Subject Index
A
Abdominal pain
_celiac plexus block for, 411
_in children, 221
Abstinence scores, 335
Abstinence syndrome, 333-335,337
Aching pain, 68,77
Acquired immunodeficiency syndrome
(AIDS) patients
_dementia of, 55,58
_functional impairment, 270
_pain syndromes, 58-59
_suicidal ideation by, 55,56-57
Acupuncture, as neuropathic pain therapy,
364
Acyclovir, 254
Addiction, 332
_medical examining boards' definition,
327
_patients' concerns about, 325-326,399-400
_tolerance in, 333-335. See also
Tolerance
Addiction Research Center, 335
Adenosine, in inflammatory hyperalgesia,
24
Adenosine-3;pr,5;pr-cyclic monophosphate
(cAMP), in inflammatory
hyperalgesia, 24,25
Adjustment disorders
_of leukemia patients, 3
_as suicide risk factor, 51,53
Adolescent patients, behavioral
interventions for, 417
Adolescent Pediatric Pain Tool, 228,229,
230
Adrenal gland, depression-related
hypertrophy, 9-10
Adrenergic receptors, in sympathetically
maintained pain, 108
Adrenocorticotropic hormone (ACTH), as
depression marker, 9
Adriamycin, as mucositis cause, 252
Affect. See Emotion
Afferent fibers, primary
_calcitonin gene-related peptide content,
69,70,78
_of cutaneous nerves, 68
_dorsal, opioid receptor binding sites,
135-139
_hyperalgesia and, 23-24
_of joints, 68,69,103
_of muscle, 68,69
_silent, 103,104
_visceral, 101,102-104,109
Ab fibers, in neuropathic pain,
129-130
A[bj3]e fibers. See also Ae mechanical
nociceptors
_in burning pain, 68
_dorsal horn termination site, 69
_in pricking pain, 68,77
_as tissue injury transducers, 89
Agency for Health Care Policy and
Research, cancer pain management
guidelines, 329
Air Force personnel, HIV-infected, suicide
by, 55
Alcoholism, as suicide risk factor, 56
Alfentanil
_infusion termination, 189
_as pediatric sedative, 378
_pharmacodynamic effects, 185
Alkylating agents, nucleic acid damage by,
252
Allodynia, 105,107-108
_in experimental mononeuropathy,[ql
141-147
Alprazolam, as neuropathic pain therapy,
362
Ae mechanical nociceptors, 67
_in primary hyperalgesia, 69
Ae mechanoheat nociceptors, 67
American Medical Association, cancer
pain management guidelines, 329
American Pain Society, 386
_cancer pain management guidelines,[ql
329
d-Aminobutyric acid (GABA), in
tolerance, 37
[ecAmitriptyline, analgesic effects, 358
Amputation-related pain. See also
Phantom limb pain
_in children, 221
Amygdala
_anatomy, 86,87
_emotional arousal role, 88
Analgesia. See also Opiate(s); Opioid(s);
Opioid receptor agonists
_adjuvant, as neuropathic pain therapy,
356,357-363
_genetic determinants, 37-40
_stimulation-produced, 31-32
Anesthesia
_general, for children, 378
_local. See Local anesthesia
Angina, cutaneous hyperalgesia of, 99
Anhedonia, as depression symptom, 1,2
Anoxia, as visceral pain cause, 102
Antibiotic therapy
_antimitotic effects, 252
_as neuropathic pain therapy, 355
Anticonvulsants
_antidepressant therapy failure and, 412
_as neuropathic pain therapy, 359-360
Antidepressants, 412
_efficacy, 13-14,15-16
_as minor depression therapy, 3
_as morphine tolerance antagonists, 119
_serotonergic neurotransmission effects,
12
_tricyclic
__dosage, 358-359
__as neuropathic pain therapy, 356,[ql
357-359
Antimetabolites, nucleic acid damage by,
252
Antisocial behavior, individual variability
in, 301
Anxiety, cancer pain-related
_in children, 222
_pain severity relationship, 269
Anxiety inventories, 208
Anxiolytics, for procedure-phobic patients,
398-399
Appetite loss, depression-related, 1-2
Arachidonic acid, nonsteroidal
antiinflammatory drug-related
inhibition, 23
Arginine vasopressin, in tolerance, 37
Aristotle, 83
Arousal, emotional, 92-93,205
Arthritis
_acute experimental, 72,73,75,78
_HIV infection-related, 59
Asparaginase, stomatotoxicity, 252
[cf2]=+Aspergillus[cf1] infection, oral, 254
Aspirin, as arachidonic acid metabolism
inhibitor, 23
Auditory stimuli, emotional responses, 88
Autonomic dysregulation, in neuropathic
pain, 353
Autonomy, of patients, 388-390
2>B2>
Baclofen, as neuropathic pain therapy, 359
Bacterial infections, cancer therapy-
related, 253,254-255
Barriers Questionnaire, 326-327
Beck Depression Inventory, 208,214
Behavioral interventions, for cancer pain
management. See also Cognitive-
behavioral interventions;
Distraction; Guided imagery;
Hypnosis; Relaxation techniques
_elderly patients' resistance to, 416-417
_group discussion on, 415-418
_immediacy of outcome, 415
_limited use of, 328
_for oral mucositis pain management, 255
Behavioral observation methods, for
pediatric pain assessment, 233-238
Behavioral Observation Tool, 236
[bcBehavior Rating Scales, of pain intensity,
200-201,204
Beneficence, 388,390
Benzodiazepines
_as neuropathic pain therapy, 362
_for pediatric sedation, 373,377
Beta-adrenergic blockers, 94-95
Bleomycin, as mucositis cause, 252
Blood drawing. See Venipuncture
Body maps, for pain self-reporting,[ql
228-229,230
Bone, radiation-related damage, 251
Bone marrow aspiration, in children,
221,372,373,374,375
_preparation for, 381-382
_sedation for, 377
Bone marrow suppression, chemotherapy-
related, 248,252-253
Bone marrow transplant patients
_Aspergillus infections, 254
_depression in, 3
_oral hemorrhage, 255
_oral mucositis, 190,248
__rating scale, 258,260-262
_patient-controlled analgesia, 190
Bone pain, colony-stimulating factor-
related, 59
Box Scale, 201-202,204
BPI Pain Assessment battery, 212
Bradykinin
_as inflammatory pain mediator, 22-23,25
_nociceptor sensitizing effect, 69
Brain. See also specific areas of brain
_depression-related structural
abnormalities, 13
_morphine-sensitive areas, 120
Breast cancer patients
_depression in, 4,15
_suicide risk, 50,53
_support groups, 404-405
_symptom reporting by, 159
Breast self-examination, 159-160
BUBU. See Enkephalins, [D-Ser2(O-tert-butyl),Leu5,Thr6(O-tert-butyl)]
Buddha, 83
Buproprion, 14
Burning pain, 68,77
_of causalgia, 143
BW 373U86, 182
2>C2>
C5a, 23
Calcitonin gene-related peptide, afferent content, 69,70,78
Calcium, in G protein-opioid receptor decoupling, 37
Cancer pain
_debilitating, 53
_individual variability of, 195
_inflammatory hyperalgesic mediators, 21-29
__altered pain sensation and, 22
__bradykinin, 22-23
__leukotriene B;i4, 23
__prostaglandins, 23-24
__second messengers, 24
__therapeutic implications, 24-25
_onset, 321
_patients' beliefs about, 325-327,399-400
_patients' denial of, 94
_patients' fear of, 21
_prevalence, 53,322
_public attitudes toward, 53-54
_sources, 195
Cancer pain management
_barriers to, 321-328
__documentation of, 321-322
__health care professionals-related,322-324
__health care system-related, 327-328
__patient education implications, 399-401
__patient-related, 325-327
__reduction of, 328-329
_guidelines, 329
_inadequate, 193,323,386,399
_legal aspects, 329
_as physicians' duty, 386
