CHRONIC ILLNESS: PAIN AND CARDIOVASCULAR DISEASE

A. Psychosocial Aspects of Pain
1. The physiology of pain
  a. The somatosensory system
  b. Pain receptors and sensory messages
  c. The role of the spinal cord
  d. Pain in the brain
    (1) Somatosensory cortex
    (2) The neurochemistry of pain
    (3) Pain modulation
2. Pain as a subjective experience
  a. Why isn’t the physiology enough?
    (1) Beecher’s studies
    (2) The role of personal variables
  b. Loeser’s model: nocioception, pain, suffering, behavior
  c. Stages of pain
    (1) Acute and prechronic
    (2) Chronic
3. Common pain syndromes
  a. Headaches
  b. Lower back pain
  c. Arthritis
  d. Cancer
  e. Phantom limb

B. Psychosocial Studies of Pain and Its Control
1. Psychosocial theories
  a. Specificity theory
  b. Gate control theory
2. Measuring pain
  a. Physiological measures
  b. Behavioral measures
  c. Self-reports: scales and questionnaires
  d. Psychological tests
3. Pain prevention
4. Medical treatments for pain
  a. Drugs: narcotic and non-narcotic
  b. Surgery
  c. Electrical stimulation
  d. Acupuncture
  e. Chiropractic
5. Psychological treatment
  a. Clearing techniques: hypnosis and meditation
  b. Focusing techniques: imagery, distraction
  c. Behavioral techniques
  d. Pain and psychopathology
    (1) Malingering
    (2) Factitious disorders
    (3) Somatoform pain disorder

C. Cardiovascular Disease: Medical Aspects
1. The cardiovascular system
  a. The heart
  b. The circulatory system: arteries and veins
2. Heart diseases
  a. Coronary artery disease: atherosclerosis, arteriosclerosis and ischemia
  b. Coronary heart disease: angina pectoris, myocardial infarction
  c. Hypertension
3. Cerebrovascular disease
  a. Ischemia and stroke
  b. Aneurysms and stroke
4. Monitoring and measuring heart function
  a. Blood pressure
  b. EKG
  c. Cardiac catheterization and angioplasty

D. Risk Factors in CVD
1. Changing rates of morbidity and mortality
2. Non-modifiable risk factors
  a. Age
  b. Sex
  c. Familial history and genetics
  d. Other physical disease
3. Modifiable risk factors
  a. Physiological
    (1) Hypertension
    (2) Serum cholesterol
  b. Behavioral
    (1) Smoking
    (2) Diet and exercise
    (3) Excessive drinking
    (4) Type A behavior pattern
  c. Emotional
    (1) Anxiety
    (2) Hostility and anger: expression and suppression
  d. Social
    (1) Education and income
    (2) Social support
4. Psychosocial intervention
  a. Barriers to behavior/lifestyle change
    (1) Habit, compulsion and addiction
    (2) Health beliefs: perceptions of risk, vulnerability, self-efficacy
  b. The objectives
    (1) Reducing hypertension
    (2) Lowering serum cholesterol
  c. The methods
    (1) Changes in diet
    (2) Weight loss and exercise
    (3) Anger management
    (4) Relaxation training and stress management

Copyright ©1998 Beverly J. Volicer and Steven F. Tello, UMass Lowell.  You may freely edit these pages  for use in a non-profit, educational setting.  Please include this copyright notice on all pages.