The Spatiality of Pain

Abstract

My remarks on Metz’s project will focus on another angle than the one Metz uses. I am more interested in thinking about whether and how far ethical standards from different cultures really differ, how to understand those differences, and how to relate them to what is objectively good, independently of people’s opinions on the matter. Of course one widely circulating opinion on the topic is that cross-cultural differences somehow demonstrate that there is no such thing as objective good at all - that each culture has its own conception of what is good, right, permitted, forbidden, and so on, and the differences are so wide that anyone at all familiar with this, can no longer take seriously the idea that there could be any “objective” values underlying such varied systems.     

The Pain of Dying

SUMMARY

Dying can be a painful and difficult business. Fears, hopes, losses, questions, and uncertainty result in a form of pain that lies beyond the therapeutic reach of science and pharmacology. Efforts to preserve and prolong life or to make things better can sometimes result in this pain being overlooked or remaining unheard. To search the deepest part of oneself is the journey that beckons us all as we are dying. Within this space resides the source of our own suffering but also the seeds for healing. This exploration has a momentum of its own but requires conditions not often found within the biomedical paradigm. If this model of care remains the only source of hope for those with a life-threatening illness, ‘the pain of dying’ may not be addressed.     

The Social Pain Posit

Although discussion of social pain has become popular among researchers in psychology and behavioural neuroscience, the philosophical community has yet to pay it any direct attention. Social pain is characterized as the emotional reaction to the perception of the loss or devaluation of desired relationships. These are argued to comprise a pain type and are explicitly intended to include the everyday sub-types grief, jealousy, heartbreak, rejection, and hurt feelings. Social pain is accordingly posited as a nested type of pain encompassing multiple emotional sub-types. Call this the social pain posit. This article focuses on whether we should endorse the social pain posit and, in particular, whether social pain is pain. I present the four lines of evidence for the social pain posit that are currently offered in the literature and I argue that each provides only inadequate support, taken either individually or together. I close by considering the significance of the presented argument for philosophical theorizing about the nature and the moral significance of affective experiences in particular and mental taxonomizing more generally.     

麻醉科医师在晚期癌痛治疗中的作用

1986年WHO推出的"三阶梯"癌痛镇痛用药方案目前在临床工作中存在误区.麻醉科医师必须明确在晚期癌痛治疗转变中的责任和义务:具有专业能力、保健与防病能力,消除使用阿片类药物成瘾恐惧症;团队协作能力、新技术的评估能力,实行跨学科综合姑息保健;遵循生物心理社会医学模式,对晚期癌痛患者实施人文关怀.不仅会运用药物和医疗技术手段,还需配合心理和社会方面进行全面的诊疗,更好地为患者服务.     

麻醉科医师在晚期癌痛治疗中的作用

1986年WHO推出的“三阶梯”癌痛镇痛用药方案目前在临床工作中存在误区。麻醉科医师必须明确在晚期癌痛治疗转变中的责任和义务:具有专业能力、保健与防病能力,消除使用阿片类药物成瘾恐惧症;团队协作能力、新技术的评估能力,实行跨学科综合姑息保健;遵循生物心理社会医学模式,对晚期癌痛患者实施人文关怀。不仅会运用药物和医疗技术手段,还需配合心理和社会方面进行全面的诊疗,更好地为患者服务。     

疼痛对心理的影响及其机制

疼痛对个体的认知、情绪等心理过程有消极影响。疼痛会干扰个体的选择性和持续性注意, 损害其记忆功能。长期疼痛还会诱发焦虑和抑郁等消极情绪。目前疼痛的机制主要有闸门控制理论和神经网络理论, 分别从脊髓水平和大脑水平解释疼痛与心理的交互作用。大脑对疼痛信息的编码方式包括特异化理论、模块化理论和中枢整合机制学说。未来研究应注意实验室研究与临床研究的差异, 区分急、慢性疼痛的特有机制, 进一步探讨疼痛理论的合理性。     

The Accuracy of the DSM-IV Pain Disorder and the ICD-10 Persistent Somatoform Pain Disorder in Chronic Pain Patients

Objectives. In this investigation we studied the relationships between different psychological relevant subgroups and the presence of different psychosomatic symptoms in a sample of chronic pain patients, testing the accuracy of the DSM- and ICD classification systems.Results. We found no evidence for a “pure” pain syndrome according to the DSM- and ICD systems. On the contrary, we found highly significant evidence of a mixed psychosomatic condition.Conclusion. The results suggest a broad somatoform classification, with subgroups based on personality characteristics taking a stress—coping model into account, including interpersonal attachment behaviour. An alternative model of a diagnostic approach is presented.     