_physicians' lack of training in, 323
Cancer therapy. See also Chemotherapy;
Radiation therapy
_oral complications, 247-265
Candidiasis, oral, 253-254,263
Capsaicin, 23
_as neuropathic pain therapy, 361-362
_spinothalamic tract cellular response, 72,73,74,76
Carbamazepine
_leukopenic effect of, 360
_as neuropathic pain therapy, 359,360
Cardiovascular disease, hostility-related, 165
Care ethics, 386,391
Carisoprodol, 363
Cartoon-face pain scales, 225,227-228
Causalgia, experimental model, 143
Causal inference, 304-305
Celiac plexus block, 328,411
Center for Epidemiological Studies
Depression Scale, 208
Central nervous system
_depression-related abnormalities, 13
_as neuropathic pain site, 351,352,353-354
_pain-inhibitory function, 31,115
Central pain, 353
Central sensitization
_excitatory amino acids in, 76
_N-methyl-[smd[nm-aspartate receptor-mediated, 35
_in visceral hyperalgesia, 104-105,107-108
Cerebellum, in mood disorders, 13
Cerebrospinal fluid, in depression, 9
C fibers
_in burning pain, 68
_in primary hyperalgesia, 69
_as tissue injury transducers, 89
Chemotherapy
_as cancer pain cause, 195
__in children, 221,372
_guided imagery intervention for, 415
_as mucositis cause, 247-248,252-253
_as neuropathic pain cause, 352
_as neuropathic pain therapy, 355
Chemotherapy patients, symptom
reporting by, 159
Childhood cancer-related pain
_assessment, 219-246,406
__behavioral observation methods,233-239
__pain experience factors, 220-222
__pain history, 223-225
__pain measurement tool selection,239-240
__physiological approaches, 238-239
__proxy measures of pain, 231-233
__self-reports, 225-231,273
__unstructured observations, 240-241
_concurrent symptoms, 222
_family factors affecting, 221-222
_incidence, 220
_invasive procedure-related, 220
_management, 371-383
__algorithms for specific procedures, 381-382
__epidemiology, 372
__behavioral interventions, 417
__individual pain responses and, 373-375
__of procedure-related pain, 372,373
__psychological interventions, 405-406
__treatment approaches, 375-381
_phobic behavior patterns, 88
_therapy-related, 220,221
Children
_antisocial behavior, 301
_cancer pain in. See Childhood cancer-related pain
Children's Hospital Eastern Ontario Pain Scale, 235
Chloral hydrate, for pediatric sedation, 373,376
Chlorpromazine, as neuropathic pain therapy, 362
Chlorprothixene, as neuropathic pain therapy, 362
Chlorzoxazone, as musculoskeletal pain therapy, 363
Cholecystokinin, somatostatin-related inhibition, 11
Cholecystokinin antagonists, opiate tolerance effects, 37,119
Chronic pain, behavioral interventions for, 416
Cingulate gyrus
_anatomy, 87
_in negative emotions, 88
Cis-platin, as mucositis cause, 252
Clinical Scoring System for Measurement of Postoperative Pain, 234
Clinical trials
_of cancer pain management strategies, 329
_design, 283-299
__choice of controls, 285-290
__choice of treatments, 285-290
__chronic dosing studies, 288-290
__dose-ranging studies, 290
__drug combinations studies, 292
__equivalency of treatments studies, 291-292
__explanatory/pragmatic schema of, 284-285
__outcome measures, 296-297,303-304
__parallel versus crossover designs,292-294
__patient sample selection, 294-296
__positive controls, 285-290
__relative potency studies, 290-291
__side effects assessment, 296-297
_of psychological interventions, 404-405
_symptom reporting in, 159-160
Clomipramine, analgesic effects, 358
Clonazepam, as neuropathic pain therapy, 359,362
Clonidine, as neuropathic pain therapy, 361
C mechanoheat receptor, 67
Cognition, as psychological intervention target, 396
Cognitive-behavioral interventions, 396-397,405,406,407
Cognitive interventions
_for chronic pain management, 416
_for oral mucositis pain management, 255
Colon cancer patients, depression in, 4,7
Colony-stimulating factor, as bone pain cause, 59
Color pain scales, 228
Common cold
_depression and, 166
_self-care procedures, 156
Communication
_emotional, 85-86
_with family of cancer patients, 396
_patient-physician
__information component, 397-399
__pain management implications, 325
__patients' attitudes toward, 400
Compliance, 326,400
Computed tomography (CT), of children, 375,381
Concentration-effect curve, 185-187,190
Conditioning, classical, in pain, 86, 87-88
Confusional disorders
_cancer pain medication-related, 325-326
_depression-related, 1-2
_as suicide risk factor, 51
Connective tissue, radiation-related injury, 251
Constipation, opioid receptor-mediated, 122,123
Consultation, regarding suicidal patients, 62,63
Control, loss of, as suicide risk factor, 51-52
Coping strategies
_for cancer pain management, 401-406
_definition, 397
_outcome appraisal following, 156,157
_stress and, 166-167
Cordotomy, 411-412
_as neuropathic pain therapy, 365
Coronary events, emotion-induced, 166
Corticosteroids
_as neuropathic pain therapy, 361
_stomatotoxicity, 252
Corticotropin-releasing factor, as depression marker, 9,10
Cortisol
_as depression marker, 9
_limbic neuronal response, 93
CP96,345, 76
C polymodal nociceptor, 67
_in burning pain, 77
Cronbach's alpha, 274-275
Cross-modality matching, 198
Crossover design, 297
_parallel design versus, 292-294
Cross-tolerance
_definition, 331
_incomplete, 340,341,345
_to mixed agonist/antagonist drugs,336,338,339,340
_receptor mechanisms, 118-119
Crying
_as pain expression, 233,237
_separation-related, 95
Culture of Pain, The (Morris), 386,390-391
Cyclobenzaprine, 363
Cytomegalovirus infection, oral, 254
[bc2>D2>
DADLE. See Enkephalins, ;obD-Ala;s2,[ql
D-Leu;s5,Cys;s6;cb
DAMGO
_antinociceptive effect, 144,146
_dorsal horn opioid binding sites, 134
__postrhizotomy, 136,137,138
[ecDarwin, Charles, 85
DDC, as peripheral neuropathy cause,[ql
58-59
DDI, as peripheral neuropathy cause,[ql
58-59
Deafferentation pain
_morphine effects, 134,135,147
_pathophysiology, 353-354
``Debbie'' (euthanasia case), 60
Decision-making
_ethical, 391
_patients' participation in, 386
Deep brain stimulation, as neuropathic
pain therapy, 364
Deep breathing, as coping strategy,[ql
403-404
Defensive behavior, 93-94
Delirium
_AIDS-related, 55,58
_of clinical trial participants, 296
_as suicide risk factor, 51,53,55
Deltorphins, 176,178
_cross-tolerance to, 179
Dem compound, 373
Dementia
_AIDS-related, 55,58
_of clinical trial participants, 296
_as suicide risk factor, 55
Demerol-Phenergan-Thorazine cocktail,
373
Denial, of cancer pain, 94
Dental treatment, prechemotherapy,[ql
254-255
Deoxyribonucleic acid (DNA) damage
_chemotherapy-related, 252
_radiation-related, 250
Dependence
_physical
__definition, 332
__human studies, 333-340
__mechanisms, 347-348
__tolerance relationship, 333-340
_psychological
__animal studies, 332-333
__definition, 332
Dependency
_as euthanasia motivation, 60
_pain severity relationship, 271-272
Depression
