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d. is less important in pain perception than the cerebellum.
43. The gate control theory of pain assumes
a. the physiological reality of pain.
b. the nature of motor output factors in pain perception.
c. that chronic pain is heavily influenced by both spinal cord and brain
activity.
d. that sensory input is not the only factor in pain perception.
44. Melzack proposed the _______ theory, which is an extension of the gate control
theory.
a. sensory decision
b. specificity
c. neuromatrix
d. cerebellar
45. Valid and reliable measures of pain are important to health psychologists
primarily because
a. such measurements permit accurate evaluation of various pain therapy
programs.
b. self-reports are more useful than physiological measures.
c. pain is a product of both physiological and emotional factors.
d. behavioral assessments are more reliable and valid.
46. Which of these methods have been used to measure pain?
a. self-reports
b. behavioral assessment
c. physiological measures
d. all of these
47. The Visual Analog Scale is considered to be
a. a self-report.
b. an evoked potential measure of pain.
c. a behavioral assessment of pain.
d. a pain questionnaire.
48. The most widely used pain questionnaire was developed by Ronald Melzack and
is known as the
a. Melzack and Wall Pain Questionnaire.
b. Visual Analog Scale.
c. Minnesota Multiphasic Personality Inventory.
d. McGill Pain Questionnaire.
Understanding and Managing Pain
49. A personality inventory sometimes used to assess pain is the
a. California Personality Inventory.
b. Minnesota Multiphasic Personality Inventory.
c. Edwards Personality Schedule.
d. Guilford-Zimmerman Temperament Survey.
50. Heart rate predicts perceptions of pain, but only for ________.
a. children
b. the elderly
c. men
d. women
51. Which of these techniques measures muscle tension as an index of pain?
a. electromyography
b. thermography
c. blood flow in the temporal artery
d. heart rate
52. _____ pain is the most common of all syndromes of pain with a lifetime incidence
rate of more than 99%.
a. Headache
b. Low back
c. Burn
d. Knee
53. Rosa suffers from recurrent attacks of pain that are accompanied by exaggerated
sensitivity to light, loss of appetite, and nausea. From these characteristics you
would diagnose Rosa as having
a. migraine headaches.
b. tension headaches.
c. cancer pain.
d. phantom limb pain.
54. With regard to migraine headaches,
a. men are somewhat more likely than women to have migraines.
b. women are much more likely than men to have migraines.
c. women are slightly more likely than men to have migraines.
d. women and men are about equally susceptible to migraines.
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55. Carlos is a 45-year-old civil engineer who has never had a migraine headache. His
chances of a first migraine are
a. very high.
b. about 50/50.
c. very low.
d. nonexistent.
56. What type of pain has a gradual onset, sensations of tightness around the neck and
shoulders, and a steady ache on both sides of the head?
a. low back pain
b. migraine headache
c. cluster headache
d. tension headache
57. Wendy suffers from headaches that occur nearly every day for about a month, but
then go away for about a year or more. From this description, it appears that
Wendy suffers from
a. cluster headaches.
b. migraine headaches.
c. tension headache.
d. none of the above.
58. The two most common types of pain are
a. cancer and headache.
b. arthritis and low back.
c. headache and low back.
d. cancer and low back.
59. Which of these conditions may contribute to low back pain?
a. pregnancy
b. improper lifting of heavy objects
c. aging
d. all of these
60. Low back pain has many causes. About what percent of back pain patients have
an identified, physical cause for their pain?
a. 20%
b. 50%
c. 75%
d. about 40% of men and about 60% of women
61. Unlike rheumatoid arthritis, osteoarthritis
a. frequently occurs in younger as well as older people.
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b. affects mostly men.
c. is an autoimmune disorder.
d. affects mostly older people.
62. Chronic pain affects approximately ____ of the population in the United States.
a. 50%
b. 10%
c. 75%
d. 30%
63. The three primary kinds of headaches are:
a. migraine, cluster, chronic
b. chronic, tension, cluster
c. migraine, cluster, tension
d. tension, migraine, chronic
64. What types of headaches are more common in men than in women?
a. chronic
b. cluster
c. migraine
d. tension
65. Almost ____ of all cancer patients’ pain was untreated.
a. 10%
b. 20%
c. 50%
d. 90%
66. Jesse’s leg was amputated when he was 20. 10 years later, he still occasionally
feels pain in that missing limb. This pain is called
a. missing limb pain.
b. phantom limb pain.
c. amputation pain.
d. neuroses.
