Article

Toward a Unifying Definition of Psychological Pain

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Abstract

Loss and trauma are often associated with psychological pain. However, a generally accepted understanding and clear definition of what is constituted by psychological pain do not exist. Morse and colleagues' criteria (definition, characteristics, boundaries, preconditions, outcomes) were used to analyze related concepts (suffering, psychache, emotional pain, and psychic pain) that could contribute to a definition of psychological pain. The analysis indicated that psychological pain may best be defined as a lasting, unsustainable, and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self. This negative self-appraisal is typically brought on by loss of someone or something, or failure to achieve something that is intimately linked to core psychological needs.

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... Other terms, in addition to psychache and emotional pain that have also been used to describe PsyPn include suffering (Morse, 2011;Rehnsfeldt & Eriksson, 2004), mental pain (Orbach, Mikulincer, Sirota, & Gilboa-Schechtman, 2003), and psychic pain (Yager, 2015). Literature reviews have been conducted on these terms and researchers argued they all refer to the same concept (Conejero et al., 2018;Meerwijk & Weiss, 2011); therefore, there was a call to unify the terms under the umbrella of "psychological pain" (Meerwijk & Weiss, 2011). The recent unification efforts led to the development of an accepted definition after careful examination of various concepts and models of PsyPn: "a lasting, unsustainable and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self" (Meerwijk & Weiss, 2011). ...
... Other terms, in addition to psychache and emotional pain that have also been used to describe PsyPn include suffering (Morse, 2011;Rehnsfeldt & Eriksson, 2004), mental pain (Orbach, Mikulincer, Sirota, & Gilboa-Schechtman, 2003), and psychic pain (Yager, 2015). Literature reviews have been conducted on these terms and researchers argued they all refer to the same concept (Conejero et al., 2018;Meerwijk & Weiss, 2011); therefore, there was a call to unify the terms under the umbrella of "psychological pain" (Meerwijk & Weiss, 2011). The recent unification efforts led to the development of an accepted definition after careful examination of various concepts and models of PsyPn: "a lasting, unsustainable and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self" (Meerwijk & Weiss, 2011). ...
... Literature reviews have been conducted on these terms and researchers argued they all refer to the same concept (Conejero et al., 2018;Meerwijk & Weiss, 2011); therefore, there was a call to unify the terms under the umbrella of "psychological pain" (Meerwijk & Weiss, 2011). The recent unification efforts led to the development of an accepted definition after careful examination of various concepts and models of PsyPn: "a lasting, unsustainable and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self" (Meerwijk & Weiss, 2011). ...
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Background Suicide is a public health concern, with an estimated 1 million individuals dying each year worldwide. Individual psychological pain is believed to be a contributing motivating factor. Therefore, establishing a psychometrically sound tool to adequately measure psychological pain is important. The Orbach and Mikulincer Mental Pain Scale (OMMP) has been proposed; however, previous psychometric analysis on the OMMP has not yielded a consistent scale structure, and the internal consistency of the subscales has not met recommended values. Therefore, the primary purpose of this study was to assess the psychometric properties of the OMMP in a diverse sample. Methods A confirmatory factor analysis (CFA) on the 9-factor, 44-item OMMP was conducted on the full sample ( n = 1151). Because model fit indices were not met, an exploratory factor analysis (EFA) was conducted on a random subset of the data ( n = 576) to identify a more parsimonious structure. The EFA structure was then tested in a covariance model in the remaining subset of participants ( n = 575). Multigroup invariance testing was subsequently performed to examine psychometric properties of the refined scale. Results The CFA of the original 9-factor, 44-item OMMP did not meet recommended model fit recommendations. The EFA analysis results revealed a 3-factor, 9-item scale (i.e., OMMP-9). The covariance model of the OMMP-9 indicated further refinement was necessary. Multigroup invariance testing conducted on the final 3-factor, 8-item scale (i.e., OMMP-8) across mental health diagnoses, sex, injury status, age, activity level, and athlete classification met all criteria for invariance. Conclusions The 9-factor, 44-item OMMP does not meet recommended measurement criteria and should not be recommended for use in research and clinical practice in its current form. The refined OMMP-8 may be a more viable option to use; however, more research should be completed prior to adoption.
... The experience of psychic pain (PP)-alternately referred to as psychological pain, emotional pain or suffering, and psychache (Meerwijk & Weiss, 2011;Shneidman, 1993)-is known to be associated with adverse clinical health outcomes, including increased risk for engagement in self-destructive behaviors (Hendin, Maltsberger, Haas, Szanto, & Rabinowicz, 2004;Maltsberger, 2004;Tossani, 2013;Verrocchio et al., 2016). Although certain definitions of PP contrast it from experiences of physical pain (Meerwijk & Weiss, 2011), recent studies have identified a substantial degree of biological overlap between emotional suffering and experiences of pain in the body ( DeWall et al., 2010;Tsur, Shahar, Defrin, Lahav, & Ginzburg, 2017). ...
... The experience of psychic pain (PP)-alternately referred to as psychological pain, emotional pain or suffering, and psychache (Meerwijk & Weiss, 2011;Shneidman, 1993)-is known to be associated with adverse clinical health outcomes, including increased risk for engagement in self-destructive behaviors (Hendin, Maltsberger, Haas, Szanto, & Rabinowicz, 2004;Maltsberger, 2004;Tossani, 2013;Verrocchio et al., 2016). Although certain definitions of PP contrast it from experiences of physical pain (Meerwijk & Weiss, 2011), recent studies have identified a substantial degree of biological overlap between emotional suffering and experiences of pain in the body ( DeWall et al., 2010;Tsur, Shahar, Defrin, Lahav, & Ginzburg, 2017). Psychological pain has been found to be strongly associated with suicide-related outcomes in particular ( Verrocchio et al., 2016), with many studies showing that PP is related to the frequency and lethality of suicide attempts over and above other well-known risk factors, such as depression and hopelessness (Campos & Holden, 2015;Troister & Holden, 2012). ...
... Psychological pain has been found to be strongly associated with suicide-related outcomes in particular ( Verrocchio et al., 2016), with many studies showing that PP is related to the frequency and lethality of suicide attempts over and above other well-known risk factors, such as depression and hopelessness (Campos & Holden, 2015;Troister & Holden, 2012). Despite the clear importance of assessing current PP during suicide risk evaluations in clinical settings, inconsistency in use of terms and definitions and a wide variety of measurement approaches have contributed to difficulty in understanding the associations between PP and clinical health outcomes across settings and studies (Meerwijk & Weiss, 2011;Tossani, 2013). There are a limited number of assessments that are rooted in clear theoretical frameworks that could help to clarify and contextualize empirical findings. ...
Article
Psychological pain is an important contributing factor to suicide risk. The present study examined the psychometric properties of the Psychic Pain Scale (PPS), a new measure assessing unbearable negative affect as described in Maltsberger’s theory of suicidality. The PPS was administered to n = 131 adult psychiatric patients as well as n = 953 undergraduate students. An initial factor analysis which replicated across both clinical and undergraduate samples identified two factors, affective deluge, and loss of control. These subscales were associated with risk factors including trauma history, severity of psychopathology, and decreased resilience, as well as a range of pathological personality traits. Findings support the utility of the PPS as a measure of psychological pain and point to future directions of empirical evaluation.
... In psychiatry, mental suffering has been conceptualised in various ways. In their summary on existing literature, Meerwijk and Weiss (2011) noted that a central component of mental suffering is the experience of negative emotions. In addition, mental suffering involves negative appraisal of a deficient self, which is a lasting experience that cannot be sustained indefinitely without adverse consequences (Meerwijk & Weiss 2011: 10). ...
... In addition, mental suffering involves negative appraisal of a deficient self, which is a lasting experience that cannot be sustained indefinitely without adverse consequences (Meerwijk & Weiss 2011: 10). Negative self-appraisal is typically triggered by the loss of someone or something or by the failure to fulfil core psychological needs (Meerwijk & Weiss 2011). ...
... The response to mental pain can be pathogenic, and consequently suffering is seen to co-occur with a wide array of psychopathological disorders, including borderline personality disorder, acute psychosis, schizophrenia and post-traumatic stress disorder (Meerwijk & Weiss 2011). Mental suffering can also be seen as a type of psychiatric symptom that indicates the severity of psychopathological conditions (Vanheule 2017), with suicide perhaps being its most radical outcome. ...
Chapter
The experience of suffering may result in a breakdown of commonly shared meaning, namely the disintegration of intersubjectivity. This article investigates patients’ expressions of suffering and professionals’ attempts to maintain intersubjective understanding in interactions that are conducted in psychiatric outpatient care. The analysis demonstrates that patients’ expressions of suffering involve a strong emotional experience and a particular kind of passivity: tolerance of agonising pain and endurance of what is unbearable. For their part, professionals attempt to verbalise and explain the patient’s experience in order to build a shared world of meaning. The article argues that by locating suffering in the symptoms of an illness, professionals structure suffering into a medical problem. This enables them to suggest appropriate treatment options aimed at eliminating suffering.