_in cancer patients, 1-19
__biological markers, 1,7-13
__cancer pain severity relationship, 269
__diagnosis, 1-3,7-13
__prevalence, 1,3-7,15
__psychiatric consultation studies of, 7,8
__as suicide risk factor, 51,53,54
__treatment, 13-15
_common colds and, 166
_in diabetics, 160
_genetic factors, 13
_in HIV-infected patients, 59
_interleukin-1 in, 169
_as suicide risk factor, 1-2
__in AIDS patients, 55,56
_symptom reporting effects, 163,166,169
_treatment, 13-15
Depression scales, 208
Dermatitis, radiation-related, 221,372
Descriptor Differential Scales
_of pain affect, 207,209
_of pain intensity, 202-203,205
Desensitization
_childhood cancer pain patients' use of,
380,381-382
_procedure-phobic patients' use of,[ql
398-399
Desipramine, analgesic effects, 358
Dexamethasone, as neuropathic pain
therapy, 361,412
Dexamethasone suppression test, of
depressed cancer patients, 10,11-12
Diabetics, symptom reporting by, 160
[cf2]=+Diagnostic and Statistical Manual-III-
Revised[cf1] (DSM-III-R), major
depression diagnostic criteria, 1-2
Diagnostic procedure-related pain, in
children, 372,373-382
Diaphoresis, as pediatric pain indicator,
238-239
Diazepam, as neuropathic pain therapy,
362
Dideoxycytidine (DDC), 58-59
Dideoxyinosine (DDI), 58-59
8(R),15-(S)-diHETE, 23,24
Dilantin, as peripheral neuropathy cause,
58-59
Disability, definition, 269
Distraction, 403,415
_children's use of, 380,406
Dorsal column stimulation, as neuropathic
pain therapy, 364
Dorsal horn
_in neuropathic pain, 353
_nociception inhibition in, 70
_nociceptive signal processing in, 69-71
_opioid receptor binding sites, 130-149
__afferent fiber distribution relationship,
135-139
__in experimental mononeuropathy,[ql
139-147
__postsynaptic proportions, 131,132,[ql
135
__postrhizotomy plasticity, 137-139,[ql
147-148
__presynaptic proportions, 131,132-135
__rostrocaudal axis distribution,[ql
130-132
_as visceral afferent termination site, 102
Dorsal horn neurons, viscerally stimulated,
102,103-104
Dorsal noradrenergic bundle, 90-92
Dorsal root entry zone lesion, as
neuropathic pain therapy, 365
Dose-ranging studies, 290
Dose-response curve, 290,291
Downregulation, of opioid receptors, 347
Doxepin, analgesic effects, 358
[bcDPDPE. See Enkephalins, ;obD-Pen;s2,[ql
D-Pen;s5;cb
Drug abusers, cancer pain management in,
327
Drug combinations studies, 292
Dynorphins, 115
Dysesthesia, lancinating
_anticonvulsant therapy, 359-360
_neuroleptic therapy, 362
[ecDysphoria, as depression symptom, 1,2
2>E2>
Eastern Cooperative Oncology Group,
322-323,324,325
Ebers papyrus, 83
Education, for cancer pain management
_of health care professionals, 323,329
_of patients, 329,399-401
_of pediatric patients, 405-406
Effect compartment models, 187-188
Effect size, 302-304,313-314
Eland Color Tool, 228,231
Elderly patients
_behavioral interventions for, 416-417
_pain assessment in, 273
Electroconvulsive shock therapy, 10,14
Electroencephalography (EEG), all-night
recording methods, 12-13
Emotion, 83-98
_adaptive functions, 85-89
_basic, 84
_cognition and, 88-89
_definition, 84-85
_as disease risk factor, 165-166
_illness cognition relationship, 163-169
_pain relationship, model of, 89-95
__central noradrenergic processing in,
89-90,94-95
__dorsal noradrenergic bundle in, 90-92
__hypothalamic-pituitary-adrenocortical
axis in, 92-94,95
__locus coeruleus in, 90-92,94
__nociception in, 89-90
__pain control implications, 94-95
__ventral noradrenergic bundle in, 92-93
_as psychological intervention target, 396
_social function, 85-86
Endogenous analgesia system, 70
Endorphin(s), as pediatric pain indicators,
238-239
[bcb-Endorphin, 115
_in ischemic pain, 169
_tolerance to, 341
Enkephalins, 115
_;obD-Ala;s2,D-Leu;s5;cb (DADLE), 176,[ql
179-180,341
_;obD-Ala;s2,Leu;s5,Cys;s6;cb (DALCE),
178,179,180
_;obD-Pen;s2,D-Pen;s5;cb (DPDPE), 176-177
__binding inhibition, 179
[ec__opioid receptor binding sites, 114,120
_;obD-Ser;s2,Leu;s5,D-Thr;s6;cb (DSLET),
176,177,179,180
_;obD-Ser;s2(O-[cf2]=+tert[cf1]-butyl),Leu;s5,Thr;s6(O-[cf2]=+tert[cf1]-
butyl);cb (BUBU), 177
__antinociceptive effect, 144,146,147
__central bioavailability, 181-182
_;obD-Thr;s2,Leu;s2,D-Thr;s6;cb (DTLET), 176,177
_leu, 175
Epidural block, with local anesthetics,[ql
412
Epidural opioid infusion
_cannulation for, 413
_with local anesthetics, 413
_of morphine, 131-132
_as neuropathic pain therapy, 364
Epidural steroid therapy, 412
Epinephrine, adrenal medulla release of,
93
Ergoreceptor, 68
Erythema
_chemotherapy-related, 253
_radiation-related injury, 251
Esophageal cancer patients, depression in,
7
Estrogen
_stomatotoxicity, 252
_in stress-induced analgesia, 35
Ethics, of cancer pain treatment, 385-391
European Organization for Research and
Treatment of Cancer, Quality-of-
Life assessment scale, 270-271
Eutectic mixture, of local anesthetics,
376,381
Euthanasia. See also Suicide
_active, 60
_illegality, 60,61
_legalization, 49
_motivations for, 60
_palliative care and, 61-62
_passive, 60
_patients' requests for, 54,59,60-61
Excitatory amino acids
_analgesic applications of, 35
_in central sensitization, 76
_in endogenous pain inhibition, 33
_somatic afferent fiber content, 69
Experimental design. See also Clinical
trials, design
_individual variability analysis in,[ql
301-319
__effect size, 302-304,313-314
__generic approach, 305-317
__graphical analysis, 306-317,318
__population sampling model, 304-305
2>F2>
Facial Action Coding System, 228
Facial expression scales, for pain intensity
assessment, 201
_cartoon-face scales, 225,227-228
_Oucher scale, 227,231
Family, of cancer pain patients,
communication with medical staff,
396
Family factors, in childhood cancer pain,
221-222
Fatigue
_depression and, 1-2
_as suicide risk factor, 52
Fear
_of cancer pain, 399
_locus coeruleus activation-related, 90
Fear conditioning, 87-88
Fentanyl
_age-related dosages, 189
_as pediatric sedative, 377
_pharmacodynamic effects, 185
Fight-or-flight response, 92
_pain inhibition during, 31-32
[cf2]=+Final Exit[cf1] (Humphry), 49
Flumazenil, as pediatric sedative, 377
5-Fluorouracil, as mucositis cause, 252
Fluoxetine, 14
Fluphenazine, as neuropathic pain therapy,
362
Formylmethionyleucylphenylalanine, 23
Forskolin, in inflammatory hyperalgesia,
24
[bcFrontal lobe, evolutionary development, 89
b-Funaltrexamine, 113,114,177-178,179
Functional capability. See also Quality-of-
life
_proxy reports of, 272-273
Fungal infections, cancer therapy-related, 253-254
2>G2>
Ganciclovir, 254
Gastrointestinal cancer patients, suicide
risk, 50
Gastrointestinal tract, distention-related
pain, 101
Gate control theory, of pain, 70,378-379
Genetic factors, in analgesia requirements, 121-122
Glycogen, somatostatin-related inhibition, 11
G proteins
_in inflammatory hyperalgesia, 24,25
_opioid receptor decoupling, 37
