Definition, measurement, clinical correlates and underlying neurobiology of psychological pain and its relation to suicidal behavior

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Title: Definition, measurement, clinical correlates and underlying neurobiology of psychological pain and its relation to suicidal behavior
Author: Lauma, Lauri
Other contributor: Helsingin yliopisto, Lääketieteellinen tiedekunta
University of Helsinki, Faculty of Medicine
Helsingfors universitet, Medicinska fakulteten
Publisher: Helsingin yliopisto
Date: 2021
Language: eng
Thesis level: master's thesis
Degree program: Lääketieteen koulutusohjelma
Degree Programme in Medicine
Utbildningsprogrammet i medicin
Specialisation: ei opintosuuntaa
no specialization
ingen studieinriktning
Abstract: Psychological pain is a concept, that describes pain in the mind, also know as psyache. It is a phenomenon closely related to suicidal acts (Shneidman, 1996; Baumeister, 1990, Troister and Holden 2010). Psycyhological pain is a relatively new concept and not yet that well known, atleast among general practicioners. For example in the USA 5,6% of the general population and 53% of the patients with severe mental illness are thought to suffer from psychological pain (American Psychiatric Association, 2003). Depression and hopelessness are perhaps the most well known factors in the development of suicidal ideation, atleast for people not familiar with the research literature of this field. However Troister and Holden (Troister and Holden, 2012) compared the effects of psychological pain, depression and hopelessness. The results were that out of depression, hopelessness and psychological pain psychological pain is the only variable that contributes significantly to a change in suicidal ideation. In this study the contributions of depression and hopelessness were reduced to statistically nonsignificant levels. Furthermore psycological pain has been identified as a high risk factor for suicide with a greater predictive power than depression (Olié et al., 2010; Pereira et al., 2010; Troister and Holden, 2010; Li et al., 2014; Troister et al., 2015). Neuroimaging can be used in psychiatric diagnostics and also in psychiatric research. In diagnostics neuroimaging can be used to for differentiate between psychiatric and somatic causes of a psychosis, as psychosis can arise from a psychiatric disorder or from for example a brain tumor. Neuroimaging can be used for example in the field of pain research. There is overlap between neural networks of physical and psychological pain, but it seems like these different types of pain have some unique brain areas as well (Meerwijk et al., 2013). In addition to neuroimaging one of the ways of measuring psychological pain is through questionnaires, of which there are several. Perhaps because of these overlapping neural networks of pain some of the medication used to treat physical pain seems to have a positive effect on suicidal population suffering from psychological pain. It seems like the dose needed to treat psychological pain is a lot smaller than a dose needed to treat equivalent physical pain (Yovell et al., 2016).

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