... Mental pain (MP) is progressively gaining clinical relevance in the field of psychiatry and clinical psychology [1][2][3][4]. It could be described as a subjective, overwhelming, and unbearable experience characterized by a number of uncomfortable emotions-such as anguish, anger, emptiness, agitation, and guilt-which arises from negative self-evaluations and self-awareness of one's own inabilities and failures [1][2][3][4]. ...
... Mental pain (MP) is progressively gaining clinical relevance in the field of psychiatry and clinical psychology [1][2][3][4]. It could be described as a subjective, overwhelming, and unbearable experience characterized by a number of uncomfortable emotions-such as anguish, anger, emptiness, agitation, and guilt-which arises from negative self-evaluations and self-awareness of one's own inabilities and failures [1][2][3][4]. Over the past decades, it has also been present in the literature as suffering [5,6], psychic pain, psych-ache, emotional pain, psychological pain, social pain, emptiness, or internal perturbation [1,[7][8][9]. ...
Article
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Mental pain (MP) is a transdiagnostic feature characterized by depression, suicidal ideation, emotion dysregulation, and associated with worse levels of distress. The study explores the presence and the discriminating role of MP in EDs in detecting patients with higher depressive and ED-related symptoms. Seventy-one ED patients and 90 matched controls completed a Clinical Assessment Scale for MP (CASMP) and the Mental Pain Questionnaire (MPQ). ED patients also completed the Beck Depression Inventory-II (BDI-II), Clinical Interview for Depression (CID-20), and Eating Attitudes Test (EAT-40). ED patients exhibited significantly greater severity and higher number of cases of MP than controls. Moreover, MP resulted the most important cluster predictor followed by BDI-II, CID-20, and EAT-40 in discriminating between patients with different ED and depression severity in a two-step cluster analysis encompassing 87.3% (n = 62) of the total ED sample. Significant positive associations have been found between MP and bulimic symptoms, cognitive and somatic-affective depressive symptoms, suicidal tendencies, and anxiety-related symptoms. In particular, those presenting MP reported significantly higher levels of depressive and anxiety-related symptoms than those without. MP represents a clinical aspect that can help to detect more severe cases of EDs and to better understand the complex interplay between ED and mood symptomatology.
... with which they can no longer cope. Psychological pain has been defined as ''a lasting, unsustainable, and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self'' (Meerwijk & Weiss, 2011) and is a significant risk factor for suicide in people with and without a mental health diagnosis (Verrocchio et al., 2016;Rizvi et al., 2017). As predicting suicide attempts remains notoriously difficult (Turecki & Brent, 2016), there is a need to explore new avenues to enhance the validity of suicide risk assessments. ...
... The PS-TF uses the same items as the original PS; however, to have respondents focus on current psychological pain, we modified the last sentence of the instructions at the top of the scale to read ''Please indicate how frequently each of the following has been occurring during the past week, including today''. This time frame was chosen because psychological pain is a lasting state that takes time for resolution (Meerwijk & Weiss, 2011) and we assumed psychological pain to linger with varying intensity for days at least. Moreover, the widely used Beck Scale for Suicide ideation (Beck, Brown & Steer, 1997) uses the same time frame to assess thoughts of suicide and suicidal behavior. ...
Article
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Background Assessing psychological pain has been recommended as an integral part of a comprehensive suicide risk assessment. The Psychache Scale, an established measure of psychological pain, does not specify a time frame for when pain is experienced, which may inadvertently increase the likelihood of identifying individuals as being at elevated suicide risk when they complete the Psychache Scale based on psychological pain experienced at some undefined time in the past. Methods We conducted a national general population survey among United States adults to determine whether addition of a time frame to the instructions of the Psychache Scale would more accurately reflect current psychological pain and more effectively identify people with current suicide ideation. A between-subjects design was used where respondents were randomized to complete the original Psychache scale or a modified scale with time frame. Data were collected online from September 2015 to June 2016. A total of 242 respondents had complete psychological pain data: 133 completed the original Psychache Scale and 109 completed the Psychache Scale with time frame. Results Addition of a time frame did not result in differences in psychological pain scores. However, when screening for participants with current suicide ideation, 13% fewer false positives were observed with the modified scale at higher cut-off values than previously reported (38 vs. 24). The substantial increase in positive predictive value suggests that a time frame is a worthwhile addition to the Psychache Scale. Discussion We recommend using the Psychache Scale with a time frame and testing the cut-off score for suicide ideation in population samples that reflect the general population more accurately. Psychological pain cut-off scores in clinical samples have yet to be established.
... Mental pain is a prominent painful experience among people who have experienced loss and trauma (e.g., Mee et al. 2006) and has been identified as one of the most important risk factors for suicidal behavior (e.g., Ducasse et al. 2017;Verrocchio et al. 2016). In its extreme form, mental pain is a core component of suicide ideation (e.g., Meerwijk and Weiss 2011) and as such is experienced by millions of people, including 5.6% in the general U.S. population and 53% in patients with severe mental illness (American Psychiatric Association 2003). In its mild form, it can be momentarily experienced by almost every person coping with life adversities and stressful events, and tend to include Ba wide range of subjective experiences characterized as an awareness of negative changes in the self and in its functions accompanied by negative feelings^ (Orbach et al. 2003b, p. 228). ...
... The OMMP scale has already proved to be particularly effective for assessing mental pain in several clinical samples (e.g., Meerwijk and Weiss 2011;Trent Haines et al. 2015) as well as in community samples (e.g., Soumani et al. 2011). It was validated in Israel (Gvion et al. 2014;Levi et al. 2008;Orbach et al. 2003a, b;Shelef et al. 2015) and Portugal (Guimarães et al. 2014). ...
Article
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The main goal of the study was to evaluate Orbach’s multidimensional model of mental pain in Italy, while constructing a reliable and valid Italian version of the 40-item Orbach and Mikulincer Mental Pain scale (OMMP) in a non-clinical sample. The sample consisted of 544 Italian adults. Findings indicated that the original 8-factor structure of the OMMP scale was not validated in our Italian version of the scale. Confirmatory factor analyses yielded a 31-item solution, with five main factors (Irreversibility, Lack of control and Freezing, Narcissistic wounds, Emotional flooding, Emptiness). Women scored higher than men in emotional flooding and lack of control, age was inversely related to the reported level of mental pain, and participants who were married or had a long, stable couple relationship showed lesser emotional suffering than singles. This study has shown the OMMP to be a valid and reliable scale for assessing mental pain in the general population. Future studies are needed in order to examine the replicability of the 5-factor model as well as the validity of the OMMP factors in clinical samples in the Italian context.
... 9 Suicide has been proposed as a strategy to alleviate an overwhelming painful internal state, 12,13 and a diminishing ability to tolerate psychological pain may precede suicidal behavior. 14 Suicidal crises, frequently triggered by interpersonal conflict, are associated with overwhelming psychological pain. 14 Unbearable psychological pain is the reason most frequently stated in suicidal notes from individuals who complete suicide. ...
... 14 Suicidal crises, frequently triggered by interpersonal conflict, are associated with overwhelming psychological pain. 14 Unbearable psychological pain is the reason most frequently stated in suicidal notes from individuals who complete suicide. 15 Moreover, psychological pain is closely correlated with suicidal ideation. ...
Article
Objective: Chronic pain is frequently comorbid with opioid abuse and severe depression, a combination that greatly compounds suicide risk. In addition to the therapeutic value of buprenorphine in addiction and analgesia, growing evidence suggests potential use as an antidepressant. Data supporting buprenorphine antisuicidal properties are scarce. We aim to contribute to the discussion of buprenorphine antisuicidal potential in patients with significant psychiatric and medical comorbidity. Methods: We performed a chart review of suicidal adult depressed patients with comorbid chronic pain and opioid use disorder who received off-label buprenorphine in outpatient and inpatient settings in a university hospital between 2013 and 2016. Results: Four of the patients had an early positive response. However, only three continue to adhere to treatment for six months or longer. Conclusions: More severe opioid use disorder seems to more negatively influence clinical outcome, independently of cluster b personality traits. Identification of patients who could benefit from buprenorphine will require further studies.