_in tolerance development, 346-348
Gram-negative bacterial infections, oral, 254
Granulocytopenia, 252
Graphic pain rating scales. See also Facial expression scales; Numerical Rating Scales
_for children, 225
_of pain intensity, 199
Grief, 86
Group therapy, for depression, 15
Guanethidine, as neuropathic pain therapy, 363
Guided imagery, 404,405
_as chemotherapy-pain intervention, 415
_children's use of, 380
_as depression therapy, 15
Gustave-Roussy Child Pain Scale, 235
Gynecological cancer patients, depression in, 10,14
2>H2>
Haloperidol, as neuropathic pain therapy, 362
Handicap, definition, 269
Headache, lumbar puncture-related, 221
Head and neck cancer patients
_depression in, 6,715
_oral infections, 253
_oral mucositis, 248,251
Health, World Health Organization definition, 269
Health care professionals. See alsoPhysicians
_cancer pain management role, 322-324
Health care system, cancer pain
management barriers of, 327-328
Helplessness, cancer pain-related, 396-397
Hemlock Society, 60
Hemorrhage, oral, 248,253,255,263
Herpes simplex infection, oral, 254
Hippocampus, in negative emotion, 88
Histamine, nociceptor sensitizing effect, 69
Hodgkin's disease patients, depression in, 5
Homosexuals, suicide risk, 57
Hopelessness, cancer pain-related,[ql
396-397
_as suicide risk factor, 51,54,55,397
Hormones. See also specific hormones
_as pediatric pain indicators, 238-239
Hostility, as cardiovascular disease risk
factor, 165
Humane and Dignified Death Act, 60
Human immunodeficiency virus (HIV) infection. See also Acquired immunodeficiency syndrome (AIDS) patients
_as suicide motivation, 57
5-Hydroxyindoleacetic acid, as depression marker, 12
Hyperalgesia
_inflammatory mediators, 21-29
_models, 76-77,78
__experimental mononeuropathy, 141-143
_neutrophil-dependent, 23
_primary, 23-25,72-73
__sensitized nociceptors in, 69
_secondary, 72-73,76
_sympathetically maintained, 22-23,77
Hypercortisolemia, of major depression, 10
Hypertensives, symptom reporting by, 158-159,160,161-162
Hypnosis
_as depression therapy, 15
_for pain management, 404-405,416
__use by children, 380
Hypochondriasis, 153
Hypothalamic-pituitary-adrenocortical axis
_in depression, 9-10
_emotional arousal function, 93-94
_in emotion/pain relationship, 92-94
Hypothalamic-pituitary-thyroid axis, in
depression, 9,11,12
Hypothalamus
_paraventricular nucleus, 92-93
_ventral noradrenergic bundle
innervation, 92
Hypoxia, neurotoxicity, 35
Hysteresis, steady-state relationship,189-190
2>I2>
Ibuprofen, placebo-controlled study, 288,289
ICI-154,129, 177,178
ICI-174,864, 178,179
Idiopathic pain, definition, 355
Illness behavior, 153
Illness cognition, in self-regulation,[ql
153-173
_of chemotherapy patients, 159
_constructive process, 156-157
__empirical data on, 158-163
__memory systems and, 157,158
_coping procedures appraisals, 156
_emotion and, 163-169
__coping and, 166-169
__depression and, 169
__negative affect traits and, 168-169
__somatic sensation generation effects, 164-166
__symptom representation and, 166-169
_of hypertensives, 158-159,160,161-162
_illness representations, 155-156
_procedures for constructing
representations, 160-163
__automatic procedures, 161-162
__extended/deliberate procedures, 162
__social comparison and minimization, 162-163
_process assumptions, 156-157
_of tamoxifen toxicity trial participants, 159-160
Imagery. See Guided imagery
Imipramine
_analgesic effects, 358
_binding in depression, 12
_low-dose, 14
Immune function, psychosocial factors, 15
Immunosuppression
_of HIV-infected patients, 59
_infection-related pain of, 195
_morphine-related, 40-42
Impairment, definition, 269
Incidents pain, 295
Individual variability
_in analgesia requirements, 121-122
_in behavioral intervention utilization,
416-417
_in cancer pain, 195
_quantification and analysis, 301-319
__effect size, 302-304,313-314
__generic approach, 305-317
__graphical analysis, 306-317,318
__population sampling model, 304-305
Indomethacin
_as arachidonic acid metabolism inhibitor,
23
_bradykinin-related hyperalgesia and,
22,23
Infant Pain Behavior Rating Scale, 234
Inflammation
_joint nociceptors in, 68
_process, 22
_silent nociceptors in, 68
_spinothalamic tract response, 72-76
_visceral, 101-102,103-104
Inflammatory pain mediators, 21-29
_of neuropathic pain, 353
Information. See also Education
_as psychological intervention, 397-399
Informed consent, 397-398
Inhalational agents, for children, 378
Interleukin-1
_in depression, 169
_as hyperalgesia inducer, 22-23
International Association for the Study of
Pain, 386
Intraspinal opioid infusion, as neuropathic
pain therapy, 364
Intrathecal block, with local anesthetics,
412
Intrathecal opioid infusion, 120,121,123,131-132
_as neuropathic pain therapy, 364
_systemic pain effects, 132
Intravenous anesthesia administration, to children, 378
Intravenous cannulation
_anesthesia for, 376,381
_pediatric patients' preparation for, 381
Invasive procedures
_as cancer pain cause, 195
_for cancer pain management, 411-412
_in children, 220,376,381
Irritable bowel syndrome, 107,108
Ischemia
_neurotoxicity of, 35
_visceral, 102
Ischemic pain, depression and, 169
Isoniazid, as peripheral neuropathy cause,
58-59
2>J2>
Joints
_afferent fibers, 68
__dorsal horn termination site, 69
__silent, 103
_nociceptors, 68
2>K2>
Kaposi's sarcoma, 54,55,58-59
Karnofsky Performance Status scale, 272
Ketamine, as pediatric anesthetic, 378
Kevorkian, Jack, 60
Kosinski, Jerzy, 49
Kynurenic acid
_as morphine analgesia enhancer, 36,37
_as morphine withdrawal attenuator, 37
_as tolerance mediator, 347
2>L2>
Larynx cancer patients, suicide risk, 50
Learning
_associative
__in pain, 86,87-88
__in tolerance, 36-37,331-332
_operant, in pain, 86-87
Leu-enkephalin, as delta opioid receptor
agonist, 175
Leukemia
_acute lymphocytic, 220
_in children, 220,371,372
_oral complications, 252
Leukemia patients
_depression in, 3,6,15
_physician-assisted suicide by, 60
Leukopenia, carbamazepine-related,[ql
360
Leukotriene B;i4, as inflammatory
hyperalgesia inducer, 23
Levorphanol, 118
Lidocaine, buffered, 376,381
Ligation models, of neuropathic pain,[ql
76-77,78
_dorsal horn opioid receptors in,[ql
139-147,148
Limbic system
_anatomy, 86,87
_in emotion, 86
Lobotomy, as pain therapy, 86
Local anesthetics
_blocks
__epidural, 412
__intrathecal, 412
__for neuropathic pain, 363-364
_for children, 376
_eutectic mixture, 376,381
_opioid combinations, 413
_oral formulations, as neuropathic pain
therapy, 360,412
_subcutaneous infusion, 412
_for tolerance management, 345
Locus coeruleus
_emotional nociceptive processing by,[ql
90-92
_morphine sensitivity, 120
_nociceptive response, 90-91
Loose ligation model, of neuropathic pain,
76-77,78
_dorsal horn opioid receptors in,[ql
139-147,148
Lumbar puncture
