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Evidence that conditioning processes can lead to increased pain and/or disability.
Evidence that conditioning processes lead to increased pain and\or disability.
Klinger and co-authors (2010) reported higher conditioning and unconditioned muscle tension responses in chronic back pain patients and in patients who reported tension-type headaches that were also related to higher pain levels. In fibromyalgia syndrome, altered trace and delayed eye blink conditioning, as well as alte....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 268
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.
Abstract
In an attempt to explain how and why some individuals with musculoskeletal pain develop a chronic pain syndrome, Lethem et al. (Lethem J, Slade PD, Troup JDG, Bentley G. Outline of fear-avoidance model of exaggerate....
Vlaeyen JW, Linton SJ, "Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.", Pain 85: 2000
...the CR [conditioned response] is not pain initially but can be pain provoking over time. Linton and colleagues (1985) stated that there is no evidence of classic conditioning of pain per se, only of anxiety and related physiological activation. This elevated anxiety may then lead to heightened sensitivity to noxious....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 268
Gentry and Bernal (1977) were the first to describe a respondent model of the development of chronic pain. They suggested that acute pain (the US) associated with sympathetic activation and increased generalized muscle tension (the UR) may evolve into a chronic pain problem through a process of classic conditioning. In....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 267
Pavlovian conditioning of muscular responses in chronic pain patients: central and peripheral correlates.
Abstract
A differential conditioning design using an aversive slide as conditioned stimulus (CS(+)) that was followed by an intracutaneous electric stimulus to the left index finger as unconditioned stimulus....
Schneider C, Palomba D, Flor H., "Pavlovian conditioning of muscular responses in chronic pain patients: central and peripheral correlates.", Pain 112: 2004
Unconditioned and conditioned muscular responses in patients with chronic back pain and chronic tension-type headaches and in healthy controls.
Abstract
Muscular tension is assigned an important role in the development and maintenance of chronic pain syndromes. It is seen as a psychophysiological correlate of le....
Klinger R, Matter N, Kothe R, Dahme B, Hofmann UG, Krug F., "Unconditioned and conditioned muscular responses in patients with chronic back pain and chronic tension-type headaches and in healthy controls.", Pain 150: 2010
[SHOULD look at this research to evaluate their interpretation of results.][This statement seems to equate "muscle tension" with EMG ratings. However, if tension is a result of the state of fasciae, tension would not show up in EMG readings.]
Several authors have emphasized that the inadequate perception of bodily s....
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 155-6
Attentional and emotional factors are known to modulate pain perception in the clinic and in the laboratory. [Apparently "psychological" in this context means "attentional and emotional." This is different than the vernacular meaning of "psychological."]...Before brain imaging allowed the exploration of psychological v....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 120
Abstract: This study evaluated a theoretically and empirically based model of the progression of acute neck and back pain to chronic pain and disability, developed from the literature in chronic pain, cognition, and stress and trauma. Clinical information and standardized psychosocial measures of cumulative traumatic ev....
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 97
Of equal importance is the operant conditioning related to the intake of pain medication. Patients are often told by their physicians or by well-meaning family members that they should not continue to take analgesic medication unless the pain increases to a point where it becomes intolerable (referred to as “prn” from t....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 266
In a study in healthy controls, Diesch and Flor (2007) showed that the use of pain as a US [unconditioned stimulus] and non-painful tactile stimuli as a CS leads to fast acquisition of conditioned increases in muscle tension, as well as expansion of the representation of the CS that signals pain in the SI cortex. In add....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 269
The role of operant conditioning in chronic pain: an experimental investigation.
Abstract
The role of operant conditioning for the development and maintenance of chronic pain was examined in 30 chronic back pain patients (CBP) and 30 matched healthy controls. Half of each group was reinforced for increased, h....
Flor H, Knost B, Birbaumer N., "The role of operant conditioning in chronic pain: an experimental investigation.", Pain 95: 2002
Operant conditioning of facial displays of pain.
Abstract
OBJECTIVE:
The operant model of chronic pain posits that nonverbal pain behavior, such as facial expressions, is sensitive to reinforcement, but experimental evidence supporting this assumption is sparse. The aim of the present study was to investiga....
Kunz M, Rainville P, Lautenbacher S., "Operant conditioning of facial displays of pain.", Psychosomatic Medicine 73: 2011
Operant conditioning of enhanced pain sensitivity by heat-pain titration.
