How expectancy violations facilitate learning to cope with pain – An experimental approach

2022 ◽  
Author(s):  
Tobias Kube ◽  
Karoline Körfer ◽  
Jenny Riecke ◽  
Julia Glombiewski
Keyword(s):  
Experimental Approach ◽  
Pain Tolerance ◽  
Experimental Paradigm ◽  
Expectancy Violations ◽  
Experienced Pain ◽  
Core Feature ◽  
Expectation Disconfirmation ◽  
Experience Pain ◽  
Expectation Confirmation

Background: Expectations of painful sensations constitute a core feature of chronic pain. An important clinical question is whether such expectations are revised when disconfirming experiences are made (e.g., less pain than expected). The present study examined how people adjust their pain expectations when the experience of decreasing pain is expected vs. unexpected. Methods: In a novel experimental paradigm, people who frequently experience pain (N=73) were provided with painful thermal stimulations. Unbeknownst to participants, the temperature applied was decreased from trial to trial. Based on the experimental instructions provided, this experience of decreasing pain was expected in one condition (expectation-confirmation), whereas it was unexpected in another (expectation-disconfirmation). Results: Expectation violations were higher in the expectation-disconfirmation condition than in the expectation-confirmation condition, F(1, 69) = 6.339, p = .014, ηp² = .084. Participants from the expectation-confirmation condition showed a greater adjustment of their pain expectations than the expectation-disconfirmation condition, F(1.666, 114.929) = 7.486, p = .002, ηp² = .098. Across groups, expectation adjustment was related to increases in pain tolerance (r = .342, p = .004) and the ability to cope with pain (r = .234, p = .045) at a one-week follow-up. Conclusions: Participants were more likely to adjust their pain expectations when the experience of decreasing pain was expected. Though participants who experienced large discrepancies between expected and experienced pain were hesitant to adjust their pain expectations immediately, experiencing expectation violations increased their ability to cope with pain one week later, suggesting some beneficial longer-term effects of expectation violations.

scholarly journals A Case of Malignant Melanoma Arising in Mediastinal Malignant Teratoma

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Ikuma Nozaki ◽  
Yumi Tone ◽  
Junko Yamanaka ◽  
Hideko Uryu ◽  
Yuko Shimizu-Motohashi ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Malignant Transformation ◽  
Poor Prognosis ◽  
Mediastinal Mass ◽  
Bone Biopsy ◽  
Systematic Evaluation ◽  
Anterior Mediastinal Mass ◽  
Malignant Teratoma ◽  
Experienced Pain

We report about a 14-year-old boy who presented with an anterior mediastinal mass that was diagnosed as malignant teratoma. Surgical resection was performed along with pre- and postoperative chemotherapy. Although elevated alpha-fetoprotein became negative, he experienced pain in his right hip joint 3 months after resection. Systematic evaluation revealed multiple locations of metastasis, and the pathological diagnosis based on bone biopsy was malignant melanoma originating from malignant teratoma, which rapidly progressed. He died 15 months after diagnosis of the original malignant teratoma. Diagnosing and treating malignant transformation of teratoma, including malignant melanoma, is difficult because it is very rare. To our knowledge, this is the second reported case of malignant melanoma arising from a mediastinum malignant teratoma, with both cases having a poor prognosis. In addition to the follow-up of tumor markers, systematic evaluation, including imaging, should be considered even after remission to monitor malignant transformation of teratoma. We expect to establish a successful therapy and improve mortality rate after more such cases are accumulated.