... The experience of temporal disintegration is associated with trauma and is much more likely in clinical settings where it may manifest as temporal distortion, confusion about time and the order of events, a sense of timelessness, feeling in slow motion, foreshortened or no sense of the future (Holman & Silver, 1998Livneh, 2013;Melges, 1982). These same per- ceptions are consistent with and central to various other psychological conditions; for example, the disintegrated self (Meerwijk & Weiss, 2011), blunting and misappraisal of PA and NA (Furman, Waugh, Bhattacharjee, Thompson, & Gotlib, 2013;Pe & Kuppens, 2012), (dissociative) fugue (Jha & Sharma, 2015), the deconstructed self (Twenge, Catanese, & Baumeister, 2003) and the dissociated self ( Dalenberg et al., 2012). It is anticipated that, although not likely to be as serious as those experiencing disintegration, the issues will be pro- found and on a spectrum towards psychopathology. ...
... One of the most important theories proposed to prevent suicide and determine its predictors is the Mental Pain Theory [6]. Psychache, which is also known as mental pain or psychological pain, is an unbearable, irritating emotion due to frustrations, lovelessness, shame, attention problems, and failure [7,8]. Verrocchio et al. [9] indicated that the predictive effect of psychache on suicide was independent of the diagnosis. ...
Article
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OBJECTIVE: Psychological pain has been accepted as one of the most critical psychological risk factors underlying suicidal ideation and behaviour. Suicide is chosen as a way to get rid of intense, painful and unbearable psychological pain. Since the level of tolerance rather than the intensity of psychological pain was considered to be more predictive for suicide, we aimed to investigate the validity and reliability of the Turkish version of Tolerance for Mental Pain Scale-10 (TMPS-10). METHODS: A total of 121 patients diagnosed with depression in 62 of them had previous suicide attempts and 105 healthy controls who applied to the outpatient clinics of Çukurova University Faculty of Medicine Psychiatry Department were included in the study. Beck Depression Inventory (BDI), Beck Scale for Suicidal Ideation (BSIS), Beck Hopelessness Scale (BHS), Psychache Scale (PS) and TMPS-10 were applied to participants. RESULTS: In the internal consistency analysis, Cronbach’s alpha coefficient was 0.96 for enduring the pain, 0.96 for managing the pain, 0.98 for the whole scale, and item-total correlation coefficients were found to be between 0.87 and 0.93. The scale fit well to both the two-factor and single-factor structure in the confirmatory factor analysis. The multi-group confirmatory factor analysis showed that both the depressive patients and the control group interpreted the scale items in the same way. In convergent validity analysis, there was a negative, linear, high and statistically significant relationship between TMPS-10 scores and PS, BSIS, BDI and BHS scores (r = −0.935; −0.779; −0.890; −0.808; p < .0.001, respectively). In discriminant function analysis, TMPS-10 successfully differentiated the depressive group and the control group, as well as the depressive patients who did or did not attempt suicide (96.5%, 88.1%, respectively). CONCLUSION: The Turkish version of TMPS-10 is valid and reliable, and may be useful in research and clinical practices about suicide.
... MP is a negative emotional experience, different from anxiety and depression with which it may share some features [23], reflecting mainly existential dissatisfaction, loss of meaning, and low self-esteem [24] suicidal tendencies [25,26]. ...
... Various authors have used different terminology to define the existence of emotional pain. Most recently, Meerwijk and Weiss (2011) used the concept of psychological pain to define "a lasting, unsustainable, and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self" (p. 410). ...
Article
This article will present an integrated approach for treating emotional distress. The authors review the purposes of emotions and explore how they operate in individuals’ lives based on learned responses and inaccurate perceptions. Distinct categories of emotions are identified, including both maladaptive and adaptive forms. Basic ideologies and negative evaluations will also be reviewed to illustrate how these patterns develop and maintain disturbing conditions. The authors will examine the complimentary association between affective and cognitive material and how treating both in therapy can be beneficial. Emotion and cognitive-based interventions will be presented through the use of a case study.
... Le sens habituel de la notion de souffrance est plus spécifique que la simple qualité désagréable d'une expérience subjective. Encore, les définitions de souffrance, ou de douleur psychologique, sont multiples et variées (Mee et al., 2006;Meerwijk & Weiss, 2011;Orbach, Mikulincer, Sirota, & Gilboa-Schechtman, 2003). La signification de souffrance inspirant le présent travail va comme suit : souffrir est vivre un état émotionnel désagréable excessivement intense ou prolongé. ...
Article
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L’article identifie trois niveaux de mentalisation de la souffrance : agonie, détresse et tristesse adaptative. L’agonie est l’expérience d’une souffrance non représentée; la détresse est l’expérience d’une souffrance représentée, mais trop « entière » ou concrète pour être gérée subjectivement; la tristesse adaptative est une souffrance représentée et tolérée qui facilite l’élaboration de la perte. L’abord clinique de ces qualités de souffrance est souvent limité à savoir s’il faut amplifier l’expérience de la souffrance ou s’il faut la soulager. L’article propose que la souffrance mal mentalisée doit être transformée afin d’aider les clients à « souffrir mieux ».
... Emotional pain Several researchers and theorists suggested that emotional pain is a key component of suicidal behavior (Barzilay & Apter, 2014). Also termed psychological pain, psychache, or mental pain, emotional pain can be defined as intense unpleasant negative emotions which may be characterized by feelings of hurt, anguish, brokenness, and being wounded (Bolger, 1999;Meerwijk & Weiss, 2011;Shneidman, 1999). The concept of psychological pain and its relation to suicidality dates back to Shneidman (1987), as he postulated that it may become so intolerable that it results in suicide. ...
Article
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Suicide is a major public health problem, and suicide rates are still on the rise. Current strategies for identifying individuals at risk for suicide, such as the use of a patient's self‐reported suicidal ideation or evidence of past suicide attempts, have not been sufficient in reducing suicide rates. Recently, research groups have been focused on determining the acute mental state preceding a suicide attempt. The development of an acute suicidal diagnosis, the Suicide Crisis Syndrome (SCS), is aimed at capturing this state to better treat individuals. The SCS has five main evidence‐based components—entrapment, affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal. The SCS may provide clinicians with the ability to identify individuals who are experiencing an acute pre‐suicidal mental state, regardless of their self‐reported suicidal ideation. Future research leading to the incorporation of this diagnosis into clinical practice could improve the quality of care and reduce the personal, societal, and legal burden of suicide.
... This pain, named psychache (Shneidman, 1993), may become so strong that cognitive constriction occurs, leading one to believe the only relief is through death. Meerwijk and Weiss (2011) analyzed five differing academic perspectives on psychache and concluded, "Psychological pain may best be defined as a lasting, unsustainable, and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self" (p. 410). ...
Thesis
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The primary purpose of this quantitative study is to understand suicide among emergency responders. The secondary purpose is to examine how educators can use information about suicide among emergency responders to develop and adapt curriculum to mitigate psychological trauma experienced by those in emergency medical services (EMS), the fire service, and law enforcement. I use social cognitive theory to investigate responder suicide and as a framework to understand the role of education. Official death records were cross-referenced with data possessed by responder credentialing agencies. I analyzed the records to determine the suicide rates of responders compared to the general population and a matched set of responders who did not die of suicide. I also analyzed educational factors hypothesized to confer protection against psychological trauma and suicide, including EMS credential level, academic education level, attainment of firefighter or law enforcement training, and various combinations of credential, education, and fire or police training. The findings suggest that emergency responders have a higher suicide rate compared to the general population. Responders who die by suicide generally have higher levels of education. Being a responder without an EMS credential confers the most protection while the interactive effects of credential and education have significant (p < .05) association with suicide. The impact of psychological trauma is the same regardless of the responder field of practice.
... Shneidman proposed "an introspective experience of negative emotions such as anger, despair, fear, grief, shame, guilt, hopelessness, loneliness and loss" (Shneidman, 1993). In an attempt to give a more unified definition, Meerwijk and Weiss (2011) proposed to define psychological pain as "a lasting, unsustainable, and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self." psychological pain, notably those occurring in situations such as social exclusion (Eisenberger and Lieberman, 2004;Danziger et al., 2006;Hsu et al., 2013;DeWall et al., 2015;Jollant et al., 2017). ...
Article
Objective: Psychological pain lies at the heart of human experience. However, it may also be abnormally intense and/or prolonged in pathological states, with negative outcomes. A simple and reliable measure of psychological pain for clinical use would be useful. In this study, we present a preliminary validation of a simple visual analog scale jointly measuring psychological and physical pain. Methods: Two samples of adult (non elderly) depressed patients and healthy controls were independently recruited in two locations in Canada and the USA (N = 46/48 and 200/20, respectively). Six dimensions were successively scored on a paper visual analog scale measuring current, mean and worst pain over the last 15 days, for physical then psychological pain. Results: All physical and psychological pain dimensions discriminated depressed from non-depressed subjects. Among depressed patients, psychological pain scores were higher than physical pain scores for a given period of assessment. Moreover, correlations between dimensions from the same pain category (physical or psychological) were higher than between different pain categories. Psychological pain was mainly correlated with depression and hopelessness scales while physical pain was mainly correlated with anxiety scales. Secondary analyses showed that psychological (and some physical) pain measures were correlated with suicidal ideas in one location, but no difference in pain scores was found between patients with vs. without a history of suicidal acts in both samples. Childhood trauma positively correlated with several pain dimensions. Conclusion: The PPP-VAS appears to be a valid tool in terms of discriminative capacities and convergent-divergent validities. Validation in different samples, including adolescents and elderly, and in various psychiatric and medical conditions will have to be conducted, in addition to the assessment of concurrent and predictive validities, and the confirmation of sensitivity to change. The role of psychological pain in the suicidal process needs to be further elucidated.
