The biopsychosocial approach to chronic pain: Scientific advances and future directions.

The evaluation and treatment of the patient with idiopathic chronic pain traditionally has involved a sequence of studies first by the internist, then the neurologist, and finally the psychiatrist. This has resulted in an overutilization of costly health care services and may paradoxically have helped to promote symptom chronicity. In keeping with recent developments in the field of psychosomatic medicine, a coordinated biopsychosocial approach is advocated with the identification and amelioration of the multiple determinants of symptom formation in each of these interrelated sub-systems. A case is presented in which the application of this holistic approach appeared to help curtail the overuse of health care services and at the same time helped to diminish psychosocial reinforcers in the form of secondary gain.

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Learning and Conditioning in Chronic Pain

10.1093/oso/9780190627898.003.0004 ◽

2018 ◽

Author(s):

Johan W. S. Vlaeyen

Keyword(s):

Chronic Pain ◽

Associative Learning ◽

Operant Conditioning ◽

External Environment ◽

Future Directions ◽

Knowledge Representations ◽

Inhibitory Processes ◽

Rapid Acquisition ◽

Observable Change ◽

New Knowledge

This chapter highlights the ways that individuals learn to adapt to changes due to painful experiences. Learning is the observable change in behavior due to events in the internal and external environment, and it includes non-associative (habituation and sensitization) and associative learning (Pavlovian and operant conditioning). Once acquired, new knowledge representations remain stored in memory and may generalize to perceptually or functionally similar events. Moreover, these processes are not just a consequence of pain; they may also modulate the perception of pain. In contrast to the rapid acquisition of learned responses, their extinction is slow, fragile, and context-dependent, and it only occurs through inhibitory processes. The chapter reviews features of associative forms of learning in humans that contribute to pain, pain-related distress, and disability. It concludes with a discussion of promising future directions.

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The biopsychosocial approach and considerations involved in chronic pain

Healthy Aging Research ◽

10.35248/har.2019.8.6 ◽

2019 ◽

Vol 08 (01) ◽

Author(s):

Ryan Hulla ◽

Danielle Brecht ◽

Jessica Stephens ◽

Eric Salas ◽

Chasley Jones ◽

...

Keyword(s):

Chronic Pain ◽

Biopsychosocial Approach

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Recommendations for the Development of Socioeconomically-Situated and Clinically-Relevant Neuroimaging Models of Pain

Frontiers in Neurology ◽

10.3389/fneur.2021.700833 ◽

2021 ◽

Vol 12 ◽

Author(s):

Marianne C. Reddan

Keyword(s):

Chronic Pain ◽

Population Based ◽

Biopsychosocial Approach ◽

Population Sampling ◽

Standard Population ◽

Idiographic Approach ◽

Chronic Pain Patients ◽

Neuroimaging Data ◽

Component Processes ◽

Pain Patients

Pain is a complex, multidimensional experience that emerges from interactions among sensory, affective, and cognitive processes in the brain. Neuroimaging allows us to identify these component processes and model how they combine to instantiate the pain experience. However, the clinical impact of pain neuroimaging models has been limited by inadequate population sampling – young healthy college students are not representative of chronic pain patients. The biopsychosocial approach to pain management situates a person's pain within the diverse socioeconomic environments they live in. To increase the clinical relevance of pain neuroimaging models, a three-fold biopsychosocial approach to neuroimaging biomarker development is recommended. The first level calls for the development of diagnostic biomarkers via the standard population-based (nomothetic) approach with an emphasis on diverse sampling. The second level calls for the development of treatment-relevant models via a constrained person-based (idiographic) approach tailored to unique individuals. The third level calls for the development of prevention-relevant models via a novel society-based (social epidemiologic) approach that combines survey and neuroimaging data to predict chronic pain risk based on one's socioeconomic conditions. The recommendations in this article address how we can leverage pain's complexity in service of the patient and society by modeling not just individuals and populations, but also the socioeconomic structures that shape any individual's expectations of threat, safety, and resource availability.

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Large-scale electrophysiology with Neuropixels: Scientific advances and future directions

IBRO Reports ◽

10.1016/j.ibror.2019.07.131 ◽

2019 ◽

Vol 6 ◽

pp. S43

Author(s):

Nicholas Steinmetz

Keyword(s):

Large Scale ◽

Future Directions ◽

Scientific Advances

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The Meditation Chamber

Metaplasticity in Virtual Worlds ◽

10.4018/978-1-60960-077-8.ch007 ◽

2011 ◽

pp. 121-133 ◽

Cited By ~ 7

Author(s):

Chris Shaw ◽

Diane Gromala ◽

Meehae Song

Keyword(s):

Chronic Pain ◽

Virtual Reality ◽

Virtual Environment ◽

Immersive Virtual Reality ◽

Meditation Practice ◽

Future Directions ◽

Scientific Methods ◽

Immersive Virtual Environment ◽

Methods Of Evaluation

The Meditation Chamber is an immersive virtual environment (VE), initially created to enhance and augment the existing methods of training users how to meditate, and by extension, to realize the benefits from meditation practice, including the reduction of stress, anxiety and pain. Its innovative combination of immersive virtual reality (VR) and biofeedback technologies added interoceptive or dimensions of inner senses to the already sensorially rich affordances of VR. Because the Meditation Chamber enabled users to become aware of autonomic senses that they are not normally conscious of, and to manipulate them in real-time, we found that it did enhance users’ abilities to learn how to meditate, particularly those who had never meditated. We describe the Meditation Chamber, scientific methods of evaluation and findings, and discuss first-person phenomenological aspects, its long-term applicability for users who have chronic pain, and future directions.

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