Pain
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Differences in the use of coping strategies have been hypothesized to explain some of the variation in adaptation among chronic pain patients. Investigators often assess coping using composite indices of different coping strategies. Although the use of composite measures has advantages, it may obscure the importance of specific coping strategies as they relate to functioning. ⋯ The scales and ratings of the CSQ were factor analyzed to create composite measures, and the ability of the composite scores and individual scales to predict adjustment was compared. The results indicated that the individual scales provided more information than the composite measures regarding the relationship between coping and adjustment to chronic pain. The results also suggested that individual scale scores may be more useful than composite scores in identifying the conditions under which coping efforts have their greatest effects on adjustment.
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This study investigated how specific expressive behaviors (verbal report of pain level and the frequency of emitting specific non-verbal facial expressions of pain) may change over the course of a chronic pain condition. Based on the concept of chronic pain behaviors, we hypothesized that both verbal and non-verbal behavior would increase with duration of pain. Thirty-six women with chronic temporomandibular disorder (TMD) pain (duration over 6 months) were compared with 35 recent onset cases (first episode, duration < or = 2 months). ⋯ Coping strategies were also similar, although chronic cases showed a greater tendency to catastrophize. Self-report measures of ambient facial pain, as well as the pain of clinical examination and cold pressor stimulation, revealed no significant differences between the 2 groups. In contrast, rates of pain facial expression were significantly higher for chronic cases under all conditions of the experiment, including baseline.(ABSTRACT TRUNCATED AT 250 WORDS)
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A number of facial actions have been found to be associated with pain. However, the consistency with which these actions occur during pain of different types has not been examined. This paper focuses on the consistency of facial expressions during pain induced by several modalities of nociceptive stimulation. ⋯ The findings suggest that the 4 actions identified carry the bulk of facial information about pain. They also provide evidence for the existence of a universal facial expression of pain. Implications of the findings for the measurement of pain expression are discussed.
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This study was designed to examine the central changes in the receptive field properties of dorsal horn neurones induced by a period of visceral noxious stimulation. The aim of this investigation was to establish whether noxious stimulation of the visceral input to the spinal cord could influence transmission of cutaneous information through dorsal horn neurones. Single-unit electrical activity was recorded in the lower thoracic spinal cord of anaesthetized cats from dorsal horn neurones with a somatic receptive field in the ipsilateral flank. ⋯ The increases were large and lasted for at least 20 min. None of the 9 spinal cord neurones without an input from the gall bladder were affected by the conditioning visceral stimulus even though 7 showed changes in receptive field size when the animals were spinalised. These results show that noxious stimulation of viscera can evoke increases in the somatic receptive fields of spinal cord neurones but only of those neurones which are also driven by the visceral stimulus.
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This paper reports the development and validation of the Pain Beliefs Questionnaire (PBQ). This is a 20-item questionnaire covering beliefs about the cause and treatment of pain. It was administered to 294 subjects, comprising 100 chronic pain patients and 194 controls. ⋯ Secondly, as predicted significant associations were observed between scores on the Organic Beliefs scale and scores on the Chance and Powerful Others scales of the Multidimensional Health Locus of Control (MHLC), and also between the Psychological Beliefs and Internal scales of the MHLC. No relationship, however, emerged between these scales and measures of pain intensity. The implications of these findings for the assessment and management of chronic pain patients, and in the understanding of the development of chronic pain, are discussed.