A Detailed Phenomenological Comparison of Complex Visual Hallucinations in Dementia With Lewy Bodies and Alzheimer's Disease

1997 ◽  
Vol 9 (4) ◽  
pp. 381-388 ◽  
Author(s):  
Clive Ballard ◽  
Ian McKeith ◽  
Richard Harrison ◽  
John O'Brien ◽  
Peter Thompson ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Time Of Day ◽  
Visual Hallucinations ◽  
Dementia Patients ◽  
Core Feature ◽  
Definition Of

Visual hallucinations (VH) are a core feature of dementia with Lewy bodies (DLB), but little is known about their phenomenology. A total of 73 dementia patients (42 DLB, 30 Alzheimer's disease [AD], 1 undiagnosed) in contact with clinical services were assessed with a detailed standardized inventory. DLB was diagnosed according to the criteria of McKeith and colleagues, AD was diagnosed using the NINCDS-ADRDA criteria. Autopsy confirmation has been obtained when possible. VH were defined using the definition of Burns and colleagues. Detailed descriptions of hallucinatory experiences were recorded. Annual follow-up interviews were undertaken. The clinical diagnosis has been confirmed in 18 of the 19 cases that have come to autopsy. A total of 93% of DLB patients and 27% of AD patients experienced VH. DLB patients were significantly more likely to experience multiple VH that persisted over follow-up. They were significantly more likely to hear their VH speak but there were no significant differences in the other phenomenological characteristics including whether the hallucinations moved, the time of day that they were experienced, their size, the degree of insight, and whether they were complete. VH may be more likely to be multiple, to speak, and to be persistent in DLB patients. These characteristics could potentially aid accurate diagnosis.

scholarly journals On the Pathogenesis of the Irritable Bowel Syndrome: The Irritable Bowel or the Irritable Patient?

1990 ◽  
Vol 4 (1) ◽  
pp. 33-38
Author(s):  
Stephen M Collins
Keyword(s):  
Irritable Bowel Syndrome ◽  
Healthy Subjects ◽  
Behavioural Problem ◽  
Pain Tolerance ◽  
Organic Disease ◽  
Gastrointestinal Dysfunction ◽  
Traditional Philosophy ◽  
Irritable Bowel ◽  
Experience Pain

The traditional perspective of irritable bowel syndrome (IBS) as a behavioural problem has tended to downplay the role of gastrointestinal dysfunction. Contrary to predictions based on the traditional philosophy, a recent study has shown that IBS patients have increased pain tolerance compared to healthy subjects. This profile of pain tolerance is similar to that seen in chronic organic disease of the gut (eg, Crohn's disease), raising the possibility that IBS patients may experience pain resulting from gastrointestinal dysfunction. The recent finding of increased airway responsiveness to inhaled methacholine in certain IBS patients provides an objective and quantifiable measurement of tissue dysfunction in that syndrome, and focuses attention on possible mechanisms underlying the altered responsiveness of hollow organs in patients with IBS; these mechanisms are discussed.

Microsurgical C-2 ganglionectomy for chronic intractable occipital pain

1998 ◽  
Vol 89 (3) ◽  
pp. 359-365 ◽  
Author(s):  
Andres M. Lozano ◽  
Graham Vanderlinden ◽  
Robert Bachoo ◽  
Peter Rothbart
Keyword(s):  
Axonal Regeneration ◽  
Excellent Result ◽  
Spontaneous Pain ◽  
Content Type ◽  
Group I ◽  
Experienced Pain ◽  
Pain Outcome ◽  
Group Ii ◽  
Fine Print

Object. The authors evaluated the effectiveness of microsurgical C-2 ganglionectomy in 39 patients with medically refractory chronic occipital pain. In this procedure the neurons transmitting sensory inputs from the occiput are removed and, unlike peripheral nerve ablation, axonal regeneration is not possible. Methods. The patients in this series had symptoms for 1 to 43 years. In 22 patients the occipital pain was caused by trauma; in 17 patients the pain was spontaneous. Pain relief failed in 17 patients who had undergone a previous occipital neurectomy or C-2 rhizolysis. Twenty-three patients experienced pain that was described as shocklike, electric, shooting, jabbing, stabbing, sharp, or exploding (Group I). Eight patients described their pain as dull, pounding, aching, throbbing, or pressurelike (Group II). The patients underwent unilateral or bilateral C-2 open microsurgical ganglionectomies. The postoperative follow-up period ranged from 19 to 48 months. Nineteen patients experienced an excellent result (> 90% reduction in pain). Pain caused by trauma or that described using Group I terms responded best to ganglionectomy (80% good or excellent response). In contrast, the majority of the patients with nontraumatic pain or those described using Group II descriptors did not achieve favorable results. Conclusions. The authors conclude that: 1) patients who suffer from chronic occipital pain after having sustained injury obtain worthwhile benefit from microsurgical C-2 ganglionectomy; 2) patients suffering from migraine, tension, and vascular headaches involving the occipital area are most often not helped by this operation; and 3) terms such as “shock,” “electric,” “shooting,” “jabbing,” and “sharp” used to describe occipital pain predict a favorable pain outcome following a C-2 ganglionectomy.