_in children, 221,376
_in infants, 374
Lung cancer patients, suicide risk, 50
Lymphoma
_in children, 371
_non-Hodgkin's
__in children, 220
__oral complications, 252
Lymphoma patients
_depression in, 5,15
_symptom reporting by, 159
Lytic cocktail, for children, 373
2>M2>
Magnetic resonance imaging (MRI), of
children, 375
Magnetic tomography, of children, 381
Maprotiline, analgesic effects, 358
Massage, 403
Maximally Discriminate Facial Coding
System, 228
McGill Pain Questionnaire, 228
_Affective subscale, 206,209,210-212
Medical examining boards, attitudes
toward cancer pain management,
327
Medical Outcomes Study Short Form,[ql
270
Medicare, noncoverage of outpatient
medications, 327-328
Melanoma patients, depression in, 15
Memorial Pain Assessment and Care
battery, 212
Memorial Sloan-Kettering Cancer Center,
opioid tolerance studies,[ql
341-342,343,345
Memory
_emotion and, 86,88
_symptom perception and,[ql
157-158,161,164-165
Mental confusion. See Confusional
disorders
Metastases, stress-induced, 41-42
Metastases-related pain, 195,322
Methadone
_pharmacodynamics, 185
_pharmacokinetics, 340
_tolerance to, 335,340
Methocarbamol, 363
Methotrexate, as mucositis cause, 252
Methotrimeprazine, as neuropathic pain
therapy, 362
3-Methoxy-4-hydroxyphenylglycol
(MHPG), in fear conditioning,[ql
87-88
[cf2]=+N[cf1]-Methyl-[smd[nm-aspartate receptor agonists, as
nociception inducers, 35
[cf2]=+N[cf1]-Methyl-[smd[nm-aspartate receptor antagonists
_in central sensitization, 108
_morphine analgesia effects of, 33
_as neurotoxicity therapy, 35
_as tolerance mediators, 347-348
[cf2]=+N[cf1]-Methyl-[smd[nm-aspartate receptors
_in central sensitization, 35
_in morphine tolerance, 35-37
Metopon, cross-tolerance to, 336,338,339
Mexiletine, as neuropathic pain therapy,
360
Mianserin, 14
Midazolam
_as neuropathic pain therapy, 362
_for pediatric sedation, 377,381
Mill, John Stuart, 304-305
MK-801
_stress-induced analgesia and, 33-35
_as tolerance mediator, 35-37,119,347
Modeling, by childhood cancer patients,
380,381-382
Monoamine oxidase inhibitors, 358
Mononeuropathy, 353
_dorsal horn opioid receptors in, 139-147
Mood assessment scales, 208
Mood disorders, cerebellum in, 13
Morphine
_abstinence syndrome, 333-334,335
_antagonists, 115
_anxiolytic effect, 95
_chronic effects, 335,336,337
_cross-tolerance to
__animal studies, 332-333
__in cancer pain patients,
336,338,339,340
_deafferentation pain effects, 134,135
_dosage, neonatal, 190
_dosage patterns, 342-343
_dose-effect relationship, 344
_epidural administration, 121,123
_hysteresis of, 187-188
_immunosuppressive effects, 40-42
_intra-articular administration, 121
_intrathecal administration, 120,121,123
__systemic pain relief efficacy, 132
_in mononeuropathy
__phasic mechanical effect, 144-147
__tonic pain effect, 143-144
_natural killer cell cytotoxicity-
suppressing action, 40-42
_as neuropathic pain therapy, 129,356
_opioid receptor action mechanisms,
118,132-134
_as pediatric sedative, 377
_pharmacodynamic effects, 185
_physicians' willingness to prescribe, 323
_systemic analgesia of, 115,132
_tolerance to
__animal studies, 332-333,334
__in cancer pain patients,[ql
335-336,337,338,339
__dosage escalation and, 119
__management of, 344-345,346
__mechanisms of, 347
__N-methyl-aspartate receptors in,[ql
35-37
__reversal, 119
Morphine-6b-glucuronide, 115
Morphine metabolites, analgesic activity, 115
[cf2]=+Mucormycosis[cf1] infection, oral, 254
Mucositis, oral, 247-265
_bone marrow transplantation-related,
190,248,258,260-262
_chemotherapy-related, 247-248,[ql
252-253,259
_measurement, 256-263
_morphine therapy, 342-343
_oral infection-related, 248,252-255
_radiation-induced, 247-248,250-252
__in children, 221
__rating scale, 259-260
Muscle, afferent fibers, 68,69
Muscle relaxants, as neuropathic pain
therapy, 363
2>N2>
Nalbuphine, 118
NalBzoH, 118,120
Naloxazone, 114
Naloxonazine, 115
Naloxone
_as mu opioid receptor antagonist, 178
_as stress-produced analgesia antagonist,
31
Naltriben, 176,178,180
Naltrindole, 176,178,179
Narcotics. See also Opioid(s)
_patients' attitudes toward, 399
5;pr-Natrindole isothiocyanate, 178,179,180
Natural killer cell cytotoxicity, stress-
related suppression, 40-42
[cf2]=+Nature of Suffering, The[cf1] (Cassell),[ql
388-389
Nausea, behavioral interventions for, 416
Neonatal Facial Coding System, 234
Nerve blocks, 354,411-412
_celiac plexus, 328,411
_group discussion on, 411-412
Nerve growth factor, 22-23
Netherlands, active euthanasia in, 60
Neuroendocrine abnormalities, in
depression, 9-10
Neuroleptics, as neuropathic pain therapy,
362
Neurolysis
_as neuropathic pain therapy, 328,[ql
363-364,365
_for tolerance management, 345-346
Neuroma-related pain, 353
_therapy, 361-362,364
[bcNeuropathic pain
_Ab fibers in, 129-130
_categories, 351-354
_definition, 295,351
_management, 354-370
[ec__anesthetic techniques, 363-364
__neurostimulatory techniques, 364
__patient assessment for, 354-355
__pharmacologic therapy, 355-363,412
__primary therapy, 355
__psychological interventions, 365
__surgery, 365
_models, 76-77
_opioid dorsal horn responses in, 129-151
__in experimental mononeuropathy,[ql
139-147
__opioid agonists and, 141-147,148
__opioid receptor distribution and,[ql
130-137
__postrhizotomy, 131,132-135,[ql
137-139,147-148
_spinothalamic tract cells in, 76-77,78
Neuropathy
_amputation-related, 221
_diabetic, capsaicin therapy, 361
_models, 76-77,78
_peripheral, HIV-related, 58-59
_vincristine-related, 221
Neurostimulatory therapy, for neuropathic
pain, 364
Neurosurgical management, of cancer
pain, 328,411-412
Neutrophil, in inflammatory hyperalgesia,
23
Nifedipine, as neuropathic pain therapy,
363
Nitric oxide, 119
_in [cf2]=+N[cf1]-methyl-[smd[nm-aspartate receptor-
mediated nociceptive reflex, 108,[ql
119
_in opioid tolerance, 348
Nitric oxide synthase, 108
_inhibitors, 119,348
Nitro-arginine, as morphine tolerance
antagonist, 119
Nitrous oxide, teratogenicity of, 378
Nociception
_definition, 196
_dorsal noradrenergic bundle in, 90-92
_in emotion-pain relationship, 89-90,[ql
94-95
Nociceptive pain. See also Somatic pain;
Visceral pain
_definition, 295,354
Nociceptor
_dorsal horn projections, 78
_sensitization, 77
_silent, 68
_somatic
__articular, 68
__cutaneous, 67-68
__muscle, 68,69
__pain quality and, 68
__sensitization of, 69
_visceral, 103-104
Nociceptor dorsal horn projections, 78
Nocifensor axons, 73
Nonsteroidal antiinflammatory drugs
(NSAIDs)
_as arachidonic acid metabolism
inhibitors, 23
_as neuropathic pain therapy, 357
_physicians' preference for, 323
Noradrenergic bundle, ventral, 92,93
Noradrenergic transmission, in emotion-
pain relationship, 89-95
Norepinephrine
_adrenal medulla release of, 93
_neural excitability function, 91-92
_in tolerance, 37
Nortriptyline, analgesic effects, 358
