Health and Wellbeing Psychology Revision Notes - Year 1

Pain

Merskey (1979) - ‘An Unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage’.

Acute or Chronic

Simple-stimulus response Models

Von Frey (1985) - Specificity Theory

• The intensity of Pain is directly related to the amount of tissue involved. Specific sensory receptors are sensitive to specific stimulation. Specific pain receptors transmit signals to a ‘brain centre’ in the brain that produces the perception of pain.

GoldSchneider (1920) - Pattern Theory

• Link between cause and pain is direct, nerve impulses determined by the degree of pain. Any somaesthetic occurred by a particular pattern of neural firing and that the spatial and temporal profile of firing of the peripheral nerves encoded the stimulus type and intensity.

Assumptions:

• Tissue damage causes the sensation of pain

• Psychology is the consequence E.g. Fear, anxiety.

• Pain is automatic

• Psychogenic or organic pain?

Challenges:

• Phantom Limb Pain

• Pain without obvious organic cause

• Placebo effect

• No room for moderation/interpretation

• Psychology has no causal influence

• Sensation of pain is caused by the amount of tissue damage

Beecher (1956) - Individuals with the same degree of tissue damage differed in their reports of pain. 80% of Civilians requested pain relief compared to 25% of soldiers. This suggests variation between individuals - The Anzio Beachhead in World War 2.

Melzack and Wall (1982/65) - The Gate Control Theory

Input to the Gate: Peripheral nerve fibres, descending central influences from the brain, large and small fibres.

• A simple stimulus-response model that acknowledges psychosocial factors.

• A gate in the substantia gelantosa of the dorsal horn

• C fibres and A-delta fibres carry pain signals to the spinal cord. A delta fibres are faster and carry sharp pain signals whilst the C fibres are slower and carry diffuse pain signals.

Physical - (Opening) - Activation of large fibres, injury.

(Closing) - medication, stimulation of small fibres.

Psychological - (Opening) - Anxiety and depression.

(Closing) - Happiness, relaxation, optimism.

Social - (Opening) - Focusing on the pain, boredom.

(Closing) - Concentration and distraction.

Strengths:

• Understands pain as a perception

• The individual is active, not passive

• Understands the role of individual variability

• Role for multiple causes

• Is pain ever organic?

• Pain and Dualism

Weaknesses:

• No location of the gate

• Still a simple-stimulus response model

• Assumes organic basis for pain

• Mind and body - separate processes

Mccaffery and Pasero (1999) - 4 stages of pain

1. Transduction - Free nerve endings of C fibres and A delta fibres respond to noxious stimuli.

2. Transmission - Impulses move from the nociceptor fibres to the dorsal horn in the spinal cord, then from the spinal cord to the brainstem then through connections in the thalamus and cortex.

3. Perception - Perception of Pain

4. Modulation - Involves changing or inhibiting transmission of pain impulses in the spinal cord.

Fordyce and Steger (1979) - Chronic Pain Cycle

Unsuccessful treatment of pain → Increased anxiety → Increase in Pain → Pain increases anxiety → Unsuccessful treatment of pain…

Mcgowen et al (1998) - Correlation between…