Automatic processing of pain: the change of implicit pain associations after psychotherapy

This study explores the utility of a pain IAT for the assessment of dysfunctional cognitive beliefs in chronic pain patients before and after a cognitive behaviour therapy. A patient group suffering from chronic pain (N=25) treated with a 4-week cognitive behavioural psychotherapy is compared with an untreated healthy control group (N=27) at two points in time. In addition, both groups completed a self-esteem questionnaire (Rosenberg-scale) and a self-esteem IAT. In the clinical group a questionnaire assessing self-reported pain cognitions was administered. The pain IAT was able to differentiate between chronic pain patients and healthy controls before the treatment. Most important, pain-related implicit associations could be shown to change over the course of treatment in the clinical group of chronic pain patients. Results provide first evidence for an application of the IAT in chronic pain research.     

Chronic Pain and Praying to a Higher Power: Useful or Useless?

In the present study a Swedish sample of 118 persons with chronic pain completed online tests on two occasions in association with treatment trials. A three item subscale measuring praying as a coping strategy was derived from the Coping Strategies Questionnaire (CSQ), but adapted to refer to “a higher power” instead of “God”. Measures of pain and anxiety/depression were also included. Results revealed significant associations between praying and pain interference and impairment. Praying was also associated with anxiety and depression scores. Results also showed that prayer predicted depression scores at follow-up, and that follow-up prayer was predicted by pain interference at first measurement occasion. Overall, if prayer had any relation with the other variables it was in the negative direction of more distress being associated with more praying both concurrently and prospectively.

Temporomandibular Disorder in Brazilian Patients: A Preliminary Study

The objective of the current study was to evaluate disease-related beliefs, adherence to treatment, quality of life, coping strategies and cognitive status in a group of Brazilian patients with Temporomandibular Disorder (TMD). Thirty patients were evaluated with a semi-directed interview, the Coping Strategies Inventory, and a Mini-Mental State Examination. Although half (50%) of the patients had known their diagnosis long term, 40% of the sample were not correctly following proposed treatment. All patients had a similar pattern of pain behavior related to TMD, while disease-related beliefs, quality of life and coping strategies were variable. Expectations about treatment also had significant association with treatment adherence. The findings of this study suggest that a more thorough understanding of individual differences in TMD is warranted.     

多模式镇痛在幻肢痛预防中的临床研究

为探讨多模式镇痛预防截肢后幻肢痛的临床效果。选择50例下肢截肢患者,随机分为2组,试验组（Ⅰ组）和对照组（Ⅱ组）,观察患者疼痛评分,患者自控镇痛按压次数,使用其他镇痛药物的情况,记录所有的不良反应及幻肢痛发生率。结果显示,镇痛评分,Ⅱ组高于Ⅰ组（P〈0．01）;PCA按压次数,Ⅱ组多于Ⅰ组（P〈0．01）;不良反应发生率Ⅱ组高于Ⅰ组（P〈0．01）;Ⅱ组幻肢痛发生率明显高于Ⅰ组（P〈0．01）。采取多模式镇痛预防幻肢痛是安全有效的。     

癌痛治疗中的辅助用药

辅助镇痛药物最初的用途都不是镇痛,但对癌痛患者却能起到缓解疼痛、降低麻醉药品用量、减轻大剂量麻醉药品带来的药物不良反应的作用。尤其适用于那些对阿片类药物不敏感或不仅对阿片类药物敏感的癌病病人。遗憾的是临床上通常在阿片类药物镇痛效果不理想的时候才考虑添加辅助用药,癌痛治疗还存在用药过于单一的弊端。因此,为了加强止痛治疗效果、优化治疗策略,必须充分重视癌痛治疗中的辅助用药。     

DISCUSSION: ALTRUISM,SPIRITUALLY MERGING WITH A FELLOW HUMAN BEING'S SUFFERING

This discussion focuses on the details of the wellsprings of altruism. The preceding articles in this section portray how spirit figures in various cultural guises appear in human lives with the gift of altruism, in a kind of seeding of the willing healer with the spirit's presence and its accompanying power of love, altruism, and healing. The word altruism is related to the French autre and autrui, “other,” with a special meaning here implying a relationship of identification.     

慢性腹痛

慢性腹痛病史较长,性质不定。引起慢性腹痛的原因很多,除器质性疾病外,一些功能性疾病也引起,如最终找不出具体原因,则可称之为功能性腹痛综合征。诊断比较困难,也容易误诊,甚至误治,外科医生应特别慎重。误诊的思维原因包括对引起慢性腹痛的原因认识不全面,思维惰性,辩证思维不周密和思维简化等。     

重视专科思维的局限，提倡多学科协同发展的应用

由于医学分科越来越细,临床工作中易逐渐形成专科思维。从一个病例就诊18次心血管专家门诊,分析表现为心血管症状和其他学科分科思维的局限性,并进一步阐明多学科协同发展的必要性。提倡在临床决策中,多进行跨学科的分析与思考。     

Growing Up Can Be Painful: A Case Report of the Bat Mitzvah and Chronic Pain

Among a subgroup of adolescents with chronic pain syndromes, anxiety about “growing up” appears common and may be exacerbated by developmental transitions. Using the bat mitzvah ceremony as one example of a developmental rite of passage, we present two cases in which adolescent girls facing this transition developed new chronic musculoskeletal pain syndromes or experienced recurrences of pain symptoms. In both cases, the transition to adulthood, symbolized by the bat mitzvah, was associated with anxiety in adolescents who were unusually focused on the negative aspects of becoming independent adults. The aims of this case report are (1) to highlight the role of developmental transitions as a possible factor in the biopsychosocial model of pediatric pain; (2) to illustrate how to address emotional and cognitive responses to these transitions in the context of cognitive-behavioral treatment for pain; and (3) to suggest systematic approaches to investigating this clinically-observed phenomenon in future research.     

Parent Anxiety and Infant Pain During Pediatric Immunizations

Infants’ procedural pain and parents’ treatment room anxiety has been largely ignored in the research and clinical domains. To understand and manage infant procedural pain, it is essential to examine the correlates and potential predictors of this pain. Given that parent anxiety is a strong predictor of preschoolers’ procedural anxiety and pain, it is likely that parents play a role in infants’ distress during medical procedures. The purpose of this study was to thoroughly examine parent anxiety and its effects on infant procedural pain for 37 parent-infant dyads. Results demonstrated that only parent self-report measures were intercorrelated and several measures of parent distress correlated with measures of infant distress. Treatment implications and recommendations for future research are discussed.This article is based on the master's thesis of the first author under the direction of the second, at West Virginia University.