[cf2]=+No Tears, No Fears [cf1](film), 379
Nucleus gigantocellularis, morphine
sensitivity, 120
Nucleus raphe magnus, morphine
sensitivity, 120
Numerical Rating Scales
_of pain intensity, 200,204,212-213
_of pain relief, 210
Nurses, attitudes toward pain
management, 324
2>O2>
Observational Scale of Behavioral
Distress, 233
Occupational therapy, for neuropathic
pain, 365
Opiate(s)
_action mechanism, 31
_action sites, 119
_cerebral injection, 121
_opioid receptor affinity, 116-117
_side effects, 32,122
_tolerance blockage, 37
_unavailability of, 328
Opioid(s)
_action sites, 119-121
_acute effects, tolerance to, 335
_addiction, 333-335
_analgesia
__mechanisms, 115-118
__peripheral, 121
__regional, 121
__spinal, 120-123
__supraspinal, 120,121
_chronic effects, 340
_cross-tolerance to, receptor
mechanisms, 118-119
_endogenous
__spinal systems, 140-141
__as stress-produced analgesia
mediators, 31
_epidural administration, 131-132,364,413
_governmental regulation of, 323-324
_intrathecal administration,
120,121,123,131-132,364,413
_long-term use, 356
_medical examining boards' attitudes
toward, 327
_as neuropathic pain therapy, 355-357,364
_as pediatric sedatives, 377-378
_pharmacokinetic-pharmacodynamic
relationships, 185-191
__concentration-effect curve,[ql
185-187,190
__nonparametric, 189
_physicians' reluctance to prescribe,[ql
323-324
_physicians' willingness to prescribe, 323
_sensitivity to, 121-122
_side effects
__acute, 335
__in children, 377
__chronic, 340
_spinal administration, 413
_tolerance to, 331-350
__animal studies, 332-333,334
__clinical studies, 295,341-344
__dose escalation implications, 119,[ql
341-344
__human studies, 333-340
__management of, 344-346
__patients' concerns about, 399-400
__receptor mechanisms, 118,119
__theories of, 346-348
Opioid peptides
_endogenous, opioid receptor affinity,
116-117
_systemic opioid tolerance and, 341
Opioid receptor(s)
_classification, 113-115
_delta, 175-182
__binding, 114
__of dorsal horn, 130-141
__opiate/opioid peptide affinity, 117
__pharmacology, 175-178
__subtypes, antinociception and,[ql
178-182
__supraspinal, 120
__in tolerance, 332-333
_downregulation, 347
_G-protein interactions, 346-348
_kappa
__in calcium channel inactivation, 347
__of dorsal horn, 130-132,133-134
__opiate/opioid peptide affinity, 116-117
__subtypes, 114-115
__in tolerance, 332-333
_kappa;i1
__genetically regulated sensitivity to,
122
__spinal, 120
__supraspinal, 121
_kappa;i3
__genetically regulated sensitivity to,
122
__supraspinal, 120,121
_mu, 25
__of dorsal horn, 130-141
__as dorsal horn afferent fiber markers,
135-137
__in morphine tolerance, 119
__opiate/opioid peptide affinity, 116
__postrhizotomy plasticity, 137-139
__potassium channel activation by, 347
__selective antagonists, 113
__subdivisions, 113-114
__in tolerance, 332-333,348
_mu;i1, 114,115
__genetically regulated sensitivity to,
122
__morphine activation, 118
__spinal, 120
__supraspinal, 120
_mu;i2, 114,115
__as constipation mediator, 122,123
__morphine activation, 118
__as respiratory distress mediator,
122,123
_synergistic interactions, 121
_in tolerance, 118-119,346-348
Opioid receptor agonists
_delta, 114,175-=n187
__as analgesic agents, 25
__antinociception and, 178-182
__centrally bioavailable, 181-182
__nonpeptide, 182
__potassium channel activation by, 347
_intrathecal administration, 131-132
_kappa, 25,34-35,114
_mechanical allodynia response, 144-147
_mu, 34-35,114
Opioid receptor antagonists
_delta, 175,176,178
_mu, selective, 113
Oral cancer patients, suicide risk, 50
Oral infections, cancer therapy-related,
247-248,252-255
Oral Mucosa Rating Scale, 259,260-262
Oral rating scales, for mucositis, 256-263
_general scales, 256-258
_multiple variable scales, 256,257,258-259
_of radiation mucositis, 259-260
Oral tissue damage, of cancer pain
patients. See Mucositis, oral
Organ distention
_pain threshold in, 107
_as visceral pain cause, 101,102-104,[ql
105-107,108
Organic affective syndrome, 3
Oropharyngeal cancer patients, depression
in, 5
Orphenadrine, 363
Oucher pain scale, 227,231
2>P2>
Pain. See also specific types of pain
_definitions
__of International Association for the
Study of Pain, 83
__for pain assessment, 194-195
_description of, to patients, 398
_as euthanasia motivation, 60
_gate control theory of, 70,378-379
_multidimensional nature of, 194
_suffering and, 389
_as symptom, 163. See also Illness
cognition, in self-regulation
Pain affect
_assessment, 205-209
__recommendations regarding, 209
__research issues regarding, 213-214
_of cancer pain versus benign pain, 211
_definition, 205
_as pain dimension, 194
Pain assessment
_batteries for, 212
_of childhood cancer-related pain,[ql
219-246,406
__behavioral observation methods,[ql
233-239
__pain experience factors, 220-222
__pain history, 223-225
__pain measurement tool selection,[ql
239-240
__physiological approaches, 238-239
__proxy measures of pain, 231-233
__self-reports, 225-231
__unstructured observations, 240-241
_in elderly patients, 273
_emotional aspects, 94
_functions, 193
_multidimensional nature of pain and,[ql
194
_of neuropathic pain, 354-355
_for psychological interventions, 395-396
Pain behavior
_of children, 373-375
__assessment, 233-239
_as pain dimension, 194
Pain beliefs
_of cancer patients, 325-327,399-400
_as pain dimension, 194
Pain Discomfort Scale, 207-208,209,236
Pain Experience History, 223-224
Pain history, in childhood cancer, 223-225
[bcPain intensity
_anxiety relationship, 269
_assessment, 196-205
__Behavior Rating Scale, 200-201,204
__Box Scale, 201-202,204
__in children. See Childhood cancer-
related pain, assessment
[ec__comparison with pain relief
assessment, 209,210
__Descriptor Differential Scale,[ql
202-203,205
__Graphic Rating Scales, 199
__Numerical Rating Scales, 200,204
__Picture Scale, 201,204
__Verbal Rating Scales,[ql
197-199,204,212-213
__Visual Analogue Scales,[ql
199-200,203,204
_depression relationship, 269
_as pain dimension, 194
_``significant'', 321-322
Pain interviews, of children, 231
Pain Ladder, 231,232
Pain quality. See also specific types of
pain
_somatic nociceptors and, 68
Pain management. See also Cancer pain
management
_assessment, 209-211
_definition, 209
_ethics of, 385-391
Pain scores, 395-396
Pain thermometer, 225
Pain threshold
_in inflammatory pain, 22
_in organ distention, 107
Palliative care, euthanasia and, 61-62
Pancoast's tumor, 411-412
Pancreatic cancer-related pain
_celiac plexus block for, 411
_depression related to, 3,4-5,7,10,15
Parallel design trials, 297
Paraventricular nucleus, 92-93
Parents, of childhood cancer patients,[ql
221-222
_behavioral intervention involvement,
415,417
_description of child's pain by, 224
_pain control role, 374-375,379
Patient-controlled analgesia, 190
Patients
