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The meaning of "cognitions" in cognitive-behavioral therapy for pain.
In an attempt to separate the cognitive and affective modulation of pain control, Villemure and Bushnell (2009) compared affective modulation by odors and distraction and found separable brain circuits to be involved. [Per the abstract of the cited study, the effect of the affective treatment (based on "pleasant" and "u....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 262
Goals...To understand the relationship between thoughts, emotions, and pain....[Automatic thoughts] can sometimes be negative and based on faulty information. They can trigger even more negative thoughts that can have an impact on how we feel and how we behave. You may think someone makes you mad, but it's what y....
Otis, John D., "Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach", Oxford University Press, 2007, 31-32
In addition to causal beliefs about pain, beliefs about the ability to control pain are important for the way people process nociceptive stimuli. A number of studies have used experimental pain stimuli and demonstrated that a conviction of personal control can ameliorate the experience of experimentally induced nocicep....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 258
In addition to beliefs about the capability to function despite pain, beliefs about pain per se appear to be of importance in understanding response to treatment, adherence to self-management activities, and disability (Kerns and Rosenberg 2000). [The referenced article discusses the ability of a questionnaire to predic....
Vlaeyen JW, Linton SJ, "Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.", Pain 85: 2000, 259
Once beliefs and expectancies about a disease are formed, they become stable and are very difficult to modify (Pennebaker et al 1985). Patients tend to avoid experiences that could invalidate their beliefs, [CERTAINLY THEY DO IF THEIR BELIEF IS THAT THESE EXPERIENCES WILL EXACERBATE SUFFERING] and they guide their beha....
Vlaeyen JW, Linton SJ, "Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.", Pain 85: 2000, 259
Certain beliefs may lead to maladaptive coping, increased suffering, and greater disability. Patients who believe that their pain is likely to persist may be passive in their coping efforts and fail to make use of available strategies (even when in their repertoire) to cope with pain. Patients who consider their pain....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 258
Maladaptive beliefs continue to be recognized as a major risk factor for poor response to treatment for chronic pain. Change in beliefs has become clearly linked to treatment outcomes. [ BUT NOT, as this implies, a causative one.]
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 79
Pain-related fear and concerns about harm avoidance all appear to exacerbate symptoms (Vlaeyen, Kole-Snijders, Boeren, & van Eek, 1995). Anxiety is an affective state that is greatly influenced by appraisal processes; to cite the stoic philosopher Epictetus, “There is nothing either bad or good but thinking makes it so.....
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., and Turk, D. C., "The BioPsychoSocial Approach to Chronic Pain: Scientific Advances and Future Directions", Psychological Bulletin, Vol. 133, No. 4: 2007 (Biopsychosocial Approach to Chronic Pain.pdf), 600
[If you live in pain, you should be very good at dealing with ....]
All-or-nothing thinking: When you see things in all-or-nothing categories. For example, if your performance falls short of perfect, you see yourself as a total failure. ["Pain doesn't equal harm."]
Overgeneralization: When you see a single negati....
Otis, John D., "Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach", Oxford University Press, 2007, 33-35
[relationships among pain, cognitive appraisal variables, and depressive affect]
Chronic pain and depression: role of perceived impact and perceived control in different age cohorts.
Abstract
Chronic pain adversely affects individuals' physical as well as emotional well-being. A cognitive-behavioral model has....
Turk DC, Okifuji A, Scharff L., "Chronic pain and depression: role of perceived impact and perceived control in different age cohorts.", Pain 61: 1995
Theoretical conceptualizations of pain catastrophizing.
Appraisal theory: Pain catastrophizing is viewed as an appraisal process. Painful stimuli are appraised in a primary (magnification, rumination) and secondary (helplessness) fashion. Behavior is deployed based on this appraisal process
Attention bias/inf....
Quartana PJ, Campbell CM, Edwards RR., "Pain catastrophizing: a critical review. (HHS Public Access Author manuscript)", Expert Review of Neurotherapeutics 9: 2009 (Pain catastrophizing: a critical review.html)
ABSTRACT: Cognitive-behavioural therapy and maintenance of exercise have emerged as major tools in the treatment of patients with chronic low back pain. Patients' beliefs about their problem may influence their uptake of and responses to particular treatment modalities. In particular, we hypothesised that patients' bel....
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 96
Cognitive interpretations will also affect how patients portray symptoms to significant others, including health care providers and employers. Overt communication of pain, distress, and suffering will enlist responses that may reinforce pain behavior and impressions about the seriousness, severity, and uncontrollability....
Turk, Dennis C., and Flor, H., "The Cognitive-Behavioral Approach to Pain Management", Chapter 42 of McMahon et al. 2013, 2013, 593
In terms of depression, patients with CLBP may have negative cognitions about the present, the future, and the world around them. They may believe that there is nothing that they can currently do to improve the situation in which they find themselves with regard to pain. The patient may also hold the false cognition tha....
Robert J. Gatchel, Ph.D., ABPP1,** and Kathryn H. Rollings, Ph.D., Candidate, "Evidence informed management of chronic low back pain with cognitive behavioral therapy (HHS Public Access Author manuscript)", Spine J. 2008 Jan-Feb; 8(1): 40–44.: 2008 (Evidence informed management of chronic low back pain with cognitive behavioral therapy.html)
People with persistent pain often have negative expectations about their own ability and responsibility [Says who?] to exert any control over their pain, and they avoid activities that they believe will exacerbate their pain or contribute to additional pain or injury. Such negative, maladaptive appraisals [Why are these....
Turk, Dennis C., and Flor, H., "The Cognitive-Behavioral Approach to Pain Management", Chapter 42 of McMahon et al. 2013, 2013, 593
The presence of pain may change the way that people process pain-related and other information. For example, the presence of chronic pain may focus attention on all types of bodily signals and lead to hypervigilance (Crombez et al 2005). People with chronic pain have been shown to report a multitude of bodily symptoms i....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 262
Turk and colleagues [1988] examined the relationship among general and specific pain-related thoughts. convictions of personal control, pain severity, and disability levels in patients with chronic back pain, rheumatoid arthritis, and fibromyalgia. The general and situation-specific convictions of uncontrollability and....
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 10
Patient's beliefs about the cause of symptoms, their trajectory, and beneficial treatments will have important influences on emotional adjustment and adherence to therapeutic interventions. Maladaptive thoughts may contribute to a sense of hopelessness, dysphoria, and unwillingness to engage in activity. These reactio....
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 193
As part of a comprehensive assessment, chronic pain patients were asked whether their symptoms were precipitated by trauma such as an automobile accident or whether they had an insidious onset. Approximately 50% of the patients attributed their symptoms to trauma.
Based on physical examination, there were no signif....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 258
End of included memoes/notes