Measurement of pain
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Pain is a personal, subjective experience influenced by cultural learning, the meaning of the situation, attention, and other psychological variables. Pain processes do not begin with the stimulation of receptors. Rather, injury or disease produces neural signals that enter an active nervous system that (in the adult organism) is the substrate of past experience, culture, anxiety, and depression. These brain processes actively participate in the selection, abstraction, and synthesis of information from the total sensory input. Pain, then, is not simply the end product of a linear sensory transmission system; rather, it is a dynamic process that involves continuous interactions among complex ascending and descending systems.