Pain
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Self-hypnosis was taught to 5 highly hypnotisable patients referred to Auckland Hospital Pain Clinic. Evaluation included the Illness Self-Concept Repertory Grid (ISCRG) and follow-up was at 1 and 6 months post treatment. Consensus grids indicated the subjects initially identified with physical illness but this association decreased over the course of the study. ⋯ An association between pain reduction and self-concepts is thus noted. This study does not identify whether self-concepts merely reflect therapeutic change or whether strong self-identification with physical illness indicates a poor prognosis for pain relief. This is a question which deserves further study.
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Randomized Controlled Trial Clinical Trial
Biofeedback of somatosensory event-related potentials: can individual pain sensations be modified by biofeedback-induced self-control of event-related potentials?
This study investigates the effects of biofeedback based upon event-related brain potentials evoked by nociceptive electrical stimuli. In a visual and monetary feedback paradigm, 10 subjects received positive feedback within one training session when systematically showing two different behavior patterns: one pattern correlated with a decrease (down-training) and one with an increase (up-training) of the peak-to-peak size of the N150-P260 complex, respectively. ⋯ Furthermore, the individual pain report measured with a visual analogue scale was altered in accordance with the biofeedback-induced behavioral modifications. A decrease in subjective pain report was achieved after down-training while an increase was observed after the up-training.
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This research was designed to identify and validate facial expressions of pain occurring in a clinical chronic pain condition. Facial expressions of 28 patients with chronic temporomandibular disorder pain were videotaped during a painful clinical examination procedure and coded using an anatomically based system. ⋯ A small number of facial expressions of specific negative emotions were also observed; pain report and pain facial expressions were higher for persons showing a greater number of negative affects. These findings support the promise of facial expressions as measures of clinical pain.
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Multiple aspects of family functioning were assessed when mothers experienced either chronic pain, a chronic illness (diabetes), or no illness. Mothers' and fathers' self-report measures of depression, anxiety, and family environment were collected. Children's self-report measures of depression and anxiety, as well as information about their overall adjustment, were collected. ⋯ Children from chronic pain families also appeared to be adversely affected. The data suggest that level of disability appeared more salient than the type of chronic illness. Implications of the findings are discussed in light of the fact that mothers with chronic pain in the present sample reported relatively mild disability and were not actively seeking treatment for their condition.
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Two theories about the relationship between anxiety and pain were compared: (1) the attribution theory that relevant but not irrelevant anxiety intensifies pain, and (2) the perceptual disruption theory that all anxiety influences pain. Three types of instructions were presented to randomly selected groups of male university students immediately before nociception: (1) a standard set of instructions, (2) the standard instructions plus a pain warning (relevant anxiety condition), and (3) the standard instructions plus a warning about a stressful interview (irrelevant anxiety condition). Pain and stress intensity ratings, heart rate, frontalis electromyographic activity, and facial expressions were recorded continuously, and pain threshold and pain tolerance were recorded once. ⋯ In addition, the relevant but not the irrelevant anxiety instructions increased electromyographic activity and facial grimaces during nociception. However, tolerance, threshold, and post-experimental ratings did not differ among groups. These results are interpreted as supporting the perceptual disruption theory.