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At least 325 records · Page 18Linked to original sources
PubMed1992

A comparison of pain perceptions in women with fibromyalgia and rheumatoid arthritis: relationship to depression and pain extent.

Two studies were conducted to characterize the pain of fibromyalgia syndrome (FMS); to compare it to rheumatoid arthritis (RA) pain; and to examine the relationships between depression, pain extent, and pain description. Two methods of administering the McGill Pain Questionnaire (MPQ) were used. When the MPQ was administered in the standard manner, FMS pain could not be distinguished from RA pain. When participants were allowed to select as many words from an adapted MPQ as they wished, significant differences in word choice emerged. Depression and pain extent were major predictors of group differences in the evaluation of pain. However, depression scores contributed only 50% of the explanation for the differences in pain extent, with group membership contributing the other 50%. These findings suggest that the character and extent of pain in FMS are at least partially due to peripheral sensory components and not simply centrally controlled pain amplification secondary to depression.

Adult↗
PubMedDate not supplied

Pain perception and assessment.

Our inability to measure pain effectively is a major barrier to progress in pain research and advancement in clinical interventions for pain. Historically, the mind-body dichotomy has constrained our thinking about pain and its quantification. One line of work has pursued pain as the sensory end product of nociception: pain is the realization of signals of tissue injury arriving at the cortex. At the other extreme, some clinicians contend that pain is ''what the patient says it is''. In other words, it is a purely mental and entirely subjective phenomenon. Research on functional brain imaging, psychophysiological research and recent neurophysiological research on animal models provide confluent evidence that both of these positions are misleading oversimplifications. Pain is the emergent product of massive, parallel, distributed processing in the brain that engages structures involved in emotion and cognition as well as in sensation. To advance pain measurement, our research team has examined Sokolov's defense response in human subjects experiencing repeated, brief painful electrical shocks delivered to a fingertip through a tiny electrode. Sokolov proposed that threatening events elicit a hypothalamically-orchestrated pattern of arousal that prepares the organism to cope with threat. Measures of sympathetic nervous system arousal and brain evoked potentials in our subjects reveal a stable pattern of this sort when we subject the data to structural equation modeling. When subjects undergo equally intense shocks delivered through a large electrode, they experience a strong vibration-like, unpleasant sensation that causes discomfort but not nociception. The non-painful shock elicits broad levels of arousal equal to those obtained with painful shocks in subjects, but structural equation modeling demonstrates that such arousal does not conform to the defense response pattern. Moreover, multivariate measures of sympathetic arousal and evoked potentials can discriminate painful from non-painful stimuli more accurately than can subjective pain reports. These observations suggest that pain may have a unique psychophysiological signature. More importantly, perhaps, this approach suggests that the combination of psychophysiological research and multivariate statistics provides an avenue for advancing pain research outside of the mind-body dichotomy.

Animals↗
PubMed1988

Ethnographic methodologic assessment of pain perceptions by verbal description.

This study was designed to use known anthropologic methods to gather and analyze qualitative data about verbal descriptors of pain among 25 Chinese, and 60 Western subjects (25 Anglo-Americans and 35 Scandinavians). The sample consisted of 54 patients and 31 dentists. Key pain descriptors from each cultural context were selected for construction of pain assessment instruments which allowed multidimensional statistical techniques to translate these data into cross-cultural quantitative indices. Results revealed dimensions of pain which were universal in all cultures examined. These included time, intensity, location, quality, cause and curability. More culture-specific dimensions included the Chinese concept suantong, a multidimensional concept of bone, muscle, joint, tooth and gingival pain. 'Real' and 'imagined' pains were contrasts described by Western subjects, especially dentists; 'imagined pain' being the conversion of fear or anxiety into perceived pain. These data indicate that the data gathering and data analytic methods were reliable and sensitive to cultural variables and that ethnicity played a stronger role in determining perceptions of pain description than professional socialization for this population sample of Chinese and Western subjects.

Adult↗
PubMed1995

Pain perception, coping strategies, and stress management among periodontal patients with repeated surgeries.

The relationships between coping strategies, stress response during periodontal surgery, and perceived pain after each of two surgical procedures were studied in 42 adult women between the ages of 28 and 67 years. The presurgical use of coping by indirect action was positively correlated with decreased stress behavior during each surgery. The use of attention-coping strategies was significantly correlated with pain measures after each surgery, while avoidance-coping strategies were not. Age and patients' rating of pain were the best predictors of the use of attention coping. These findings suggest that preoperative preparation which includes information on enhancing attention-coping may assist some patients with postsurgical pain and discomfort.

