Background & Aims
Painful vaso-occlusive crises (VOC) constitute one of the most frequent acute complications of sickle cell disease. These painful attacks are unpredictable, repeated, sometimes hyperalgesic, and persistent in certain patients. Paroxysmal pain caused by vaso-occlusive crises (VOC) leads to lasting neurochemical and synaptic modifications of the nervous system allowing memory storage of pain. The objective of this study was to explore the existence and nature of the relationship between pain memory of the worst attack experienced and patients’ self-reported pain intensity during a new VOC.
Methods
We conducted a cross-sectional, non-experimental quantitative study (8 months) at the integrated sickle cell treatment center at Laquintinie hospital in Douala. Data collection was carried out from a sample (obtained by reasoned choice) of 53 sickle cell patients aged 10 to 30 years, hospitalized for severe painful VOC. This sample size was determined by an a priori power analysis using G*Power software. The pain intensity of current VOC was assessed by visual analog scale (VAS). The dimensions of pain memory of the worst attack were evaluated retrospectively with the following tools: the Saint Anthony pain questionnaire (QDSA), the subjective units of distress scale (SUDS), and the VAS. The data analysis was done with the SPSS-v21 software and for the examination of our research hypotheses, we opted for the Pearson correlation test, the multiple regression test.
Results
The results of the correlational analyzes made it possible to conclude on the basis of the correlation coefficients (r) and the respective degrees of significance (P-value) (H1: r = 0.733 and P(0.000); H2: r=0.623 and P(0.000); H3: r = 0.511 and P(0.000); H4: r = 0.627 and P(0.000)) to the existence of a significantly positive association between the dimensions of pain memory of the worst attack experienced and self-reported pain intensity of current VOC. The regression analysis made it possible to conclude on the basis of a regression coefficient R=0.803 with an associated P-value p=0.000 and an R-two=0.644 that 3/4 dimensions of pain memory explain 64.4 % of pain severity in sickle cell patients during new VOC with persistent pain.
Conclusions
The results obtained in this study underline the words of Milton H. Erickson who said that in all pain, there was for one third the current pain, for another third the memorized pain, and that the last third was made up of fear of future pain.
References
– Albanese, M. C., Duerden, E. G., Rainville, P., Duncan G. H. (2007). Memory traces of pain in human cortex. J Neuroscience 27:4612–20
– Angers, M. (1996). Practical introduction to human sciences methodology. Casbah University
Anie, K.A., Egunjobi, F.E., Akinyanju, O.O. (2010). Psychosocial impact of sickle cell disorder: perspectives from a Nigerian setting. Global Health, 6, 2.
– Atkinson, R. C. & Shiffrin, R. M. (1968). Human memory: A proposed system and its control processes. In K. W. Spence and J. T. Spence (Eds.). The Psychology of Learning and Motivation: Advances in Research and Theory (Vol. 2, pp. 89-195). New York: Academic Press.
– Baddeley, A. D. & Hitch, G. J. (1974). Working memory. In G.A. Bower (Ed.) Recent advances in learning and motivation, Vol. 8, 47-90. New York: Academic Press.
– Baddeley, A. D. (1974). The episodic buffer: A new component of working memory? Trends in Cognitive Sciences, 12: 417-423.
– Bioy A. & Lignier B. (2020). Clinic and psychopathology of pain. Dunod
– Cascella M., Thompson N.S., Muzio M.R., Forte C.A. Cuomo A. (2016, August). The underestimated role of psychological and rehabilitation approaches for management of cancer pain. A brief commentary. Recenti Prog Med. 107(8):418-21. [PubMed]
– Croisile, B. (2009). All about memory. Éditions Odile-Jacob, Paris
– Croisile, B. (2009). Neurocognitive approach to memory
– Dale, J. C., Cochran, C. J., Roy, L., Jernigan, E., Buchanan, G. R. (2011). Health-related quality of life in children and adolescents with sickle cell disease. J Pediatr Health Care. 25(4):208–15. [PMC free article] [PubMed] [Google Scholar] [Ref list]
– Danziger, N., Faillenot, I., Peyron, R. (2009). Can we share a pain we never felt? Neural correlates of empathy in patients with congenital insensitivity to pain. Neuron 61:203–12
– Dennis, S. G. & Melzack, R. (1979). Self-mutilation after dorsal rhizotomy in rats: effects of anterior pain and pattern of radicular lesions. Experimental Neurology. 65 (2):412–421. doi: 10.1016/0014-4886(79)901080)901080 [PubMed] [ CrossRef ] [Google Scholar]
– Duncan, G. (2000, August). Mind-body dualism and the biopsychosocial model of pain: what did Descartes really say? JMed Philos.; 25 (4):485-513. [PubMed]
-Ebakisse-Badassou, E. (2010). The International Organization Against Sickle Cell Disease (OILD) and the fight against sickle cell disease. Med Trop. 70(5-6):464–6. [PubMed] [Google Scholar] [Ref list]
Erskine, A., Morley, S., Pearce, S. (1990). Memory for pain: a review. Bread 41:255–65
– Faure, J., Hanquet, P. (2009). Suffering and complaints in adult sickle cell patients in painful crisis. Nursing research.