... De manière générale, cette idée de la douleur psychologique naissant de besoins frustrés rappelle la douleur physique comme signal d'alarme d'une menace d'atteinte à l'intégrité, au fonctionnement normal, et le danger que cela représente pour la survie de l'individu. Meerwijk et Weiss [3], dans une revue de la littérature, proposent une définition réunissant les composantes communes aux diverses propositions de définition : la douleur psychologique est l'expérience durable, désagréable ou insoutenable résultant de l'évaluation négative d'une incapacité ou déficience du soi. La douleur psychologique résulte donc aussi bien de la manière d'être d'autrui envers soi que des propres capacités de l'individu face à l'environnement ou encore de la perception de soi vis-à-vis des autres et des attentes de l'individu quant au futur. ...
... There is no clear definition for emotional pain, which is also referred to as psychogenic, psychic, psychological or mental pain (Meerwijk & Weiss, 2011). Joffe and Sandler (1967) propose emotional pain to measure discrepancy between the ideal and perceived actual selfimage. ...
Article
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Traditionally pain has been considered to be a physiological phenomenon. More recently, however, cognitive and social psychological effects have been found to play important roles in the experience of acute and chronic pain. This also has shed new light on the sources of pain and alleys for treatment. In this essay, I will review relevant theories and research and derive pain-perception, pain-aversion, motivation, and psychogenesis as the recurrent mechanisms through which the impact of cognitive, somatic, social, and therapeutic processes on pain-suffering can be described. Building on this, I put forward what I would like to call a Computational Theory of Pain to explain the experience of pain and psychological approaches for treating it.
... [4] Levi, et al. in 2008, found that variables from mental pain domain predicted the presence of suicidal behavior. [5] ...
Article
Background: Emotional discomfort in health professional students many times results in mental health-related problem in the future. First-year students face emotionally stormy transitional phase which leads to more psychological pain. Impulse control (patience) is considered as an absolute virtue of health professionals. Health professional students are expected to possess good impulse control for they come across varied natured people with diverse health problems in different stages of severity. Objectives:(1) The primary objective of this study is to identify the relationship between psychological pain and impulse control among new entrants studying in BAMS course. Research Design: This was correlation study. Population: First-year students both male and female from 1 st year BAMS course. Sample Size: 100, (50 males and 50 females). Setting: Ayurveda Science Colleges in Nagpur and Wardha districts. Materials and Methods: Orbach Mikulincer Mental Pain Scale and Impulse control scale by Shrivastava and Naydoo. Results: Psychological pain and impulse control among male new entrants show a strong negative nonsignificant correlation (r =-0.475, P > 0.05), and for females, the correlation is statistically significant weak-positive (r = 0.181, P < 0.05). Together male and female new entrants have a negative statistically significant correlation (r =-0.363, P < 0.05). Conclusion: The findings suggest that higher the psychological pain, lower is the impulse control for both male and female new entrants of Ayurveda Science discipline. Male students show the greater magnitude of negative relation as compared to that of female students. © 2019 Journal of Datta Meghe Institute of Medical Sciences University.
... Este autor atribui a causa da dor psicológica à frustração de necessidades psicológicas básicas, como as necessidades de conforto, segurança, autonomia e afiliação, à impossibilidade de evitar a vergonha e à rutura de relações interpessoais importantes. A dor psicológica traduz-se por um sentimento desagradável e insuportável (Meerwijk, 2012;Meerwijk & Weiss, 2011;Orbach et al., 2003), sendo que o suicídio não ocorre sem que esta variável esteja presente, independentemente da presença de outras variáveis de risco. Uma dor psicológica intensa pode levar o indivíduo a 7 Pio, Santos, & Campos considerar o suicídio como a única solução para fugir a essa situação insuportável, quando as experiências anteriores, padrões de coping e mecanismos de suporte percebidos não forem suficientes para enfrentar a dor (Shneidman, 1993(Shneidman, , 1998. ...
... Traumas of ubiquitous quality, all coincide to their association with emotional ache, a persistent and disconcerting feeling linked to a sense of personal ineptness and inferiority to external circumstances (Meerwijk & Weiss, 2011). Beyond this feature, trauma can be embodied in different manifestations such as an action deliberated from one person to another, such as a personal attack for revenge, that has more persistent negative effects than a non-targeted event such as an earthquake (Wamser -Nanney & Vandenberg, 2013). ...
... The aim was to explore cancer-related psychological distress experienced by young survivors of cancer during adolescence reporting a need for psychological treatment. In this study, distress refers to an unpleasant experience of a psychological, i.e., cognitive, behavioural, emotional, social, or spiritual nature [19,20]. ...
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Objective In this qualitative study, we aimed to provide an in-depth exploration of cancer-related psychological distress experienced by young survivors of cancer during adolescence reporting a need for psychological support. Methods Two individual interviews were held with ten young survivors of cancer diagnosed in adolescence. The interviews were audio-recorded and transcribed verbatim. Analysis followed the guidelines for inductive qualitative manifest content analysis. Results The survivors described distress experienced during and after the end of treatment. Five categories comprising 14 subcategories were generated. The categories included: A tough treatment, Marked and hindered, Not feeling good enough, Struggling with the fragility of life, and finally, An ongoing battle with emotions. Conclusion Young survivors of adolescent cancer reporting a need for psychological support described feeling physically, socially, and mentally marked by the cancer experience. They struggled with powerlessness, insecurity, social disconnection, loneliness, and feelings of being unimportant and a failure, and had difficulties understanding and managing their experiences. These concerns should be addressed in psychological treatments for the population irrespective of which approach or model is used to understand survivors’ difficulties. A trans-diagnostic approach targeting processes that underpin different manifestations of distress may be effective.
... Recognising 'dvorce' as a potential misspelling of 'divorce' and 'divorced' as past tense of 'divorce', we can then add those terms to our terms-to-concept map for connectedness, so they will be appropriately identified when tagging clinical progress notes in aim 2. Similarly for the concept of psychological pain, the embedding model may indicate a strong correlation between the phrase 'emotional pain' and 'psychological pain'. Knowing that emotional pain is often used as a synonym of psychological pain, 32 we can then add emotional pain as a new term to the terms-to-concept map for psychological pain, so 'emotional pain' will be identified as an instance of psychological pain. Embedding models are essential for solving most modern NLP problems, and we have applied them in prior work to enhance terms-to-concept maps for other clinical areas. ...
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Introduction The state-of-the-art 3-step Theory of Suicide (3ST) describes why people consider suicide and who will act on their suicidal thoughts and attempt suicide. The central concepts of 3ST—psychological pain, hopelessness, connectedness, and capacity for suicide—are among the most important drivers of suicidal behaviour but they are missing from clinical suicide risk prediction models in use at the US Veterans Health Administration (VHA). These four concepts are not systematically recorded in structured fields of VHA’s electronic healthcare records. Therefore, this study will develop a domain-specific ontology that will enable automated extraction of these concepts from clinical progress notes using natural language processing (NLP), and test whether NLP-based predictors for these concepts improve accuracy of existing VHA suicide risk prediction models. Methods and analysis Our mixed-method study has an exploratory sequential design where a qualitative component (aim 1) will inform quantitative analyses (aims 2 and 3). For aim 1, subject matter experts will manually annotate progress notes of clinical encounters with veterans who attempted or died by suicide to develop a domain-specific ontology for the 3ST concepts. During aim 2, we will use NLP to machine-annotate clinical progress notes and derive longitudinal representations for each patient with respect to the presence and intensity of hopelessness, psychological pain, connectedness and capacity for suicide in temporal proximity of suicide attempts and deaths by suicide. These longitudinal representations will be evaluated during aim 3 for their ability to improve existing VHA prediction models of suicide and suicide attempts, STORM (Stratification Tool for Opioid Risk Mitigation) and REACHVET (Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment). Ethics and dissemination Ethics approval for this study was granted by the Stanford University Institutional Review Board and the Research and Development Committee of the VA Palo Alto Health Care System. Results of the study will be disseminated through several outlets, including peer-reviewed publications and presentations at national conferences.