67. For phantom limb pain, the pain is more likely in the missing limb when:
a. there was much pain before the amputation.
b. there was no pain before the amputation.
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c. the amputated limb is a leg.
d. all phantom pain is the same pain intensity.
68. _______ occurs when the body needs more and more of the drug to reach the
same effect and _______ occurs when removal of the drug causes withdrawal
symptoms.
a. Withdrawal; dependence
b. Dependence; withdrawal
c. Tolerance; dependence
d. Dependence; tolerance
69. The tendency to catastrophize is associated with ________.
a. magnification of pain.
b. lessening of pain.
c. no differences in perception of pain.
d. magnification of pain, but only when other people are present.
70. Cognitive behavioral therapy has been shown to be effective in relieving pain for
a. headache patients
b. fibromyalgia patients
c. patients with AIDS pain
d. all of the above
71. One variation of cognitive behavioral therapy, encourages participants to _____
their pain and focus their attention on valued activities.
a. deny
b. accept
c. enjoy
d. commit to
72. Approximately _____ % of all terminal cancer cases experience pain.
a. 15-20
b. 25-40
c. 45-65
d. 98 to 99
73. Medical procedures used in pain management have traditionally included
a. cognitive therapy.
b. drugs.
c. surgery.
d. both drugs and surgery.
Understanding and Managing Pain
74. Opiate drugs
a. are effective analgesics.
b. produce dependence.
c. produce tolerance.
d. all of these.
75. About what percentage of people who receive opiates during a hospital stay
becomes addicted?
a. less than 1%
b. more than 5% but less than 25%
c. about 50%
d. almost 100%
76. Systems of self-paced administration of analgesic drugs
a. overcome the problem of undermedication.
b. increase the probability of addiction.
c. lead to a situation in which about 45% of patients overmedicate
themselves.
d. all of these.
77. Aspirin-type analgesic drugs are most effective in
a. treating gastric disorders.
b. relieving cancer pain.
c. treating injuries that are accompanied by inflammation.
d. treating patients who are candidates for surgery.
78. Analgesic drugs are effective for pain control, but
a. most people misuse these drugs, using dangerous amounts.
b. NSAIDS are more effective than opiates.
c. anesthetic drugs are preferable for controlling chronic pain.
d. antidepressant drugs may also be useful in treating some types of pain.
79. Bailey has tried many treatments for chronic back pain. His treatment of last
resort would probably be
a. surgery.
b. TENS.
c. opium-based drugs.
d. hypnosis.
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80. Researchers have found that transcutaneous electrical nerve stimulation (TENS)
a. is effective for acute but not chronic pain.
b. increases pain during stimulation, but patients report less pain after
stimulation.
c. is not very effective in relieving pain.
d. has no advantage over other medical methods.
81. The type of spinal stimulation that is most effective in controlling pain is
a. transcutaneous electrical nerve stimulation (TENS).
b. stimulation from implanted devices that stimulate the spinal cord.
c. subcutaneous chemical stimulation (SCS).
d. alternating stimulation of the peripheral nerves near the site of injury and
stimulation close to the spinal cord.
82. Relaxation training has been used successfully to
a. treat rheumatoid arthritis.
b. treat low back pain.
c. reduce headache pain.
d. all of these.
83. Behavior modification techniques rely most heavily on
a. classical conditioning concepts.
b. operant conditioning principles.
c. observational learning theory.
d. cognitive learning strategies.
84. Wilbert Fordyce, along with others who advocate a behavior modification view of
pain, claimed that
a. pain itself is rewarding to the individual pain patient.
b. pain sensations can be eliminated by the use of behavior modification.
c. pain behaviors may have reinforcing consequences for the pain patient.
d. cognitive therapy is the most effective means of pain control.
85. Pain authority Frank Andrasik proposed that pain traps occur when
a. situations push people experiencing pain toward chronic pain.
b. a person with a pain-prone personality experiences pain.
c. A-delta fibers are stimulated at the same time as C fibers.
d. a person experiences pain at the same time as some positive situation.