– Garland, E. L. (2012, September). Pain processing in the human nervous system: a selective review of nociceptive and biobehavioral pathways. Prim Care. 39(3):561-71. [PMC free article] [PubMed]
– Ghaemi, S. N. (2009, July). The rise and fall of the biopsychosocial model. Br J Psychiatry. 195(1):3-4. [PubMed]
– Hase, M., Balmaceda, U. M., Ostacoli, L., Liebermann, P., Hofmann, A. (2017, September). The AIP Model of EMDR Therapy and Pathogenic Memories. Front Psychol. 21; 8:1578. doi: 10.3389/fpsyg.2017.01578. PMID: 28983265; PMCID: PMC5613256.
– Jackson, P.L., Meltzoff, A.N., Decety, J. (2005). How do we perceive the pain of others? A window into the neural processes involved in empathy. Neuro-Image 24:771–9
– Jensen, M. P., Turk, D. C. (2014, Feb-Mar). Contributions of psychology to the understanding and treatment of people with chronic pain: why it matters to ALL psychologists. Am Psychol. 69(2):105-18. [PubMed]
– Ji, R.R., Kohno, T., Moore, K.A., Woolf, C.J. (2003). Central sensitization and LTP: do pain and memory share similar mechanisms? Trends Neurosci 26:696–705
– Katz, J., Melzack, R. (1990). “Memories” in phantom limbs: assessment and clinical observations. PAIN. 43 (3):319–336. doi: 10.1016/0304-3959(90)90029D)90029D [ PubMed ] [ CrossRef ] [ Google Scholar ]
– Kengne Fotsing, B. C., Pieme, A. C., Biapa Nya, C. P., Chedjou, P. J., Ashusong, S., Njindam, G., Nengom, J. T., Teto G., Nguemeni C., Fon Mbacham W., Gatsing D. (2021 , October). Haptoglobin Gene Polymorphism among Sickle Cell Patients in West Cameroon: Hematological and Clinical Implications. Adv Hematol. 20;2021:6939413. doi:10.1155/2021/6939413. PMID: 34721583; PMCID: PMC8550853.
– Laurent, B. (2011) Memory of pain. Anal pain 24:S2-S13 DOI 10.1007/s11724-011-0249-5
Loeser, J. D., Melzack R. (1999, May) Pain: an overview. Lancet. 08; 353(9164):1607-9. [PubMed]
– Luboya, E., Tshilonda, J-C. B., Ekila M. B., Aloni M. N. (1999, May) Psychosocial repercussions of sickle cell disease on parents of children living in Kinshasa, Democratic Republic of Congo: a qualitative study. Pan African Medical Journal. 19:5. [PMC free article] [PubMed] [Google Scholar] [Ref list]
– Lugg, W. (2022, Feb). The biopsychosocial model – history, controversy and Engel. Australas Psychiatry. 30(1):55-59. [PubMed]
– Mbassi, A.H.D., Dongmo, F., Ngo Um, S., Maffo, F.V., Yanda, A.A., Njom, N.A.E., et al. Epidemiological, clinical and therapeutic aspects of vaso-occlusive crises in children with sickle cell disease in hospitals in Yaoundé Health Sci Dis. 2017;18(4):89–97. [Google Scholar] [Ref list]
– Mehta, N. (2011, January) Mind-body dualism: a critique from a health perspective. Men Sana Monogr. 9 (1):202-9. [Free PMC article] [PubMed]
– Meints, S.M., Edwards, R.R. (2018, December). Evaluating psychosocial contributions to chronic pain outcomes. Prog Neuropsychopharmacol Biol Psychiatry. 20;87(Pt B):168-182. [PMC free article] [PubMed]
– Melzack, R. (2001, December). Pain and the neuromatrix in the brain. J Dent Educ. 65(12):1378-82. [PubMed]
– Melzack, R. (2004). Evolution of the neuromatrix theory of pain. The Prithvi Raj Lecture: presented at the third World Congress of World Institute of Pain, Barcelona. Pain Pract. 5(2):85-94. [PubMed]
Melzack, R. Wall, P. D. (1965, November). Pain mechanisms: a new theory. Science. 19; 150(3699):971-9. [PubMed]
– Monfils, M. H., Cowansage, K. K., Klann, E., LeDoux, J. E. (2009). Extinction-reconsolidation boundaries: key to persistent attenuation of fear memories. Science 324:951–5
– Morley, R. (1993). Vivid memory for “everyday” pains. Bread 55:55–62
– Moro, M-R. (1998). “Pain, cultures and migration”, Medical publishing and communication, Rhône-Poulence, Everyday health
– Morrison, I., Lloyd, D., di Pellegrino, G., Roberts, N. (2004). Vicarious responses to pain in anterior cingulate cortex: is empathy a multisensory issue? Cogn Affect Behav Neurosci 4:270–8
– N’Da, P. (2015). Research and methodology in social and human sciences: Succeed in your thesis, master’s or professional thesis, and article. The harmattan
