How does the GCT differ from earlier models of pain

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288 HEALTH PSYCHOLOGY
Fig. 12-1 The gate control theory of pain
integrated psychology into the traditional biomedical model of pain and described not
only a role for physiological causes and interventions, but also allowed for psychological
causes and interventions.
Input to the gate
Melzack and Wall suggested that a gate existed at the spinal cord level, which received
input from the following sources:
I Peripheral nerve fibres. The site of injury (e.g. the hand) sends information about pain,
pressure or heat to the gate.
I Descending central influences from the brain. The brain sends information related to the
psychological state of the individual to the gate. This may reflect the individual’s
behavioural state (e.g. attention, focus on the source of the pain); emotional state
(e.g. anxiety, fear, depression); and previous experiences or self-efficacy (e.g. I have
experienced this pain before and know that it will go away) in terms of dealing with
the pain.
I Large and small fibres. These fibres constitute part of the physiological input to pain
perception.
Output from the gate
The gate integrates all of the information from these different sources and produces an
output. This output from the gate sends information to an action system, which results in
the perception of pain.
How does the GCT differ from earlier models of pain?
The GCT differs from earlier models in a number of fundamental ways.
I Pain as a perception. According to the GCT, pain is a perception and an experience
rather than a sensation. This change in terminology reflects the role of the individual
in the degree of pain experienced. In the same way that psychologists regard vision as
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