... Physical pain is used to refer to negative affective states of a somatic origin and includes states for which the term pain is not commonly used, such as the unpleasantness associated with unmet physiological needs (e.g., thirst, hunger) and certain sensory signals (e.g., cold, loud noises). Negative affective states that are more related to the primary emotional systems [14], such as fear, anxiety, frustration, boredom, and anger, are operationally referred to as psychological pain [15,16]. ...
Preprint
We describe a recently developed approach to quantify welfare loss in animals, the Cumulative Pain metric. It combines the two most relevant dimensions of negative affective experiences: intensity and duration. The metric enables estimating the time individuals spend in negative affective states of a physical or psychological nature (operationally referred to simply as ‘pain’) of different intensities as the result of one or more challenges (e.g., diseases, injuries, deprivations). A new notation protocol (the Pain-Track) is used in which the duration of the experience is represented along the horizontal axis and intensity is represented by four categories in the vertical axis. Pain experiences are partitioned into temporal segments, where hypotheses for the experienced duration and intensity are proposed based on existing welfare indicators (e.g., neurophysiological, behavioral, anatomical, evolutionary). This structure forces transparency about assumptions and uncertainties, highlights knowledge gaps, and enables estimates to be continuously adjusted. Because the Cumulative Pain metric is based on parameters with a broadly common biological meaning, it provides the much needed interoperability among assessments of animal welfare. It enables comparing the impact of practices and living conditions, policies and interventions, and the calculation of welfare footprints of animal-sourced products using a universal measurement unit.
... De manière générale, cette idée de la douleur psychologique naissant de besoins frustrés rappelle la douleur physique comme signal d'alarme d'une menace d'atteinte à l'intégrité, au fonctionnement normal, et le danger que cela représente pour la survie de l'individu. Meerwijk et Weiss [3], dans une revue de la littérature, proposent une définition réunissant les composantes communes aux diverses propositions de définition : la douleur psychologique est l'expérience durable, désagréable ou insoutenable résultant de l'évaluation négative d'une incapacité ou déficience du soi. La douleur psychologique résulte donc aussi bien de la manière d'être d'autrui envers soi que des propres capacités de l'individu face à l'environnement ou encore de la perception de soi vis-à-vis des autres et des attentes de l'individu quant au futur. ...
Article
La douleur psychologique fait partie de l’expérience humaine. Toutefois, elle prend parfois un caractère pathologique — par son intensité, sa durée ou les processus cognitifs associés — qui augmente notamment le risque d’idées suicidaires et de passage à l’acte. Sa définition reste l’objet de débats. Plusieurs échelles ont en outre été développées pour améliorer sa mesure. Des études récentes, notamment de neuro-imagerie en contexte social, suggèrent l’implication d’un réseau cérébral, incluant le cortex cingulaire antérieur et l’insula antérieure, qui chevauche partiellement les circuits de la douleur physique. En outre, le système opiacé pourrait jouer un rôle dans la modulation de la douleur psychologique. Des travaux récents pointent également vers le système inflammatoire dans une relation bidirectionnelle avec la douleur psychologique. La douleur sociale, forme particulière de douleur psychologique, pourrait ainsi représenter un système d’alarme lors de la menace de déconnexion sociale, processus mettant en jeu la survie de l’individu. Récemment, plusieurs études préliminaires en attente de réplication suggèrent des pistes de traitement spécifique de la douleur psychologique, incluant la buprénorphine, le paracétamol ou la stimulation cérébrale.
... Human behaviour can have similar consequences for different reasons. But it is not possible to understand the reasons that led someone to act based solely on the consequences of their actions (65)(66)(67)(68)(69)(70)(71)(72)(73). ...
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Objective To conduct a comprehensive review of scientific publications related to mental pain and suicide risk in order to deepen relevant aspects to guide clinical interventions. Method Using a text analysis tool, we collected the terms most frequently linked with that situation in published results of research using various tools to evaluate mental pain or psychache. Discussion We propose clinical interventions for the clinical conditions most commonly associated with mental pain.
... Psychological pain has been referred to as emotional pain, mental pain, psychic pain, and as a psychache (Meerwink & Weiss, 2011). In an analysis of five academic perspectives on psychological pain, a unifying definition was constructed that asserts, "psychological pain may best be defined as a lasting, unsustainable, and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self" (p. ...
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Paramedics regularly respond to emergency calls for suicidal ideation and attempts secondary to psychache. Until now, there were not many options for paramedics to deal with this life-threatening situation. A volume of research now indicates that sub-anesthetic administration of ketamine provides alleviation of suicidal ideation and the symptoms of severe depression. This effect is temporary but may provide enough time to allow for slower acting, longer lasting, evidence-based treatment modalities to be initiated. This article demonstrates that psychache is more lethal than physical pain and makes the case for prehospital treatment by paramedics.
... For instance, it has been found that people with perceived social injury or hurt feelings react with amplified aggressive behavior (e.g., Buckley et al., 2004 [36]; Muhammad &Rasool, 2014) [37]and reduced prosocial behavior (Twenge, Baumeister, DeWall, Ciarocco, & Bartels, 2007) [38]. In some cases association between emotional pain and depression and suicidal ideation (Mee, Bunney, Reist, Potkin, Bunney, 2006) [39] has also been observed. ...
... In the last 60 years, the literature has used various forms to mention psychological pain (i.e., mental pain, psychic pain, or psychache). Meerwijk and Weiss (2011) point out that the elements common to the different conceptions are: an unpleasant, lasting and unbearable feeling characterized by a perception of disablement or impairment of the self. ...
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According to the literature, psychological pain and entrapment are fundamental variables in the prediction of suicidal ideation. The aim of this paper is to analyse the moderating role of psychological pain in the relationship between entrapment-suicidal ideation. A sample of 620 participants between the ages of 18-35 years (51.1% women) was recruited through a quota sampling and administered an online questionnaire. Psychological pain and entrapment were significant predictors of suicidal ideation. Likewise, the interaction of both variables was also statistically significant, according to a moderating effect. These findings suggest that the use of measuring instruments that evaluate each other's constructs may improve the screening of people with suicidal ideation.
... Something has been missing from the study of suicide and mental illness. It is a phenomenon of major import, but it barely has a name (Meerwijk & Weiss, 2011): the subjective experience of extreme mental suffering. Properly understood, excruciating mental states explain the apparent relationship between mental illness and suicide. ...
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This review of recent evolutionary theories on psychopathology takes on controversies and contradictions both with established psychological thought and within the evolutionary field itself. Opening with the ancestral origins of the familiar biopsychosocial model of psychological conditions, the book traces distinctive biological and cultural pathways shaping human development and their critical impact on psychiatric and medical disorders. Analyses of disparate phenomena such as jealousy, social anxiety, depressive symptoms, and antisocial behavior describe adaptive functions that have far outlasted their usefulness, or that require further study and perhaps new directions for treatment. In addition, the book’s compelling explorations of violence, greed, addiction, and suicide challenge us to revisit many of our assumptions regarding what it means to be human. Included in the coverage: · Evolutionary foundations of psychiatric compared to non-psychiatric disorders.· Evolutionary psychopathology, uncomplicated depression, and the distinction between normal and disordered sadness. · Depression: is rumination really adaptive? · A CBT approach to coping with sexual betrayal and the green-eyed monster. · Criminology’s modern synthesis: remaking the science of crime with Darwinian insight. · Anthropathology: the abiding malady of the species. With its wealth of interdisciplinary viewpoints, The Evolution of Psychopathology makes an appropriate supplementary text for advanced graduate courses in the evolutionary sciences, particularly in psychology, biology, anthropology, sociology, and philosophy.
... Both physical and mental pain partially share the same neural network [57••]. Furthermore, mental pain is reported by more than 90% of suicide attempters [58•], and is the most common reason for suicide [59]. Indeed, we have recently suggested that mental pain is what unifies SB [12•]. ...
Article
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Purpose of review: The current serotonin-based biological model of suicidal behavior (SB) may be too simplistic. There is emerging evidence that other biomarkers and biological systems may be involved in SB pathophysiology. The literature on the endocannabinoid (EC) systems and SB is limited. The objective of the present article is to review all available information on the relationship between cannabinoid receptors (CB1and CB2receptors), and SB and/or psychological pain. Recent findings: Our review is limited by the small number and heterogeneity of studies identified: (1) an autopsy study describing elevated levels of CB1receptor activity in the prefrontal cortex and suicide in both depression and alcoholism and (2) studies supporting the involvement of both CB1and CB2receptors in the regulation of neuropathic pain and stress-induced analgesia. We conclude that cannabinoid receptors, particularly CB1receptors, may become promising targets for the development of novel therapeutic tools for the treatment of SB.