scholarly journals Behavior Change Following Pain Neuroscience Education in Middle Schools: A Public Health Trial

2020 ◽  
Vol 17 (12) ◽  
pp. 4505
Author(s):  
Adriaan Louw ◽  
Regina Landrus ◽  
Jessie Podolak ◽  
Patricia Benz ◽  
Jen DeLorenzo ◽  
...  
Keyword(s):  
Middle School ◽  
Middle School Students ◽  
Medication Use ◽  
Pain Medication ◽  
School Students ◽  
Experienced Pain ◽  
Neuroscience Education ◽  
Initial Intervention ◽  
Pain Knowledge

Chronic pain and the opioid epidemic need early, upstream interventions to aim at meaningful downstream behavioral changes. A recent pain neuroscience education (PNE) program was developed and tested for middle-school students to increase pain knowledge and promote healthier beliefs regarding pain. In this study, 668 seventh-grade middle-school students either received a PNE lecture (n = 220); usual curriculum school pain education (UC) (n = 198) or PNE followed by two booster (PNEBoost) sessions (n = 250). Prior to, immediately after and at six-month follow-up, pain knowledge and fear of physical activity was measured. Six months after the initial intervention school, physical education, recess and sports attendance/participation as well as healthcare choices for pain (doctor visits, rehabilitation visits and pain medication use) were measured. Students receiving PNEBoost used 30.6% less pain medication in the last 6 months compared to UC (p = 0.024). PNEBoost was superior to PNE for rehabilitation visits in students experiencing pain (p = 0.01) and UC for attending school in students who have experienced pain > 3 months (p = 0.004). In conclusion, PNEBoost yielded more positive behavioral results in middle school children at six-month follow-up than PNE and UC, including significant reduction in pain medication use.

scholarly journals Importance of rheology in the prediction of structural transition phenomena in geopolymer matrices loaded with phosphogypsum

2019 ◽  
Vol 286 ◽  
pp. 07005
Author(s):  
N. Lahlou ◽  
M. Ouazzani Touhami ◽  
R. Hattaf ◽  
R. Moussa
Keyword(s):  
Rheological Behavior ◽  
Structural Transition ◽  
Experimental Approach ◽  
Fresh State ◽  
Hardened State ◽  
Definition Of ◽  
The Impact ◽  
Kinetics Of

Through a purely experimental approach, we proceed here to the description of the rheological behavior of the geopolymer matrices in the fresh state according to one or other of the parameters characterizing their formulation. This consolidates the different physicochemical techniques usually used for their characterization. This comes to allow us especially the definition of drafts for the implementation of empirical laws ensuring a better follow-up in the elaboration of these materials or even more optimization in their formulation. This description also allows us to follow the structural transition phenomena from the fresh state to the hardened state. We are particularly interested in demonstrating the impact of the addition of Phosphogypsum on the rheological behavior of geopolymers or on their kinetics of setting.

