Deck 9: The Psychology of Pain

Question 1

The estimated total cost of chronic pain in Canada is ________.

A) $1-$10 billion/year
B) $10-$50 billion/year
C) $50-$100 billion/year
D) $100-$900 billion/year

Answer 1

B

Question 2

Chronic pain is defined as pain that has lasted for at least ________.

A) one to two months
B) three to four months
C) two to four months
D) three to six months

Answer 2

D

Question 3

A recent review of chronic pain studies showed that single modality approaches (e.g. surgery alone or medication alone) led to a ________ of pain ________ restoration of overall psychological functioning.

A) modest reduction; and minimal
B) robust reduction; but minimal
C) complete suppression; but minimal
D) modest reduction; but complete

Answer 3

A

Question 4

Acceptance and commitment therapy encourages patients to ________.

A) change their thoughts about pain
B) accept their pain
C) disregard their pain
D) control distressing thoughts about pain

Question 5

Pain is primarily ________.

A) a chronic experience
B) a physiological experience
C) a psychological experience
D) a traumatic experience

Question 6

Early theories of pain had a ________ focus.

A) psychological
B) biophysical
C) biopsychosocial
D) biological

Question 7

Patients with chronic pain are at risk of suffering from ________.

A) anxiety
B) substance abuse
C) social isolation
D) all of the above

Question 8

According to Descartes' specificity theory of pain, ________.

A) there is a one-to-one correspondence between tissue damage and pain
B) only very specific types of tissue damage lead to pain
C) specific attention is required to feel pain
D) the brain can localize the source of pain on the body

Question 9

Cognitive behavioural theorists have not argued that pain-related beliefs and cognitions develop as a result of the patients' ________.

A) early histories
B) social experiences
C) cultural backgrounds
D) genes (solely)

Question 10

The neuromatrix model of pain emphasizes the role of the ________ in pain perception.

A) spinal cord
B) brain
C) cardiovascular system
D) large-diameter fibres

Question 11

Phantom limb pain can be explained via the neuromatrix model of pain because the model ________.

A) demonstrates that pain behaviours can be generated or perpetuated by previously conditioned cues
B) emphasizes the role of the spinal cord
C) emphasizes the role of small-diameter fibres
D) can be adapted to multiple kinds of pain

Question 12

Biopsychosocial models of pain ________.

A) do not take into account social and psychological factors on the pain experience
B) focus only on biological processes
C) fail to explain the success of psychological interventions in pain management
D) focus on the interplay of biological, psychological, and social parameters in pain

Question 13

Biomedical models of pain ________.

A) are related to gate control theory of pain
B) focus only on biological processes
C) explain the success of psychological interventions in pain management
D) focus on the interplay of biological, psychological, and social parameters in pain

Question 14

The operant model of pain stresses ________.

A) the importance of Pavlovian conditioning
B) the observation that imitating the actions of others is an important basis of learning to cope with pain
C) the importance of reinforcement in the development and maintenance of pain behaviour
D) the idea that the appraisal of pain guides behaviour

Question 15

The cognitive behavioural conceptualization of pain is based on ________.

A) the idea that thoughts and beliefs influence how we perceive pain
B) the concept of learning automatic responses
C) the importance of reinforcement in the development and maintenance of pain behaviour
D) the idea that certain behaviours become associated with pain

Question 16

The psychological assessment of pain is not ________.

A) based on biomedical formulations of the pain experience
B) focused on dimensions of the pain experience
C) interested in the impact of pain on quality of life
D) focused on functional analysis of pain behaviour

Question 17

During a psychological evaluation of a pain patient, it is important to assess the multidimensional nature of pain because certain cognitive constructs, such as ________ and ________ are associated with poor rehabilitation outcomes.

A) catastrophic ideas; avoidance of action for fear of pain
B) a self-centred attitude; avoidance of action for fear of pain
C) catastrophic ideas; a problem-solving attitude
D) self-centred attitude; a problem-solving attitude

Question 18

The following statement best describes the effect of social support on the outcome of a pain patient: ________.