Chapter
Sketching the likely parameters of evolved protections against suicide, an engineering specification is proposed for a system of reactive, last-line, anti-suicide defenses, keepers, biologically designed as a final defense against wilful self-killing. Twenty predicted design features of keepers are specified, including, inter alia (a) an input trigger in the emotional experiencing of chronic, intense pain; (b) a developmental condition, recognizing that a protective mechanism would be superfluous until the individual reaches the developmental stage, at around puberty, of being able to organize suicide; and (c) potentially drastic output behaviors and mental states that would prevent suicides occurring most (but not all) of the time, by dulling the motivation to escape (pain-type) and/or by interfering with the individual’s intellectual means to plan and enact a suicide endeavor (brain-type).
Chapter
Something has been missing from the study of suicide and mental illness. It is a phenomenon of major import, but it barely has a name (Meerwijk & Weiss, 2011): the subjective experience of extreme mental suffering. Properly understood, excruciating mental states explain the apparent relationship between mental illness and suicide. But suicide is the tip of the iceberg: excruciating mental states are themselves an enormous problem that current medical and mental health models do not address. Easing the suffering of excruciating mental states would be a moral accomplishment comparable to curing cancer—and the tools to do so already exist.
Chapter
An integrated “pain and brain” theory of the evolution of suicide is proposed, which appears to fulfil the original objectives set for the investigation. The theory may help to elucidate, incidentally, a diversity of human psychological and psychiatric phenomena that are otherwise difficult to explain and synthesise. Some implications of this theoretical framework are noted for suicide research, suicide prevention strategies, and broader mental health policy. The model offers theoretical support for the view that a search for usefully predictive biomarkers of suicide risk is unlikely to succeed, and that more effective preventative solutions probably lie in public health measures to restrict access to lethal means. A psychopharmaceutical paradigm for the treatment of mental disorders is challenged. The suicide taboo may be broadly protective, but it may also impede the study of suicide. An invitation to look more closely at the evolution of suicide is made, on the grounds that it may underlie many aspects of human thought and behaviour, including most people’s sense that life is worth living.
Article
Objectives The aim of this research was to confirm the structure of time orientation and affects associated with the past, present, and future and self‐esteem of those beginning therapy and a comparison group. Method Responses from clinical respondents (n = 217; mean age 33 years) and non‐clinical respondent (n = 196; mean age 34 years) were used to analyse the structure of the measures. A matched group method was used to investigate group differences based on clinical status and gender of the respondent. Results The measures of time orientation and measures of affects associated with the past, present, and future were well structured and provide evidence of a balanced view in which an orientation to each time dimension is important. Results showed that the therapeutic group was less future, present, and past oriented. Further, the therapeutic group was consistently and significantly higher on negative affect and lower on positive affect and self‐esteem than the comparison group. The findings are discussed in reference to therapeutic and theoretical implications. Conclusions The concept of time orientation and the associated affects is of substantial interest to therapeutic interventions and the findings provide some evidence of the utility of attending to the strength of orientation to the three time dimensions and the dependency between them over their apparent separateness. The measures have utility in providing insights that inform the focus of therapy.
Article
Can close brand relationships insulate against physical pain? The idea that close interpersonal relationships help people cope with pain has received increasing support in social psychology. It is unknown, however, whether close brand relationships can do the same and, if so, why. Seven studies are reported here to fill this knowledge gap. Experiments 1a and 1b are the first to demonstrate that when confronted with a loved brand (vs. control), consumers are able to insulate themselves against physical pain. Experiment 2 provides evidence that the paininsulating effectiveness of close brand relationships is not just due to brands representing mere distractions. Using a multistudy, multimethod approach to test for mediation, experiments 3 through 5 provide convergent empirical support for the hypothesis that feelings of social connectedness mediate the effect of close brand relationships on pain. Study 6 categorizes the 1,105 brand love essays written by participants in our experiments to show that loved brands provide feelings of social connectedness, mostly metaphorically and indirectly and, to a lesser extent, directly. In summary, close brand relationships can help insulate consumers against physical pain due to brands' ability to provide a semblance of social connectedness. © The Author 2017. Published by Oxford University Press on behalf of Journal of Consumer Research, Inc. All rights reserved.
Chapter
Suicidality most likely evolved as an unfortunate side effect of two important primary adaptations in the human species, “pain and brain”: the aversive emotional experience of pain, which is biologically designed to aid self-preservation by motivating adaptive escape action, combined with a cognitive sophistication that offers most mature humans the means to escape pain maladaptively by self-killing. Suicide may thus be categorized alongside other major fitness costs of human cognition and encephalization, such as obstetric complications arising from the parturition of large-skulled infants and the necessity for human young to remain dependent on carers for many years while the brain develops, adaptive problems of such severity that they drove the natural selection of complex physiological and behavioral solutions to control their costs. Equally, the notion of suicidality as a costly by-product implies that countermeasures would expectably have evolved to prevent mature humans from using self-extinction to escape from pain. Inferences are made concerning the likely timing of the emergence of these countermeasures during human prehistory.
Article
Introduction Psychological pain is understood as an intolerable and disturbing mental state characterized by an internal experience of negative emotions. This study was aimed at making a Spanish adaptation of the Psychache Scale by Holden and colleagues in a sample of young adults. Material and methods The scale evaluates psychological pain as a subjective experience. It is composed of 13 items with a Likert-type response format. Following the guidelines of the International Tests Commission for the adaptation of the test, we obtained a version conceptually and linguistically equivalent to the original scale. Through an online questionnaire, participants completed the psychological pain scale along with other scales to measure depression (BDI-II), hopelessness (Beck’s scale of hopelessness) and suicide risk (Plutchik suicide risk scale). The participants were 234 people (94 men, 137 women and three people who identified as a different sex) from 18 to 35 years old. Results The EFA showed a one-factor solution, and the FCA revealed adequate indexes of adjustment to the unifactorial model. It also showed good reliability of the test scores. The evidence of validity of the scale in relation to the other variables showed high, positive and statistically significant correlations with depression, hopelessness, suicidal ideation and suicidal risk. Conclusion In summary, this Spanish adaptation of the Psychache Scale could contribute to improving the evaluation of both the patient with suicide risk and the effectiveness of psychological therapy, as well as suicidal behaviour prevention and intervention.
Article
Introducción: El dolor psicológico es entendido como un estado mental intolerable y perturbador caracterizado por una experiencia interna de emociones negativas. El presente estudio tiene como objetivo realizar una adaptación al contexto español de la escala de dolor psicológico de Holden et al. en adultos jóvenes. Material y métodos: La escala evalúa el dolor psicológico como experiencia subjetiva. Está compuesta por 13 ítems con un formato de respuesta tipo Likert. Siguiendo las directrices de la International Tests Commission para la adaptación de test, obtuvimos una versión equivalente conceptual y lingüísticamente a la escala original. A través de un cuestionario online los participantes completaron la escala de dolor psicológico junto a otras escalas para medir depresión (BDI-II), desesperanza (escala de desesperanza de Beck) y riesgo suicida (escala de riesgo suicida de Plutchik). Los participantes fueron 234 personas (94 hombres, 137 mujeres y 3 personas de otro sexo) de 18 a 35 años. Resultados: El AFE mostró una solución de un factor y el AFC reveló adecuados índices de ajuste del modelo unifactorial. También mostró una buena fiabilidad de las puntuaciones del test, y evidencias favorables de validez de la escala en relación con la depresión, desesperanza, ideación suicida y riesgo suicida (correlaciones altas, positivas y estadísticamente significativas). Conclusión: La adaptación al español de la escala de dolor psicológico puede contribuir a mejorar la evaluación tanto del paciente con riesgo suicida como la eficacia de la terapia psicológica, así como la prevención e intervención del comportamiento suicida.