Sequentially Staged Resection and 2-Column Reconstruction for C2 Tumors Through a Combined Anterior Retropharyngeal–Posterior: Approach Surgical Technique and Results in 11 Patients

2011 ◽  
Vol 69 (suppl_2) ◽  
pp. ons184-ons194 ◽  
Author(s):  
Xinghai Yang ◽  
Zhipeng Wu ◽  
Jianru Xiao ◽  
Honglin Teng ◽  
Dapeng Feng ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Posterior Approach ◽  
Tumor Resection ◽  
The Other ◽  
Neurological Improvement ◽  
Experienced Pain ◽  
Alive With Disease ◽  
Solid Fusion ◽  
Deep Location

Abstract BACKGROUND Surgical treatment of C2 tumors remains challenging. Because of the deep location and unique anatomical complexity, anterior exposure in this region is considered difficult and dangerous, and few reports concerning anterior tumor resection and reconstruction exist. OBJECTIVE To describe a technique of sequentially staged resection and 2-column reconstruction for C2 tumors through a combined anterior retropharyngeal–posterior approach. METHODS Eleven patients with C2 tumors underwent sequentially staged tumor resection and 2-column reconstruction in our institute. Eight primary lesions and 3 metastases were involved. Tumor resections and anterior reconstructions with conventional constructs were accomplished by an anterior retropharyngeal approach, and occipitocervical fusions through posterior access were performed in the same anesthesia. RESULTS No operative mortality occurred in this series. All patients experienced pain relief and neurological improvement after surgery. Except for 1 incidence of screw pullout, which was corrected by revision surgery, solid fusion was achieved in all patients. A follow-up period of 12 to 37 months was available for this study. Two patients with chordoma relapsed; 1 died of disease, and the other was alive with disease. Two patients with metastasis died of multiple remote metastases. No evidence of local recurrence was found in the other patients. CONCLUSION The anterior retropharyngeal approach is a favorable route to treat tumor lesions of the C2 vertebral body that allows tumor resection and placement of anterior constructs between C1 and the subaxial vertebral body. Tumor resection and 2-column reconstruction could safely be accomplished simultaneously through the combined anterior retropharyngeal–posterior approach.

Schwannomatosis, sporadic schwannomatosis, and familial schwannomatosis: a surgical series with long-term follow-up

2011 ◽  
Vol 114 (3) ◽  
pp. 756-762 ◽  
Author(s):  
Augusto Gonzalvo ◽  
Adam Fowler ◽  
Raymond John Cook ◽  
Nicholas Scott Little ◽  
Helen Wheeler ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Disease Onset ◽  
Neurofibromatosis Type ◽  
Extent Of Resection ◽  
Spinal Nerve ◽  
Specific Information ◽  
Experienced Pain ◽  
Familial Form ◽  
Long Term Follow Up

Object The aim of this study was to provide disease-specific information about schwannomatosis in its different forms and to present 2 particular cases of malignant schwannomas in the context of familial schwannomatosis (FS). Methods The authors analyzed patients with pathologically defined schwannomas and identified those with varied forms of schwannomatosis. Each case was retrospectively analyzed for patient sex and age, number of operations and tumors excised, symptoms, location and size of tumors, extent of resection, nerve function pre- and postoperatively, complications, other nonsurgically treated tumors, malignancy, results of brain MR imaging, and follow-up data. Results One hundred fifty-eight patients underwent the excision of 216 schwannomas. One hundred forty-two patients presented with solitary schwannomas, 2 had neurofibromatosis Type 2 (NF2), and 14 presented with schwannomatosis. The average follow-up was 52 months. Six individuals had sporadic schwannomatosis, whereas 8 had the familial form of the disease. These 14 patients had an average age of 28.3 years at the time of disease onset (median 27.5 years) and 35.4 years at the time of the first operation (median 37 years) Thirteen of the 14 patients with schwannomatosis experienced pain as the first symptom. Eight (57%) of the 14 patients presented with at least 1 tumor in the spinal canal or attached to the spinal nerve roots. Malignant schwannomas developed in 2 patients from the same family during the follow-up. Conclusions Patients suffering from schwannomatosis tend to be younger than those presenting with solitary schwannomas. Therefore, individuals presenting at a young age with multiple schwannomas but not meeting the criteria for NF2 should prompt the physician to suspect schwannomatosis. Patients with schwannomatosis who report pain should be exhaustively examined. The spine is affected in the majority of patients, and MR imaging of the spine should be part of the routine evaluation. Rapid enlargement of schwannomas in the context of FS should raise suspicion of malignant transformation.