Understanding and Managing Pain
86. In behavior modification programs for pain management, pain behaviors are
a. ignored.
b. punished.
c. rewarded.
d. Any of these can be a component of a behavior modification program for
pain.
87. What might be a reinforcer for pain behavior?
a. the sensory input
b. the motor output
c. the disapproval of family members
d. monetary compensation for injury
88. Cognitive therapists emphasize a change in
a. personality traits.
b. overt behavior.
c. thinking patterns.
d. philosophy of life.
89. In comparison to behavior modification techniques, cognitive therapy
a. is less effective.
b. is more solidly based in learning theory.
c. places more emphasis on the interpretation of events.
d. has a longer tradition of use for pain management.
90. According to cognitive therapists, beliefs, personal standards, and ________
strongly affect people’s behavior.
a. history of reinforcement
b. “catastrophizing”
c. suggestibility
d. implicit memory
91. Of the medical and psychological interventions for managing chronic pain,
__________ is/are probably the most effective.
a. surgery
b. opiate drugs
c. biofeedback
d. cognitive behavioral therapy
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True/False Questions
1. The largest organ of the body is the skin.
2. A recent study examined social rejection and found that the resulting emotional pain
affected brain activity similarly to physical pain.
3. Based on recent research by Yoshino et al. (2010) on mood and pain, if Courtney is
feeling happy, she should experience less pain than when she is feeling sad.
4. Efferent neurons carry nerve impulses away from the brain, whereas afferent neurons
carry nerve impulses toward the brain.
5. Women are more than twice as likely to develop rheumatoid arthritis as men.
6. Acute pain has no benefit to the person who is experiencing it.
7. Delmar constantly complained to his wife Merna about pain in his knee. Merna decided
to stop sympathizing with Delmar and to withhold any sort of positive reinforcement to his
pain behaviors, so we would expect Delmar to stop feeling pain in his knee.
8. Some people have a pain-resistant personality and are much more sensitive to pain than
other people.
9. In general, women are much more sensitive to pain than men.
10. The gate control theory assumes that pain experiences can be increased or decreased by
mechanisms in the brain and spinal cord.
11. Approximately 50% of people have reported severe headaches in the last 3 months.
12. The most common type of pain is low back pain.
13. People who complain about pain in an amputated limb are simply imagining the pain.
Understanding and Managing Pain
14. The dangers of opiate drugs outweigh their risks for pain control.
15. Medication is an important treatment for people with low back pain, and
undermedication is a serious problem for these patients.
16. Surgery is not a successful treatment for many people with low back pain.
17. According to the gate control theory, pain has only sensory components.
18. Low-back pain patients who use pain medications are at an increased risk for more
health problems than patients who do not use pain medications.
19. Providing positive feedback and assistance are the best ways to help someone with
low back pain recover.
20. Behavior modification attempts to change behavior without altering the environment.
21. Cognitive therapy and cognitive behavioral therapy both strive to alter patterns of
Essay Questions
1. Jonathan has just cut his left hand while chopping onions. Trace the sensory input
from finger to brain, mentioning the important structures in the nervous system.
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2. Did Jonathan’s cut finger hurt? What experiences and psychological factors might
increase or decrease his experience of pain?
Understanding and Managing Pain
3. Differentiate among the three stages of pain.
4. Discuss the statement “Injury does not necessarily equal pain.”
5. Compare the specificity and the gate control theory on their emphasis of
psychological factors in pain.
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6. What are the advantages and disadvantages of physiological measures, behavioral
assessments, and self-report measures of pain?
7. Evaluate the success and hazards of medical interventions for pain.
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8. What are the similarities and differences of behavior modification and cognitive
therapy as used for pain management? How does cognitive behavior therapy combine
these approaches?
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9. Eric hurt his back two years ago when he was at work, and since that time he has
experienced periods during which he could not work because of his low back pain.
Workers’ compensation has helped financially during those times, but his wife has
been burdened by doing Eric’s chores and caring for him when he is incapacitated.
His physician is reluctant to continue his prescription of opiate analgesics but
understands that Eric’s back pain is a problem and would like to get him into a
program that would help his pain. After reviewing the options, recommend a program
for Eric.