_attitudes toward pain management,[ql
325-327,399-400
_autonomy, 388-390
_cancer pain management education for,
329,399-401
_``good patient'' role, 325,326,327
_stereotyping, 386
Pavlovian conditioning, 36
Pelvic nerve, visceral afferents,
102,103,104
Pentazocine
_cross-tolerance to, 336,338,339,340
_opioid receptor activation by, 118
Pentobarbital, for pediatric sedation, 376
Peptides, in central sensitization, 76
Percutaneous electrical nerve stimulation,
as neuropathic pain therapy, 364
Periaqueductal gray matter
_morphine sensitivity, 120
_stimulation-related analgesia, 115
_in stress-produced analgesia, 31
Periventricular gray matter, stimulation-
related analgesia, 115
Peripheral nervous system, as neuropathic
pain site, 351,352,353,354
Perphenazine, as neuropathic pain therapy,
362
Personality adjustment, pain severity
relationship, 271-272
Personality disorders, as suicide risk
factor, 52
Pethidine, long-term administration,[ql
343-344
Phantom limb pain, 353,354
_in children, 221
_perceptual memory in, 157
[bcPharmacokinetic-pharmacodynamic
relationships, of opioids, 185-191
_concentration-effect curve, 185-187,190
_nonparametric, 189
[ecPharmacologic management, of cancer
pain, 412. See also specific drugs
Pharyngeal cancer patients, suicide risk,
50
Phenoxybenzamine, as neuropathic pain
therapy, 363
Phentolamine test, 108
Phenytoin, as neuropathic pain therapy,
359
Phosphodiesterase inhibitors, in
inflammatory hyperalgesia, 24
Physical therapy
_for cancer pain, 328
_for neuropathic pain, 364-365
Physicians
_cancer pain management practices of,
322-324
_communication with patients
__information component, 397-399
__pain management implications, 325
__patients' attitudes toward, 400
_communication with patients' families,
396
_lack of training in pain management, 323
Picture Scale, 201,204
Pilot studies, 285
Pimozide, as neuropathic pain therapy,
359,362
Pituitary gland, depression-related
hypertrophy, 10
Placebo
_behavioral effects, 159-160
_in cancer pain analgesia studies,
284,285,286,287,288-290
_efficacy for pain relief, 37
Plant alkaloids, antimitotic effects, 252
Poker Chip Tool, 225-227,230,232
Polymyositis, HIV infection-related, 59
Polyneuropathy, 353
Population sampling method, 304-305
Postherpetic neuralgia, 361-362,365
Posthypnotic suggestion, 416
Postmastectomy syndrome, capsaicin
therapy, 361
Postoperative pain, 195
_in children, 221
__assessment scales for, 234,236
_neuropathic, 352
_syndrome, 352
Potentiation, long-term, 36
Prayer, as distraction intervention, 417
Prazosin, as neuropathic pain therapy, 363
Prednisone, as neuropathic pain therapy,
363
Prescriptions, multiple-copy, 324
Pricking pain, 68,77
Procarbazine, stomatotoxicity, 252
Procedural information, 398-399
Procedure Behavior Checklist, 233
Procedure Behavior Rating Scale, 233,[ql
237
Procedures
_as childhood cancer-related pain cause,
372,273
_description of, to patients, 398-399
Profile of Mood States, 208
Prognosis, suicide risk relationship, 51
Prolactin, somatostatin-related inhibition,
11
Propranolol, as neuropathic pain therapy,
363
Prospective surveys, 285
Prostaglandins
_as hyperalgesia inducers, 23,24,25
_nociceptor sensitizing effects, 69
Prostate cancer, bone metastases-related
pain of, 269-270
Proxy measures
_of pediatric pain, 231-233
_of quality-of-life, 272-273
Psychiatric consultation, for suicidal
patients, 53,62,63
Psychiatric evaluation, of cancer-pain
patients, 395
Psychoanalysis, as depression therapy,[ql
15
Psychological disorders, idiopathic pain
and, 355
Psychological distress
_assessment, 213,214
_scales, 208-209
Psychological interventions
_for cancer pain management, 393-409
__for children, 378-382,405-406
__clinical trials of, 404-405
__coping strategies as, 401-406
__emotional basis, 95
__for neuropathic pain, 365
__treatment goals, 394
_in standard medical practice, 394,[ql
395-401
Psycho-oncology, 15,16
Psychosocial interventions, for depression,
14-15,16
Psychostimulants, as depression therapy,
14
Psychotherapy, for depression, 15
2>Q2>
Quality-of-life
_assessment, 193,267-282
__clinical trials scales, 275-277
__core-plus-module approach, 274
__data quality control in, 277
__generic versus disease-specific
approach, 273-274,276,277
__measurement issues, 272-275
__psychometric properties, 274-275
__single instrument versus battery of
measures, 274
[bc_Behavior Rating Scale, 200-201
_as pain dimension, 194
Quill, Timothy E., 60
[ec2>R2>
Radiation therapy
_as cancer pain cause, 195
_as mucositis cause, 247-248,250-252
__in children, 221
__rating scale, 259-260
_as neuropathic pain cause, 352,355
Radiation therapy patients, depression in,
3,4
Randomization, 301
Random sampling, 305
Recombinant-inbred mice, opioid
responses of, 37-38
Referral, of depressed patients, 7,8
Referred pain, visceral, 99,100,105-107
Reflex sympathetic dystrophy, 143
Reframing, 401,402,403
Rehearsal techniques, 380
Reinforcement, positive and negative, 87
Reinforcer, 87
Reiter's syndrome, 59
Relative potency bioassays, 290-291
Relaxation techniques, 403-404,405
_as depression therapy, 15
REM sleep, in depression, 12-13
Respiratory arrest, opioids-related, 377
Respiratory depression, opioids-related,
122,123,377
Reticulocortical pathways, 90
Retrospective surveys, 285
Rhizotomy, dorsal, opioid receptor
responses following
_plasticity, 137-139,147-148
_postsynaptic, 131,132-135
_presynaptic, 131,132-135
Right to die, 59,60-61
Root avulsion-related pain, 353
Rosary beads, as distraction intervention,
417
2>S2>
Salivary glands
_chemotherapy-related injury, 253
_medication-related dysfunction,[ql
262
_radiation-related injury, 251-252
Sarcoma
_Ewing's, in children, 220
_Kaposi's, 54,55,58-59
_soft-tissue, in children, 372
SC-488,26, 181
Schizophrenia, somatostatin in, 11-12
Sciatic nerve ligature model, dorsal horn
opioid receptor binding in,[ql
139-142,148
Second messengers, in primary afferent
hyperalgesia, 24,25
Sedation, of children, 376-377
Self-control, in children, 379-380
Self-help groups, as depression therapy,[ql
15
Self-regulation. See Illness cognition, in
self-regulation
Self-reports
_of cancer pain, 193-218
__by children, 225-231,273
__factors affecting, 194-196
__with McGill Pain Questionnaire,
206,210-212
__for pain affect assessment,[ql
205-209,213-214
__for pain intensity assessment,[ql
196-205,212-213
__for pain relief assessment, 209-210
_of quality-of-life, 272,273
Self-statements, 402
Sensitization. See also Central
sensitization
_of nociceptors, 69
Sensory information, 398
Separation crying, 95
Serotonin
_as depression marker, 12
_in inflammatory hyperalgesia, 24
_nociceptor sensitizing effect, 69
_in tolerance, 37
Sertraline, 14
Sex factors, in endogenous pain inhibition,
35
Sickness Impact Profile, 270
Side effects
_during drug trials, 296-297