Treatment of neoplastic epidural cord compression by vertebral body resection and stabilization

1985 ◽  
Vol 63 (5) ◽  
pp. 676-684 ◽  
Author(s):  
Narayan Sundaresan ◽  
Joseph H. Galicich ◽  
Joseph M. Lane ◽  
Manjit S. Bains ◽  
Patricia McCormack
Keyword(s):  
Vertebral Body ◽  
De Novo ◽  
Cord Compression ◽  
Cervical Region ◽  
Lumbar Region ◽  
Content Type ◽  
Prior Therapy ◽  
Results Of Treatment ◽  
Experienced Pain

✓ The results of treatment of neoplastic spinal cord compression by vertebral body resection and immediate stabilization in 101 consecutive patients over a 5-year period have been analyzed. Sites of primary cancer included the lung (25 patients), kidney (15 patients), breast (14 patients), connective tissue (12 patients), and a variety of others (35 patients). Of the 101 patients, 23 received surgery de novo; the remaining 78 patients had undergone previous therapy. Sites of involvement included the cervical region in 13 patients, the thoracic region in 68 patients, and the lumbar region in 20 patients. Prior to surgery, severe pain was noted in 90% of the patients, and 45% were non-ambulatory. Using an anterolateral surgical exposure, the vertebral body was resected along with all epidural tumor. Immediate stabilization was achieved with methyl methacrylate and Steinmann pins. Following surgery, the overall ambulation rate was 78%, and 85% of patients experienced pain relief. Of the 23 patients who had received no prior therapy, 90% continued to be ambulatory at their last follow-up examination or until death. The authors believe that surgery prior to irradiation is indicated in selected patients with neoplastic cord compression. In patients with solitary osseous metastasis to the spine, potentially curative resection can be undertaken if surgery is performed when the tumor is still confined to the vertebral body.

External Qigong for Chronic Pain

2010 ◽  
Vol 38 (04) ◽  
pp. 695-703 ◽  
Author(s):  
Ann Vincent ◽  
Jamia Hill ◽  
Kelly M. Kruk ◽  
Stephen S. Cha ◽  
Brent A. Bauer
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Primary Outcome ◽  
Primary Outcome Measure ◽  
Low Back ◽  
Analog Scale ◽  
Experienced Pain ◽  
Before And After ◽  
To Receive

External qigong as a pharmacotherapy adjunct was investigated in 50 subjects with chronic pain (pain lasting > 3 months with pain score of ≥ 3 on 0–10 numeric analog scale) who presented to a qigong healing center. Participants were randomized to receive either external qigong treatment (EQT) or equivalent attention time (EAT) in weekly 30-min sessions for four consecutive weeks. Outcomes were assessed before and after sessions. The primary outcome measure was intensity of pain by a 10-cm visual analog scale used to rate all pain severity measurements. At 8-week follow-up, participants were contacted by telephone and mailed a questionnaire. Most had experienced pain for > 5 years (66%); the rest, for > 3 to 5 years (8%), 1 to 3 years (10%), or < 1 year but > 3 months (10%). The most frequent concomitant diagnoses were multifactorial (26%), osteoarthritis (18%), and low back pain (12%). Most patients were also receiving other treatments (74%); none previously had EQT. Participants were randomly assigned to EQT ( n = 26) or EAT ( n = 24). These groups had no significant differences at baseline except for prior awareness of qigong (EQT 31% vs. EAT 63%; p = 0.025). Compared to the EAT group, EQT participants had a significant decrease in pain intensity in the 2nd ( p = 0.003), 3rd ( p < 0.001), and 4th weeks of treatment ( p = 0.003). At week 8, these differences in overall decreased pain intensity persisted but were not statistically significant.

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