Pain
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Comparative Study
The McGill Pain Questionnaire reconsidered: confirming the factor structure and examining appropriate uses.
A major problem in the understanding and psychological treatment of chronic pain patients is the inadequacy of available assessment procedures. Currently, the most frequently used instrument is the Pain Rating Index (PRI) of the McGill Pain Questionnaire, designed to assess 3 components of pain (i.e., sensory, affective, and evaluative) postulated by the Gate Control Theory. The PRI has been used in many studies to make differential diagnoses, to describe different groups of pain patients, and to identify the factor composition of the instrument itself. ⋯ Subsequent analyses revealed that the 3 components of the PRI do not display adequate discriminant validity. The current use of 3 subscales to establish differential diagnoses or patterns of different pain syndromes may lead to inappropriate classification and treatment decisions. The major conclusion of these findings is that use of only the total score of the PRI is appropriate for pain assessment.
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Non-verbal expressive behaviour may provide important information about pain not available through verbal report. Nevertheless, it has received little attention in pain research. In the present study, changes in expressive behaviour resulting from electric shock were related to shock intensity, self-report of discomfort, observers' judgements of subjects' distress and social modelling influences. ⋯ Change in expressive reactions to the shocks was directly related to stimulus intensity, self-report of pain, and observers' judgements of subjects' distress. Expressive behaviour resulting from high shocks was diminished by exposure to a tolerant model. These findings establish the feasibility of pain measurement based on expressive behaviour, suggest that expressive behaviour provides a sensitive and valid index of pain, and indicate that tolerant modelling reduces evidence of pain across multiple measures.
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In 144 healthy subjects tonic heat stimuli were applied with a contact thermode and systematically varied with respect to 3 parameters: temperature T, rate of temperature change RTC, and duration D. In addition, the stimulus temperature at which the first sensation of pain occurred was produced by some subjects. In both types of experiments, subjects compared heat intensity felt at the beginning and the end of the stimulus and then set stimulus temperature to correspond with their initial sensation. ⋯ The average skin temperature of the point of transition from adaptation to sensitization was equal to the average pain threshold temperature. The temperature change response maintained individual differences of thermal and pain sensitivity and was highly consistent for each subject. Potential applications of the procedure in clinical and experimental pain research are discussed.
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Recent evidence has underscored the importance of parental models and vicarious learning in the etiology of pain behavior. The present study investigated the relationships between the number of familial pain models to which an individual has been exposed, the individual's reports of current pain experiences, and the role of gender. ⋯ Additionally, pain models had a greater impact on females than on males. These findings are discussed in terms of vicarious learning and health locus of control processes.