Adaptation, Psychological↗
PubMedDate not supplied

Pain perception in patients with eating disorders.

The heat pain threshold was measured with phasic and tonic stimuli under basal conditions and after naloxone administration in 10 anorectic and 10 bulimic patients as well as in 11 healthy control subjects. Under both kinds of stimulation, the basal threshold values were elevated in the bulimic patients and in some of the anorectic patients. Naloxone did not differ from placebo in its effect on the pain thresholds (phasic and tonic), suggesting that a nonopioid mechanism was responsible for the threshold elevation found in the eating disorder patients. The plasma cortisol concentration was similar in the three groups and not correlated with the basal pain thresholds in the patients. Other indicators of dieting such as beta-hydroxybutric acid and triiodothyronine also showed no correlation with the basal pain thresholds. Significant height correlations can be interpreted as weak evidence that neuropathy is the cause of the increase in the pain threshold.

Adult↗
PubMed1989

Gender effects in pain perception.

Studies have shown that women report more pain than men when pain is induced in the laboratory. As sex differences in perceived pain have not been established with clinical or endogenous pain, research was undertaken to compare reported pain of males and females arising from one of three sources. Two groups of adults and one group of children were studied. Analysis indicated no sex differences in reported clinical or endogenous pain for children or adults.

Adolescent↗
PubMed1995

[The Pain Perception Scale--a differentiated and change-sensitive scale for assessing chronic and acute pain].

Presented is a diagnostic instrument to assess chronic and acute pain, that allows multifaceted and standardized quantification of pain experience. This tool--the Pain Experience Scale ("Schmerzempfindungsskala"--SES)--measures two dimensions of subjectively felt pain, the affective characterization as well as modes of sensory characterization of pain. Applications range from degenerative or inflammatory joint and back pain to headache/migraine, neuropathias and other pain-related diseases (age 16 to 80 years). Completion, evaluation, and interpretation are done easily. Scale development had comprised 3 steps of research for obtaining a model of invariant structure and homogenous factors. Scale analyses demonstrated the instrument's reliability, and numerous studies illustrated the validity of the scale. They showed that factorial, convergent and discriminant validity can be regarded as given. Moreover, the scale proved to be sensitive in experimental pain studies. Additionally, specific patterns of scores could be observed validly for 18 different groups of disease/pain. Special efforts were invested to show its sensitivity to change in the course of pains. Here, the Pain Experience Scale proved to be suitable in postoperative pain, drug-based pain therapies, different psychological pain management approaches, physiotherapeutic prevention, and a multimodal treatment programme of a specialized pain clinic. In German-speaking countries, the SES has been in use for several years as a well-proven instrument in medical care, clinical research as well as field evaluation.

Acute Disease↗
PubMed2002

Functional imaging of pain perception.

The application of functional imaging techniques has revolutionized the field of human pain physiology and has elaborated the understanding of mechanisms involved in pain processing at the cortical and subcortical levels. With these insights, new therapeutic interventions are being developed in the treatment of acute and chronic pain conditions.

Acute Disease↗
PubMed1998

Imipramine decreases oesophageal pain perception in human male volunteers.

BACKGROUND: Visceral hyperalgesia is a hallmark of functional gastrointestinal disorders. Antidepressants improve symptoms in these patients, although their mode of action is unclear. Antidepressant, anticholinergic, and analgesic mechanisms have been proposed. AIMS: To investigate whether imipramine, which has a visceral analgesic effect, increases pain thresholds to experimental visceral pain. METHODS: Visceral perception for first sensation and pain was measured with intraoesophageal balloon distension in 15 male volunteers. The effect of imipramine was studied in a double blind, placebo controlled, crossover study. Imipramine was given in ascending doses for 12 days (25 mg days 1-3, 50 mg days 4-6, 75 mg days 7-12), with oesophageal perception studied on day 13. RESULTS: Inflation volumes and intraballoon pressures at first sensation were not different between placebo and imipramine. Balloon inflation volume at pain threshold was higher on imipramine (p = 0.015). Median intraballoon pressures were not different at pain threshold for placebo and imipramine. Oesophageal wall compliance was not affected by imipramine. CONCLUSION: Increased pain thresholds on imipramine in this group of normal male volunteers in the absence of changes in oesophageal tone imply the presence of a visceral analgesic effect.

Adult↗