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p>This text is formed from a series of detailed conversations with Andrea Pagnes of performance art duo VestAndPage (Italian artist Andrea Pagnes and German artist Verena Stenke) on the questions of pain, suffering and blood rituals in their performances. VestAndPage perform extreme physical acts in constrictive physical situations not to glorify pain, but as possibilities for a poetic encounter with suffering as a source of creativity, thus to liberate aesthetics from the justification of sacrifice. Drawing from their personal life experience, they translate their wounds into performative actions to seek authenticity and to speak about existential concerns belonging to mankind, the individual and society. Keywords: Body, Pain, Suffering, Blood, Performance art.</p
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This article analyses the different assumptions about migrants in South Africa, coupled with levels of abuses and marginalisation of black African immigrants, which seem to be a source of depression and emotional pain for them in their strange land. Previous studies did reveal that African migrants face rejection, xenophobic attacks, abuses, marginalisation and socio-economic exclusion through rowdy practices of public officials and perceived institutionalised prejudice in South Africa. However, White Western and Indian-origin migrants are perceived to be better treated with dignity and respect in the same host country. This article investigates the argument that emotional pain suffered by the abused and traumatised Nigerian and other African immigrants could be responsible for the deviant behaviour of some of them in South Africa. Moreover, this article also scrutinises the notion people have that xenophobia in South Africa is Afrophobia. Most South African citizens are of the perception that all African immigrants are criminals, harbingers of disease and drug dealers, whose presence in their country is responsible for all their woes. On the other hand, Nigerian migrants are of the notion that they are the most hated at community and individual levels in South Africa. However, if appropriate social coalition policies are formulated and adopted by the government and all stakeholders, it can be of assistance in tackling the issues concerning citizens’ suspicions, migrant abuses, marginalisation and social exclusion, which seem to be hampering the co-existence of citizens and African migrants in South Africa. We should bear in mind that almost all of us in South Africa are from somewhere or the other, as clearly explained in sahistory.org.za. The whites and Indian migrants, whom I call ‘earlier alien settlers’, are from Europe and Asia, respectively. I call black Bantus from Great lakes in Central Africa, ‘earlier alien settlers’, whereas the Khoikhoi who originated in the northern area of Botswana as the ‘earlier dwellers’, while Nigerians and Ghanaians from West Africa, Zimbabweans, Malawians, etc., are called the ‘new alien settlers’. Do the ‘earlier alien settlers’ have the right to deprive the ‘earlier dwellers’ and the other ‘new alien settlers’ the right to have their space and settle in a democratic South Africa? Finally, an instructive pastoral care methodology is proposed in this article for traumatised migrants to be appropriately cared for and provided with wholesome wellness.
Article
Objective Emotional pain (i.e., pain affect in response to psychological experiences such as rejection or loss) may be a component of chronic pain syndromes given high co-occurrence with depression and neurobiological overlaps in pain affect resulting from physical and emotional experiences. In the current set of studies, we examined the relationship between emotional and physical pain using both nomothetic (i.e., group-level) and idiographic (i.e., individual-level) approaches. Methods Individuals with chronic pain were recruited from the Washington University Pain Center. First, we assessed the relationship between emotional and physical pain at the group level. Then, three individuals from the group-level study completed ecological momentary assessment four times per day for at least four weeks. We assessed relationships between emotional and physical pain using correlations and Dynamic Structural Equation Modeling. Results Emotional pain severity was significantly positively correlated with physical pain at the group level. However, results from idiographic analyses suggested that one individual did not display a significant correlation between physical and emotional pain, and two individuals displayed correlations larger than expected based on the group-level data. Competing models suggested that emotional and physical pain represented distinct constructs for the individuals studied. Conclusions These results suggest that emotional pain may be an important component of chronic pain syndromes. However, idiographic models revealed heterogeneity that may have important implications for treatment. Further research is needed to understand whether idiographic relationships between emotional and physical pain can help identify effective treatment targets for individuals with co-occurring emotional and physical symptoms.
Article
Objective Emotional or psychological pain is a core symptom of complicated grief (CG), yet its correlates are largely unexamined among bereaved individuals. Method Bereaved adults (N = 135) completed self‐reports regarding psychological pain, CG, depression, and suicidality. We assessed correlations among these variables and tested whether psychological pain was elevated among individuals with CG and individuals with current or past suicidal thoughts and behaviors. Using logistic regression, we also assessed psychological pain, depression, and CG symptom severity as predictors of suicide risk. Results Psychological pain was strongly associated with both CG and depression severity and was elevated among subjects reporting current or past suicidality. CG and depression were not statistically significant predictors of suicidal ideation after accounting for the effects of psychological pain. Conclusions Psychological pain is strongly associated with bereavement‐related psychopathology and warrants further investigation in studies examining the nature and treatment of CG.
Article
This study provides a first-of-its-kind interdisciplinary integrative literature review on pain, including several potential manifestations of relevance to everyday life and consumption. Importantly, it explores pain’s symbiotic relationship to pleasure, especially in the context of various marketing and consumption experiences. This research draws from a vast array of disciplines, including psychology, sociology, biology, neuroscience, medicine, business, and marketing, to identify definitional issues of pain, uncover the processes and underlying sources and determinants, and explore various forms in which consumers approach, consume, and experience pain. The study offers novel theoretical insights and concludes with future research directions, as well as relevant managerially important lessons, on the intersection of pain, pleasure, and consumption.
Article
When consumers become fans of celebrities, they can form intense emotional attachments that resemble a kind of love. Although the love felt for celebrities is based on one-sided parasocial relationships, fans nevertheless experience a trauma that they consider to be very real when these illusory relationships end. We explore how fans manage and perform their break-up with a beloved celebrity brand following public allegations of wrongdoing. Building on Giddens’ theorization of loveshock – which encapsulates the disorienting after-effects of falling out of love – we propose the new concept of para-loveshock. Para-loveshock is performed socially and discursively through three fan practices: grief enfranchisement; flagellation; and indignation. Recognizing how fans perform and legitimize their trauma through these practices helps to sensitize managers to the importance of consumer identity work following celebrity transgressions. This has implications for how damage control efforts are planned and how managers engage with fans when responding to celebrity transgression.
Article
This essay discusses sentient robot (SR) research through the lens of suffering. First three kinds of suffering are considered: physical, psychological, and existential. Physical pain is shown to be primarily subjective, and distinctive psychological and existential sufferings probably do exist, which are neither reducible to neurobiological events, nor replicable through algorithms. The current stage of SR research is then reviewed. Many creative proposals are presented, together with some philosophical and technical challenges posed by other scholars. I then offer my critique of SR research, claiming that it is based on a superficial understanding of suffering and unjustified philosophical presuppositions, namely, reductive physicalism. Without the capability to suffer, robots probably cannot love in any real sense, and no meaningful relationship may be developed between such a robot and a human. Therefore, we are probably unable to produce sentient robots that can become our companions (friends, lovers, etc.).
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Etimologicamente falando, a angústia é um estado emocional caracterizado como uma sensação de dor ou mal-estar cuja causa remete para a sensação de perigo iminente, que ao contrário do que ocorre com o perigo real, é um perigo de característica confusa e vaga. É um estado emocional funciona como uma represa com as comportas fechadas, - a água vai subindo, a pressão das águas vai apertando as paredes, e a dada altura esse acúmulo de tensão requer uma saída: ou as comportas se abrem para a produção de energia ou a pressão das águas rebenta com tudo, provocando inundações. O mesmo acontece com o indivíduo acometido pela angústia, como não se encontra em vigor uma explicação em forma de linguagem para se explicar o que sente, surge a sensação de algo perdido. Falta algo que não se sabe explicar o que é realmente. Essa falta de algo que faz com que o indivíduo tenha a sensação de vazio, um ser incompleto, é consequência da separação do indivíduo com Deus. O ser humano foi criado para ser a imagem do criador e para ser um ser completo, total. Ele foi criado para a graça, equilíbrio, alegria, saúde, felicidade, criatividade, liberdade. Houve, exatamente aí a separação do indivíduo e Deus no momento em que o indivíduo desobedeceu a Deus e praticou o pecado. Nesse momento, instala-se a sensação de vazio, de que falta algo e, a partir daí, o indivíduo teve que trabalhar, correr atrás do prejuízo, tentar suprir esse vazio e essa falta de algo que tanto o atormenta. A Bíblia Sagrada faz referência a várias passagens onde as personagens passam por momentos de profunda angústia. As personagens que a Bíblia Sagrada menciona como tendo experienciado o sentimento de angústia são Moisés, Jó, Davi, Jeremias, Elias, Jonas, Paulo e Jesus Cristo. Contudo, o contexto que desencadeou o sentimento de angústia em cada um dos personagens é distinto. Moisés sentiu-se assolado pela angústia quando seguia com o povo hebreu rumo à terra prometida, uma angústia também designada por angústia geográfica; Jó sentiu uma angústia espiritual quando foi desafiado por Satanás a desobedecer a Jeová; Davi experienciou o sentimento de angústia no contexto de grandes batalhas e também por cometer inúmeros e desastrosos pecados, como a destruição de uma família; Jeremias foi atormentado pela angústia quando recebe o chamado de Deus para se proclamar rei e diante desse fato sentiu-se incapaz de desempenhar tal tarefa pois não passava de um menino; Elias sentiu angústia aquando de uma ameaça de morte; Jonas, também conhecido por ser um profeta rebelde foi acometido pelo sentimento de angústia quando pediu a Deus a própria morte, proferindo as palavras de que para ele seria melhor morrer do que viver; Paulo sentiu-se assolado pelo sentimento de angústia quando, no contexto de uma das suas prisões foi abandonado pelos seus amigos; e Jesus Cristo foi assombrado pela angústia no momento da sua crucificação sentindo-se repudiado por Deus.