– Nga Motaze, A. C. Neonatal screening for sickle cell disease in Cameroon: retrospective study on 5846 newborns at the Essos Hospital Center. Health Sci Dis. 2013 [Google Scholar] [Ref list]
– Nijs, J.; D’Hondt, E., Clarys, P., Deliens, T., Polli, A., Malfliet, A., Coppieters, I., Willaert, W., Tumkaya Yilmaz, S., Elma, Ö., Ickmans, K. (2020, April) Lifestyle and Chronic Pain across the Lifespan: An Inconvenient Truth? PM R. 12(4):410-419. [PubMed]
– Pearce, J. M. (2006, December) Von Frey’s pain spots. J Neurol Neurosurg Psychiatry. 77(12):1317. [PMC free article] [PubMed]
– Perl, E.R. (2011 June). Pain mechanisms: a commentary on concepts and issues. Prog Neurobiol. 94(1):20-38. [PMC free article] [PubMed]
– Perruchoud C., Albrecht E., Moret V. (2017). Practical algology manual: Management of chronic pain. Elsevier Masson SAS
– Peyron, R., García-Larrea, L., Grégoire M. C., et al (1999). Haemodynamic brain responses to acute pain in humans: sensory and attentional networks. Brain 122:1765–79
– Pickering, G., Laurent, B. (2013). Memory of pain. Anal pain 26:38-44 DOI 10.1007/s11724-013-0327-y
WHO. Sickle cell disease: A strategy for the WHO African region. Report of the Director of the Regional Committee for Africa, Sixtieth session Malabo, Equatorial Guinea. Geneva, Switzerland: WHO; 2010. [Google Scholar] [Reference list]
– Ropero Peláez, F.J., Taniguchi, S. (2016). The Gate Theory of Pain Revisited: Modeling Different Pain Conditions with a Parsimonious Neurocomputational Model. Neural Plast. 2016:4131395. [PMC free article] [PubMed]
– Ruffieux, N. (2011). Cognitive deficits in children and adolescents with sickle cell disease. Doctoral thesis: Univ. Geneva, no. FPSE 482. DOI: 10.13097/archive-ouverte/unige:16874
– Senba, E., Kami, K. (2017, Jan-Jul). A new aspect of chronic pain as a lifestyle-related disease. Neurobiol Pain. 1:6-15. [PMC free article] [PubMed]
– Shapiro, F. (2001a). Eye Movement Desensitization and Reprocessing – Basic Principles, Protocols and Procedures. New York, NY: Guilford. [Google Scholar] [List of references]
– Singer, T., Seymour, B., O’Doherty, J. et al (2004). Empathy for pain involves the affective but not sensory components of pain. Science 303:1157–62
– Solomon, R.M., Shapiro, F. (2008). EMDR and the adaptive information processing model as potential mechanisms of change. J. EMDR practice. Res. 2 315–325. 10.1891/1933-3196.2.4.315 [CrossRef] [Google Scholar]
– Squire, L.R. (1980). Specifying the defect in human amnesia: storage, retrieval and semantics. Neuropsychology; 18(3): 369-372.
– Trachsel, L.A., Munakomi, S., Cascella, M., (2022, April 20). Pain Theory. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545194/
– Tulving E. (1972). Episodic and Semantic Memory. In Endel Tulving, Wayne Donaldson (Eds), Organization of Memory. Academic Press, New York: 381-403. no130_pp 011a 029.indd 29 o130_pp 011 a 029.indd 29 30/09/09 17:09:30 0/09/09 17:09:30© Fondation Nationale de Gérontologie | Downloaded on
– Van Campendhout, B., Quivy, R. (2011). Social science research handbooks. Dunod. (4th Ed.)
– Viard, A., Piolino, P., Desgranges, B. et al (2007). Hippocampal activation for autobiographical memories over the entire lifetime in healthy aged subjects: an fMRI study. Cereb Cortex 17:2453–67
– Wonkam, A., Ngo Bitoungui, V.J., Ngogang, J. (2015). Perspectives in genetics and prevention of sickle cell disease in Africa: beyond preliminary data from Cameroon. Public health genomics. 18 (4): 237-241. Do I: 10.1159/000431020. [PMC free article] [PubMed] [CrossRef] [Google Scholar] [Reference list]
– Yoo, H., Cho, Y., and Cho, S. (2023). Does past/current pain change the experience of pain? Compare self-assessments and student responses. In front. Psycholic.14:1094903. Do I: 10.3389/fpsyg.2023.1094903
Presenting Author
Aichatou Nguumpouwouo
Poster Authors
Topics
- Specific Pain Conditions/Pain in Specific Populations: Acute Pain and Nociceptive Pain