疼痛表情对秒下及秒上时距知觉的影响

采用二分法和泛化法范式,在秒下及秒上呈现时距探究疼痛表情对时距知觉的影响。结果发现,使用二分法,疼痛表情在秒上秒下都显著延长了个体的主观时距,但使用泛化法,疼痛表情仅在秒上产生影响。根据时间分段综合模型和范式特点,该实验结果反映疼痛表情对时距知觉的影响在秒上秒下的作用机制可能不同,在秒下主要是通过唤醒影响,在秒上则可能由唤醒和注意共同调节。     

The Future of Psychology in Pain Management

Pain treatment facilities have proliferated in recent years and psychology has enjoyed considerable success in the clinical and research arenas of pain management. However, changes in the health care environment present significant challenges to the future of psychology in pain management. This article discusses concerns in three important areas of pain treatment that psychologists must address if they are to maintain a strong presence in this field: (1) evaluating and treating patients in the pain treatment setting, (2) evaluating and enhancing the efficacy of pain treatment, and (3) applying pain treatment services to other patient populations. With appropriate attention to these issues, psychology can continue to thrive in pain treatment settings.     

The Neurobiological Underpinnings of Coping With Pain

ABSTRACT— The biopsychosocial model treats pain as resulting from a complex interaction of biological, psychological, and social factors. Individual differences in approaches to coping with pain-related symptoms are important determinants of pain-related outcomes, and are often classified under the "psychological" category within the biopsychosocial model. However, engagement in various cognitive, affective, and behavioral pain-coping strategies appears to exert biological effects, which we review here. Pain-coping activities such as catastrophizing, distracting oneself from pain sensations, or reappraisal of pain may exert effects on activity in a variety of pain-processing and pain-modulatory circuits within the brain, as well affect the functioning of neuromuscular, immune, and neuroendocrine systems. The interface between pain-related neurobiology and the use of specific pain-coping techniques represents an important avenue for future pain research.     

疼痛条件下时间目标对时距估计的影响

本研究采用冷压任务引发疼痛,以健康大学生为被试,试图探讨在疼痛条件下时间目标对时距估计的影响。结果发现：疼痛条件下的时距估计值小于非疼痛条件下时距估计值,疼痛条件下具体时间目标的时距估计值显著大于无目标时距估计值。临床上给患者提供具体的时间目标或许有助于他们应对疼痛。     

The Analogical Argument for Animal Pain

Philosophical defenders of animal liberation believe that we have direct duties to animals. Typically a presumption of that belief is that animals have the capacity to experience pain and suffering. Notoriously, however, a strand of Western scientific and philosophical thought has held animals to be incapable of experiencing pain, and even today one frequently encounters in discussions of animal liberation expressions of scepticism about whether animals really experience pain.
The Analogical Argument for Animal Pain responds to this scepticism by claiming that it is just as reasonable for me to believe that animals feel pain, given my only evidence for this is shared behaviour and physiology, as it is for me to believe that other humans feel pain on the basis of similar evidence. In this paper I expound and defend this Argument.     

疼痛恐惧对疼痛的影响及其认知机制

疼痛恐惧是把将要出现的疼痛刺激视为主要威胁而产生的一种恐惧,它会影响与疼痛相关的感知觉、注意、回避行为以及安慰剂止痛的效果.疼痛恐惧的认知模型主要有活动回避模型、恐惧-回避模型以及内感受性恐惧条件模型.未来的研究要进一步探究疼痛恐惧的认知机制,完善疼痛恐惧的认知模型并扩展疼痛恐惧的研究方法.     

The Effect of Anxiety Sensitivity and Gender on the Experience of Pain

The association between negative affectivity (NA) and health complaints is thought to reflect a stronger attentional focus on bodily sensations in high NA persons. Perceiving these sensations as rather threatening, high NA persons may scan their internal environment for impending signs of pain and trouble. Using an on-line registration of attentional deployment, we tested whether high NA persons were allocating more attentional resources to internal sensations and less to external stimuli compared to low NA persons. High and low NA participants (N = 68) performed a Stroop-like primary task during a number of trials in which: (1) only an internal; (2) only an external; or (3) both an internal and an external stimulus could occur. Internal stimuli consisted of 7.5% carbon dioxide administrations, causing slight increases in ventilation. An increase in time interval between successive tones served as the external stimulus. Participants were asked to press a button when they noticed one of both events. Results showed that high NA participants: (1) detected the effects of a first respiratory stimulus faster; (2) performed poorer on the tone task when anticipating a respiratory challenge; (3) performed slower on the Stroop task during respiratory stimuli. These findings may indicate that high NA participants show a stronger attentional bias to internal sensations.