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This book uses the modern theory of artificial intelligence (AI) to understand human suffering or mental pain. Both humans and sophisticated AI agents process information about the world in order to achieve goals and obtain rewards, which is why AI can be used as a model of the human brain and mind. This book intends to make the theory accessible to a relatively general audience, requiring only some relevant scientific background. The book starts with the assumption that suffering is mainly caused by frustration. Frustration means the failure of an agent (whether AI or human) to achieve a goal or a reward it wanted or expected. Frustration is inevitable because of the overwhelming complexity of the world, limited computational resources, and scarcity of good data. In particular, such limitations imply that an agent acting in the real world must cope with uncontrollability, unpredictability, and uncertainty, which all lead to frustration. Fundamental in such modelling is the idea of learning, or adaptation to the environment. While AI uses machine learning, humans and animals adapt by a combination of evolutionary mechanisms and ordinary learning. Even frustration is fundamentally an error signal that the system uses for learning. This book explores various aspects and limitations of learning algorithms and their implications regarding suffering. At the end of the book, the computational theory is used to derive various interventions or training methods that will reduce suffering in humans. The amount of frustration is expressed by a simple equation which indicates how it can be reduced. The ensuing interventions are very similar to those proposed by Buddhist and Stoic philosophy, and include mindfulness meditation. Therefore, this book can be interpreted as an exposition of a computational theory justifying why such philosophies and meditation reduce human suffering.
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Objective: Research suggests that emotional abuse is associated with adolescent suicidal ideation. But how they are related is still unclear. The present study tested the temporal relationship between emotional abuse and suicidal ideation, with psychache as the potential mediator. We also examined the reciprocal relationship between psychache and suicidal ideation. Method: A number of 2,259 Chinese high school students (53.8% females, mean age = 15.11, SD = 1.57) in Hong Kong completed questionnaires assessing emotional abuse, psychache, and suicidal ideation three times at 6-month intervals. Results: The results supported the mediating effect of psychache in the path from emotional abuse to suicidal ideation. In addition, psychache and suicidal ideation were related reciprocally over time. Conclusion: The findings of this study may help researchers and practitioners understand the pathways by which emotional abuse impacts adolescent suicidal ideation. Implications for preventions and interventions of suicidal ideation were discussed.
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This study sought to investigate suicide notes drawn from Mexico and the United States (US) as these countries share geographical proximity, but markedly different cultures and suicide rates. A theoretical conceptual analysis of 102 suicide notes drawn from these countries, matched for age and sex, was undertaken based on a thematic model of suicide developed by Leenaars,1,2 across countries. The inter-judge reliability was adequate (.86 coefficient of concordance). The results suggested that there are more psychological commonalities than differences. Yet, as this study marks the first one using suicide notes, between Mexico and the USA, much greater study is warranted.
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The analysis of suicide notes is an integral part of understanding suicidal behaviour. To this end, Leenaars (1996, 1992) has developed the Thematic Guide to Suicide Prediction (TGSP) for profiling the psychological correlates of suicide. The utility of this tool in suicide prevention, however, is not known. This study applied the TGSP to suicide notes (n = 45), interpreted in the light of coroner's inquest papers, drawn from a Northern Irish population. The results yielded support for the existence of psychological suicidal correlates. Moreover, qualitative differences between depressed and not depressed notewriters and those with and without a previous suicidal attempt were identified. For example, depressed suicides were more likely to communicate difficulties in developing attachments, or to exhibit cognitive constriction than nondepressed notewriters. Analysis of age differences was limited because of the paucity of suicide notes (in this sample, written by individuals aged 65 years or older). This research has further helped to identify psychological differences that should be beneficial in the prevention of suicide. Such differences should be integrated into existing risk assessment schedules. It is also argued that the analysis of suicide notes should form one strand in an integrated research framework.
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This paper defines a symptom construct termed psychological pain and reviews clinical and neuroimaging evidence relevant to it. The psychological pain associated with severe depression is often perceived as worse than any physical pain that the individual has experienced and could be a critical component of suicidality that could be systematically assessed in potentially suicidal patients. Converging evidence from brain imaging studies suggests overlapping patterns of brain activation induced by both psychological pain and by physical pain. Future research on the role of psychological pain and its interaction with nociceptive pathways may provide novel clues to the understanding and treatment of depression and other psychiatric illnesses.
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Seven adult children of alcoholic clients participated in interviews to explore the phenomenon of emotional pain. The analysis of the interviews was guided by the grounded theory method. The emerging model provided a detailed portrayal of emotionally painful experience, and outlined the stages in the process of working through pain. The essence of the experience is captured in the core category, The Broken Self, characterized by four properties including Woundedness, Disconnection, Loss of Self, and Awareness of Self, and a set of visceral and spatial descriptors. The Broken Self exists in relation to two other concepts of self that are not broken. The Covered Self refers to a self that has been organized in a way that conceals essential aspects of the self. The Transformed Self evolves out of the brokenness, as the individual integrates new information that has emerged as a result of experiencing a Broken Self.
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Contends that suicide is caused by psychache (hurt, anguish, soreness, aching, psychological pain in the psyche, the mind). A principal task for contemporary suicidology is to operationalize (and metricize) the key dimension of psychache. The prevention of suicide (with a highly lethal person) is primarily a matter of addressing and partially alleviating those frustrated psychological needs that are driving that person to suicide (i.e., mollify the psychache). Seven components in the progression to suicidal outcome are outlined, as are 7 beliefs about suicide that represent the author's current thought after 40 yrs of experience. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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One of the roles of qualitative enquiry is the utilization of qualitative methods for the development, refinement or modification of concepts Yet, to date, there are no criteria for evaluating the adequacy of a concept In this paper, the anatomy of a concept is presented, methods of concept analysis critiqued, and criteria for evaluation of the level of maturity of a concept suggested Evaluation of criteria include assessment of the definition of the concept, the characteristics of the concept, the conceptual preconditions and outcomes, and the conceptual boundaries The authors argue that evaluation of a concept must necessarily precede concept development research (using a Wilsoman-derived method, a critical analysis of the literature, or qualitative enquiry) and precede more formal research procedures (such as operationalization or identification of the variables)
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Since 1999 when the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) added pain assessment and management to their regulatory standards, which were implemented in 2001, ?pain management? has been elevated in level of importance. The phrase ?pain management,? used by health care regulatory agencies, health care organizations, and health care providers has become a buzzword that is used without thinking of its broader implications or its exclusionary taken-for-granted meaning.
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This article revises and summarizes the major findings from a research program exploring the behavioral-experiential nature of suffering. Suffering is perceived as comprising two major behavioral states: enduring (in which emotions are suppressed; it is manifested as an emotionless state) and emotional suffering (an overt state of distress in which emotions are released). Individuals who are suffering move back and forth between these two states according to their own needs, their recognition/acknowledgment/acceptance of events, the context, and the needs and responses of others. Implications for the provision of comfort during suffering states are presented.
Article
This article revises and summarizes the major findings from a research program exploring the behavioral-experiential nature of suffering. Suffering is perceived as comprising two major behavioral states: enduring (in which emotions are suppressed; it is manifested as an emotionless state) and emotional suffering (an overt state of distress in which emotions are released). Individuals who are suffering move back and forth between these two states according to their own needs, their recognition/acknowledgment/acceptance of events, the context, and the needs and responses of others. Implications for the provision of comfort during suffering states are presented.
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There is a lack of research focusing directly on both patients' suffering and alleviated suffering in relation to care. The aim of this paper was to investigate the progression of suffering in relation to the encounter between the suffering person and the caregiver from the perspective of an understanding of life. The progression of suffering is assumed to be an existential 'sign' of the development of understanding of life as an ontological or spiritual entity, which demands a meaning-creating encounter between the patient and caregiver. The concept 'existential caring encounter' was used to describe how the encounter between patient and caregiver can create meaning in communion and thereby alleviate suffering by making it bearable. The study was carried out using an interpretive, hermeneutic approach. The study as a whole comprises three parts, and these include letter-writing and interviews. The findings are described by the following main theses: (a) a darkness in life understanding is existentially experienced as unbearable suffering and requires an encounter involving attentive care and confrontation; (b) the turning point means that the struggle of suffering begins; and (c) the encounter involves being meaning-creating in a communion in the struggle of suffering. An understanding of the patterns of unbearable and bearable suffering can be of help to the caregiver in caring for the patient by serving as a basis for meaning-creation in communion. This may thereby be a way of alleviating the patient's suffering by making it bearable during the progression of suffering.
American Psychiatric Association Practice guideline for the assessment and treatment of patients with suicidal behaviors Grounded theory analysis of emotional pain
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Washington, DC: Author. American Psychiatric Association. (2003). Practice guideline for the assessment and treatment of patients with suicidal behaviors. Arlington, VA: Author. Bolger, E. A. (1999). Grounded theory analysis of emotional pain. Psychotherapy Research, 9, 342–362.
1532-5024 print=1532-5032 online DOI: 10.1080/15325024.2011.572044 REFERENCES American Psychiatric Association
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