Chronic pain - Theories & explanatory models
7 important questions on Chronic pain - Theories & explanatory models
Which three unidimensional models exist to explain pain?
2. Psychogenic
3. Learning model
What does the learning model from Fordyce state in relation to pain?
What does the Gate Control Theory of Melzack and Wall state?
bijv. Worry, anxiety, paying a lot of attention to the pain, pain avoidant behaviours & sluit in reactie op bijv. Helpende coping/cognities/ relaxatie.
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What does the biopsychosocial model state in relation to pain?
Incorporates aspects from CBT
Cognitions
Emotions --> depression --> hopelessness --> avoidant behaviours --> mental and physical deconditioning
Anger --> activation of the autonomic nerves system & muscle tension --> increase in pain
Behaviours
In the biopsychosocial model, what is the influence of different emotions?
- Depression --> hopelessness --> more negative cognitions --> isolation. Or the idea that you can cope with the disease
- anxiety --> fear of re-injury --> avoidance behaviours
- anger: could lead to increased tension in the body --> extra pain
In the biopsychosocial model, which cognitive factors influence the pain experience?
- - attention
- - about the meaning of pain
- - Catastrophic thinking --> als je denkt dat pijn schade is door een progressieve ziekte dan vermijd je mogelijk veel activiteiten, waardoor er physical deconditioning plaatsvind en je nog meer beperkt wordt in je functioneren.
- - expectencies about disease outcome
- - self-efficacy
In the biopsychosocial model, what is the influence of three types of behavioural influences on pain?
- Operant conditioning:
- complaining --> increased attention --> positive reinforcement
- medication intake --> decreased pain --> negative reinforcement (taking more medication)
- Classical conditioning --> fear of pain (--> pain) in an increasing number of situations
- For instance a person gets an injury while running, and then fear of pain comes in place, whereby the unconditioned stimuli becomes a conditioned stimuli, where everyday walking is going to trigger pain.
- Social learning (modeling)
- For instance, your parents always got backpain after stress, then you as a child have an increased chance of also developing back pain in reaction to stress.
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