A) Social support has a negligible effect on rehabilitation outcome
B) An optimal level of social support is required for a better rehabilitation outcome
C) Social support always has a positive effect on rehabilitation outcome
D) Support received from friends is more effective than support received from family

Question 19

The McGill Pain Questionnaire does not provide an assessment of the ________ pain dimension.

A) sensory
B) objective
C) affective
D) evaluative

Question 20

The following statement regarding cognitive behaviour therapy (CBT) for chronic pain is true: ________.

A) It is not widely used
B) It is considered to be an alternative to medical treatment modalities
C) It does not incorporate behavioural procedures
D) It is part of an interdisciplinary approach

Question 21

"Socratic dialogue," a component of cognitive behavioural therapy for chronic pain, ________.

A) attempts to nurture alternative thought about pain via meditation
B) uses hypnosis to discover the fundamental beliefs reinforcing pain
C) promotes the acceptance of pain as a part of the human condition
D) is a way to obtain a new point of view through dialogue and critical evaluation of ideas and logic

Question 22

The following statement regarding psychological interventions for acute pain management is not true: ________.

A) They have been studied as adjuncts to standard pharmacological approaches
B) They have been shown to be equally effective in the absence of pharmacological pain management
C) Their efficacy in the absence of pharmacological pain management is unclear
D) Technological advancements-such as immersion in virtual reality environments-have been incorporated with good results

Question 23

Rubbing a painful area often helps reduce pain because the act of rubbing activates the ________ fibres that tend to ________ nociceptive transmission.

A) large-diameter; inhibit
B) large-diameter; facilitate
C) small; inhibit
D) small; facilitate

Question 24

The neuromatrix model does not ________.

A) posit that the body is perceived as a unit
B) posit that the perception of unity of the body, including pain, is produced by a central neural process
C) posit that the perception of unity of the body, excluding pain, is produced by a central neural process
D) describe repeated cyclical processing and synthesis of nerve impulses through the neuromatrix

Question 25

According to the communications model of pain, the chain of pain communication is seen as a ________ process.

A) dynamic
B) static
C) three-step
D) four-step

Question 26

Briefly outline the epidemiological, clinical, and psychosocial significance of chronic pain.

Question 27

Briefly discuss how a purely biomedical approach to chronic pain can affect the long-term treatment of patients seeking help from a physician.

Question 28

Succinctly review some of the evidence indicating that pain is not simply another sensation.

Question 29

Briefly list and discuss three cognitive processes engaged in the processing of chronic pain.

Question 30

Review two of the frequent long-term psychological consequences of untreated chronic pain.

Question 31

Briefly discuss the chain of events leading to a common social outcome of untreated chronic pain.

Question 32

Describe Descartes' influential theory of pain.

Question 33

Describe the different methods that tend to be incorporated into cognitive behavioural therapy for pain.

Question 34

Compare and contrast biopsychosocial theories of pain with strictly biomedical models, such as those influenced by Descartes.

Question 35

Briefly present a real-life example to illustrate how cultural/ethnic differences underlie distinct experiences of pain. Discuss which among the various biopsychosocial models of pain best accounts for these observations.

Question 36

Present one example, from your own experience, in which nociception was present, but no actual pain was perceived. Then, discuss (a) the psychological mechanisms involved, and (b) how these same mechanisms are exploited in the psychological therapy of chronic pain.

Question 37

Describe phantom limb pain and the paradoxical nature of this phenomenon. Then discuss (a) which pain theories can explain it and which cannot, and (b) how it is being addressed in the clinic (tip: see the work of UC San Diego neurologist V.S. Ramachandran).

Question 38

Using the example you have selected in essay question (1), describe the likely neural systems involved.

Question 39

Describe the way in which the neuromatrix model accounts for the conscious unity of the body/self.

Question 40

Briefly describe the operant and the fear avoidance models of pain, including their historical origin. Finally, discuss their strengths and limits.