PSY 325 1st Edition Lecture 6 Outline of Current Lecture I. Pain Syndromes A. Types of Pain SyndromesII. Phantom Limb PainIII. Managing and Treating PainIV. Behavioral ApproachesV. Cardiovascular Disease and BehaviorVI. Cardiovascular SystemVII. Treatment for CAD/CHDa. Consequences of HypertensionVIII. Death Rates for CVDIX. Heart Disease Worldwidea. Risk FactorsX. Reducing CVDXI. Cancera. What is Cancer?b. Cancer TrendsXII. Risk Factors for CancerXIII. Living with CancerCurrent LecturePain SyndromesMore than 30% of people in the US experience chronic or intermittent persistent painChronic pain is categorized as a syndrome—symptoms that occur togetherTypes of Pain Syndrome:Headache pain:Most common of all types of pain; 90% of people will experience headachesThree primary types of headaches:1. Migraine headachesThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.2. Tension headaches3. Cluster headachesLow back painApproximately 80% of people will experience lower back painInjuries, pregnancy, infections, degenerative diseases, and malignancies can all cause lower back painTypes of Pain Syndromes- Arthritis PainRheumatoid arthritisOsteoarthritis- Fibromyalgia- Cancer PainPain is present in 44 percent of all cancer casesAlmost half of all cancer patients’ pain is left untreated (Chemotherapy is painful and doctors don’t necessarily treat the pain)Pain tends to be more common in cancers that involve cervix, neck and throat.Phantom Limb PainThe experience of chronic pain in a part of the body that is missing (Amputations etc.)Reports vary but it may be that 90% of amputees experience phantom limb painPain is more likely to occur when a person experienced much pain before the amputation.There may be an emotional basis to this pain but also the CNS and PNS may make maladaptive adaptations after the amputation.After Iraqi and Afghanistan wars, this will be a more prevalent problem. Better medical treatments are leading to higher survival rates and more amputation. Therefore, there is a greater demand to understand this phenomenon.Phantom pain will dissipate eventually but in some it can last for years on end. *Mirror therapy is used: makes patients feel like their limb is there. Brain is still firing, thinking there’s something there. The mirror tricks the brain and calms down the neural activity. Managing and Treating PainTreatment for pain varies*Acute pain is easier to treat because the source of pain is clear (broken bone, cut)*Chronic pain is more difficult because there is not usually an obvious sourceRelief can be sought by two methods:o Medical approacheso Behavioral management approachesMedical ApproachesMedications and Drugs*Analgesic drugs—relieve pain; most likely to be opiated or nonnarcotic analgesicsLimitations to using drugs to treat pain: 1. Tolerance and dependence on drugs2. OvermedicationEnds up masking pain you would normally have… thus can make the pain worse once you stop using the medication. For long term, there are a lot of questions about how effective these drugs will be.SurgerySurgery aims to repair the source of the pain or alter the nervous system to alleviate the painLimitations of surgeryIt may not always repair damaged tissueIt may not provide patients with reliefExpensive50/50 chance the surgery will work.Behavioral Approaches Relaxation therapy—systematic tensing and relaxing of musclesUsed successfully to treat tension and migraine headaches, rheumatoid arthritis, low back painDeep breathing exercises, guided visual imagery (listen to therapist or video talk to you describing a relaxing or vivid scene)All these things can be helpful in reducing chronic pain. It is unclear if it is indirectly or directly helping… *Behavioral Therapy/behavioral modification—process of shaping behavior through the application of operant principlesRemoval of reinforcers that may have been prompting “pain traps”Has been effective in decreasing pain intensity and improving quality of lifeBehavioral activation: getting people more active… sometimes rest is not going to help as much as being active. Rest tends to lead to greater chronic pain and depression. Socializing, going to physical therapy… some effective methods *Cognitive Therapy—based on the principle that people’s beliefs, personal standards, and feelings of self-efficacy strongly affect their behaviorIdentify irrational thoughts or ”catastrophizing” and eliminate or change them“Oh no! It’s going to be a bad pain day!”“My life is completely ruined!”Have people keep a thought log, see what they’re thinking when they’re experiencing chronic pain.  *Cognitive Behavioral Therapy (CBT)—type of therapy aimed at developing beliefs, attitudes, thoughts, and skills to make positive changes in behaviorOne form of CBT is acceptance and commitment therapy (ACT), which encourages acceptance of pain by focusing attention on other valuable goals and activitiesAccept pain you have, be mindful and aware but just know it is not the end of their lifeCardiovascular Disease and BehaviorCardiovascular System• The cardiovascular system consists of the heart, arteries, and veins: • Heart—a muscle that pumps blood throughout the body• Arteries—carry oxygenated blood away from the heart• Veins—carry blood back to the heartDamage to coronary arteries can result in the formation of *atheromatous plaquesFormation of plaques on the arteries is called *atherosclerosisArteriosclerosis can also occur to the arteries, which is the loss of elasticity of the arteries.Coronary Artery Disease (CAD)Damage of the coronary arteries by either atherosclerosis or arteriosclerosisIschemia—restriction of blood flowAngina Pectoris—results from restriction of the blood supplySymptoms include: crushing pain in chest and difficulty breathingUsually caused by stress or exerciseCoronary Heart Disease (CHD)—damage to the myocardium as a result of insufficient blood supplyMyocardial infarction—Heart attack; the death of myocardial tissueCommon signs: Feeling weak or dizzy, Nauseous Cold sweating Difficulty breathing Pain in chest/arms/shoulders/backTreatment for CAD/CHD Treatments for CADBypass Surgery—replaces blocked portion of the coronary arteryExpensive and risky but usually relieves angina and improves quality of lifeCardiac rehabilitationHelps