_patients' awareness of, 401
_patients' concerns about, 325-326
Signal detection analysis, 153
Skin, hyperalgesia of, 99-100,101-102,[ql
104-108,109
Sleep
_depression-related abnormalities,[ql
1-2,12-13
_REM, vigilance and, 91-92
Small cell lung cancer, chemotherapy, 270
Somatic pain
_definition, 295
_mechanisms, 67-82
__dorsal horn nociceptive processing,
69-71
__injury/inflammatory-related
alterations, 71-76
__nerve injury-related alterations, 76-77
__somatic nociceptors, 67-69
_as nociceptive pain subtype, 354
_spinothalamic tract in, 70-77,78
Somatic sensory evaluation. See Illness
cognition, in self-regulation
Somatostatin, as depression marker, 11-12
Spijkervet radiation mucositis scale,[ql
259-260,262
Spine. See also specific areas
_opioid analgesia mechanisms, 120
Spinomesencephalic tract, 70-71
Spinoreticular tract, 70-71,89-90
Spinothalamic tract, 89-90
_inhibition, 70
_as somatic nociceptor terminal synapse,
69-70
_in somatic pain, 70-77
__inflammation/injury-related, 71-77,78
_thalamic ventroposterolateral nucleus
projections, 70-71,78
Spiradoline, 118,123
Spitzer Quality-of-Life Index, 272-273
Splanchnic pain, 99
Spontaneous pain, neural mechanisms, 21
State-Trait Anxiety Inventory, 208,214
Statistical analysis, of individual
variability, 301-319
_50% confidence intervals, 316,317
_95% confidence intervals, 312-313,316
_effect size, 302-304,313-314
_generic approach, 305-317
_graphical analysis, 306-317,318
_population sampling model, 304-305
_mean standard change, 311,313
Stereotyping, of patients, 386
Steroids. See also Corticosteroids
_as neuropathic pain therapy, 412
Stomach cancer patients, depression in,
4,5,7,10
Streptococcal infection, oral, 254
Stress
_coping strategies and, 166-167
_as depression inducer, 10
_natural killer cell cytotoxicity
suppression by, 40-42
_as somatic sensation indicator, 162,[ql
166-169
Stress-induced analgesia, 31-32
_animal models, 37-40
_estrogen-dependent, 35
_genetic determinants, 37-40
_nonopioid, 32
__mechanisms, 33-35
_opioid, 32
Substance abuse
_implications for pain control, 407
_as suicide risk factor, 56
Substance P, 69,76,78
Sufentanil
_as pediatric sedative, 378
_pharmacodynamics, 185
Suffering
_definition, 268
_pain and, 389
Suicidal ideation
_by AIDS patients, 55,56-57,59
_by cancer patients, 52-53
_depression-related, 1-2
_pain as basis for, 54,58-59
_rationality of, 49-50,59,61
Suicide, 49-65
_by AIDS patients, 49-50,54-63
_by cancer patients, 49-54,62-63,325,399
_hopelessness as risk factor, 51,54,55,397
_pain as motivation for, 49-50,53-54, 58-63
_physician-assisted
__definition, 60
__illegality, 60,61
__patients' requests for, 54,59
_psychiatric disorders risk factors,[ql
49-50,51,52,54,55,57,61
Support groups, 404-405
Surgery
_as cancer pain cause, 195
_as neuropathic pain cause, 352
_as neuropathic pain therapy, 355
Surveys, 285
Swallowing impairment, oral pain-related, 248
_rating scale, 258
Sympathetically maintained pain
_hyperalgesia, 22-23,77
_neuropathic, 353
__pharmacologic therapy, 363
_as receptor disorder, 108
Sympathetic nerve block, for neuropathic pain, 353,363
Symptom reporting, self-regulation model. See Illness cognition, in self-regulation
2>T2>
Tamoxifen toxicity trial participants,
symptom reporting by, 159-160
Temperament, as pain response indicator,
374,375
Temporal cortex, limbic function, 89
Temporal information, 398
Terminally ill patients
_euthanasia requests by, 54,59,60-61
_pain experienced by, 267
_suicide by, 51
Thalamocingulate, 86,87
Thalamus, ventroposterolateral, 70-71,78
Thioridazine, as neuropathic pain therapy, 362
Threat, perception of, 85
Thrombocytopenia
_chemotherapy-related, 253
_oral mucositis and, 255
Thyroid-stimulating hormone, as depression marker, 11
Thyrotropin-releasing hormone, as depression marker, 11
Tight ligation model, of neuropathic pain, 77
Time distortion technique, 416
Tocainide, as neuropathic pain therapy, 359,360
Toddler-Preschooler Postoperative Pain Scale, 236
Tolerance
_acute, 331
_associative, 36-37,331-332
_chronic, 331
_definition, 331-332
_nonassociative, 331-332
_to opioids, 331-350
__animal studies, 332-333,334
__clinical studies, 296,341-344
__dose escalation effects, 119,341-344
__human studies, 333-340
__management, 344-346
__patients' concerns about, 399-400
__receptor mechanisms, 118,119
__theories of, 346-348
_pain-related, 333,334
_physical dependence relationship, 333-340
Tolerance index, 334
Tongue cancer patients, suicide risk, 50
Transcutaneous electrical nerve stimulation (TENS), as neuropathic pain therapy, 364
Trauma, neurotoxic effects, 35
Trazodone, analgesic effects, 358
Treatment response, individual difference analysis of, 301-319
_effect size, 302-304,313-314
_generic approach, 305-317
_graphical analysis, 306-317,318
_population sampling model, 304-305
Trigeminal neuralgia, 360,362
Trigger point injections, for neuropathic pain, 363
Tumor, as cancer pain cause, 195,267
2>U2>
U-50,488H
_as intrathecal analgesia antagonist, 120
_MK-801 blockade, 34-35
_opioid receptor selectivity, 118
Ulceration, oral, chemotherapy-related, 253. See also Mucositis, oral
Unstructured observations, for childhood cancer-related pain assessment, 240-241
Urogenital cancer patients, suicide risk, 50
2>V2>
Vagus nerve, visceral afferents, 102
Valproate, as neuropathic pain therapy, 359
Varicella zoster virus infection, oral, 254
Vasculature, radiation-related damage, 251
Vasoactive-intestinal peptide, inhibition, 11
Venipuncture
_as pain cause, 221
_pediatric patients' preparation for, 381
Venous cannulation, anesthesia for, 376
Verbal Rating Scales
_of pain affect, 206-207,209
_of pain intensity, 197-199,204
__advantages, 198-199
__cross-modality matching, 198
__disadvantages, 197-198,199
__verbal end points, 212-213
_of pain relief, 210
Vigilance, dorsal noradrenergic bundle in, 90-92
Vincristine, as neuropathy cause, 58-59,221
Viral infections, cancer therapy-related, 253,254
Virtue ethics, 386,389-390
Visceral pain, 99-111
_characteristics, 99-100
_cutaneous hyperalgesia of, 99-100,[ql
101-102,104-108,109
_definition, 295
_as nociceptive pain subtype, 354
_visceral afferent fibers in, 101,[ql
102-104,109
Visual Analogue Pain Scales
_for children, 225,231,232
_of pain affect, 207-209
_of pain intensity, 199-200,203,204
_of pain relief, 210
Vital signs, as pediatric pain indicators, 238-239
2>W2>
Walking, as coping strategy, 403
War wounds, analgesia requirements, 115
Western Consortium for Cancer Nursing Research, 259
Wilms' tumor, 220
Wind-up, N-methyl-aspartate receptor-mediated, 35
Wisconsin Cancer Pain Initiative, 325-326,386
World Health Organization (WHO)
_cancer pain management guidelines, 267,329
_health definition, 269
_oral mucositis rating scale, 256,260
_performance status scale, 272