UNIT 2: Week 10

Question 1

Dimensions of the pain experience

Answer 1

• who has pain
• impact of pain
• treatment response
• long-term prognosis

Question 2

Sex

Answer 2

• set of biological attributes
• male/female

Question 3

Gender

Answer 3

• socially constructed roles, behaviours, expressions and identities of girls, women, boys, men and gender diverse people

Question 4

Factors related to sex differences in pain

Answer 4

• genetics
• gene expression
• hormones
• immune response to tissue injury
• structure and function of brain

Question 5

Factors related to gender differences in pain

Answer 5

• gender roles and norms
• masculine/feminine traits

Question 6

Sex and genetics differences in pain prevalence

Answer 6

• 1/2 of all chronic pain conditions are more prevalent in females
• 1/5 are more prevalent in males (mostly MSK conditions)

Question 7

Sex and gender differences in pain intensity

Answer 7

• females have higher pain intensity ratings than males
• BUT in another study when accounting for sex, masculine traits were associated with lower pain intensity
  *Not clearly one or the other

Question 8

Sex and gender differences in coping strategies

Answer 8

• mixed evidence with sex-dependent response to analgesic meds
• women benefit more from emotion-focused therapy and social support
• men benefit more from problem-solving and distraction techniques

Question 9

Race

Answer 9

• socially constructed categorization of people based on perceived shared physical traits that result in a sociopolitical hierarchy
• ie. Black, White, Asian

Question 10

Ethnicity

Answer 10

• socially constructed categorization of people based on a perceived shared culture related to common ancestry/history
• Hispanic, jewish, irish

Question 11

Race and ethnicity differences in pain prevalence rates

Answer 11

• lowest rates among asian americans
• highest rates among native americans and multiracial groups
• multiple co-founders examined, socio-economic status was sig.

Question 12

Race and ethnicity differences in pain experience

Answer 12

• pain-related coping strategies
• preferences for treatment modalities
• beliefs about the meaning of pain
• treatment outcomes
• racial bias in treatments offered by health care providers

Question 13

Immigration status and prevalence of chronic pain

Answer 13

• Immigrants have higher pain prevalence rates
• countries with greater racist and anti-immigration attitudes had greater prevalence

Question 14

State

Answer 14

• temporary, can change over time

Question 15

Trait

Answer 15

• continuity throughout lifespan, may be inheritable

Question 16

Psychological attributes: protective attributes

Answer 16

• self-efficacy
• able to use coping skills
• readiness to change and engage in active treatment
• acceptance of pain and limitations

Question 17

Psychological attributes: risk factors

Answer 17

• fear of pain
• depression
• negative thoughts
• maladaptive coping behaviours

Question 18

Psychological traits

Answer 18

• negative affectivity
• anxiety sensitivity

Question 19

Negative affectivity

Answer 19

• tendency to view the world as threatening/distressing
• associated with hypervigilance of bodily sensations including pain

Question 20

Anxiety sensitivity

Answer 20

• interpretation of unpleasant physical sensations as a sign of danger
• risk factor for developing chronic pain, associated with disability

Question 21

Psychological states

Answer 21

• appraisal and beliefs
• pain catastrophizing
• perceived control
• self efficacy
• coping

Question 22

Appraisal and beliefs

Answer 22

• meaning that one assigns to pain (cause, prognosis, effective treatments)
• maladaptive beliefs associated with higher pain intensity, disability, avoidance behaviours

Question 23

Pain catastrophizing

Answer 23

• an exaggerated negative orientation towards actual or anticipated pain
• risk factor for developing chronic pain

Question 24

What is pain catastrophizing associated with?

Answer 24

• with greater pain intensity, disability, and opioid use/misuse
• associated with poor prognosis with treatment

Question 25

What is the #1 predictor of who will develop chronic pain?

Answer 25

- pain catastrophizing

Question 26

Three main pillars of pain catastrophizing

Answer 26

1. Magnification 2. Rumination 3. Helplessness

Question 27

Perceived control

Answer 27

- belief that one can exert influence on pain (eg. intensity, duration, unpleasantness) - associated with lower disability and lower pain intensity

Question 28

Self-efficacy

Answer 28

- conviction that one can successfully perform a task or produce a desirable outcome - associated with better prognosis with rehab treatment for pain

Question 29

Coping

Answer 29

- self regulation of pain - passive strategies (depending on others) associated with greater pain and depression

Question 30

Psychological diagnoses

Answer 30

- anxiety - depression

Question 31

Anxiety

Answer 31

- persistent and excessive fears/worries that interfere with daily function

Question 32

What is anxiety associated with?

Answer 32

- medication side effects - inactivity - greater disability - avoidance coping - hypervigilence of symptoms/pain

Question 33

Depression

Answer 33

- persistent sadness, emptiness, irritability that co-occurs with physical and cognitive symptoms such as pain

Question 34

Depression and pain

Answer 34

- mutually reinforcing - sig predictor of development of low back pain

Question 35

How are anxiety and depression related to pain?

Answer 35

- co-morbidities, not causative