Alexander Millar

A2 Psychology
The Role of Cognition in Pain
Refers to the thought process behind the experience of pain, and its management. Cognition has an
important role in the experience of pain as what the pain means to a person often affects the perceived
severity of it.
Catastrophizing
Catastrophizing refers to a three part thought process about pain, generally occurring in patients
suffering chronic pain. First, rumination- A focus on threatening information from both internal and
external sources. This could be something like a continued focus on a clicking neck, or a health risk
warning from a doctor. This continued focus leads to the second part, magnification- An inflated risk
perception of the situation. For example, I have a persistent headache, therefore I have a tumor in my
brain that is killing me. The final part is helplessness- An underestimation of the personal resources as
well as broader resources that may minimize or mitigate the chance of risk or danger. I.e., there is no
one who knows whats happening to me or how to fix it, and this pain is too much for me to handle.
Catastrophizing leads to a heightened perception if pain and may even lead to the development of new
pains. Crombez et al (2003), found that catastrophizing occurs independent of age or gender, and those
who suffered from it invariably had heightened feelings of pain.
Meaning
Pain is seen to have a strongly and predominantly negative association and meaning, but this is not
always true. What the pain means to a person is highly important part of how they experience it and
cope with it. There is the argument between men and women over which hurts more, child birth or
being hit in the crotch. Child birth has a very clear cause and benefit, which can play a huge role in the
experiencing of that pain. If that same level of pain were to happen without the reward, it would
probably have a totally different experience, and likely far more painful. A hit in the crotch has no such
reward, and therefore has no mitigating factors, making it harder for the person undergoing the pain to
justify its management.
Attention
Studies have been done on the relationship between the attention paid to pain, and the intensity and
longevity of the pain. These studies have found that attention focused on the pain can exacerbate the
pain or intensify it, compared to where a reduction in the attention paid can lead to a reduced
experience of the pain. Eccleston and Crombez(1999) put forward a model on the relationship between
pain and attention. Assuming that you have a limited maximum cognitive load, pain is a cognitive
process that takes up some of your attention. This means that the more cognitive time you spend on it,
the greater the pain will be. By focusing on other matters, your cognitive load is increased, decreasing
the amount of space you have to think about and experience the pain.
Self-Efficacy
Pain self-efficacy may have a role in pain perception and the reduction of it. You confidence in your
ability to handle all the steps required to cope with the pain can have an impact on its severity. This
belief of control has the opposite effect from the helplessness from catastrophizing. This goes hand-in-
hand with a locus of control over who is responsible for pain relief and management.