a common component of the pain experience that has evolved along with language and other nonverbal signals within the context of human society.

Gate control Theory

In 19th century advances in our understanding of the biology of pain took place In the mid-20th century, the Gate Control Theory (GCT, Melzack and Wall, 1965) introduced pain as a complex psychological phenomenon modulated by peripheral and central nociceptive systems Provided a neurophysiological basis for conceptualizing

Gate Control Theory

the biological substrates of psychological (cognitive, affective, and sensory) and environmental (physical, family, and cultural) determinants of pain experience and expression. substantial elaboration of our understanding of the facilitatory and inhibitory mechanisms that modulate nociceptive processes GCT also has diverse implication for biomedical and psychosocial interventions.

The Gate Control Theory

Pain vs. Nociception

IASP(2005) definition of PAIN: An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage pain represents a perceptual process associated with conscious awareness that will vary with the organism, but in typical adult humans is associated with meaning, appraisal, learning, and emotional reactions

Pain vs. Nociception

Nociception defined as: the neurophysiological translation of events that stimulate nociceptors (peripheral receptors that respond to potentially damaging stimuli) and that are capable of being experienced as pain

Psychological Mechanisms and Novel Pain Interventions