Abstract
Operant conditioning mechanisms have been demonstrated to be important in the development of chronic pain. Most experimental studies have investigated the operant modulation of verbal pain reports with extrinsic reinforcement,....
Becker S, Kleinböhl D, Klossika I, Hölzl R., "Operant conditioning of enhanced pain sensitivity by heat-pain titration.", Pain 140: 2008
Sullivan and colleagues advanced a communal coping model, suggesting that catastrophizing represents an interpersonal style of coping with pain and suffering [30]. The model hinges on the notion that catastrophizing represents a behavioral coping strategy employed by individuals experiencing pain to elicit emotional and....
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)
[Continuous observation] often yields important clues as to environmental variables controlling a particular behavior. ["controlling"]
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 136
None of the studies cited above assessed both the contribution of situation-specific pain-related self-statements and more general convictions of personal control over the pain experience, the two general classes of cognitive variables postulated to be of importance by the cognitive–behavioral formulation of chronic pai....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 261
The influence of early experience on the perception of pain has also been demonstrated experimentally. Melzack and Scott (1957) raised Scottish terriers in isolation cages from infancy to maturity so that they were deprived of normal environmental stimuli, including the bodily knocks and scrapes that young animals get i....
Melzack, R. and Wall, P. D., "The Challenge of Pain (Reprint of 1988 edition)", Penguin Books, 2008, 20
Affective associative learning modifies the sensory perception of nociceptive stimuli without participant's awareness.
Abstract
The present experiment examined the possibility to change the sensory and/or the affective perception of thermal stimuli by an emotional associative learning procedure known to opera....
Wunsch A, Philippot P, Plaghki L., "Affective associative learning modifies the sensory perception of nociceptive stimuli without participant's awareness.", Pain 102: 2003
In addition to explicit memories of pain that are accessible to consciousness, implicit, non-conscious memories of pain may also play an important role in the development of chronic pain. [This turn of phrase unfortunately implies that it is causative.] Non-declarative, implicit, or somatosensory pain memories that are....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 263
...it is apparent [why??] that although biomedical factors, in the majority of cases, appear to instigate the initial report of pain; over time, psychological and behavioral factors may serve to maintain and exacerbate the level of pain, influence adjustment, and contribute to excessive disability....the experience of p....
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 189
Patients have many opportunities to learn that the display of pain behaviors may lead to reinforcing consequences, such as attention, and the opportunity to avoid unwanted responsibilities. [Also have opportunities to learn to suppress pain behaviors. Wonder why so little mention of that? OF COURSE, this is only one of....
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 9
[Physician Stephen Brena, based on experience running a pain clinic in Atlanta in the early 70s:] ...Brena began writing about a new problem he called the "learned pain syndrome" and described many people at his clinic as exhibiting a kind of "learned helplessness." [Fordyce came to similar ideas at about that same time....
Wailoo, Keith, "Pain: a political history", Johns Hopkins University Press, 2014, 96
Memories of pain, established over a period of time, might also explain why many patients suffer from chronic pain after a long-term injury or disease. As the experience of pain is implanted in the memory, it continues to torture the patient even after the disease or injury has been treated. [DOES this imply 'successful....
Flor H, "Painful memories: Can we train chronic pain patients to ‘forget’ their pain?", EMBO Reports 34: 2002 (Painful memories.html)
In humans, one [brain memory] system can be described as "declarative, explicit, cognitive, and conscious," in contrast to a second system, which is a "procedural, implicit, and unconscious" memory that encompasses habit formation.
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 355
Becker and colleagues (2008) showed that pain sensitivity as assessed by a sensitization measure can be operantly modified. Kunz and co-workers (2011) extended these findings to facial expressions of pain. They reported that facial pain expressions could be enhanced or reduced by contingent reinforcement and that change....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 266
Past and current physical and sexual abuse have been reported to be more prevalent in people with chronic pain (e.g., Walker et al 1997). Riley and co-workers (1998) suggested that physical and sexual abuse may lead to overly high attentiveness to and over-interpretation of bodily symptoms, a view that is compatible wit....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 262
To illustrate the proposed process from a respondent conditioning perspective, the patient may have learned to associate increases in muscle tension with all kinds of stimuli that were originally associated with nociceptive stimulation. Thus, sitting, walking, bending, or even thoughts about these movements may elicit a....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 268
End of included memoes/notes